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Impact of the motivational interviewing for childhood obesity treatment: The Obemat2.0 randomized clinical trial 动机访谈对儿童肥胖症治疗的影响:Obemat2.0 随机临床试验。
IF 3.8 3区 医学 Q1 PEDIATRICS Pub Date : 2024-05-11 DOI: 10.1111/ijpo.13125
Veronica Luque, Albert Feliu, Ricardo Closa-Monasterolo, Judit Muñoz-Hernando, Natalia Ferré, Desirée Gutiérrez-Marín, Núria Guillen, Josep Basora, Pablo Hsu, Clara Alegret-Basora, M. Àngels Serrano, Marta Mallafré, Ana M. Alejos, Eva N. Balcells, Àngels Boada, Sandra Paixà, Gisela Mimbrero, Susana Gil-Mancha, Càrol Tudela-Valls, Mireia Alcazar, Joaquín Escribano, Obemat2.0 Study Group

Background and Objective

The aim was assessing a short training for healthcare providers on patient-focused counselling to treat childhood obesity in primary care, along with dietitian-led workshops and educational materials.

Methods

Randomized clustered trial conducted with paediatrician-nurse pairs (Basic Care Units [BCU]) in primary care centres from Tarragona (Spain). BCUs were randomized to intervention (MI) (motivational interview, dietitian-led education, and educational materials) or control group (SC, standard care). Participants were 8–14-year-old children with obesity, undergoing 1–11 monthly treatment visits during 1 year at primary care centres. The primary outcome was BMI z-score reduction.

Results

The study included 44 clusters (23 MI). Out of 303 allocated children, 201 (n = 106 MI) completed baseline, final visits, and at least one treatment visit and were included in the analysis. BMI z-score reduction was −0.27 (±0.31) in SC, versus −0.36 (±0.35) in MI (p = 0.036).

Mixed models with centres as random effects showed greater reductions in BMI in MI than SC; differences were B = −0.11 (95% CI: −0.20, −0.01, p = 0.025) for BMI z-score, and B = −2.06 (95% CI: −3.89, −0.23, p = 0.028) for BMI %. No severe adverse events related to the study were notified.

Conclusion

Training primary care professionals on motivational interviewing supported by dietitians and educational materials, enhanced the efficacy of childhood obesity therapy.

背景和目的目的是评估在初级保健中为医疗服务提供者提供的以患者为中心的治疗儿童肥胖症咨询短期培训,以及由营养师主导的研讨会和教育材料:方法:在塔拉戈纳(西班牙)的初级保健中心进行随机分组试验,由儿科医生和护士结成对子(基础护理单位 [BCU])。基础护理室被随机分为干预组(MI)(动机访谈、营养师指导的教育和教育材料)或对照组(SC,标准护理)。参与者为 8-14 岁的肥胖症儿童,他们在初级保健中心接受了为期 1 年、每月 1-11 次的治疗。主要结果是体重指数 Z 值下降:研究包括 44 个群组(23 个 MI)。在分配的 303 名儿童中,201 人(n = 106 MI)完成了基线、最终访问和至少一次治疗访问,并纳入分析。SC的BMI z分数减少了-0.27(±0.31),而MI则减少了-0.36(±0.35)(p = 0.036)。以中心为随机效应的混合模型显示,MI 的 BMI 下降幅度大于 SC;BMI zcore 的差异为 B = -0.11 (95% CI: -0.20, -0.01, p = 0.025),BMI % 的差异为 B = -2.06 (95% CI: -3.89, -0.23, p = 0.028)。研究未发现严重不良事件:结论:在营养师和教育材料的支持下,对初级保健专业人员进行动机访谈培训可提高儿童肥胖症治疗的效果。
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引用次数: 0
Impact of COVID-19 pandemic on physical health amongst children: Difference-in-differences analyses of nationwide school health checkup database COVID-19 大流行对儿童身体健康的影响:全国学校健康检查数据库的差异分析。
IF 3.8 3区 医学 Q1 PEDIATRICS Pub Date : 2024-05-10 DOI: 10.1111/ijpo.13126
Yusuke Okubo, Kazue Ishitsuka, Atsushi Goto

Introduction

The COVID-19 pandemic posed tremendous challenges for children. However, the long-term effects of the pandemic on various aspects of physical health at a national level remain unclear.

Methods

In this retrospective cohort study, we analysed data from nationwide health checkup records amongst children aged 7–15 years. The dataset comprised 3 544 146 records from 393 794 individuals who graduated from junior high school during fiscal years 2007 to 2022. Difference-in-differences (DID) analyses with multiple time periods were used to examine the impact of COVID-19 on physical health outcomes.

Results

Compared with the pre-pandemic period, the COVID-19 pandemic was associated with excess increases in obesity for boys and girls, persisting over the 3 years (+0.42%; [95% CI, 0.23–0.61]). Also, it was associated with excess increases in underweight (+0.28% [0.25–0.32]) and poor visual acuity amongst boys in the 3rd year (+1.80% [1.30–2.30]). There were excess reductions in dental caries (−1.48% [−2.01 to −0.95]), glucosuria (−0.55 [−0.88 to −0.23]) and hematuria (−0.43% [−0.73 to −0.13]) during the 3rd year of the pandemic.

Conclusions

These findings underscore the multifaceted impact of the pandemic on various health indicators for school-aged children. This information could be valuable for public health policy and paediatric healthcare planning in the post-pandemic era.

简介COVID-19 大流行给儿童带来了巨大的挑战。然而,大流行对全国儿童身体健康各方面的长期影响仍不清楚:在这项回顾性队列研究中,我们分析了全国范围内 7-15 岁儿童健康体检记录中的数据。数据集包括 2007 至 2022 财年期间初中毕业的 393 794 人的 3 544 146 份记录。研究人员采用多时段差分法(DID)分析COVID-19对身体健康结果的影响:结果:与大流行前相比,COVID-19 大流行与男孩和女孩肥胖率的超常增长有关,并且在 3 年中持续存在(+0.42%; [95% CI, 0.23-0.61])。此外,体重不足(+0.28%[0.25-0.32])和男孩视力不良(+1.80%[1.30-2.30])的人数在第 3 年也出现了超常增长。在大流行的第 3 年,龋齿(-1.48% [-2.01 至 -0.95])、葡萄糖尿(-0.55 [-0.88 至 -0.23])和血尿(-0.43% [-0.73 至 -0.13])的发病率超额下降:这些发现强调了大流行对学龄儿童各种健康指标的多方面影响。这些信息对大流行后时期的公共卫生政策和儿科医疗保健规划很有价值。
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引用次数: 0
Exploring the association between internalized weight bias and mental health among Canadian adolescents 探索加拿大青少年内化体重偏差与心理健康之间的关系
IF 3.8 3区 医学 Q1 PEDIATRICS Pub Date : 2024-04-27 DOI: 10.1111/ijpo.13118
Kristen M. Lucibello, Gary S. Goldfield, Angela S. Alberga, Scott T. Leatherdale, Karen A. Patte

Background

Internalized weight bias (IWB) has been identified as a correlate of higher depressive and anxiety symptoms in adolescents with higher weights. However, there has been limited investigation into how IWB relates to positive mental health and whether these associations differ across genders.

Objectives

To examine the associations between IWB and mental health (depression, anxiety, flourishing) in adolescents with higher weights, and to test the potential moderating role of gender.

Methods

Canadian adolescents with higher weights (N = 7538, 60% boys, 36% girls, 4% gender diverse, ages 12–19) from the COMPASS study completed a survey during the 2021–2022 school year. Data were analysed using generalized linear models.

Results

Highest IWB and poorest mental health were noted within gender diverse adolescents, followed by girls then boys. Gender moderated the relationship between higher IWB and higher depression, higher anxiety and lower flourishing, with the strongest relationships noted among girls.

Conclusion

IWB interventions should be tailored to gender subgroups that may be particularly vulnerable to maladaptive mental health outcomes associated with IWB. System-level changes that mitigate perpetuation of weight bias and discrimination which lead to IWB are also essential, particularly for girls.

摘要背景内化体重偏差(IWB)已被确定为体重较重青少年抑郁和焦虑症状较高的相关因素。方法COMPASS研究中的加拿大体重偏高青少年(N = 7538,60%为男生,36%为女生,4%为不同性别,年龄在12-19岁之间)在2021-2022学年期间完成了一项调查。我们使用广义线性模型对数据进行了分析。结果发现,不同性别青少年的 IWB 最高,心理健康最差,其次是女孩,再次是男孩。性别调节了较高的 IWB 与较高的抑郁、较高的焦虑和较低的欣欣向荣之间的关系,其中女孩之间的关系最为密切。结论IWB 干预措施应针对性别亚群量身定制,这些亚群可能特别容易出现与 IWB 相关的适应不良的心理健康结果。系统层面的变革也很重要,这些变革可以减轻导致 IWB 的体重偏见和歧视的长期存在,尤其是对女孩而言。
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引用次数: 0
Prediction of resting energy expenditure for adolescents with severe obesity: A multi-centre analysis 预测重度肥胖青少年的静息能量消耗:多中心分析。
IF 3.8 3区 医学 Q1 PEDIATRICS Pub Date : 2024-04-24 DOI: 10.1111/ijpo.13123
Amy A. Rydin, Cameron Severn, Laura Pyle, Nazeen Morelli, Ashley H. Shoemaker, Stephanie T. Chung, Jack A. Yanovski, Joan C. Han, Janine A. Higgins, Kristen J. Nadeau, Claudia Fox, Aaron S. Kelly, Melanie G. Cree

Background and Objectives

Resting energy expenditure (REE) assessments can help inform clinical treatment decisions in adolescents with elevated body mass index (BMI), but current equations are suboptimal for severe obesity. We developed a predictive REE equation for youth with severe obesity and obesity-related comorbidities and compared results to previously published predictive equations.

Methods

Data from indirect calorimetry, clinical measures, and body composition per Dual x-ray absorptiometry (DXA) were collected from five sites. Data were randomly divided into development (N = 438) and validation (N = 118) cohorts. A predictive equation was developed using Elastic Net regression, using sex, race, ethnicity, weight, height, BMI percent of the 95th%ile (BMIp95), waist circumference, hip circumference, waist/hip ratio, age, Tanner stage, fat and fat-free mass. This equation was verified in the validation cohort and compared with 11 prior equations.

Results

Data from the total cohort (n = 556, age 15 ± 1.7 years, 77% female, BMIp95 3.3 ± 0.94) were utilized. The best fit equation was REE = −2048 + 18.17 × (Height in cm) – 2.57 × (Weight in kg) + 7.88 × (BMIp95) + 189 × (1 = male, 0 = female), R2 = 0.466, and mean bias of 23 kcal/day.

Conclusion

This new equation provides an updated REE prediction that accounts for severe obesity and metabolic complications frequently observed in contemporary youth.

背景和目的esting 能量消耗(REE)评估有助于为体质指数(BMI)升高的青少年的临床治疗决策提供依据,但目前的公式对于重度肥胖并不理想。我们为患有严重肥胖症和肥胖相关合并症的青少年开发了一种预测性能量消耗方程,并将结果与之前公布的预测性方程进行了比较。方法从五个地点收集了间接热量计、临床测量和双 X 射线吸收测量(DXA)的身体成分数据。数据被随机分为开发组(N = 438)和验证组(N = 118)。通过使用性别、种族、民族、体重、身高、体重指数第 95%ile 百分位数(BMIp95)、腰围、臀围、腰/臀比、年龄、坦纳阶段、脂肪和去脂质量,使用弹性网回归法建立了一个预测方程。该方程在验证队列中得到了验证,并与之前的 11 个方程进行了比较。结果 使用了全部队列(n = 556,年龄为 15 ± 1.7 岁,77% 为女性,BMIp95 为 3.3 ± 0.94)的数据。最佳拟合方程为:REE = -2048 + 18.17 ×(身高,厘米)- 2.57 ×(体重,千克)+ 7.88 ×(BMIp95)+ 189 ×(1 = 男性,0 = 女性),R2 = 0.466,平均偏差为 23 千卡/天。结论:这一新方程提供了最新的 REE 预测,考虑到了当代青少年中经常出现的严重肥胖和代谢并发症。
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引用次数: 0
FirstStep2Health: A cluster randomised trial to promote healthy behaviours and prevent obesity amongst low-income preschoolers FirstStep2Health:促进低收入学龄前儿童健康行为和预防肥胖的分组随机试验
IF 3.8 3区 医学 Q1 PEDIATRICS Pub Date : 2024-04-15 DOI: 10.1111/ijpo.13122
Jiying Ling, Wachira Suriyawong, Lorraine B. Robbins, Nanhua Zhang, Jean M. Kerver

Objective

To evaluate the preliminary effects of a theory-based, multi-component intervention on improving healthy lifestyle behaviours and preventing obesity amongst low-income preschoolers.

Methods

A cluster randomised controlled trial was conducted at 10 daycare centres. The 16-week FirstStep2Health intervention, grounded in the Actor-Partner Interdependence Model and the Social Cognitive Theory, included five components: a Facebook-based parent programme, three virtual parent meetings, three weekly motivational text messages, parent–child learning via weekly child letters and daycare centre-based child programme.

Results

A total of 95 preschoolers (53 intervention and 42 control) participated. Preschoolers' mean age was 49.27 months, with 57.9% being female, 12.6% being Hispanic and 40% being African American. The intervention significantly decreased intervention preschoolers' fat intake (B = −33.76, p = 0.047) and % body fat (B = −1.18, p = 0.036) compared to the control. During year 2, there were significant intervention effects on increasing skin carotenoids (B = 87.06, p = 0.035). Although not statistically significant, the intervention showed positive effects on increasing preschoolers' fruit/vegetable intake; and decreasing screen time, body mass index z-score and proportion of overweight/obesity.

Conclusions

Even with some potential limitations (small sample size, measurement concerns and confounding with Coronavirus Disease 2019 pandemic), the study's results support the preliminary efficacy of the FirstStep2Health intervention in preventing obesity amongst low-income racially diverse preschoolers.

摘要目的评估基于理论的多成分干预措施对改善低收入学龄前儿童的健康生活方式行为和预防肥胖的初步效果。 方法在 10 个日托中心进行了分组随机对照试验。为期 16 周的 FirstStep2Health 干预以行动者-伙伴相互依存模型和社会认知理论为基础,包括五个组成部分:基于 Facebook 的家长计划、三次虚拟家长会、每周三次激励短信、通过每周儿童信件进行亲子学习以及基于日托中心的儿童计划。学龄前儿童的平均年龄为 49.27 个月,其中 57.9% 为女性,12.6% 为西班牙裔,40% 为非裔美国人。与对照组相比,干预组学龄前儿童的脂肪摄入量(B=-33.76,p=0.047)和体脂率(B=-1.18,p=0.036)明显减少。在第二年,干预措施对增加皮肤类胡萝卜素有显著效果(B = 87.06,p = 0.035)。结论即使存在一些潜在的局限性(样本量小、测量问题以及与 2019 年冠状病毒疾病大流行的混淆),该研究的结果仍然支持 FirstStep2Health 干预措施在预防低收入种族学龄前儿童肥胖方面的初步效果。
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引用次数: 0
Infant feeding practices and body mass index up to 7.5 years in the French nationwide ELFE study 法国全国性 ELFE 研究中 7.5 岁以下婴儿的喂养方式和体重指数
IF 3.8 3区 医学 Q1 PEDIATRICS Pub Date : 2024-04-15 DOI: 10.1111/ijpo.13121
Aurore Camier, Aminata Hallimat Cissé, Barbara Heude, Sophie Nicklaus, Claire Chabanet, Jonathan Y. Bernard, Sandrine Lioret, Marie Aline Charles, Blandine de Lauzon-Guillain

Background/Objectives

The infant diet represents one of the main modifiable determinants of early growth. This study aimed to investigate the associations of infant feeding practices with body mass index (BMI) until 7.5 years.

Subjects/Methods

Analyses were based on data from the French nationwide ELFE birth cohort. Data on breastfeeding (BF) and complementary feeding (CF) were collected monthly from 2 to 10 months. Infant feeding practices were characterized using principal component analyses (PCA) and hierarchical ascendant classification. BMI z-score was computed at 1, 2, 3, 5 and 7.5 years, from data collected in the child's health booklet; 7.5-year overweight was defined according to IOTF references. Associations between infant feeding practices and BMI were investigated by linear regression models adjusted for main confounders.

Results

Ever breastfeeding was not associated with BMI up to 7.5 years. Compared to intermediate breastfeeding duration (1 to <3 months), longer breastfeeding duration (≥6 months) was related to lower 1-year BMI, but not at older ages. Compared to the recommended age at CF introduction (4–6 months), early CF (<4 months) was related to higher BMI up to 5 years with a similar trend at 7.5 years, but not to the risk of overweight. The PCA patterns characterized by early baby cereal introduction and late food pieces introduction or by frequent intake of main food groups were related to a lower BMI up to 7.5 years.

Conclusion

Breastfeeding was related with a lower BMI in infancy but not thereafter, whereas an early CF initiation (<4 months) was associated with a higher BMI in childhood.

摘要背景/目的婴儿饮食是早期生长的主要可调节决定因素之一。本研究旨在调查婴儿喂养方式与7.5岁前体重指数(BMI)之间的关系。每月收集2至10个月的母乳喂养(BF)和辅食喂养(CF)数据。采用主成分分析(PCA)和分层升序分类法对婴儿喂养方式进行了特征描述。根据儿童健康手册中收集的数据,计算了1、2、3、5和7.5岁时的体重指数z-score;7.5岁超重是根据IOTF参考标准定义的。在对主要混杂因素进行调整后,通过线性回归模型研究了婴儿喂养方式与体重指数之间的关系。与中间母乳喂养持续时间(1 至 3 个月)相比,较长的母乳喂养持续时间(≥6 个月)与较低的 1 年体重指数有关,但与较大年龄的体重指数无关。与母乳喂养的建议年龄(4-6 个月)相比,早期母乳喂养(4 个月)与 5 岁前较高的体重指数有关,7.5 岁时也有类似趋势,但与超重风险无关。结论母乳喂养与婴儿期较低的体重指数有关,但与此后的体重指数无关,而较早开始喂养 CF(4 个月)与儿童期较高的体重指数有关。
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引用次数: 0
The role of mesenchymal stem cells in early programming of adipose tissue in the offspring of women with obesity 间充质干细胞在肥胖妇女后代脂肪组织早期编程中的作用
IF 3.8 3区 医学 Q1 PEDIATRICS Pub Date : 2024-04-08 DOI: 10.1111/ijpo.13120
Sofía Bellalta, Torsten Plösch, Marijke Faas, Paola Casanello

Maternal obesity is a well-known risk factor for developing premature obesity, metabolic syndrome, cardiovascular disease and type 2 diabetes in the progeny. The development of white adipose tissue is a dynamic process that starts during prenatal life: fat depots laid down in utero are associated with the proportion of fat in children later on. How early this programming takes place is still unknown. However, recent evidence shows that mesenchymal stem cells (MSC), the embryonic adipocyte precursor cells, show signatures of the early setting of an adipogenic committed phenotype when exposed to maternal obesity. This review aims to present current findings on the cellular adaptations of MSCs from the offspring of women with obesity and how the metabolic environment of MSCs could affect the early commitment towards adipocytes. In conclusion, maternal obesity can induce early programming of fetal adipose tissue by conditioning MSCs. These cells have higher expression of adipogenic markers, altered insulin signalling and mitochondrial performance, compared to MSCs of neonates from lean pregnancies. Fetal MSCs imprinting by maternal obesity could help explain the increased risk of childhood obesity and development of further noncommunicable diseases.

摘要母体肥胖是导致后代过早肥胖、代谢综合征、心血管疾病和 2 型糖尿病的一个众所周知的风险因素。白色脂肪组织的发育是一个动态过程,在产前就已经开始:在子宫内形成的脂肪储层与日后孩子的脂肪比例有关。目前还不清楚这一过程发生的时间。不过,最近的证据显示,间充质干细胞(MSC)作为胚胎脂肪细胞的前体细胞,在暴露于母体肥胖的情况下,显示出脂肪生成表型的早期设置特征。本综述旨在介绍目前关于肥胖妇女后代间充质干细胞的细胞适应性研究结果,以及间充质干细胞的代谢环境如何影响其早期向脂肪细胞的承诺。总之,母体肥胖可通过调节间充质干细胞诱导胎儿脂肪组织的早期编程。与瘦孕妇的间充质干细胞相比,这些细胞具有更高的脂肪形成标志物表达、胰岛素信号改变和线粒体性能。母体肥胖对胎儿间充质干细胞的影响可能有助于解释儿童肥胖风险增加和进一步发展为非传染性疾病的原因。
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引用次数: 0
Understanding family dynamics of obesity: Do parents and children lose and gain weight together? 了解肥胖症的家庭动态:父母和孩子会一起减肥和增重吗?
IF 3.8 3区 医学 Q1 PEDIATRICS Pub Date : 2024-04-07 DOI: 10.1111/ijpo.13097
Karina M. Chan, Sarra M. Rahem, Hugo O. Teo, Joan Curcio, Savi Mushiyev, Robert Faillace, Risa Bochner, Renee Bargman, Farbod Raiszadeh

Background

Obesity is prevalent among children and adults. Yet, understanding the relationship between parent and child weight trajectories is limited.

Objective

(1) Examine the association between parent/child undesirable body mass index (BMI) category change. (2) Assess whether parental BMI category predicts child modified BMI z-score (mBMIz) annual change.

Methods

We conducted a cross-sectional study of weight trajectories of 3821 parent–child dyads between March 2020 and December 2021 within the NYC Health + Hospitals system. Undesirability of child and parental BMI category change and the magnitude of mBMIz change by parental BMI are analysed.

Results

Of 3821 children (mean [SD] baseline age, 9.84 [3.51]), 1889 were female. Of the 3220 parents (mean [SD] baseline age, 39.9 [8.51]), 2988 were female. Most children (53.52%) and parents (81.94%) presented with overweight and obesity. Undesirable BMI change in children was associated with concordant change in parents (adjusted OR: 1.7, 95% CI [1.45, 2.01], adjusted p < 0.001). Children of parents with obesity (adjusted coef: 0.076, 95% CI [0.004, 0.147], p < 0.038) and severe obesity (adjusted coef: 0.1317, 95% CI [0.024, 0.239], adjusted p < 0.016) demonstrated greater change in mBMIz than those of parents with normal weight or underweight.

Conclusion

Parents and children have concordant weight trajectories, and public health interventions targeting both populations are essential.

肥胖症在儿童和成年人中普遍存在。然而,人们对父母与子女体重轨迹之间关系的了解还很有限。
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引用次数: 0
Cumulative environmental stress and emerging cardiometabolic risk during childhood 累积性环境压力与儿童期新出现的心脏代谢风险。
IF 3.8 3区 医学 Q1 PEDIATRICS Pub Date : 2024-03-28 DOI: 10.1111/ijpo.13116
Alicia S. Kunin-Batson, Jacob Haapala, A. Lauren Crain, Megan R. Gunnar, Elyse O. Kharbanda, Aaron S. Kelly, Elisabeth M. Seburg, Nancy E. Sherwood, Simone A. French

Objective

To prospectively evaluate the relationship between cumulative environmental stress and cardiometabolic risk in middle childhood, and to examine whether hair cortisol, a measure of hypothalamic pituitary adrenal-axis activity, mediates this relationship.

Methods

In a cohort of children from low-income households (n = 320; 59% Hispanic, 23% Black, body mass index (BMI) percentile >50th at enrollment), environmental stressors including family and neighbourhood factors representing disadvantage/deprivation, and cortisol concentrations from hair samples, were measured over five timepoints beginning when children were 2–4 years old. Cardiometabolic risk factors (i.e., BMI, blood pressure, lipids, blood sugar, C-reactive protein) were measured at the final timepoint when children were 7–11 years of age.

Results

In adjusted logistic regression models, greater cumulative environmental stress was associated with a higher likelihood of elevated cardiometabolic risk in middle childhood (p = 0.01). Children from minoritized racial/ethnic groups had a higher prevalence of both stressors and cardiometabolic risk factors. Cumulative environmental stress was associated with higher hair cortisol concentrations (p < 0.01). However, hair cortisol was not directly associated with cardiometabolic risk factors and did not explain the association between environmental stress and cardiometabolic risk in causal mediation analysis.

Conclusions

The influence of cumulative stress on cardiometabolic health can be observed in middle childhood and may contribute to cardiometabolic health disparities, highlighting the importance of public health interventions to mitigate disadvantage.

目的前瞻性评估儿童中期累积环境压力与心脏代谢风险之间的关系,并研究毛发皮质醇(下丘脑垂体肾上腺轴活动的一种测量指标)是否能调节这种关系:在一组低收入家庭的儿童(n = 320;59% 为西班牙裔,23% 为黑人,入学时体重指数(BMI)百分位数大于第 50 位)中,从儿童 2-4 岁开始的五个时间点测量了环境压力因素(包括代表弱势/贫困的家庭和邻里因素)和头发样本中的皮质醇浓度。心血管代谢风险因素(即体重指数、血压、血脂、血糖、C反应蛋白)在儿童7-11岁时的最后一个时间点进行测量:在调整后的逻辑回归模型中,累积环境压力越大,儿童中期心脏代谢风险越高(p = 0.01)。来自少数种族/族裔群体的儿童在压力因素和心脏代谢风险因素方面的发病率都较高。累积性环境压力与较高的毛发皮质醇浓度有关(p 结论:累积性环境压力对心脏代谢风险的影响与毛发皮质醇浓度有关:累积性压力对心脏代谢健康的影响可在儿童中期观察到,并可能导致心脏代谢健康差异,这凸显了采取公共卫生干预措施以缓解不利条件的重要性。
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引用次数: 0
Identifying elevated child weight from 3 to 24 months: Early transitions into nonparental care and to solid foods 识别 3 到 24 个月体重增加的儿童:早期过渡到非父母照料和固体食物。
IF 3.8 3区 医学 Q1 PEDIATRICS Pub Date : 2024-03-23 DOI: 10.1111/ijpo.13115
Jennifer M. Barton, Alexandra Lundquist, Meghan C. Fisher, Barbara H. Fiese, Brent A. McBride

Background

Early entry into nonparental care (NPC) and introduction to solid foods (ITS) have been linked to elevated weight, however, little research exists on the combined influence of these transitions on child weight over time.

Objectives

Identify groups of children based on early NPC and ITS timing and examine whether NPC-ITS groups differentially affect child weight over time.

Method

Data were drawn from STRONG Kids2 (n = 468). Primary predictors include NPC (by 3M)-ITS (< or ≥6M) groups; outcome variables include child weight-for-length/height z-scores (WFL/WFHz) (3, 12, 18, and 24 months). Multilevel regression was used to examine the NPC-ITS groups as predictors of child WFL/WFHz.

Results

Six groups were identified: 27% Parental Care-ITS before 6M, 31% Parental Care-ITS after 6M, 12% Daycare-ITS before 6M, 14% Daycare-ITS after 6M, 10% Kincare-ITS before 6M, and 7% Kincare-ITS after 6M. Children who were in daycare (regardless of ITS) or kincare-ITS before 6M demonstrated the highest WFL/WFHz over time, compared to their parental care counterparts.

Conclusions

NPC-ITS combinations on child WFL/WFHz across the first 2 years of life highlight the need for a partnership approach among parental and nonparental caregivers to support the feeding of infants throughout the transition to solid foods.

背景:过早进入非父母照料(NPC)和开始进食固体食物(ITS)与体重增加有关,但是,关于这些过渡时期对儿童体重的综合影响的研究却很少:根据早期 NPC 和 ITS 的时间确定儿童群体,并研究 NPC-ITS 群体是否会随着时间的推移对儿童体重产生不同的影响:方法:数据来自 STRONG Kids2(n = 468)。主要预测因素包括NPC(3M前)-ITS(<或≥6M)组;结果变量包括儿童体重身长/身高Z值(WFL/WFHz)(3、12、18和24个月)。采用多层次回归法研究了预测儿童 WFL/WFHz 的 NPC-ITS 组别:结果:确定了六个组别:结果:共确定了六个组别:6 个月前 27% 的父母照顾-ITS 组别、6 个月后 31% 的父母照顾-ITS 组别、6 个月前 12% 的日托-ITS 组别、6 个月后 14% 的日托-ITS 组别、6 个月前 10% 的 Kincare-ITS 组别和 6 个月后 7% 的 Kincare-ITS 组别。与父母照顾的儿童相比,6 个月前接受日托(无论 ITS 如何)或亲子-ITS 的儿童随着时间的推移表现出最高的 WFL/WFHz 值:结论:NPC-ITS组合在儿童出生后头两年的WFL/WFHz上的影响突出表明,在婴儿向固体食物过渡的整个过程中,父母和非父母照顾者需要采取合作的方式来支持婴儿的喂养。
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引用次数: 0
期刊
Pediatric Obesity
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