A Randomised Control Trial Investigating the Efficacy of the MapMe Intervention on Parental Ability to Correctly Categorise Overweight in Their Child and the Impact on Child BMI Z-Score Change at 1 Year.

Research suggests parental ability to recognise when their child has overweight is limited. It is hypothesised that recognition of child overweight/obesity is fundamental to its prevention, acting as a potential barrier to parental action to improve their child's health-related behaviours and/or help seeking. The purpose of this study was to investigate the efficacy of an intervention (MapMe) to improve parental ability to correctly categorise their child as having overweight one-month post-intervention, and reduce child body mass index (BMI) z-score 12 months post-intervention. MapMe consists of body image scales of known child BMI and information on the consequences of childhood overweight, associated health-related behaviours and sources of support. We conducted a three-arm (paper-based MapMe, web-based MapMe and control) randomised control trial in fifteen English local authority areas with parents/guardians of 4-5- and 10-11-year-old children. Parental categorisation of child weight status was assessed using the question 'How would you describe your child's weight at the moment?' Response options were: underweight, healthy weight, overweight, and very overweight. Child weight status and BMI z-scores were calculated using objectively measured height and weight data and UK90 clinical thresholds. There was no difference in the percentage of parents correctly categorising their child as having overweight/very overweight (n = 264: 41% control, 48% web-based, and 43% paper-based, p = 0.646). BMI z-scores were significantly reduced for the intervention group at 12 months post-intervention compared to controls (n = 338, mean difference in BMI z-score change -0.11 (95% CI -0.202 to -0.020, p = 0.017). MapMe was associated with a decrease in BMI z-score 12 months post-intervention, although there was no direct evidence of improved parental ability to correctly categorise child overweight status. Further work is needed to replicate these findings in a larger sample of children, investigate mechanisms of action, and determine the use of MapMe as a public health initiative.

Differences Between Self-Reported and Objectively Measured Hearing Loss at Age 61-63 Years: The Newcastle Thousand Families Birth Cohort.

PURPOSE: Hearing loss is most prevalent among older adults, yet underestimated by patients, clinicians, and research communities. This study aimed to assess the accuracy of self-reported hearing difficulties among a group of adults aged 61-63 years, against audiometric measures. METHOD: The analysis used a sample (N = 346) of the Newcastle Thousand Families Study birth cohort. Data from audiological examinations and self-reported hearing difficulties were used to compare subjective and objective hearing. Hearing aid use was also assessed. RESULTS: Over 40% of the participants had some level of hearing loss (n = 155, 44.8%), and 31% (n = 133) of these reported having hearing problems during subjective assessment. Only 18 (10%) of those with objectively measured hearing loss reported using hearing aids. CONCLUSIONS: There was an inconsistency between measured and self-perceived hearing loss among adults aged 61-63 years in this cohort. The small number of hearing aid users in the cohort is a concern, in that people in this age group appear not to be getting the help they need. The data also add to the research evidence that people at this age underestimate their hearing loss.

Predicting Patient Deterioration: A Review of Tools in the Digital Hospital Setting.

BACKGROUND: Early warning tools identify patients at risk of deterioration in hospitals. Electronic medical records in hospitals offer real-time data and the opportunity to automate early warning tools and provide real-time, dynamic risk estimates. OBJECTIVE: This review describes published studies on the development, validation, and implementation of tools for predicting patient deterioration in general wards in hospitals. METHODS: An electronic database search of peer reviewed journal papers from 2008-2020 identified studies reporting the use of tools and algorithms for predicting patient deterioration, defined by unplanned transfer to the intensive care unit, cardiac arrest, or death. Studies conducted solely in intensive care units, emergency departments, or single diagnosis patient groups were excluded. RESULTS: A total of 46 publications were eligible for inclusion. These publications were heterogeneous in design, setting, and outcome measures. Most studies were retrospective studies using cohort data to develop, validate, or statistically evaluate prediction tools. The tools consisted of early warning, screening, or scoring systems based on physiologic data, as well as more complex algorithms developed to better represent real-time data, deal with complexities of longitudinal data, and warn of deterioration risk earlier. Only a few studies detailed the results of the implementation of deterioration warning tools. CONCLUSIONS: Despite relative progress in the development of algorithms to predict patient deterioration, the literature has not shown that the deployment or implementation of such algorithms is reproducibly associated with improvements in patient outcomes. Further work is needed to realize the potential of automated predictions and update dynamic risk estimates as part of an operational early warning system for inpatient deterioration.

The whole grain content of foods consumed in the UK.

This study aimed to assess the whole grain (WG) content of foods consumed in the UK which include ingredients that retain all three structural components of the grain, and contained ⩾10% WG. Dietary data from seven studies with 10,474 UK subjects were examined for foods containing WG. The WG content was then determined from ingredient lists, manufacturers' information and recipes. 372 food descriptors from nine food groups (4.4% of all food codes) contained ⩾10% WG. Of these 372 foods, 31.5% contained ⩾51%, 30.6% 25-50%, and 37.9% 10-24% WG dry matter as eaten. The relatively small number of WG foods identified in the total number of foods consumed confirms the low contribution of WG foods to the overall pattern of foods consumed in the UK. Since foods containing <51% WG accounted for the majority of WG food codes identified, recognising the importance of these foods to WG intake is essential.

Providing evidence to support the development of whole grain dietary recommendations in the United Kingdom.

Observational evidence suggests that increased whole grain (WG) intake reduces the risks of many non-communicable diseases, such as CVD, type 2 diabetes, obesity and certain cancers. More recently, studies have shown that WG intake lowers all-cause and cause-specific mortality. Much of the reported evidence on risk reduction is from US and Scandinavian populations, where there are tangible WG dietary recommendations. At present there is no quantity-specific WG dietary recommendation in the UK, instead we are advised to choose WG or higher fibre versions. Despite recognition of WG as an important component of a healthy diet, monitoring of WG intake in the UK has been poor, with the latest intake assessment from data collected in 2000-2001 for adults and in 1997 for children. To update this information we examined WG intake in the National Diet and Nutrition Survey rolling programme 2008-2011 after developing our database of WG food composition, a key resource in determining WG intake accurately. The results showed median WG intakes remain low in both adults and children and below that of countries with quantity-specific guidance. We also found a reduction in C-reactive protein concentrations and leucocyte counts with increased WG intake, although no association with other markers of cardio-metabolic health. The recent recommendations by the UK Scientific Advisory Committee on Nutrition to increase dietary fibre intake will require a greater emphasis on consuming more WG. Specific recommendations on WG intake in the UK are warranted as is the development of public health policy to promote consumption of these important foods.

Development of sedentary behavior across childhood and adolescence: longitudinal analysis of the Gateshead Millennium Study.

BACKGROUND: In many parts of the world policy and research interventions to modify sedentary behavior of children and adolescents are now being developed. However, the evidence to inform these interventions (e.g. how sedentary behavior changes across childhood and adolescence) is limited. This study aimed to assess longitudinal changes in sedentary behavior, and examine the degree of tracking of sedentary behavior from age 7y to 15y. METHODS: Participants were part of the Gateshead Millennium Study cohort. Measures were made at age 7y (n = 507), 9y (n = 510), 12y (n = 425) and 15y (n = 310). Participants were asked to wear an ActiGraph GT1M and accelerometer epochs were defined as sedentary when recorded counts were ≤25 counts/15 s. Differences in sedentary time and sedentary fragmentation were examined using the Friedman test. Tracking was examined using Spearman's correlation coefficients and trajectories over time were assessed using multilevel linear spline modelling. RESULTS: Median daily sedentary time increased from 51.3% of waking hours at 7y to 74.2% at 15y. Sedentary fragmentation decreased from 7y to 15y. The median number of breaks/hour decreased from 8.6 to 4.1 breaks/hour and the median bout duration at 50% of the cumulative sedentary time increased from 2.4 min to 6.4 min from 7y to 15y. Tracking of sedentary time and sedentary fragmentation was moderate from 7y to 15y however, the rate of change differed with the steepest increases/decreases seen between 9y and 12y. CONCLUSION: In this study, sedentary time was high and increased to almost 75% of waking hours at 15y. Sedentary behavior became substantially less fragmented as children grew older. The largest changes in sedentary time and sedentary fragmentation occurred between 9y to 12y, a period which spans the transition to secondary school. These results can be used to inform future interventions aiming to change sedentary behavior.

Whole grain intake and its association with intakes of other foods, nutrients and markers of health in the National Diet and Nutrition Survey rolling programme 2008-11.

Epidemiological evidence suggests an inverse association between whole grain consumption and the risk of non-communicable diseases, such as CVD, type 2 diabetes, obesity and some cancers. A recent analysis of the National Diet and Nutrition Survey rolling programme (NDNS-RP) has shown lower intake of whole grain in the UK. It is important to understand whether the health benefits associated with whole grain intake are present at low levels of consumption. The present study aimed to investigate the association of whole grain intake with intakes of other foods, nutrients and markers of health (anthropometric and blood measures) in the NDNS-RP 2008-11, a representative dietary survey of UK households. A 4-d diet diary was completed by 3073 individuals. Anthropometric measures, blood pressure levels, and blood and urine samples were collected after diary completion. Individual whole grain intake was calculated with consumers categorised into tertiles of intake. Higher intake of whole grain was associated with significantly decreased leucocyte counts. Significantly higher concentrations of C-reactive protein were seen in adults in the lowest tertile of whole grain intake. No associations with the remaining health markers were seen, after adjustments for sex and age. Over 70% of this population did not consume the minimum recommend intake associated with disease risk reduction, which may explain small variation across health markers. Nutrient intakes in consumers compared with non-consumers were closer to dietary reference values, such as higher intakes of fibre, Mg and Fe, and lower intakes of Na, suggesting that higher intake of whole grain is associated with improved diet quality.

Low whole grain intake in the UK: results from the National Diet and Nutrition Survey rolling programme 2008-11.

Increased whole grain intake has been shown to reduce the risk of many non-communicable diseases. Countries including the USA, Canada, Denmark and Australia have specific dietary guidelines on whole grain intake but others, including the UK, do not. Data from 1986/87 and 2000/01 have shown that whole grain intake is low and declining in British adults. The aim of the present study was to describe whole grain intakes in the most current dietary assessment of UK households using data from the National Diet and Nutrition Survey rolling programme 2008-11. In the present study, 4 d diet diaries were completed by 3073 individuals between 2008 and 2011, along with details of socio-economic status (SES). The median daily whole grain intake, calculated for each individual on a dry weight basis, was 20 g/d for adults and 13 g/d for children/teenagers. The corresponding energy-adjusted whole grain intake was 27 g/10 MJ per d for adults and 20 g/10 MJ per d for children/teenagers. Whole grain intake (absolute and energy-adjusted) increased with age, but was lowest in teenagers (13-17 years) and younger adults up to the age of 34 years. Of the total study population, 18% of adults and 15% of children/teenagers did not consume any whole-grain foods. Individuals from lower SES groups had a significantly lower whole grain intake than those from more advantaged classifications. The whole grain intake in the UK, although higher than in 2000/01, remains low and below that in the US and Danish recommendations in all age classes. Favourable pricing with increased availability of whole-grain foods and education may help to increase whole grain intake in countries without whole-grain recommendations. Teenagers and younger adults may need targeting to help increase whole grain consumption.

Pathways between birth weight and later body size in predicting blood pressure: Australian Aboriginal Cohort Study 1987-2007.

BACKGROUND: Although a large number of previous studies suggest an association between birth weight and later blood pressure, others do not. Controversy surrounds the relative importance of these associations, in particular in relation to more modifiable factors in later life and whether the association would be seen in a, relatively disadvantaged, Indigenous population. The aim of this study, within the Aboriginal Birth Cohort study, was to examine the relative contributions and mediating pathways of birth weight, and later growth and lifestyle factors to variation in blood pressure at age 16-20 years. METHODS: Detailed information was collected prospectively, including maternal smoking, birth weight, childhood BMI. At age 16-20 years, 451 underwent clinical examination, including the measurement of diastolic and systolic blood pressures. These data were analyzed using linear regression and path analyses, incorporating adjustment for potential confounders. RESULTS: Increased BMI at age 18 years was significantly associated with both increasing systolic and diastolic blood pressures. BMI had the highest relative importance and mediated the effects from earlier in life, including birth weight. Being female and living in remote residence were also independently associated with a reduction in systolic blood pressure. CONCLUSION: Blood pressure in this cohort is primarily influenced by contemporaneous BMI, which in this population at this age is generally lower than that seen in non-Indigenous populations in developed countries. However, other factors, including birth weight, do appear to play a role that is mediated through later BMI.

The effect of childhood infection on hearing function at age 61 to 63 years in the newcastle thousand families study.

OBJECTIVES: It is known that childhood hearing function can become impaired after the occurrence of specific infections. However, evidence on the effect of common childhood infections on adult hearing function is limited. The objective of the study was to identify whether associations exist between the occurrence of common childhood infections in a UK birth cohort and hearing function across different frequencies at age 61 to 63 years. DESIGN: The Newcastle Thousand Families study is a birth cohort of all individuals born in May and June 1947 to mothers resident in Newcastle upon Tyne, United Kingdom. Of the original cohort members who had an audiometry test at age 61 to 63 years, 333 had data available on infections during their first year of life and 296 on infections up to their fifth year of life. These data were analyzed using linear regression in relation to adult hearing function across differing frequencies in isolation. RESULTS: After adjustment for sex, overcrowding in the first year, having had an ear operation, and having worked in a loud environment, significant negative associations were identified between adult hearing and tonsillitis at 250 Hz (p = 0.013), 1 kHz (p = 0.018), 6 kHz (p = 0.012), and 8 kHz (p = 0.033); otorrhea at 4 kHz (p = 0.005), 6 kHz (p = 0.003), and 8 kHz (p = 0.002); bronchitis (two or more episodes) at 2 kHz (p = 0.001), 3 kHz (p = 0.005), 4 kHz (p = 0.009), 6 kHz (p < 0.001), and 8 kHz (p < 0.001); and the total number of severe respiratory infections in the first year at 2 kHz (p = 0.037), 3 kHz (p = 0.049), 4 kHz (p = 0.030), 6 kHz (p < 0.001), and 8 kHz (p = 0.006). That is, individuals who had tonsillitis, bronchitis (twice or more), otorrhea, or a severe respiratory infection (twice or more) in their first year of life were more likely to have impaired adult hearing function than those who did not have any infections in early life. CONCLUSION: The occurrence of some, but not all, childhood infections appears to have an effect on adult hearing function across different frequencies. Reducing the incidence of infectious diseases in early life may reduce subsequent incidence of hearing impairment among adults. However, further research in modern cohorts is needed to clarify the links between infectious childhood diseases and adult hearing function.

Prevalence and validity of self-reported smoking in Indigenous and non-Indigenous young adults in the Australian Northern Territory.

BACKGROUND: In this study, we used data from Australia's Northern Territory to assess differences in self-reported smoking prevalence between the Indigenous and non-Indigenous populations. We also used urinary cotinine data to assess the validity of using self-reported smoking data in these populations. METHODS: The Aboriginal Birth Cohort (ABC) is a prospective study of 686 Aboriginal babies born in Darwin 1987-90. The Top End Cohort (TEC) is a study of non-Indigenous adolescents, all born in Darwin 1987-91. In both studies, participants aged between 16 and 21 years, were asked whether they smoked. Urinary cotinine measurements were made from samples taken at the same visits. RESULTS: Self-reported smoking prevalence was 68% in the ABC and 14% in the TEC. Among the self-reported non-smokers, the median cotinine levels were higher in the ABC (33 ng/ml) than in the TEC (5 ng/ml), with greater percentages of reported non-smokers in the under 50 ng/ml group in the TEC than in the ABC CONCLUSIONS: Prevalence of smoking was much higher in the ABC than in the TEC. The higher cotinine levels in ABC non-smokers may reflect an underestimated prevalence, but is also likely to reflect higher levels of passive smoking. A broader approach encompassing social, cultural and language factors with increased attention to smoking socialisation factors is required.

Population prevalence of ultrasound features of osteoarthritis in the hand, knee and hip at age 63 years: the Newcastle thousand families birth cohort.

BACKGROUND: Musculoskeletal ultrasound has been found to be more sensitive than radiographs in detecting osteophytes. Our objective was to measure the prevalence of features of osteoarthritis (OA), in the dominant hand, knees and hips using ultrasound, within the Newcastle Thousand Families birth cohort. METHODS: Participants were aged 61-63 (mean 63) years. Knee images were scored for presence of osteophytes and effusion. Hip images were scored for the presence of osteophytes and femoral head abnormality. The first carpometacarpal joint, metacarpophalangeal, proximal interphalangeal and distal interphalangeal joints of the index finger (dominant hand) were imaged for osteophytes. RESULTS: Among 311 participants, prevalence of osteophytes at the distal interphalangeal joint was 70% while it was 23%, 10% and 41% for index proximal interphalangeal and metacarpophalangeal and thumb base carpometacarpal joints respectively. Prevalence of knee osteophytes was 30%, hip OA was 41%. Prevalence of knee effusions was 24% (right) and 20% (left). Ultrasound evidence of generalised OA (48%) and isolated hand OA (31%) was common, compared to isolated hip or knee OA (5%) and both hip and knee OA (3%). CONCLUSION: This is the first study to assess prevalence of ultrasound features of OA in a population-based sample. The higher prevalence of hand/hip OA, when compared to previous radiographic studies, supports the hypothesis that ultrasound is more sensitive than radiography in detecting OA, particularly for osteophytes.

Deprivation, timing of preschool infections and H. pylori seropositivity at age 49-51 years: the Newcastle Thousand Families birth cohort.

BACKGROUND: Helicobacter pylori infection is acquired in early childhood and persists for life (or until eradication treatment is taken). Seropositivity of H. pylori at age 49-51 years was assessed in relation to socio-economic deprivation in early life and the timing of other childhood infections common at that time. METHODS: Prospectively collected socio-economic and morbidity data from the Newcastle Thousand Families study, a birth cohort established in 1947. H. pylori IgG seropositivity was assessed at 49-51 years and examined in relation to both whether the individual had been diagnosed with one of measles, mumps or chicken pox, and, if so, the age at first infection. This was done in logistic regression models, allowing adjustment for socio-economic status and housing quality in childhood. RESULTS: Adult H. pylori status was strongly linked to disadvantaged socio-economic status in early life (p ≤ 0.002), unlike measles, mumps and chicken pox which showed no associations. Early measles infection was independently associated with H. pylori seropositivity (p = 0.01). CONCLUSIONS: Of the four infectious diseases that we have studied, it appears that H. pylori differs from the others by the strength of association with socio economic deprivation in early childhood. Our findings further highlight the complex interaction between measles, childhood infections and other non-microbiological factors that occur within a whole population. These data suggest a strong association between H. pylori and deprivation and raise the possibility of an interaction between early measles exposure and increased risk of exposure to H. pylori infection.

Birthweight and fasting glucose and insulin levels: results from the Aboriginal Birth Cohort Study.

OBJECTIVE: To examine the relationships between birthweight, current size, and fasting glucose and fasting insulin levels in Aboriginal adolescents. DESIGN, PARTICIPANTS AND SETTING: Longitudinal prospective study of a Northern Territory Aboriginal birth cohort of 686 Aboriginal babies born at the Royal Darwin Hospital between January 1987 and March 1990, and followed up between December 2006 and January 2008 in over 40 NT locations. MAIN OUTCOME MEASURES: Fasting insulin and glucose levels, adjusted for gestational age, sex and contemporary age. RESULTS: Among the 134 participants with complete data, those with fetal growth restriction (FGR) or low birthweight (LBW) at birth were not overweight at 18 2013s. In these circumstances, birthweight showed a significant positively directed association with fasting glucose levels (P = 0.002). Current weight showed a significant and positively directed association with both fasting insulin (P < 0.001) and fasting glucose levels (P = 0.001), and current height showed a significant and positively directed association with insulin levels (P = 0.006). CONCLUSIONS: Birthweight was only positively associated with fasting glucose levels, with no association with fasting insulin levels. The high-risk combination for type 2 diabetes of LBW or FGR with later overweight or obesity was rare in this adolescent Aboriginal population.

Childhood infections, but not early life growth, influence hearing in the Newcastle thousand families birth cohort at age 14 years.

BACKGROUND: While current research priorities include investigations of age-related hearing loss, there are concerns regarding effects on childhood hearing, for example through increased personal headphone use. By utilising historical data, it is possible to assess what factors may have increased hearing problems in children in the past, and this may be used to inform current public health policies to protect children against hearing loss and in turn reduce the long-term burden on individuals and services that may possible evolve. The aim of this study was to investigate which factors in early life significantly impacted on hearing level in childhood using existing data from the Newcastle Thousand Families Study, a 1947 birth cohort. METHODS: Data on early life factors, including growth, socio-economic status and illness, and hearing at age 14 years were collated for a representative subset of individuals from the cohort (n = 147). Factors were assessed using linear regression analysis to identify associations with hearing thresholds. RESULTS: Males were found to have lower hearing thresholds at 250 Hz, 500 Hz and 1 kHz. Main analyses showed no associations between hearing thresholds and early life growth or socio-economic indicators. An increasing number of ear infections from birth to age 13 years was associated with hearing thresholds at 250Hz (p = 0.04) and 500Hz (p = 0.03), which remained true for females (p = 0.050), but not males (p = 0.213) in sex-specific analysis. Scarlet fever and bronchitis were associated with hearing thresholds at 8 kHz. After adjustment for all significant predictors at each frequency, results remained unchanged. CONCLUSIONS: We found no associations between childhood hearing thresholds and early life growth and socio-economic status. Consistent with other studies, we found associations between childhood infections and hearing thresholds. Current public health strategies aimed at reducing childhood infections may also have a beneficial effect upon childhood hearing.

Early life influences kidney function at age 63-64 years, but so does adult body size: results from the newcastle thousand families birth cohort.

BACKGROUND: It is suggested that impaired fetal growth can affect kidney development, resulting in fewer glomeruli being formed and reduced kidney function later in life. The aim of this study was to investigate early life variables in relation to adult kidney function, and compare these to the influence of later life variables. METHODS: Detailed information was collected prospectively regarding 1,142 babies, born in 1947 in Newcastle upon Tyne. At the age of 63-64 years, 335 participants had serum creatinine successfully measured and completed a lifestyle questionnaire. These measurements were used to calculate their estimated glomerular filtration rate (eGFR). RESULTS: Body mass index (BMI) and being female were significantly negatively associated with eGFR. Birth weight was significantly positively associated with eGFR. In sex-specific analyses, BMI and cigarette smoking remained significant for males (n = 154), with a near significant association for birth weight, whereas none of the variables remained significant for females (n = 181). CONCLUSIONS: The findings suggest that sex, size at birth and BMI may be important variables influencing adult kidney function. However, as only a small amount of variance in eGFR was explained by these variables, additional longitudinal studies would be beneficial for assessing lifecourse influences on kidney function.

Differing lifecourse associations with sport-, occupational- and household-based physical activity at age 49-51 years: the Newcastle Thousand Families Study.

OBJECTIVES: We investigated the contributions of a range of factors from across life to variations in physical activity within the Newcastle Thousand Family's birth cohort. METHODS: At age 49-51 years, 574 study members returned questionnaires, including details of physical activity (occupational, commuting, household and sport). Factor analysis of activity types produced two retained factor scores, 'sport' and 'other physical activity', analysed by path analysis. RESULTS: More advantaged current social class, higher education level and not smoking were associated with increased sport activity, but not 'other physical activity'. Males had higher levels of occupational and lower levels of household activity than females. Smokers had increased work activity. Long-term illness was associated with lower activity across all types. Current social class and smoking showed the highest relative contribution for 'sport' and long-term illness for 'other physical activity'. CONCLUSION: Increasing activity in adults requires better understanding what the barriers to maintaining or taking on new levels of physical activity are, and long-term strategies and public health interventions need to be developed to engage adults in interesting, affordable and available activities.

Childhood growth, IQ and education as predictors of white blood cell telomere length at age 49-51 years: the Newcastle Thousand Families Study.

BACKGROUND: Telomere length is emerging as a potential factor in the pathogenesis of cardiovascular disease. We investigated whether birth weight, infant growth, childhood cognition and adult height, as well as a range of lifestyle, socio-economic and educational factors, were associated with white blood cell telomere length at age 49-51 years. METHODS: The study included 318 members of the Newcastle Thousand Families Study, a prospectively followed birth cohort which includes all individuals born in Newcastle, England in May and June 1947, who attended for clinical examination at age 49-51 years, and had telomere length successfully measured using real-time PCR analyses of DNA extracted from peripheral blood mononuclear cells. RESULTS: No association was found between birth weight and later telomere length. However, associations were seen with other factors from early life. Education level was the only predictor in males, while telomere length in females was associated with gestational age at birth, childhood growth and childhood IQ. CONCLUSIONS: While these findings may be due to chance, in particular where differing associations were seen between males and females, they do provide evidence of early life associations with telomere length much later in life. Our findings of sex differences in the education association may reflect the sex differences in achieved education levels in this generation where few women went to university regardless of their intelligence. Our findings do not support the concept of telomere length being on the pathway between very early growth and later disease risk.

Early predictors of objectively measured physical activity and sedentary behaviour in 8-10 year old children: the Gateshead Millennium Study.

BACKGROUND: With a number of studies suggesting associations between early life influences and later chronic disease risk, it is suggested that associations between early growth and later physical activity (PA) may be a mediator. However, conflicting evidence exists for association between birth weight and childhood PA. In addition, it is important to know what other, potentially modifiable, factors may influence PA in children given its' association with childhood and later adiposity. We used the Gateshead Millennium Study (GMS) to identify predictors of childhood PA levels. METHODS: The GMS is a cohort of 1029 infants born in 1999-2000 in Gateshead in northern England. Throughout infancy and early childhood, detailed information was collected. Assessments at age 9 years included body composition, objective measures of habitual PA and a range of lifestyle factors. Mean total volumes of PA (accelerometer count per minute, cpm) and moderate-vigorous intensity PA (MVPA), and the percentage of time spent in sedentary behaviour (%SB) were quantified and related to potential predictors using linear regression and path analysis. RESULTS: Children aged 8-10 years were included. Significant differences were seen in all three outcome variables between sexes and season of measurement (p<0.001). Restricting children's access to television was associated with decreased MVPA. Increased paternal age was associated with significant increases in %SB (p = 0.02), but not MVPA or total PA. Increased time spent in out of school sports clubs was significantly associated with decreased %SB (p = 0.02). No significant associations were seen with birth weight. CONCLUSION: A range of factors, directly or indirectly, influenced PA and sedentary behaviour. However, associations differed between the different constructs of PA and %SB. Exploring further the sex differences in PA would appear to be useful, as would encouraging children to join out of school sports clubs.

How the Newcastle Thousand Families birth cohort study has contributed to the understanding of the impact of birth weight and early life socioeconomic position on disease in later life.

Much has been made of the potential influence of birth weight and early socioeconomic disadvantage in influencing adult health, but little has been published in terms of how important these associations may be with respect to exposures throughout the lifecourse. The objective of this review is to describe the contributions of the Newcastle Thousand Families Study in understanding the relative impacts of factors in early life, particularly birth weight and socio-economic position at birth, in influencing health in later life. The Newcastle Thousand Families Study is a prospective birth cohort established in 1947. It originally included all births to mothers resident in Newcastle upon Tyne, in northern England, in May and June of that year. Study members were followed extensively throughout childhood and intermittently in adulthood. At the age of 49-51 years, study members underwent a large-scale follow-up phase enabling an assessment of how early life may influence their later health, and also incorporating adult risk factors which enabled the relative contributions of factors at different stages of life to be assessed. While some findings from the study do support birth weight and early socio-economic position having influences on adult health status, the associations are generally small when compared to risk factors later in life. Using path analyses on longitudinal data of this nature enables mediating pathways between early life and later health to be assessed and if more studies were to take this approach, the relative importance of early life on adult disease risk could be better understood.