目的:基于前瞻性队列比较不同方法确定的儿童早期体重指数(body mass index,BMI)轨迹与超重风险的关联,识别在儿童早期生长发育重要窗口期具有较高肥胖风险的人群。方法:共纳入北大通州出生队列的1330名儿童,分别在儿童刚出生,1、3、6、...目的:基于前瞻性队列比较不同方法确定的儿童早期体重指数(body mass index,BMI)轨迹与超重风险的关联,识别在儿童早期生长发育重要窗口期具有较高肥胖风险的人群。方法:共纳入北大通州出生队列的1330名儿童,分别在儿童刚出生,1、3、6、9、12、18、24月龄和3岁进行随访,根据其身长/身高和体质量计算BMI Z评分。应用潜类别增长混合模型(growth mixture modelling,GMM)和基于纵向数据的k-means聚类方法(k-means for longitudinal data,KML)分析儿童早期(从出生至24月龄)BMI轨迹分组,采用线性回归比较不同方法确定的儿童早期BMI轨迹和儿童3岁时BMI Z评分的关联,通过五折交叉验证的平均受试者工作特征曲线下面积,比较Logistic回归模型中不同方法确定的儿童早期BMI轨迹分组对儿童3岁超重风险(BMI Z评分>1)的预测性能。结果:在纳入的研究对象中,用GMM确定的三分类轨迹分为低、中、高轨迹,分别占39.7%、54.1%、6.2%;用KML方法确定的二分类轨迹分为低轨迹和高轨迹,分别占50.3%和49.7%;用KML方法确定的三分类轨迹分为低、中、高轨迹,分别占31.1%、47.4%、21.5%。用不同方法确定的儿童早期BMI轨迹反映的生长模式存在一定差异。线性回归分析发现,在调整母亲民族、受教育水平、分娩方式、产次、分娩时年龄、分娩孕周、胎儿性别和1月龄母乳喂养等协变量后,用KML方法确定的三分类轨迹中的高轨迹组(表现为出生时BMI Z评分略高、婴儿期快速生长后持续稳定在高水平的生长模式)和儿童3岁BMI Z评分的关联最强。Logistic回归分析发现,KML三分类轨迹分组对儿童3岁超重风险具有最佳的预测效果。在额外调整儿童平衡膳食指数正端分、平均每天身体活动时间和视屏时间后,结果基本一致。结论:采用不同方法识别具有不同变化特征的儿童早期BMI轨迹,发现KML方法确定的高轨迹组能更好地发现儿童早期具有较高超重风险的人群,为选择适宜方法开展儿童早期BMI轨迹相关研究提供了依据。展开更多
Objective To test the validity of Working Group on Obesity in China (WGOC) reference in screening childhood obesity using obesity-related metabolic syndrome (MS) and its components as disease risk evidence. Method...Objective To test the validity of Working Group on Obesity in China (WGOC) reference in screening childhood obesity using obesity-related metabolic syndrome (MS) and its components as disease risk evidence. Methods A total of 2020 adolescents (1007 boys and 1013 girls) aged 14-16 years were sampled in Beijing, China. Anthropometric and biochemical measurements, as well as blood pressure parameters were available. Prevalence of overweight/obesity and related MS risk factors were analyzed across different body mass index (BMI) categories. The sensitivity and specificity of the WGOC cut-offs were compared with those of National Central Health Statistics (NCHS). Results Significantly high prevalence of MS and its components were found both in the obesity and overweight groups, which were classified by the WGOC and NCHS references. Similar distribution pattern of MS risk factors existed among different BMI categories, but the frequency and clustering of these factors in the obesity group classified by the NCHS were much higher. Owing to its irrelevant high cut-offs for overweight/obesity (especially for girls since the mid- adolescence), the NCHS reference had a high specificity but a low sensitivity. By contrast, the WGOC reference with a high sensitivity (90.1% for boys and 89.2% for girls) and a relative high specificity (96.4% and 92.8% for obese boys and girls, 78.1% and 68.9% for overweight boys and girls respectively) was more suitable to support the need for early screening, intervention, and treatment of childhood obesity in China. Conclusion High sensitivity is more important than specificity in choosing appropriate screening tools for childhood obesity. Validity test demonstrates that it is rational to use the WGOC reference, established on the basis of the Chinese own reference population as a uniform screening tool for childhood obesity, which can effectively overcome the unnecessary treatment and psychosociai implications of stigmatization caused by misclassification.展开更多
The issue of childhood obesity is expanding at an accelerated rate compared to previous generations. Both medical and societal conesquences have arisen from this predicament in children and adults. The significance of...The issue of childhood obesity is expanding at an accelerated rate compared to previous generations. Both medical and societal conesquences have arisen from this predicament in children and adults. The significance of parental influence as a factor is of key interest in developing possible prevention programs. Three major categories of focus are parental control, attitudes, and behavior in association with childhood overweight and obesity. This comprehendsive systematic and evidence-based review summarizes currently published results, as well as addresses gaps and flaws which should be included in future research on pediatric obesity and parental influence.展开更多
Childhood overweight and obesity, is an emerging public health concern in developing countries like Bangladesh. However, regular television watching by child’s mother and its impact on excess weight gain or overweigh...Childhood overweight and obesity, is an emerging public health concern in developing countries like Bangladesh. However, regular television watching by child’s mother and its impact on excess weight gain or overweight and obesity to their offspring is not reported elsewhere. The aim of the present analysis was to determine the socio-demographic characteristics among overweight and obese children based on those mothers who watch television regularly and compare this finding with malnourished and well-nourished under-5 children. A total of 20,800 under-5 children were enrolled during 1996 to 2012 in the Diarrheal Disease Surveillance System (DDSS) of Dhaka Hospital of International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b). Mean weight-for-age z-score (–1.61 vs. –2.30;mean difference: ?0.69;p < 0.001), height-for-age z-score (–1.42 vs. –1.99;–0.57;<0.001), weight-for-height z-score (–1.59 vs. –1.07;–0.53;<0.001), BMI-for-age z-score (–1.09 vs. –1.61, –0.52;<0.001) differed significantly between the children whose mother did and did not watch television regularly. Under-5 children whose mother watched television regularly (2%) compared to those who did not (1%), had 2.28 [(95% CI-1.61 - 3.24) p < 0.001] times increased odds of being overweight and obese. Television watching of mothers is associated with childhood overweight and obesity and is one of the most public health concerns in Bangladesh. These changes may be in part of better socio-economic condition, changes in life style behaviour and dietary pattern.展开更多
Background: Continually rising prevalence of obesity and overweight in children and adolescents is a major public health concern. This is due to its various and serious health hazards on one side and its preventable n...Background: Continually rising prevalence of obesity and overweight in children and adolescents is a major public health concern. This is due to its various and serious health hazards on one side and its preventable nature on the other side. This study aims at identification of prevalence of overweight and obesity and its risk factors among children between 6 - 14 years of age in Sohag, Egypt. Method: A cross sectional study was conducted on 711 school children between 6 - 14 years in four months’ period from February to May 2016. Weight and height of the studied children were measured to calculate BMI, which was compared with standard Egyptian growth charts for determining overweight and obesity. Then a questionnaire containing data about socio demographic, parental obesity, early life and dietary risk factors was completed by the children’s parents. Result: Out of 711 studied children, 117 (16.5%) were overweight and 104 (14.6%) were obese. Residing in urban area, having an obese parent or both of them, low level of maternal education, being on formula feeding during early life and lack of fresh vegetables and fruits in diets were significant risk factors for overweight and obesity in the studied children (P value < 0.05). Conclusion: Improperly educated mothers together with sedentary life style manifested in obesity among the parents and lack of sport practice among children constituted the majors risk factors for childhood obesity. This emphasizes the need for increased health awareness of the community about the importance of proper nutrition and physical activity.展开更多
Objective: To evaluate the effectiveness of a dietary intervention to increase target vegetable intake in overweight, postpartum mothers;and their children. Methods: Overweight mothers attending their six-week postpar...Objective: To evaluate the effectiveness of a dietary intervention to increase target vegetable intake in overweight, postpartum mothers;and their children. Methods: Overweight mothers attending their six-week postpartum follow-up visit and their infants (n = 104 pairs) were randomized to intervention or usual care groups during the time period 2008-2011. Mothers received four 60 minute education sessions with a nutrition professional and eight monthly follow-up phone calls. Counseling began at the obstetrician office and continued at the regularly scheduled pediatric visits. The primary study outcome was the change in maternal target vegetable intake. Secondary outcomes included child target vegetable intake and whether child vegetable intake was modified by exposure to breastfeeding. Mother/child energy intake and weight indices were also assessed. Outcomes were measured at baseline (6-weeks postpartum), 6, 12 (post-intervention), and 18 (follow-up) months. Mixed-effects models were used to estimate the impact of the dietary intervention on study outcomes relative to usual care. Results: Mothers randomized to the intervention had greater consumption of target vegetables at 6, 12 and 18 months (P P P = 0.03, respectively). There were no differences between groups in maternal energy intake, body mass index, or child target vegetable or energy intake. The child’s target vegetable intake at 12 months was related to the mother’s intake at 6 months (P = 0.03), however, this relationship was not modified by exposure to breastfeeding. Conclusion: A dietary intervention targeting the diet of the mother/child dyad resulted in improved maternal vegetable intake.展开更多
Background/Objectives: The prevalence of overweight in children is a growing health problem. The aim of this study was to investigate the relationship between overweight and dietary patterns in preschoolers. Methods: ...Background/Objectives: The prevalence of overweight in children is a growing health problem. The aim of this study was to investigate the relationship between overweight and dietary patterns in preschoolers. Methods: In total, 232 preschoolers (age 5) residing in the city of Diamantina, Brazil, were evaluated. Dietary intake from a food frequency questionnaire, anthropometric parameters and socioeconomic/behavioral information from a questionnaire were evaluated using a cross-sectional design. Dietary patterns were identified using principal component analysis, and the relationship between overweight and dietary patterns was examined by logistic regression analysis. Results: “Mixed diet”, “snack” and “unhealthy” dietary patterns were identified. Children daughters of obese mothers, and those who had higher average weight gain in the first four months of life had a significantly higher chance of being overweight (respective values: OR = 3.81;p = 0.002;and OR = 2.97;p = 0.009). Higher levels of maternal education were associated with higher “mixed diet” scores (p < 0.001), whereas lower levels of maternal education (p < 0.001), higher per capita income (p < 0.001) and higher average weight gain from 0 to 4 months (p = 0.002) were associated with higher “snack” scores. Higher per capita income was also associated with lower “unhealthy” scores (p Conclusions: In the present study, overweight was not associated with dietary pattern. However, unhealthy eating habits are known to be risk factors for overweight, and considering that eating habits are formed in childhood, it is very important that healthy eating be encouraged in the family environment and in other spaces like childcare and school.展开更多
Background: The etiology of adult obesity is still poorly understood. It has been shown that over-weight children suffer from adverse psychological events, but less is known about the association of adverse psychologi...Background: The etiology of adult obesity is still poorly understood. It has been shown that over-weight children suffer from adverse psychological events, but less is known about the association of adverse psychological factors among normal weight children and adult obesity. Aim: The aim of this study was to examine if the exposure of perception of being bullied during childhood could be associated with development of adult obesity. Methods: Adult, same-sexed twin pairs discordant for BMI were identified from the Danish Twin Registry. The twins underwent an interview and a physical examination. Data were analyzed by means of a growth-curve model and an intra-pair comparison. This design controls for other influences of early lifestyle and socio economic status and is therefore a powerful tool to study independent effects of specific exposures. Results: In total 236 (81.7%) of the twin individuals identified participated in the study. Participants who reported having been bullied in school, had attained a BMI which was on average 1.4 kg/m2 (95% CI = 0.2;2.5, p = 0.02) higher than those not bullied. Two other questions on specific types of bullying resulted in BMI that were 1.1 kg/m2 (CI = 0.1;2.2, p = 0.03) and 1.9 kg/m2 (CI = 0.7;3.1, p = 0.002) larger than subjects who had not been exposed to bullying. There was a direct association between intra pair differences in BMI and exposure to bullying. Conclusion: The results of the study could indicate that being bullied during childhood seems be associated with adult obesity.展开更多
Objective Gestational diabetes mellitus(GDM)and gestational weight gain(GWG)are important risk factors that are known to affect offspring growth,but these outcomes are inconsistent and it remains unknown if both risk ...Objective Gestational diabetes mellitus(GDM)and gestational weight gain(GWG)are important risk factors that are known to affect offspring growth,but these outcomes are inconsistent and it remains unknown if both risk factors have a synergetic effect on early childhood growth.The present study aimed to conduct offspring body mass index-for-age Z-scores(BMIZ)trajectories and to evaluate the independent and interactive effect of the status of GDM and excessive GWG on the risks of overweight/obesity from birth to 24 months of age.Methods A total of 7949 mother-child pairs were enrolled in this study.The weight and length of children were measured at birth,6,12,and 24 months of age to calculate BMIZ.Results The status of GDM was positively associated with offspring BMIZ and risk of macrosomia at birth but was not associated with offspring BMIZ or the risks of overweight/obesity at 6,12,and 24 months of age.In contrast,excessive GWG was positively linked to offspring BMIZ,the stable high BMIZ trajectory pattern,and risks of overweight/obesity in the first 24 months of age.These two risk factors also had a significant synergistic effect on macrosomia at birth,but the interactive effect was only significant in boys during the follow-up years in the sex-stratified analyses.Conclusion The maternal GWG was a more pronounced predictor than GDM with relation to BMIZ and risk of overweight/obesity in early childhood.The interactive effect between these risk factors on offspring overweight/obesity may vary by sex.展开更多
Background Knowledge on the impact of the temporary kindergarten closure policy under COVID-19 in 2020 on childhood overweight and obesity is inadequate.We aimed to examine differences in rates of overweight and obesi...Background Knowledge on the impact of the temporary kindergarten closure policy under COVID-19 in 2020 on childhood overweight and obesity is inadequate.We aimed to examine differences in rates of overweight and obesity from 2018 to 2021 among kindergarten children aged 3–7 years.Methods Overweight was defined as body mass index(BMI)>1 standard deviation(SD)for age and sex,and obesity was defined as BMI>2 SD for age and sex.Generalized linear mixed modeling was used for analysis.Results A total of 44,884 children and 71,216 growth data points from all 57 public kindergartens in Jiading District,Shanghai,China were analyzed.The rates of obesity from 2018 to 2021 were 6.9%,6.6%,9.5%,and 7.3%in boys and 2.8%,2.8%,4.5%,and 3.1%in girls,respectively.The rates of overweight from 2018 to 2021 were 14.3%,14.3%,18.2%,and 15.3%in boys and 10.6%,10.9%,13.9%,and 11.6%in girls.The rates of obesity and overweight among kindergarten children in 2020 were significantly higher than those in 2018,2019,and 2021.Compared to 2020,the odds ratios of the obesity rate in 2018,2019,and 2021 were 0.67[95%confidence interval(CI)=0.58–0.77,P<0.001],0.72(95%CI=0.64–0.80,P<0.001)and 0.81(95%CI=0.72–0.92,P=0.001),respectively.The odds ratios of the overweight rate in 2018,2019,and 2021 were 0.75(95%CI=0.69–0.82,P<0.001),0.78(95%CI=0.72–0.84,P<0.001),and 0.89(95%CI=0.81–0.97,P=0.008),respectively,compared to 2020.Conclusions The rates of overweight and obesity significantly increased among kindergarten children in 2020 after the 5-month kindergarten closure.It was critical to provide guidance to caregivers on fostering a healthy lifestyle for children at home under public health emergencies.展开更多
基金International Life Sciences Institute, Focal Point in China
文摘Objective To test the validity of Working Group on Obesity in China (WGOC) reference in screening childhood obesity using obesity-related metabolic syndrome (MS) and its components as disease risk evidence. Methods A total of 2020 adolescents (1007 boys and 1013 girls) aged 14-16 years were sampled in Beijing, China. Anthropometric and biochemical measurements, as well as blood pressure parameters were available. Prevalence of overweight/obesity and related MS risk factors were analyzed across different body mass index (BMI) categories. The sensitivity and specificity of the WGOC cut-offs were compared with those of National Central Health Statistics (NCHS). Results Significantly high prevalence of MS and its components were found both in the obesity and overweight groups, which were classified by the WGOC and NCHS references. Similar distribution pattern of MS risk factors existed among different BMI categories, but the frequency and clustering of these factors in the obesity group classified by the NCHS were much higher. Owing to its irrelevant high cut-offs for overweight/obesity (especially for girls since the mid- adolescence), the NCHS reference had a high specificity but a low sensitivity. By contrast, the WGOC reference with a high sensitivity (90.1% for boys and 89.2% for girls) and a relative high specificity (96.4% and 92.8% for obese boys and girls, 78.1% and 68.9% for overweight boys and girls respectively) was more suitable to support the need for early screening, intervention, and treatment of childhood obesity in China. Conclusion High sensitivity is more important than specificity in choosing appropriate screening tools for childhood obesity. Validity test demonstrates that it is rational to use the WGOC reference, established on the basis of the Chinese own reference population as a uniform screening tool for childhood obesity, which can effectively overcome the unnecessary treatment and psychosociai implications of stigmatization caused by misclassification.
文摘The issue of childhood obesity is expanding at an accelerated rate compared to previous generations. Both medical and societal conesquences have arisen from this predicament in children and adults. The significance of parental influence as a factor is of key interest in developing possible prevention programs. Three major categories of focus are parental control, attitudes, and behavior in association with childhood overweight and obesity. This comprehendsive systematic and evidence-based review summarizes currently published results, as well as addresses gaps and flaws which should be included in future research on pediatric obesity and parental influence.
文摘Childhood overweight and obesity, is an emerging public health concern in developing countries like Bangladesh. However, regular television watching by child’s mother and its impact on excess weight gain or overweight and obesity to their offspring is not reported elsewhere. The aim of the present analysis was to determine the socio-demographic characteristics among overweight and obese children based on those mothers who watch television regularly and compare this finding with malnourished and well-nourished under-5 children. A total of 20,800 under-5 children were enrolled during 1996 to 2012 in the Diarrheal Disease Surveillance System (DDSS) of Dhaka Hospital of International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b). Mean weight-for-age z-score (–1.61 vs. –2.30;mean difference: ?0.69;p < 0.001), height-for-age z-score (–1.42 vs. –1.99;–0.57;<0.001), weight-for-height z-score (–1.59 vs. –1.07;–0.53;<0.001), BMI-for-age z-score (–1.09 vs. –1.61, –0.52;<0.001) differed significantly between the children whose mother did and did not watch television regularly. Under-5 children whose mother watched television regularly (2%) compared to those who did not (1%), had 2.28 [(95% CI-1.61 - 3.24) p < 0.001] times increased odds of being overweight and obese. Television watching of mothers is associated with childhood overweight and obesity and is one of the most public health concerns in Bangladesh. These changes may be in part of better socio-economic condition, changes in life style behaviour and dietary pattern.
文摘Background: Continually rising prevalence of obesity and overweight in children and adolescents is a major public health concern. This is due to its various and serious health hazards on one side and its preventable nature on the other side. This study aims at identification of prevalence of overweight and obesity and its risk factors among children between 6 - 14 years of age in Sohag, Egypt. Method: A cross sectional study was conducted on 711 school children between 6 - 14 years in four months’ period from February to May 2016. Weight and height of the studied children were measured to calculate BMI, which was compared with standard Egyptian growth charts for determining overweight and obesity. Then a questionnaire containing data about socio demographic, parental obesity, early life and dietary risk factors was completed by the children’s parents. Result: Out of 711 studied children, 117 (16.5%) were overweight and 104 (14.6%) were obese. Residing in urban area, having an obese parent or both of them, low level of maternal education, being on formula feeding during early life and lack of fresh vegetables and fruits in diets were significant risk factors for overweight and obesity in the studied children (P value < 0.05). Conclusion: Improperly educated mothers together with sedentary life style manifested in obesity among the parents and lack of sport practice among children constituted the majors risk factors for childhood obesity. This emphasizes the need for increased health awareness of the community about the importance of proper nutrition and physical activity.
文摘Objective: To evaluate the effectiveness of a dietary intervention to increase target vegetable intake in overweight, postpartum mothers;and their children. Methods: Overweight mothers attending their six-week postpartum follow-up visit and their infants (n = 104 pairs) were randomized to intervention or usual care groups during the time period 2008-2011. Mothers received four 60 minute education sessions with a nutrition professional and eight monthly follow-up phone calls. Counseling began at the obstetrician office and continued at the regularly scheduled pediatric visits. The primary study outcome was the change in maternal target vegetable intake. Secondary outcomes included child target vegetable intake and whether child vegetable intake was modified by exposure to breastfeeding. Mother/child energy intake and weight indices were also assessed. Outcomes were measured at baseline (6-weeks postpartum), 6, 12 (post-intervention), and 18 (follow-up) months. Mixed-effects models were used to estimate the impact of the dietary intervention on study outcomes relative to usual care. Results: Mothers randomized to the intervention had greater consumption of target vegetables at 6, 12 and 18 months (P P P = 0.03, respectively). There were no differences between groups in maternal energy intake, body mass index, or child target vegetable or energy intake. The child’s target vegetable intake at 12 months was related to the mother’s intake at 6 months (P = 0.03), however, this relationship was not modified by exposure to breastfeeding. Conclusion: A dietary intervention targeting the diet of the mother/child dyad resulted in improved maternal vegetable intake.
文摘Background/Objectives: The prevalence of overweight in children is a growing health problem. The aim of this study was to investigate the relationship between overweight and dietary patterns in preschoolers. Methods: In total, 232 preschoolers (age 5) residing in the city of Diamantina, Brazil, were evaluated. Dietary intake from a food frequency questionnaire, anthropometric parameters and socioeconomic/behavioral information from a questionnaire were evaluated using a cross-sectional design. Dietary patterns were identified using principal component analysis, and the relationship between overweight and dietary patterns was examined by logistic regression analysis. Results: “Mixed diet”, “snack” and “unhealthy” dietary patterns were identified. Children daughters of obese mothers, and those who had higher average weight gain in the first four months of life had a significantly higher chance of being overweight (respective values: OR = 3.81;p = 0.002;and OR = 2.97;p = 0.009). Higher levels of maternal education were associated with higher “mixed diet” scores (p < 0.001), whereas lower levels of maternal education (p < 0.001), higher per capita income (p < 0.001) and higher average weight gain from 0 to 4 months (p = 0.002) were associated with higher “snack” scores. Higher per capita income was also associated with lower “unhealthy” scores (p Conclusions: In the present study, overweight was not associated with dietary pattern. However, unhealthy eating habits are known to be risk factors for overweight, and considering that eating habits are formed in childhood, it is very important that healthy eating be encouraged in the family environment and in other spaces like childcare and school.
文摘Background: The etiology of adult obesity is still poorly understood. It has been shown that over-weight children suffer from adverse psychological events, but less is known about the association of adverse psychological factors among normal weight children and adult obesity. Aim: The aim of this study was to examine if the exposure of perception of being bullied during childhood could be associated with development of adult obesity. Methods: Adult, same-sexed twin pairs discordant for BMI were identified from the Danish Twin Registry. The twins underwent an interview and a physical examination. Data were analyzed by means of a growth-curve model and an intra-pair comparison. This design controls for other influences of early lifestyle and socio economic status and is therefore a powerful tool to study independent effects of specific exposures. Results: In total 236 (81.7%) of the twin individuals identified participated in the study. Participants who reported having been bullied in school, had attained a BMI which was on average 1.4 kg/m2 (95% CI = 0.2;2.5, p = 0.02) higher than those not bullied. Two other questions on specific types of bullying resulted in BMI that were 1.1 kg/m2 (CI = 0.1;2.2, p = 0.03) and 1.9 kg/m2 (CI = 0.7;3.1, p = 0.002) larger than subjects who had not been exposed to bullying. There was a direct association between intra pair differences in BMI and exposure to bullying. Conclusion: The results of the study could indicate that being bullied during childhood seems be associated with adult obesity.
基金Fundamental Research Funds for the Central Universities(No.2015ZDTD047,No.2016YXZD043 and No.2018KFYXMPT00)Program for HUST Academic Frontier Youth Team(No.2018QYTD12)Grants from the National Key Research and Development Plan(No.2016YFC0206203).
文摘Objective Gestational diabetes mellitus(GDM)and gestational weight gain(GWG)are important risk factors that are known to affect offspring growth,but these outcomes are inconsistent and it remains unknown if both risk factors have a synergetic effect on early childhood growth.The present study aimed to conduct offspring body mass index-for-age Z-scores(BMIZ)trajectories and to evaluate the independent and interactive effect of the status of GDM and excessive GWG on the risks of overweight/obesity from birth to 24 months of age.Methods A total of 7949 mother-child pairs were enrolled in this study.The weight and length of children were measured at birth,6,12,and 24 months of age to calculate BMIZ.Results The status of GDM was positively associated with offspring BMIZ and risk of macrosomia at birth but was not associated with offspring BMIZ or the risks of overweight/obesity at 6,12,and 24 months of age.In contrast,excessive GWG was positively linked to offspring BMIZ,the stable high BMIZ trajectory pattern,and risks of overweight/obesity in the first 24 months of age.These two risk factors also had a significant synergistic effect on macrosomia at birth,but the interactive effect was only significant in boys during the follow-up years in the sex-stratified analyses.Conclusion The maternal GWG was a more pronounced predictor than GDM with relation to BMIZ and risk of overweight/obesity in early childhood.The interactive effect between these risk factors on offspring overweight/obesity may vary by sex.
基金This study was funded by the Program of Public Health Outstanding Scholars,Jiading District,Shanghai Discipline Leadership Scholars,the Fifth Round of the Three-Year Public Health Action Plan of Shanghai Key Discipline Program(GWV-10.1-XK08)the Shanghai Municipal Public Health Outstanding Discipline Leadership Program(GWV-10.2-XD10).
文摘Background Knowledge on the impact of the temporary kindergarten closure policy under COVID-19 in 2020 on childhood overweight and obesity is inadequate.We aimed to examine differences in rates of overweight and obesity from 2018 to 2021 among kindergarten children aged 3–7 years.Methods Overweight was defined as body mass index(BMI)>1 standard deviation(SD)for age and sex,and obesity was defined as BMI>2 SD for age and sex.Generalized linear mixed modeling was used for analysis.Results A total of 44,884 children and 71,216 growth data points from all 57 public kindergartens in Jiading District,Shanghai,China were analyzed.The rates of obesity from 2018 to 2021 were 6.9%,6.6%,9.5%,and 7.3%in boys and 2.8%,2.8%,4.5%,and 3.1%in girls,respectively.The rates of overweight from 2018 to 2021 were 14.3%,14.3%,18.2%,and 15.3%in boys and 10.6%,10.9%,13.9%,and 11.6%in girls.The rates of obesity and overweight among kindergarten children in 2020 were significantly higher than those in 2018,2019,and 2021.Compared to 2020,the odds ratios of the obesity rate in 2018,2019,and 2021 were 0.67[95%confidence interval(CI)=0.58–0.77,P<0.001],0.72(95%CI=0.64–0.80,P<0.001)and 0.81(95%CI=0.72–0.92,P=0.001),respectively.The odds ratios of the overweight rate in 2018,2019,and 2021 were 0.75(95%CI=0.69–0.82,P<0.001),0.78(95%CI=0.72–0.84,P<0.001),and 0.89(95%CI=0.81–0.97,P=0.008),respectively,compared to 2020.Conclusions The rates of overweight and obesity significantly increased among kindergarten children in 2020 after the 5-month kindergarten closure.It was critical to provide guidance to caregivers on fostering a healthy lifestyle for children at home under public health emergencies.