Vitamin D3 among neonates born after in vitro fertilization compared with neonates from the general population.

INTRODUCTION: Sufficient levels of vitamin D have been associated with higher chances for both clinical pregnancy and live birth among women undergoing assisted reproductive techniques, whereas low levels of maternal vitamin D have been associated with preeclampsia and late miscarriage. In Denmark, subgroups at risk for low vitamin D levels, including neonates and toddlers, are recommended to use supplementation. The aim was to study the level of vitamin D3 among neonates born after in vitro fertilization compared with neonates from the general population. MATERIAL AND METHODS: In this cohort study a random sample of 1326 neonates representing the general population and 1200 neonates conceived by in vitro fertilization born in Denmark from 1995 to 2002 were identified from registries covering the whole Danish population. Information on use of assisted reproduction was collected from the Danish In Vitro Fertilization register, ICD-10 code: DZ358F. 25-Hydroxyvitamin D was measured from dried blood spots routinely collected by heel prick 48-72 h after birth and corrected according to the hematocrit fraction for capillary blood of neonates. Linear regression analysis was performed, both crude and adjusted, for predefined putative confounders, identified through directed acyclic graphs. RESULTS: Vitamin D3 analysis could be performed from a total of 1105 neonates from the general population and 1072 neonates conceived by in vitro fertilization that were subsequently included in the study. The median vitamin D3 was 24.0 nmol/L (interquartile range [IQR] 14.1-39.3) and 33.0 nmol/L (IQR 21.3-48.8) among neonates from the general population and neonates conceived by in vitro fertilization, respectively. The adjusted mean difference between neonates from the general population and those conceived by in vitro fertilization was 6.1 nmol/L (95% confidence interval 4.1-8.1). CONCLUSIONS: In this study, children born after in vitro fertilization have a higher vitamin D3 than a random sample of neonates in Denmark.

Night work during pregnancy and small for gestational age: a Danish nationwide register-based cohort study.

OBJECTIVE: The aim was to investigate the association between night work during pregnancy and risk of having a small for gestational age (SGA) child. METHODS: This cohort study had payroll data with detailed information on working hours for employees in all Danish administrative regions (primarily hospital employees) between 2007 and 2015, retrieved from the Danish Working Hour Database. Pregnancies, covariates and outcome were identified from the national birth registry. We used logistic regression to investigate the association between intensity and duration of night work during the first 32 pregnancy weeks and SGA. The adjusted model included age, body mass index, socioeconomic status and smoking. Using quantitative bias analysis and G-estimation, we explored potential healthy worker survivor bias (HWSB). RESULTS: The final cohort comprised 24 548 singleton pregnancies in 19 107 women, primarily nurses and medical doctors. None of the dimensions of night work were associated with an increased risk of SGA. We found a tendency towards higher risk of SGA in pregnancies where the women stopped having night shifts during pregnancy. Using G-estimation we found an OR<1 for the association between night work and SGA if all workers continued having night work during pregnancy compared with daywork only. CONCLUSION: We found no increased risk of SGA in association with night work during pregnancy among healthcare workers. G-estimation was not precise enough to estimate the observed indication of HWSB. We need better data on pregnancy discomforts and complications to be able to safely rule out HWSB.

Vitamin D Supplementation and Vitamin D Status during Pregnancy and the Risk of Congenital Anomalies-A Systematic Review and Meta-Analysis.

Maternal dietary factors have been suggested as possible contributing influences for congenital anomalies (CAs). We aimed to assess the association between vitamin D supplementation or vitamin D status (s-25OHD) during pregnancy and CAs in the offspring. A comprehensive literature search was conducted in the three electronic databases: PubMed, Embase, and Cochrane Library. Included studies were critically appraised using appropriate tools (risk of bias 2, ROBINS-I). A protocol was registered in the International Prospective Register of Systematic Reviews (CRD42019127131). A meta-analysis of four randomised controlled trials (RCTs) including 3931 participants showed no effect of vitamin D supplementation on CAs, a relative risk of 0.76 (95% CI 0.45; 1.30), with moderate certainty in the effect estimates by GRADE assessment. Of the nine identified observational studies, six were excluded due to a critical risk of bias in accordance with ROBINS-I. Among the included observational studies, two studies found no association, whereas one case-control study identified an association between s-25OHD < 20 nmol/L and neural tube defects, with an adjusted odds ratio of 2.34 (95% CI: 1.07; 5.07). Interpretation of the results should be cautious given the low prevalence of CAs, RCTs with onset of supplementation after organogenesis, and low-quality observational studies.

Types of kindergarten and their relationship with parental and children's socio-demographic characteristics in Denmark.

In Danish outdoor kindergartens, children are spending most of the day outdoors often in forests or similar nature environments. These children are assumed to be healthier than children attending conventional kindergartens, however, factors related to choosing a specific type of kindergarten may explain the differences. To better understand this, we aimed to investigate parents reasons for choosing either outdoor or conventional kindergartens based on a mixed-method participatory Concept Mapping approach, and further if parental socio-demographics and early child characteristics differed prior to enrolling children to either type of kindergarten using a cohort register-based approach. Parents of children attending outdoor kindergartens (n = 23) weighed reasons such as "physical setting, outdoor life, and freedom of movement" high, whereas "a good first impression of the kindergarten" was an important reason for parents choosing a conventional kindergarten (n = 22). In the register-based approach, 2434 and 2643 children attended outdoor or conventional kindergartens, respectively. The parents choosing outdoor kindergartens as well as their children differed according to most investigated characteristics, including origin (maternal non-Western: 4.2% vs. 21.9%, p < .0001), educational level (maternal long education: 45.6% vs. 33.0%, p < .0001), prematurity (5.1% vs. 7.1%, p = 0.004) and sex (females: 43.5% vs. 48.6%, p = <0.0013). In conclusion, parental reasons for choosing kindergarten as well as parental socio-demographics differed substantially among kindergarten type. These differences might cause selection bias if not considering when comparing health outcomes among children attending different kinds of kindergartens.

Does attendance in outdoor kindergartens reduce the use of antibiotics in children?

AIM: The aim of this study was to determine whether children enrolled in rural outdoor kindergartens had a lower risk of redeeming at least one prescription for antibiotics compared with children enrolled in urban conventional kindergartens, and if type of antibiotics prescribed differed according to kindergarten type. METHODS: Two Danish municipalities provided data including civil registration numbers from children enrolled in a rural outdoor kindergarten in 2011-2019, and a subsample of all children enrolled in urban conventional kindergartens in the same period. Civil registration numbers were linked to individual-level information on redeemed prescriptions for antibiotics from the Danish National Prescription Registry. Regression models were performed on 2132 children enrolled in outdoor kindergartens, and 2208 children enrolled in conventional kindergartens. RESULTS: There was no difference between groups in risk of redeeming at least one prescription for all types of antibiotics (adjusted risk ratio: 0.97 [95% confidence intervals 0.93, 1.02, p = 0.26]). Similarly, there were no differences between kindergarten type and risk of redeeming at least one prescription for systemic, narrow-spectrum systemic antibacterial, broad-spectrum systemic antibacterial or topical antibiotics. CONCLUSION: Compared with children who were enrolled in conventional kindergartens, children who were enrolled in outdoor kindergartens did not have a lower risk of redeeming prescriptions for any type of antibiotics.

Outdoor Kindergartens: A Structural Way to Improve Early Physical Activity Behaviour?

BACKGROUND: Studies have shown that outdoor play in nature is associated with a higher physical activity level than indoor play. We aimed to examine the effect of outdoor versus conventional kindergartens on objectively measured physical activity. METHOD: Using a pre-test-post-test design, we collected data in four kindergartens that provided a rotating outdoor and conventional kindergarten setting. Step counts were measured during one week in the outdoor setting and one week in the conventional setting. Differences in step counts between the outdoor and conventional setting were analysed using a paired t-test. RESULTS: In total, 74 children were included. There was no statistically significant difference in total daily step counts between children in the two settings. When we looked at step counts during kindergarten hours, we saw that children were more physically active in the outdoor setting compared to the conventional setting (mean difference: 1089, p < 0.0001). When we looked at activity during time outside the kindergarten, we discovered that children had a lower step count in the outdoor setting as compared to the conventional setting (mean difference -652, p = 0.01). CONCLUSION: This study indicates that children are more physically active during the time they spend in outdoor kindergartens compared to conventional kindergartens, but may compensate with more inactivity outside kindergarten hours.

Comparison of Motor Difficulties Measured in the First Year of School among Children Who Attended Rural Outdoor or Urban Conventional Kindergartens.

BACKGROUND: Kindergartens can potentially contribute substantially to the daily level of physical activity and development of motor skills and might be an ideal setting for improving these as a public health initiative. We aimed to examine whether children from rural outdoor kindergartens had a lower risk of motor difficulties than children from urban conventional kindergartens. METHODS: Motor test results were measured during the first school year by school health nurses using a six-item test of gross- and fine motor skills (jumping, handle a writing tool, cutting with a scissor following a line, one-leg stand on each leg, throwing and grabbing). Register-based information was available on potential confounding factors. RESULTS: We included 901 children from outdoor kindergartens and 993 from conventional kindergartens with a mean (SD) age of 6.5 years (0.4). The children from the two types of kindergarten differed according to demographic information, with outdoor kindergarten children more often being from more affluent families (long maternal education level: 47.5% vs. 31.0%, p < 0.0001) and fewer girls attending the outdoor kindergartens (42.7% vs. 49.5%, p = 0.003). In the adjusted models, we found no evidence of differences in the risk of motor difficulties between children attending either type of kindergarten (OR: 0.95, 95%CI: 0.71; 1.27, p = 0.72). CONCLUSION: Our results do not support outdoor kindergartens as a potential intervention to improve motor abilities among children. Randomized controlled trials are needed to confirm these findings.

Working from home during COVID-19 in a Danish hospital research setting: experiences of researchers and healthcare providers, explored by Group Concept Mapping.

OBJECTIVES: The COVID-19 pandemic has changed the working environment, how we think of it and how it stands to develop into the future. Knowledge about how people have continued to work on-site and adjusted to working from home during the COVID-19 lockdown will be vital for planning work arrangements in the post-pandemic period. Our primary objective was to investigate experiences of working from home or having colleagues working from home during a late stage of the COVID-19 lockdown among researchers and healthcare providers in a hospital research setting. Second, we aimed to investigate researchers' productivity through changes in various proxy measures during lockdown as compared with pre-lockdown. DESIGN: Mixed-method participatory Group Concept Mapping (GCM). SETTING AND PARTICIPANTS: GCM, based on a mixed-method participatory approach, was applied involving researchers' and healthcare providers' online sorting and rating experiences working from home during the COVID-19 pandemic. At a face-to-face meeting, participants achieved consensus on the number and labelling of domains-the basis for developing a conceptual model. RESULTS: Through the GCM approach, 47 participants generated 125 unique statements of experiences related to working from home, which were organised into seven clusters. Using these clusters, we developed a conceptual model that illustrated the pros and cons of working from home. CONCLUSION: The future work setting, the role of the office and the overall work environment need to respond to workers' increased wish for flexible work arrangements and co-decision.

"I would never be able to forgive myself if it ended up having consequences for the child": A qualitative study of perceptions of stress and worries among healthy first-time pregnant Danish women.

BACKGROUND: Becoming a mother is one of the most transitional experiences in life. It requires psychological, physical, and social adjustment and adaptation in various areas and can be conceived as both a stressful and joyful experience by many women. Especially, first-time pregnancies are recognised as a period of emotional sensitivity. Moreover, stress is a well-established risk factor for premature birth and low birth weight and might affect the health of the offspring. Thus, this study explores the perception of stress and worries in healthy Danish pregnant nulliparous women. METHODS: We used a qualitative, inductive, exploratory design. Three focus group interviews were conducted with 16 healthy pregnant nulliparous women. Data from the focus group interviews were analysed using content analysis according to Graneheim and Lundman. FINDINGS: Three main categories contributed to the core theme "Identity Limbo". The categories were: (1) The great responsibility, (2) Imagining picture-perfect, and (3) Two-in-one body. The participants expressed that holding on to their current identity was extremely important. They simultaneously tried to incorporate their new identity as mothers, which imposed sadness about saying goodbye to their old life, leaving them in an identity limbo. These women did not experience classic stressors such as bereavement, poverty, or trauma. Still, the great responsibility for the child's future, changes to their work and career, and saying goodbye to their pre-pregnancy identity were all essential contributors to feelings of stress in the women's current pregnancy and life. CONCLUSION: Our findings suggest that the identity limbo triggered by pregnancy can make the transition to motherhood stressful for some women. Therefore, with the potentially severe consequences of stress in mind, developing tools that can help women and midwives focus on the mental transition of pregnancy is needed.

Association between intake of marine fat and adiposity development among children ages 2 to 6 y: Substitution analyses from the Healthy Start intervention study.

OBJECTIVES: A few previous studies have described a potential role of Ω-3 long-chain polyunsaturated fatty acids from marine animals in obesity in children, but the results are conflicting. The objectives of this study were to examine if intake of marine fat was related to less gain in body mass index (BMI) and body fat (BF) over a 15-mo period among Danish children age 2 to 6 y, and if potential associations depended on which types of fatty acids were replaced. METHODS: A total of 355 children age 2 to 6 y were included in the study. Weight, height, and BF percentage (BF%) assessed by bioimpedance were measured by trained research personnel. Multivariable linear regression models were used to investigate associations between marine fat intake and changes in BMI or BF% over the subsequent 15 mo. To investigate substitution effects, we constructed regression models that included marine fat and all other energy yielding dietary components, except for the nutrient to be substituted for either all fats or specific subgroups (saturated, monounsaturated, or other polyunsaturated fatty acids). RESULTS: No significant associations were observed between intake of marine fat and development in BMI or BF% in any of the analyses, either with or without specified substitutions. Furthermore, the results were independent on whether intake was expressed in g/d or percentage of energy, and were not modified by age or BMI status. CONCLUSIONS: This study suggests that marine fat intake and fat composition in a diet may have little or no effect on weight and adiposity development among preschool-aged children.

Effects of the healthy start randomized intervention on psychological stress and sleep habits among obesity-susceptible healthy weight children and their parents.

Poor sleep and psychological stress are obesity determinants that are rarely included in obesity prevention programs. The aim was to report the effects of the Healthy Start randomized intervention on the secondary outcomes psychological stress and sleep duration and onset latency. Data was obtained from the Healthy Start randomized intervention conducted in 2009-2012 among Danish healthy weight children aged 2-6 years, who had either a high birth weight (>4,000 g), high maternal pre-pregnancy body mass index (>28 kg/m2), or low maternal educational level (≤10 years of schooling) and their parents. The intervention was designed to deliver improvements in diet and physical activity habits, optimization of sleep habits, and reduction of psychological family stress. The average intervention period was 15 months. Children with information on a 7-day sleep record, sleep onset latency, Strengths and Difficulties Questionnaire (SDQ), and a modified version of Parenting Stress Index (PSI) were included. The effects of the intervention on sleep habits, PSI scores, SDQ Total Difficulties (SDQ-TD) and Pro-social Behavior scores, and 95% Confidence Intervals (95% CI) were analyzed using linear regression intention-to-treat (n = 543 (intervention group n = 271, control group n = 272)) analyses. No statistically significant effects on sleep duration, sleep onset latency, PSI score, or SDQ Pro-social Behavior score were observed. Values both before and after the intervention were within the normal range both for children in the intervention and children in the control group. Mean change in SDQ-TD was 0.09 points (95% CI -0.57;0.59) in the intervention group, and -0.69 points (95% CI -1.16; -0.23) in the control group (p = 0.06). In conclusion, there were no intervention effects in relation to sleep duration, sleep onset latency, PSI score, or SDQ Pro-social behavior. There was an indication that children in the intervention group had slightly more behavioral problems than the control group after the intervention, but values were within normal range both before and after the intervention, and the difference is not considered to be clinically meaningful.

Vitamin D Concentrations at Birth and the Risk of Rheumatoid Arthritis in Early Adulthood: A Danish Population-Based Case-Cohort Study.

Background: Low vitamin D in pregnancy may impair the development of the fetal immune system and influence the risk of later development of rheumatoid arthritis (RA) in the offspring. The aim was to examine whether lower 25-hydroxyvitamin D3 (25(OH)D) concentrations at birth were associated with the risk of developing RA in early adulthood. Methods: This case-cohort study obtained data from Danish registers and biobanks. Cases included all individuals born during 1981−1996 and recorded in the Danish National Patient Register with a diagnosis of RA with age >18 years at first admission. The random comparison consisted of a subset of Danish children. Vitamin D concentrations were measured in newborn dried blood. In total, 805 RA cases and 2416 individuals from the subcohort were included in the final analysis. Weighted Cox regression was used to calculate hazard ratio (HR). Results: The median (interquartile rage (IQR)) 25(OH)D concentrations among cases were 24.9 nmol/L (IQR:15.4;36.9) and 23.9 nmol/L (IQR:13.6;36.4) among the subcohort. There was no indication of a lower risk of RA among individuals in the highest vitamin D quintile compared with the lowest (HRadj.:1.21 (0.90;1.63)). Conclusion: The risk of RA in early adulthood was not associated with vitamin D concentrations at birth.

Physical Activity and Subsequent Change in Body Weight, Composition and Shape: Effect Modification by Familial Overweight.

BACKGROUND: Physical activity (PA) has been shown to attenuate the genetic risk of obesity as measured using polygenic risk scores. However, familial obesity history might be an easier predictor. We examined associations between PA and subsequent changes in BMI, body fat percentage (BF%) and waist circumference (WC) among participants with and without adiposity and a familial overweight. METHODS: In total, 1971 participants from the Danish MONICA cohort were included. Mean differences for 6-year changes in BMI, BF% and WC across PA levels were estimated. Association between walking and biking and subsequent change in adiposity were analysed. Effect modification by familial obesity was assessed by adding product terms to the models. RESULTS: We observed weak associations between leisure PA level and changes in WC [participants with low PA: 3.4 cm (95%CI: 2.8;4.0), participants with high PA: 2.4 cm (95%CI: 1.8;3.0)], with no evidence of effect modification by familial obesity. We found effect modification in analyses on walking and biking in relation to changes in BMI (P-interaction<0.01) and BF% (P-interaction=0.04), suggesting lower gain with more hours of activity among participants with adiposity and familial overweight. CONCLUSIONS: The results were modest but suggested that PA, especially walking and biking, may prevent future adiposity.

Intake of n-3 LCPUFA and trans-fatty acids is unrelated to development in body mass index and body fat among children.

BACKGROUND: The number of children and adolescents with obesity has increased worldwide. Some studies have found an increase in the intake of n-3 long-chain polyunsaturated fatty acid (LCPUFA) to be beneficial for weight and obesity status. The objectives of this study were to examine if intake of trans-fatty acids (TFA) and n-3 LCPUFA at school start was associated with weight and body fat development in the following 3 and 7 years, and if substituting other fats for n-3 LCPUFA in regression models influenced weight and body fat development. METHODS: A total of 285 children (boys:130, girls:155) were included in this study. Weight, height and skinfold thickness (SF) of children were measured at age 6, 9 and 13 years by trained research personnel. Multivariate linear regression models were used to investigate the associations between n-3 LCPUFA or TFA intake and subsequent changes in body mass index (BMI) or SF. To investigate substitution effects, we constructed regression models including information on n-3 LCPUFA and all other energy given components of the diet, except for the nutrient to be substituted (all other fats and specific subgroups; saturated fatty acids (SFAs), monounsaturated fatty acids (MUFAs) and other polyunsaturated fatty acids (PUFAs)). RESULTS: No significant associations were observed between intake of TFA or n-3 LCPUFA and changes in BMI and SF. Also, results from regression analysis showed substituting other fats for n-3 LCPUFA did not associate with BMI or SF development. CONCLUSION: The lack of associations between n-3 LCPUFA and TFA and adiposity suggests that fat composition in the diet does not play a major role in obesity development among school-aged children.

Early Postpartum Stress, Anxiety, Depression, and Resilience Development among Danish First-Time Mothers before and during First-Wave COVID-19 Pandemic.

On 11 March 2020, a lockdown to limit the spread of COVID-19 was implemented in Denmark. The pandemic and the lockdown might have caused stress, depression, and anxiety in new mothers. Individuals with high resilience to stress may have been less affected. This study aimed to investigate if changes in perceived stress, anxiety, depression, and resilience from the second trimester until two months postpartum were different before and during the COVID-19 pandemic in Denmark in spring 2020. Pregnant women enrolled in an ongoing feasibility study completed an online questionnaire measuring perceived stress, depression, anxiety, and resilience in the second trimester and two months postpartum. Changes in scores between women completing the two-month postpartum questionnaire before (n = 26) or during (n = 47) the COVID-19 pandemic were calculated. No statistically significant differences in changes from baseline to follow-up between pre- and during-pandemic groups in Cohen's Perceived Stress Scale (PSS), the Depression, Anxiety, Stress Scale (DASS), or the Connor-Davidson Resilience Scale (CD-RISC) were found. Adjusted differences in group means were as follows: PSS: 0.70 (CI-2.45; 3.85); DASS Stress: 0.76 (CI-3.59; 2.08); DASS Anxiety: 0.47 (CI-0.84; 1.77); DASS Depression: 0.88 (CI-0.95; 2.71); and CD-RISC: 1.19 (CI-3.16; 5.54). In conclusion, we did not find significant differences in the development of stress, depression, anxiety, or resilience before or during the Danish COVID-19 pandemic in spring 2020.

Three-Year Intervention Effects on Food and Beverage Intake-Results from the Quasi-Experimental Copenhagen School Child Intervention Study (CoSCIS).

The diet of Danish children is often not in accordance with dietary guidelines. We aimed to evaluate changes in the intake of selected foods and beverages during a multi-component school-based physical activity intervention, and to investigate if changes were modified by socioeconomic status (SES). The study included 307 children (intervention group: 184; comparison group: 123) with information on dietary intake pre- and post-intervention as well as on SES. Linear regression models were conducted to assess the effect of the intervention on changes in dietary factors. Children from the intervention group increased their intake of whole-grain bread during the intervention (group means: 6.1 g/d (95% CI: 2.2 to 10.0) vs. 0.3 g/d (95% CI: -3.1 to 3.7) in the comparison group, p = 0.04). A significant interaction between SES and group allocation was observed to change in fruit intake (p = 0.01). Among children from low SES families, only those from the comparison group decreased their fruit intake (group means: -40.0 g/d (95% CI: -56.0 to -23.9) vs. 9.3 g/d (95% CI: -16.1 to 94) in the intervention group, p = 0.006). The present study found no convincing effect of introducing a multi-component intervention on dietary intake except a small beneficial effect on whole-grain bread consumption. However, beneficial intervention effects in fruit intake were found particularly among children from low SES families.

Age and Sex Specific Trends in Incidence of Juvenile Idiopathic Arthritis in Danish Birth Cohorts from 1992 to 2002: A Nationwide Register Linkage Study.

This study reports age- and sex-specific incidence rates of juvenile idiopathic arthritis (JIA) in complete Danish birth cohorts from 1992 through 2002. Data were obtained from the Danish registries. All persons born in Denmark, from 1992-2002, were followed from birth and until either the date of first diagnosis recording, death, emigration, 16th birthday or administrative censoring (17 May 2017), whichever came first. The number of incident JIA cases and its incidence rate (per 100,000 person-years) were calculated within sex and age group for each of the birth cohorts. A multiplicative Poisson regression model was used to analyze the variation in the incidence rates by age and year of birth for boys and girls separately. The overall incidence of JIA was 24.1 (23.6-24.5) per 100,000 person-years. The rate per 100,000 person-years was higher among girls (29.9 (29.2-30.7)) than among boys (18.5 (18.0-19.1)). There were no evident peaks for any age group at diagnosis for boys but for girls two small peaks appeared at ages 0-5 years and 12-15 years. This study showed that the incidence rates of JIA in Denmark were higher for girls than for boys and remained stable over the observed period for both sexes.

Associations between Child Mental Well-Being or Conflicts during Mealtime and Picky Eating Behaviour.

Pickiness is an eating behavior that many families with young children face. Having joint family meals may impact the child's pickiness, for instance by influencing their willingness to try novel foods. Moreover, picky children have been shown to display greater emotionality. The aim of this study was to investigate if children's mental well-being and parent-reported conflicts during mealtime were associated with pickiness among obesity-prone children. Data was obtained from the baseline examination of the Healthy Start intervention study, the Danish Medical Birth registry and the Danish Health Visitor's Child Health Database, and included 635 children aged 2-6 years that were all at high risk for becoming overweight later in life. Children's mental well-being was measured by the strengths and difficulties questionnaire. Crude and adjusted ordinal logistic regressions were used to investigate the cross-sectional associations. Children had a higher odds associated with changing from a category of less pickiness to a category of more pickiness for each one point higher SDQ score (ORadj. = 1.35, 95% CI = 1.14; 1.61) and lower odds (ORadj. = 0.57, 95% CI = 0.38; 0.86) associated with changing pickiness category towards more pickiness for each one point higher SDQ prosocial score. Moreover, children with conflicts during mealtime had higher odds of being in a worse pickiness category compared to children without conflicts (ORadj. = 3.37, 95% CI = 2.27; 5.01). This study showed that among obesity-prone children, behavioral problems, as well as conflicts during mealtime, were associated with more picky behaviors. Further longitudinal studies are needed to confirm the findings, as are studies including general child population subsets.

Changes in Emotional-Behavioral Functioning Among Pre-school Children Following the Initial Stage Danish COVID-19 Lockdown and Home Confinement.

Unintended negative outcomes on child behavior due to lockdown and home confinement following the corona virus disease (COVID-19) pandemic needs highlighting to effectively address these issues in the current and future health crises. In this sub-study of the ODIN-study, the objectives were to determine whether the Danish lockdown and home confinement following the COVID-19 pandemic affected changes in emotional-behavioral functioning of pre-school-aged children using the validated Strength and Difficulties Questionnaire (SDQ) answered by parents shortly before lockdown and 3 weeks into lockdown, and moreover, to examine whether baseline family and social characteristics could predict change in child emotional-behavioral functioning during lockdown. Parents of 40 (82%) children with a mean(SD) age of 5.0(0.7) completed the baseline questionnaire and the lockdown follow-up questionnaire. The SDQ-Total difficulties score (SDQ-TD) and Prosocial Behavioral score (PSB) changed significantly from pre- to lockdown [SDQ-TD mean(SD): 6.0(3.8) and 7.9(5.2); P = 0.02, respectively and PSB mean(SD): 8.5(1.4) and 7.9(1.5); P = 0.03, respectively]. Attending leisure time activities before lockdown was a predicting factor of changes to the worse in the children's SDQ-TD scores, with a mean difference in SDQ-TD between those with and without activities of 3.16 (95%CI 0.27-6.12); P = 0.03. In conclusion, the study showed a modest decrease in child-emotional behavioral functioning during the COVID-19 lockdown, potentially due to parental stress. Although these results might not be generalizable due to small sample size and selected population, the results point to a need of a greater awareness of child mental wellbeing during a lockdown situation.

Dietary trans-fatty acid intake in relation to cancer risk: a systematic review and meta-analysis.

CONTEXT: Apart from ruminant fat, trans-fatty acids are produced during the partial hydrogenation of vegetable oils, (eg, in the production of ultraprocessed foods). Harmful cardiovascular effects of trans-fatty acids are already proven, but the link with cancer risk has not yet been summarized. OBJECTIVE: A systematic review (following PRISMA guidelines) - including observational studies on the association of trans-fatty acid intake with any cancer risk - was conducted, with no limitations on population types. DATA SOURCES: The electronic databases PubMed and Embase were searched to identify relevant studies. DATA EXTRACTION: This systematic review included 46 articles. Quality was assessed via the Newcastle-Ottawa scale. Meta-analyses were conducted if at least 4 articles exploring the same transfat-cancer pairings were found. DATA ANALYSIS: Nineteen cancer types have been researched in cohort and case-control studies on trans-fatty acids, with breast cancer (n = 17), prostate cancer (n = 11), and colorectal cancer (n = 9) as the most researched. The meta-analyses on total trans-fat showed a significant positive association for prostate cancer (odds ratio [OR] 1.49; 95%CI, 1.13-1.95) and colorectal cancer (OR 1.26; 95%CI, 1.08-1.46) but not for breast cancer (OR 1.12; 95%CI, 0.99-1.26), ovarian cancer (OR 1.10; 95%CI, 0.94-1.28), or non-Hodgkin lymphoma (OR 1.32; 95%CI, 0.99-1.76). Results were dependent on the fatty acid subtype, with even cancer-protective associations for some partially hydrogenated vegetable oils. Enhancing moderators in the positive transfat-cancer relation were gender (direction was cancer-site specific), European ancestry, menopause, older age, and overweight. CONCLUSION: Despite heterogeneity, higher risk of prostate and colorectal cancer by high consumption of trans-fatty acids was found. Future studies need methodological improvements (eg, using long-term follow-up cancer data and intake biomarkers). Owing to the lack of studies testing trans-fatty acid subtypes in standardized ways, it is not clear which subtypes (eg, ruminant sources) are more carcinogenic. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42018105899.