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1.
Pediatrics ; 144(4)2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31492765

RESUMO

BACKGROUND AND OBJECTIVES: Celiac disease (CeD) is associated with psychopathology in children. It is unknown whether this association is present in children with celiac disease autoimmunity (CDA) identified by screening. We examined the associations between subclinical CDA and emotional and behavioral problems in children without previous CeD diagnosis. METHODS: In a population-based cohort study of 3715 children (median age: 6 years), blood titers of tissue transglutaminase autoantibodies were analyzed. CDA was defined as a measurement of tissue transglutaminase autoantibodies ≥7 U/mL (n = 51). Children with previous CeD diagnosis or children on a gluten-free diet, were excluded. The Child Behavior Checklist (CBCL) was filled in by parents and was used to assess behavioral and emotional problems of children at a median age of 5.9 years. Multiple linear regression models were applied to evaluate the cross-sectional associations between CDA and CBCL scores. Sensitivity analyses were done in a subgroup of children who were seropositive carrying the HLA antigen risk alleles for CeD. RESULTS: In basic models, CDA was not associated with emotional and behavioral problems on the CBCL scales. After adjustment for confounders, CDA was significantly associated with anxiety problems (ß = .29; 95% confidence interval 0.02 to 0.55; P = .02). After exclusion of children who did not carry the HLA-DQ2 and/or HLA-DQ8 risk alleles (n = 4), CDA was additionally associated with oppositional defiant problems (ß = .35; 95% confidence interval 0.02 to 0.69). Associations were not explained by gastrointestinal complaints. CONCLUSIONS: Our results reveal that CDA, especially combined with the HLA-DQ2 and HLA-DQ8 risk alleles, is associated with anxiety problems and oppositional defiant problems. Further research should be used to establish whether behavioral problems are a reflection of subclinical CeD.

2.
Int J Obes (Lond) ; 43(10): 1891-1902, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31320694

RESUMO

OBJECTIVES: Snacks contribute to overconsumption of energy-dense foods and thence obesity. Previous studies in this area are limited by self-reported data and small samples. In a large population-based cohort of parent-child dyads, we investigated how modification of pre-packaged snack food, i.e. (a) item quantity and variety, and (b) dishware (boxed container) size affected intake. METHODS: Design: Randomized trial nested within the cross-sectional Child Health CheckPoint of the Longitudinal Study of Australian Children, clustered by day of visit. SAMPLE: 1299 11-12 year olds, 1274 parents. EXPOSURE: 2 × 2 manipulation of snack box container size and item quantity/variety: (1) small box, few items, (2) large box, few items, (3) small box, more items, (4) large box, more items. PROCEDURE: Participants received a snack box during a 15 min break within their 3.5 h visit; any snacks remaining were weighed. OUTCOMES: Consumed quantity (grams) and energy intake (kilojoules). ANALYSES: Unadjusted linear regression. RESULTS: Children who were offered a greater quantity and variety of snack items consumed considerably more energy and a slightly higher food mass (main effect for energy intake: 349 kJ, 95% CI 282-416, standardized mean difference (effect size) 0.66; main effect for mass: 10 g, 95% CI 3-17, effect size 0.17). In contrast, manipulating box size had little effect on child consumption, and neither box size nor quantity/variety of items consistently affected adults' consumption. CONCLUSION: In children, reducing the number and variety of snack food items available may be a more fruitful intervention than focusing on container or dishware size. Effects observed among adults were small, although we could not exclude social desirability bias in adults aware of observation.

3.
BMJ Open ; 9(Suppl 3): 147-156, 2019 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-31273025

RESUMO

OBJECTIVES: Snack foods-typically high in salt, sugar, fat and/or energy-are likely important to the obesity epidemic. In the context of a population-based health assessment involving parent-child dyads at child age 11-12 years, we report cross-generational concordance in intake at a controlled snack food observation. DESIGN: Cross-sectional study (Child Health CheckPoint), nested within the Longitudinal Study of Australian Children. SETTING: Assessment centres in seven Australian cities, February 2015-March 2016. PARTICIPANTS: Of all participating CheckPoint families (n=1874), 1299 children (50.3% girls) and 1274 parents (85.9% mothers) with snack data were included. Survey weights and methods were applied to account for the clustered multistage sample design. OUTCOME MEASURES: Partway through the 3.5-hour assessment, parents and children attended Food Stop separately for a timed 15 min 'snack break'. One of four standardised box size/content combinations was randomly provided to all participants on any given day. Total food mass, energy, nutrients and sodium consumed was measured to the nearest 1 g. Pearson's correlation coefficients and adjusted multivariable linear regression models assessed parent-child concordance in each variable. RESULTS: Children consumed less grams (151 g [SD 80] vs 165 g [SD 79]) but more energy (1393 kJ [SD 537] vs 1290 kJ [SD 658]) than parents. Parent-child concordance coefficients were small, ranging from 0.07 for sodium intake to 0.17 for carbohydrate intake. Compared with children with parents' energy intake on the 10th centile, children whose parents were on the 90th centile ate on average 227 kJ more. If extrapolated to one similar unsupervised snack on a daily basis, this equates to an additional 83 050 kJ per year, which could have a cumulative impact on additional body fat. CONCLUSIONS: Although modest at an individual level, this measured parent-child concordance in unsupervised daily snack situations could account for substantial annual population differences in energy, fat and sodium intake for children aged 11-12 years. TRIAL REGISTRATION NUMBER: ISRCTN12538380.

4.
Environ Int ; 131: 104927, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31326824

RESUMO

BACKGROUND: The association between air pollution exposure and emotional and behavioural problems in children is unclear. We aimed to assess prenatal and postnatal exposure to several air pollutants and child's depressive and anxiety symptoms, and aggressive symptoms in children of 7-11 years. METHODS: We analysed data of 13182 children from 8 European population-based birth cohorts. Concentrations of nitrogen dioxide (NO2), nitrogen oxides (NOx), particulate matter (PM) with diameters of ≤10 µm (PM10), ≤ 2.5 µm (PM2.5), and between 10 and 2.5 µm (PMcoarse), the absorbance of PM2.5 filters (PM2.5abs), and polycyclic aromatic hydrocarbons (PAHs) were estimated at residential addresses of each participant. Depressive and anxiety symptoms and aggressive symptoms were assessed at 7-11 years of age using parent reported tests. Children were classified in borderline/clinical range or clinical range using validated cut offs. Region specific models were adjusted for various socio-economic and lifestyle characteristics and then combined using random effect meta-analysis. Multiple imputation and inverse probability weighting methods were applied to correct for potential attrition bias. RESULTS: A total of 1896 (14.4%) children were classified as having depressive and anxiety symptoms in the borderline/clinical range, and 1778 (13.4%) as having aggressive symptoms in the borderline/clinical range. Overall, 1108 (8.4%) and 870 (6.6%) children were classified as having depressive and anxiety symptoms, and aggressive symptoms in the clinical range, respectively. Prenatal exposure to air pollution was not associated with depressive and anxiety symptoms in the borderline/clinical range (e.g. OR 1.02 [95%CI 0.95 to 1.10] per 10 µg/m3 higher NO2) nor with aggressive symptoms in the borderline/clinical range (e.g. OR 1.04 [95%CI 0.96 to 1.12] per 10 µg/m3 higher NO2). Similar results were observed for the symptoms in the clinical range, and for postnatal exposures to air pollution. CONCLUSIONS: Overall, our results suggest that prenatal and postnatal exposure to air pollution is not associated with depressive and anxiety symptoms or aggressive symptoms in children of 7 to 11 years old.

5.
Child Obes ; 15(6): 379-386, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31219339

RESUMO

Background: Short sleep duration in childhood has often been linked with obesity in later childhood or adolescence. However, whether infant sleep duration affects body composition trajectories and cardiovascular health through to mid-adolescence remains unknown. Methods: Participants were 336 adolescents from a community-based prospective birth cohort in Melbourne, Australia. Mothers completed 24-hour time diaries, including infant sleep in 5-minute intervals at ages 2, 4, and 12 months. BMI and body composition outcomes were measured 6-monthly between 4 and 6.5 years and at 10 and 14 years. Cardiovascular outcomes at 14 years comprised blood pressure, pulse wave velocity, retinal arteriole-to-venule ratio, and carotid intima-media thickness. We used multivariable linear regression and multinomial logistic regression analyses adjusted for sex, age, BMI at birth, gestational age, ethnicity, maternal education, maternal BMI, and neighborhood socioeconomic position. Results: At 2 months, infants slept on average 14.1 hours [standard deviation (SD) 1.9], decreasing to 13.4 hours (SD 2.0) by 12 months. We observed no associations between the different sleep duration time points in infancy and later BMI or body composition. Moreover, a shorter sleep duration did not increase the odds of being on a high body composition trajectory compared with longer sleep (e.g., odds ratio per hour of sleep at 4 months is 0.85, 95% confidence interval 0.65-1.11). Infant sleep duration was also not associated with cardiovascular function or large or small artery structure at 14 years of age. Conclusions: We found no evidence that sleep duration very early in life affects adolescent body composition or cardiovascular health.

6.
Appetite ; 141: 104295, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31128200

RESUMO

INTRODUCTION: Only a few studies have prospectively examined stability of eating behaviors in childhood. These argue that eating behaviors are fairly stable from early childhood onwards, but knowledge on individual patterns across childhood is lacking. Here, we examined patterns of eating behaviors from ages 4-10 years in a population-based sample and aimed to identify parental and earlylife predictors of these patterns. METHODS: Participants were 3514 children from The Generation R Study with repeated assessments of the Child Eating Behavior Questionnaire at ages 4 and 10 years. Patterns of emotional overeating, food responsiveness, enjoyment of food and satiety responsiveness were studied with person-centered Latent Class Growth Analysis with the aim to identify sub-groups of children with distinct eating behavior patterns. Using univariate multinomial logistic and linear regression, parental and early life predictors of eating behavior patterns were examined. RESULTS: We identified three patterns of emotional overeating (stable low (n = 2240); moderately increasing (n = 1028); strongly increasing (n = 246)) and five patterns of food responsiveness (stable low (n = 2343); high decreasing (n = 238); moderately increasing (n = 679); strongly increasing (n = 141); stable high (n = 113)) from 4 to 10 years. For enjoyment of food and satiety responsiveness a similar pattern was identified for all children. Obesogenic eating behavior patterns were associated with a higher birth weight and BMI, emotional and behavioral problems, maternal overweight/obesity and controlling feeding strategies. DISCUSSION: This study suggests that children develop distinct patterns of emotional overeating and food responsiveness across childhood. Parental and early life predictors, particularly a higher weight status and psychiatric problems, are potential correlates of the development and maintenance of unhealthy eating behavior patterns across childhood. This knowledge might help identifying children at risk of developing obesogenic eating behaviors.

7.
Clin Nutr ; 2019 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-30967308

RESUMO

BACKGROUND: A balanced diet in childhood is important for growth and development. We aimed to examine associations of overall diet quality in both early and mid-childhood with trajectories of growth and body composition until age 10 years. METHODS: We included 3991 children from the Generation R Study, a population-based, prospective cohort in Rotterdam, the Netherlands. At child's ages of 1 and 8 years, dietary intake was assessed using food-frequency questionnaires to calculate diet quality scores (0-10), which measure adherence to age-specific dietary guidelines. Height and weight were measured repeatedly between ages 1 and 10 years. Body composition was assessed using dual-energy X-ray absorptiometry at ages 6 and 10 years. We calculated sex- and age-specific SD-scores for body mass index (BMI), fat mass index (FMI), fat-free mass index (FFMI), and body fat percentage (BF%). RESULTS: After adjustment for socioeconomic and lifestyle factors, results from linear mixed models showed that higher diet quality at 1 year was associated with higher height, weight, and BMI up to age 10 years. Using linear regression analyses, similar associations were observed for diet quality at 8 years. For diet quality at both time points, positive associations with BMI were fully driven by a higher FFMI (ß = 0.07 SDS, 95%CI: 0.05, 0.10 for diet quality at 8 years), and not FMI or BF%. Most of the observed associations were independent of diet quality at the other time point. CONCLUSION: We observed that better diet quality in both early and mid-childhood was associated with higher height, weight, and FFMI, but not with body fatness up to age 10 years. This was independent of diet quality at an earlier or later time point. Our findings suggest that dietary intake according to dietary guidelines may have a beneficial impact on growth and body composition throughout childhood.

8.
J Nutr ; 149(5): 788-794, 2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-30989177

RESUMO

BACKGROUND: Feeding practices have been implicated in childhood overweight, but the long-term effects of using food to comfort a distressed child remain unknown. OBJECTIVE: This study examined whether the use of food to soothe in infancy was associated with later body composition, and whether children's eating behaviors mediate this relation. METHODS: Participants were 3960 children of Generation R, a population-based birth cohort in the Netherlands. Parents reported on the use of food to soothe when infants were 6 mo old and on child eating behavior (food responsiveness, emotional eating) at ages 4 and 10 y. Body mass index (BMI), fat mass, and fat-free mass were measured at ages 6 and 10 y. Linear regression and mediation analyses were conducted, accounting for various potential confounding factors. RESULTS: The use of food to soothe when infants were 6 mo old predicted a higher BMI from age 6 y onwards, independently of infant weight, maternal BMI, and other confounders. Specifically, frequent use was associated with a BMI z score 0.13 higher at age 10 y (95% CI: 0.03, 0.22) as compared with never use. Children's emotional eating mediated this association (indirect effect B = 0.04; 95% CI: 0.02, 0.06). The feeding-body composition association was most evident for fat mass (P for trend = 0.014) and somewhat less for fat-free mass (P for trend = 0.079). CONCLUSIONS: The use of food to comfort a distressed infant was consistently associated with obesogenic eating behaviors and an unhealthy body composition throughout middle and late childhood. As our design precludes conclusions on causal associations, we recommend further studies with precise, repeated assessments of infant feeding practices. Such research can help ascertain the direction of effect, which is needed for establishing evidence-based guidelines for parents regarding the use of food to soothe early in life.

9.
Obesity (Silver Spring) ; 27(5): 822-829, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30957987

RESUMO

OBJECTIVE: This study examined the prospective, potentially bidirectional association of aggressive behavior with BMI and body composition across childhood in three population-based cohorts. METHODS: Repeated measures of aggression and BMI were available from the Generation R Study between ages 6 and 10 years (N = 3,974), the Netherlands Twin Register (NTR) between ages 7 and 10 years (N = 10,328), and the Swedish Twin Study of Child and Adolescent Development (TCHAD) between ages 9 and 14 years (N = 1,462). In all samples, aggression was assessed with the Child Behavior Checklist. Fat mass and fat-free mass were available in the Generation R Study. Associations were examined with cross-lagged modeling. RESULTS: Aggressive behavior at baseline was associated with higher BMI at follow-up in the Generation R Study (ß = 0.02, 95% CI: 0.00 to 0.04), in NTR (ß = 0.04, 95% CI: 0.02 to 0.06), and in TCHAD (ß = 0.03, 95% CI: -0.02 to 0.07). Aggressive behavior was prospectively associated with higher fat mass (ß = 0.03, 95% CI: 0.01 to 0.05) but not fat-free mass. There was no evidence that BMI or body composition preceded aggressive behavior. CONCLUSIONS: More aggressive behavior was prospectively associated with higher BMI and fat mass. This suggests that aggression contributes to the obesity problem, and future research should study whether these behavioral pathways to childhood obesity are modifiable.

10.
J Nutr ; 149(4): 642-648, 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-30915449

RESUMO

BACKGROUND: As an adjuvant for medication, dietary changes focused on specific nutrients have been proposed to prevent or reduce attention-deficit/hyperactivity disorder (ADHD) symptoms. However, whether an overall healthy dietary pattern is associated with ADHD symptom severity during childhood remains unclear. Furthermore, it is not clear what the direction of this association is. OBJECTIVES: We aimed to examine the association between dietary patterns and ADHD symptoms in school-aged children. In addition, we aimed to identify the temporal direction of this association-that is, whether dietary patterns predict ADHD symptoms or vice versa. METHODS: We analyzed data from 3680 children participating in the Generation R Study, a prospective cohort in Rotterdam, Netherlands. ADHD symptoms were assessed with parent-report questionnaires at ages 6 and 10 y using the Child Behavior Checklist. Dietary intake was assessed at the age of 8 y with a validated food-frequency questionnaire. We computed a diet quality score reflecting adherence to dietary guidelines. We examined bidirectional associations of diet quality with ADHD symptom scores using multivariable linear regression analysis and cross-lagged modeling. RESULTS: Linear regressions showed that more ADHD symptoms at age 6 y were associated with a lower diet quality score at age 8 y (SD score = -0.08; 95% CI: -0.11, -0.05) but that diet quality at age 8 y was not associated with ADHD symptoms at age 10 y. Cross-lagged models confirmed a unidirectional relation from ADHD symptoms to diet quality but not vice versa. Associations did not differ by overweight status or between boys and girls. CONCLUSION: Our study suggests that children with more ADHD symptoms may be at higher risk of an unhealthy diet but that overall diet quality does not affect ADHD risk.

11.
Int J Obes (Lond) ; 43(10): 1903-1913, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30622313

RESUMO

OBJECTIVE: Exposure to impaired gestational glucose tolerance has been shown to have sex-specific associations with offspring obesity risk, perhaps by affecting the development of appetite regulation. We examined the extent to which prenatal exposure to impaired glucose tolerance was associated with eating in the absence of hunger (EAH) in early adolescent offspring, and in turn, whether EAH was cross-sectionally associated with body composition. METHODS: We included data from 1097 adolescents participating in Project Viva, a pre-birth longitudinal cohort. We obtained the results of two-stage prenatal glycemic screening (50 g glucose challenge test, followed if abnormal by 100 g oral glucose tolerance test) at 26-28 weeks of gestation, and categorized mothers as having normal glucose tolerance, isolated hyperglycemia (IH, n = 92, 8.4%), impaired glucose tolerance (IGT, n = 36, 3.3%), or gestational diabetes mellitus (GDM, n = 52, 4.7%). At a median age of 13 years, offspring reported on two modified items of the Eating in the Absence of Hunger in Children and Adolescents questionnaire, we measured height and weight, and performed dual X-ray absorptiometry scans to assess fat and fat-free mass. We used multivariable linear regression analyses adjusted for sociodemographic and prenatal covariates, including maternal pre-pregnancy BMI. RESULTS: On a ten-point scale, the mean (SD) EAH score was 4.4 points (SD = 1.5) in boys and 4.4 (SD = 1.4) in girls. In girls, prenatal exposure to both IH and IGT was associated with more EAH compared with normal glucose tolerance (e.g., for IH: 0.56 points, 95% CI: 0.17, 0.96), whereas in boys, prenatal exposure to IGT was associated with less EAH (-0.81 points, 95% CI: -1.41, -0.21). We did not observe an association between exposure to GDM and EAH, nor did we observe associations between EAH and body composition in early adolescence. CONCLUSIONS: These findings suggest sex-specific associations of exposure to impaired gestational glucose tolerance with offspring EAH in early adolescence.

12.
Int J Epidemiol ; 2018 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-30508111

RESUMO

Background: Although studies showed that an adverse intrauterine environment increases the obesity risk in adulthood, little is known about consequences of fetal growth and birth size for eating behaviour. We examined whether fetal and birth size are associated with childhood eating behaviour. Methods: Participants were 4350 mother-child dyads of the prospective cohort study Generation R. We assessed the relation between fetal and birth size measurements with child eating behaviour at age 4 years by maternal report on the Child Eating Behaviour Questionnaire. Child body mass index (BMI) was measured at age 2 years. Results: Per one standard deviation (SD) larger birthweight, children scored lower on Satiety Responsiveness [-0.29 points; 95% confidence interval (CI): -0.39; -0.18], higher on Food Responsiveness (0.28 points; 95% CI: 0.17; 0.39) and on Enjoyment of Food (0.21 points; 95% CI: 0.12; 0.31) at age 4 years. Similar associations were found in late pregnancy. Per one SD increase in fetal growth from late pregnancy to birth, children scored lower on Satiety Responsiveness (-0.15 points; 95% CI: -0.26; -0.04). Children within the 10% highest birthweight scored higher on food approach and lower on food avoidant scales, whereas associations in children within the 10% lowest birthweights were absent. Although child BMI partly mediated the association, direct effects of birthweight on appetitive traits remained. Conclusions: This study indicates that fetal size, especially being large in utero, is associated with obesity-inducing eating behaviour. Our findings point to intrauterine influences on appetite and satiety, and contribute to understanding the complex aetiology of obesity.

13.
Pediatrics ; 142(6)2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30409841

RESUMO

BACKGROUND AND OBJECTIVES: Parents often do not accurately perceive overweight and/or obesity in their children. Changing this is widely considered an essential first step to reducing child overweight, but recent research suggests that, in fact, this could promote greater weight gain. We aimed to determine the directionality over time between higher child adiposity and parental perception of child overweight. METHODS: Participants were from 2 cohorts of the population-based Longitudinal Study of Australian Children followed biennially since 2004. Repeated measures of BMI z scores and parental perceptions of overweight were available for the kindergarten cohort at 6 waves (ages 4-5, 6-7, 8-9, 10-11, 12-13, and 14-15 years; n = 4632) and for the birth cohort at 4 waves (ages 2-3, 4-5, 8-9, and 10-11 years; n = 4445). Bidirectionality between overweight perception and BMI z score was examined by using cross-lagged regression models. RESULTS: In both cohorts, wave-on-wave lagged effects were strong (all: P < .001) but much larger from BMI z score to parent perception. For every unit increase in the BMI z score, the odds of a child being perceived as overweight in the next wave ranged from 2.9 (birth cohort: age 2-3 years) to 10.4 (kindergarten cohort: age 6-7 years). These effects were ∼3 to 12 times larger than the reverse, whereby the perception of overweight predicted 0.2 to 0.5 higher BMI z score in the next wave. CONCLUSIONS: Higher child BMI z scores strikingly predicted a subsequent parental perception of child overweight. Parent-perceived overweight preceded rising (not falling) BMI, but these effects were small. Clinician efforts to make parents aware of overweight may not be harmful but seem unlikely to improve children's BMI status.

14.
Int J Behav Nutr Phys Act ; 15(1): 96, 2018 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-30285789

RESUMO

BACKGROUND: Although many cross-sectional studies reported that children with overweight or obesity show more food approaching and less food avoidant eating behaviors, there is a lack of replication in longitudinal studies. Therefore, the question remains whether healthcare professionals should target eating behaviors in childhood obesity interventions and prevention. We aimed to examine the longitudinal and possible bi-directional associations between eating behavior and body composition across childhood. METHODS: Data was included from 3331 children participating in the Generation R Study. At 4 and 10 years, mothers reported on the Child Eating Behavior Questionnaire including the subscales Food Responsiveness, Enjoyment of Food, Emotional Overeating and Satiety Responsiveness, and children's BMI was measured. Body composition, consisting of Fat Mass Index and Fat Free Mass Index was measured at 6 and 10 years with Dual-energy-X-ray-Absorptiometry scans. RESULTS: Cross-lagged models including both directions of the BMI - eating behavior association showed that a higher BMI at the age of 4 years predicted more food responsiveness and enjoyment of food and less satiety responsiveness at 10 years (e.g. satiety responsiveness:ß = - 0.10, 95% CI = - 0.14, - 0.07), but no associations were found in the opposite direction. For emotional overeating, however, a bi-directional association was found with BMI predicting more emotional eating and vice versa. Multivariable linear regression analyses showed that associations were stronger for Fat Mass Index than for Fat Free Mass Index. CONCLUSIONS: Results showed that a higher BMI, and particularly higher fat mass, at pre-school age predicted more food approaching and less food avoidant eating behaviors at the age of 10 years, rather than the hypothesized reverse direction. This suggests that increased adiposity in early childhood might upregulate appetite and related eating behaviors.

15.
Thorax ; 73(2): 167-173, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29101282

RESUMO

BACKGROUND: Early-life respiratory tract infections could affect airway obstruction and increase asthma risk in later life. However, results from previous studies are inconsistent. OBJECTIVE: We examined the associations of early-life respiratory tract infections with lung function and asthma in school-aged children. METHODS: This study among 5197 children born between April 2002 and January 2006 was embedded in a population-based prospective cohort study. Information on physician-attended upper and lower respiratory tract infections until age 6 years (categorised into ≤ 3 and >3-6 years) was obtained by annual questionnaires. Spirometry measures and physician-diagnosed asthma were assessed at age 10 years. RESULTS: Upper respiratory tract infections were not associated with adverse respiratory outcomes. Compared with children without lower respiratory tract infections ≤3 years, children with lower respiratory tract infections ≤3 years had a lower FEV1, FVC, FEV1:FVC and forced expiratory flow at 75% of FVC (FEF75) (Z-score (95% CI): ranging from -0.22 (-0.31 to -0.12) to -0.12 (-0.21 to -0.03)) and an increased risk of asthma (OR (95% CI): 1.79 (1.19 to 2.59)). Children with lower respiratory tract infections >3-6 years had an increased risk of asthma (3.53 (2.37 to 5.17)) only. Results were not mediated by antibiotic or paracetamol use and not modified by inhalant allergic sensitisation. Cross-lagged modelling showed that results were not bidirectional and independent of preschool wheezing patterns. CONCLUSION: Early-life lower respiratory tract infections ≤3 years are most consistently associated with lower lung function and increased risk of asthma in school-aged children.


Assuntos
Asma/epidemiologia , Infecções Respiratórias/complicações , Infecções Respiratórias/fisiopatologia , Fatores Etários , Criança , Pré-Escolar , Feminino , Volume Expiratório Forçado/fisiologia , Humanos , Lactente , Masculino , Estudos Prospectivos , Fatores de Risco , Capacidade Vital/fisiologia
16.
Obesity (Silver Spring) ; 25(11): 1956-1964, 2017 11.
Artigo em Inglês | MEDLINE | ID: mdl-28944615

RESUMO

OBJECTIVE: Extensive evidence suggests that children and adolescents often inaccurately perceive their body size. However, the extent of this misperception is unclear. This paper describes the agreement between children's actual weight and the perception of body size (self-reported and maternally reported) and the association of actual weight with self-reported body satisfaction. METHODS: In a population-based cohort study of 3,408 children aged 9 to 10 years, we assessed the children's self-perception and ideal perception of their body size with the Children's Body Image Scale. Maternal perception of offspring body size was assessed with the question "How would you describe your child at the moment?" Children's height and weight were measured. RESULTS: Children tended to rate themselves toward average proportions; e.g., 83.0% of 499 children with overweight/obesity perceived themselves as less heavy then they were. Of those who underestimated their body size, most (79.2%) had a desire to be thinner; all of the children who correctly recognized their overweight/obesity had such a desire. CONCLUSIONS: Despite the misperception of body size, the majority of children with overweight/obesity indicated dissatisfaction with their body size, suggesting more self-awareness than would be assumed based on the self-perception assessment of body size alone.


Assuntos
Imagem Corporal/psicologia , Tamanho Corporal/fisiologia , Peso Corporal/fisiologia , Satisfação Pessoal , Criança , Feminino , Humanos , Masculino , Autorrelato
17.
Am J Clin Nutr ; 106(3): 783-790, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28793987

RESUMO

Background: Parental restrictive feeding (i.e., limiting food intake of children) has been linked to childhood overweight. However, the directionality of the causal pathway remains unknown.Objective: The objectives of this study were to examine the bidirectional association of maternal restrictive feeding with children's weight and body composition across childhood and to explore a possible mediating role of maternal concern about child weight.Design: Data were available for 4689 mother-child dyads participating in Generation R, a prospective birth cohort in the Netherlands. At ages 4 and 10 y, restrictive feeding was assessed with the parent-reported Child Feeding Questionnaire, and children's body mass index (BMI) was measured. At age 6 y, fat mass index (FMI) and fat-free mass index (FFMI) were measured with dual-energy X-ray absorptiometry. Both directions of the relation between restriction and child body composition were examined with multivariable linear regression analyses and cross-lagged modeling. Mediation analyses were performed to examine concern about child weight (mother reported at child age of 10 y) as a potential mediator.Results: Higher child sex- and age-adjusted BMI SD scores (zBMI) at age 4 y predicted more restrictive feeding at age 10 y (B = 0.15; 95% CI: 0.11, 0.18). Both sex- and age-adjusted FMI SD scores (zFMI) and sex-and age-adjusted FFMI SD scores (zFFMI) at 6 y were also positively associated with restrictive feeding at 10 y. Maternal concern about child weight partially mediated these associations from child body composition to restrictive feeding (e.g., for zBMI at 4 y: Bindirect = 0.10; 95% CI: 0.07, 0.13). There was no temporal association from restrictive feeding at age 4 y to child zBMI at age 10 y after adjustment for baseline zBMI.Conclusions: The continued use of restrictive feeding practices at age 10 y appeared to be primarily a response of mothers to an unhealthy weight of their child rather than a cause of children's overweight. Guidelines discouraging restrictive feeding for preventing childhood overweight should therefore be reconsidered.


Assuntos
Composição Corporal , Comportamento Infantil , Ingestão de Energia , Comportamento Alimentar , Mães/psicologia , Poder Familiar , Obesidade Pediátrica , Absorciometria de Fóton , Índice de Massa Corporal , Peso Corporal , Criança , Pré-Escolar , Ingestão de Alimentos , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Países Baixos , Obesidade Pediátrica/etiologia , Obesidade Pediátrica/prevenção & controle , Estudos Prospectivos , Inquéritos e Questionários
18.
Child Obes ; 13(5): 400-408, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28604071

RESUMO

BACKGROUND: A short sleep duration is associated with a higher obesity risk from midchildhood onward. However, whether sleep duration in early childhood is associated with body composition and cardiometabolic health remains unclear. This study aims to examine the prospective association of sleep duration in infancy and early childhood with body composition and cardiometabolic health at 6 years of age. METHODS: Data were available for 5161 children from a population-based cohort in the Netherlands. Sleep duration was assessed at ages 2, 6, 24, and 36 months by parental reports. When children were 6 years old, measures of body composition (iDXA), blood pressure, insulin, and lipid levels were collected. Longitudinal associations among sleep duration, body composition, and cardiometabolic health were studied with multivariable linear regression analyses. In addition, potential bidirectional associations between sleep duration and BMI were studied by using cross-lagged modeling. RESULTS: Shorter sleep duration at 2 months predicted higher BMI and fat mass in 6-year-old children, accounting for confounders and BMI at 2 months (e.g., for BMI, per hour sleep, B = -0.018, 95% CI = -0.026; -0.009). No temporal relationships among sleep duration at other ages, later body composition, and cardiometabolic outcomes were found. The cross-lagged model indicated a bidirectional association between sleep duration and BMI in early life (2 to 6 months of age). CONCLUSIONS: Shorter sleep duration at 2 months, but not at later ages, predicted poorer body composition 6 years later. We found no clear evidence for an effect of sleep duration in early life on cardiometabolic health.


Assuntos
Composição Corporal/fisiologia , Nível de Saúde , Coração/fisiologia , Metabolismo/fisiologia , Sono/fisiologia , Peso ao Nascer , Pressão Sanguínea , Índice de Massa Corporal , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Insulina/sangue , Lipídeos/sangue , Estudos Longitudinais , Masculino , Países Baixos , Estudos Prospectivos , Fatores de Risco , Fatores de Tempo
19.
Appetite ; 114: 374-381, 2017 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-28400303

RESUMO

Fussy/picky eating - i.e. consistently avoiding certain foods - is common in childhood and can be worrisome for parents. Repeated exposure to various flavors as occurs in breastmilk and early exposure to complementary feeding may increase food acceptance and thereby decrease fussy eating. This study examines the associations between infant feeding and child fussy eating in 4779 participants of Generation R, a Dutch population-based cohort. Breastfeeding initiation and continuation, and timing of complementary feeding were assessed by questionnaires at 2, 6, and 12 months. The food fussiness scale of the Children's Eating Behaviour Questionnaire was administered at 4 years. Linear regression analyses were performed, adjusted for confounders. Children who were never breastfed did not differ in fussy eating frequency from children breastfed for 6 months or longer. However, children who were breastfed for less than 2 months had a 0.70 points higher food fussiness sum-score (95%CI:0.27; 1.12) than children breastfed for 6 months or longer. An earlier introduction of vegetables was associated with less fussy eating behavior (p-for-trend:0.005). Particularly children who were introduced to vegetables between 4 and 5 months had a 0.60 point lower food fussiness score (95%CI: 1.06;-0.15) than children introduced to vegetables after 6 months. An early introduction to fruits or any solids was not significantly related to fussy eating, although the effect estimates were in the same direction as for introducing vegetables early. Results suggest that breastfeeding does not predict fussy eating. However, introducing vegetables into a child's diet before 5 months might be protective against fussy eating, although future research should account for parents' own fussy eating.


Assuntos
Desenvolvimento Infantil , Métodos de Alimentação , Transtornos de Alimentação na Infância/prevenção & controle , Preferências Alimentares , Alimentos Infantis , Fenômenos Fisiológicos da Nutrição do Lactente , Verduras , Aleitamento Materno , Estudos de Coortes , Comportamento Alimentar , Transtornos de Alimentação na Infância/epidemiologia , Transtornos de Alimentação na Infância/etiologia , Feminino , Humanos , Lactente , Comportamento do Lactente , Masculino , Mães , Países Baixos/epidemiologia , Estudos Prospectivos , Risco , Autorrelato
20.
Obesity (Silver Spring) ; 25(4): 765-772, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-28245097

RESUMO

OBJECTIVE: Childhood eating behaviors are associated with body mass index (BMI). Recent genome-wide association studies have identified many single-nucleotide polymorphisms (SNPs) associated with adult and childhood BMI. This study hypothesized that these SNPs also influence eating behavior. METHODS: In a population-based prospective cohort study among 3,031 children (mean age [standard deviation]: 4.0 [0.1] years), two weighted genetic risk scores, based on 15 childhood and 97 adult BMI SNPs, and ten individual appetite- and/or satiety-related SNPs were tested for association with food fussiness, food responsiveness, enjoyment of food, satiety responsiveness, and slowness in eating. RESULTS: The 15 SNP-based childhood BMI genetic risk score was not associated with the eating behavior subscales. The 97 SNP-based adult BMI genetic risk score was nominally associated with satiety responsiveness (ß: -0.007 standard deviation, 95% confidence interval [CI] -0.013, 0.000). Of the 10 individual SNPs, rs11030104 in BDNF and rs10733682 in LMX1B were nominally associated with satiety responsiveness (ß: -0.057 standard deviation, 95% CI -0.112, -0.002). CONCLUSIONS: These findings do not strongly support the hypothesis that BMI-associated SNPs also influence eating behavior at this age. A potential role for BMI SNPs in satiety responsiveness during childhood was observed; however, no associations with the other eating behavior subscales were found.


Assuntos
Índice de Massa Corporal , Ingestão de Alimentos/genética , Comportamento Alimentar , Polimorfismo de Nucleotídeo Único , Adulto , Apetite/genética , Criança , Feminino , Estudo de Associação Genômica Ampla , Humanos , Lactente , Masculino , Obesidade/genética , Estudos Prospectivos , Fatores de Risco , Saciação
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