Infant and Early Child Appetite Traits and Child Weight and Obesity Risk in Low-Income Hispanic Families

BackgroundChild appetite traits (ATs) are associated with later child weight and obesity risk. Less research has focused on ATs in low-income Hispanic children or included longitudinal associations with infant weight.ObjectiveTo determine stability of ATs during infancy and childhood and their relationship with subsequent weight and obesity risk at age 3 years among low-income Hispanic children.DesignA secondary longitudinal analysis of data from the Starting Early Program randomized controlled obesity prevention trial.Participants/settingThree hundred twenty-two low-income, Hispanic mother–child pairs enrolled between 2012 and 2014 in a public hospital in New York City.Main outcome measuresATs, including Slowness in Eating, Satiety Responsiveness, Food Responsiveness, and Enjoyment of Food were assessed using the Baby and Child Eating Behavior Questionnaires at ages 3 months, 2 years, and 3 years. Main outcome measures were child standardized weight-for-age z score (WFAz) and obesity risk (WFA≥95th percentile) at age 3 years.Statistical analyses performedAT stability was assessed using correlations and multilevel modeling. Linear and logistic regression analyses examined associations between ATs and child WFAz and obesity risk at age 3 years.ResultsThere was limited stability for all ATs measured over time. During infancy, Slowness in Eating was associated with lower 3-year WFAz (B = –0.18, 95% CI –0.33 to –0.04; P = 0.01). At age 2 years, Slowness in Eating and Satiety Responsiveness were associated with lower WFAz (B = –0.29, 95% CI –0.47 to –0.12; P < 0.01; B = –0.36, 95% CI –0.55 to –0.17; P < 0.01) and obesity risk (adjusted odds ratio 0.49, 95% CI 0.28 to 0.85; adjusted odds ratio 0.61, 95% CI 0.38 to 0.99) at 3 years. Increased Slowness in Eating and Satiety Responsiveness over time were associated with lower 3-year WFAz (B = –0.74, 95% CI –1.18 to –0.2 [Slowness in Eating]; B = –1.19, 95% CI –1.87 to –0.52 [Satiety Responsiveness], both P values = 0.001). Higher Enjoyment of Food over time was associated with higher 3-year WFAz (B = 0.62, 95% CI 0.24 to 1.01; P = 0.002).ConclusionsInfants with lower Slowness in Eating and Satiety Responsiveness may have higher levels of obesity risk and need more tailored approaches to nutrition counseling and obesity prevention.     

Is overweight or obesity associated with anemia in children? Follow-up of Samoans in the Ola Tuputupua’e “Growing Up” study

ObjectivesGlobally, there is growing evidence of a double burden of malnutrition with obesity coexisting alongside micronutrient deficiencies across the life course. An emergent double burden poses a threat to health during childhood in Samoa: among 2–4-year-olds with overweight/obesity, 42.9% were anemic. Previous research suggests that obesity-related inflammation may increase the risk of iron deficiency or anemia in children. To test this hypothesis, we examined whether overweight/obesity at 2–4 is associated with anemia at 3.8–6 years old among Samoan children.MethodsData were obtained from the Ola Tuputupua’e “Growing Up” cohort study. Overweight/obesity at 2–4 years old was classified by body mass index-for-age Z-score > +2 SD. Anemia was defined as hemoglobin < 110 g/L for under 5-year-olds and < 115 g/L for 5–6-year-olds. Prevalence ratios (PRs) for anemia at 3.8–6 years old were estimated by fitting modified Poisson regression models.ResultsIn our sample of 197 children, 16.24% (n = 32) were affected by overweight/obesity at 2–4 years old and 26.90% (n = 53) had anemia at 3.8–6 years old. After covariate adjustment, the prevalence of anemia was 18% lower among children with overweight/obesity at 2–4 years old compared to those without (PR:0.82; 95% CI:0.42–1.63); however, the corresponding confidence interval was imprecise and inclusive of a higher prevalence.ConclusionsThere was not strong evidence to support a relationship between overweight/obesity and anemia in Samoan children, suggesting that obesity-related inflammation may not be related to iron deficiency nor anemia in this setting. Further investigation of the antecedents of overweight/obesity and anemia is critical to inform integrated action to improve health in Samoa.     

Developmental Trends in Sleep Duration in Adolescence and Young Adulthood: Evidence From a National United States Sample

PurposeTo present normative values of mean sleep duration from adolescence through young adulthood (ages 13–32 years), prevalence of short (<6 hours) and long (>10 hours) sleep durations, and differences in each by sex and race/ethnicity.MethodsMean sleep duration and prevalence of extremely short and long sleep were estimated using data from the United States National Longitudinal Study of Adolescent Health, Waves 1–4 (N = 15,701).ResultsSleep duration showed age-related trends, with decreases across the adolescent period from 8.5 hours per night at age 13 years to 7.3 hours at age 18 years, an increase through the emerging adulthood period to 8.5 hours at age 22, and a gradual decline across early adulthood to 7.7 hours at age 32 years. Prevalence of extremely long and short sleep followed similar developmental trends. Adolescent girls reported lower mean sleep duration than did boys, but women reported longer average sleep duration than did men from age 19 years onward. Short sleep duration was most common among African-Americans at all ages. Long sleep was most common among African-Americans in adolescence and emerging adulthood and among Hispanics in early adulthood.ConclusionsSleep duration is developmentally patterned from adolescence through early adulthood. Mean and extreme sleep durations vary systematically by sex and race/ethnicity as well as age. These normative data on sleep duration will inform studies of the role of sleep in the etiology of a wide range of health conditions affecting adolescents and young adults.     

The association of sleep duration and cardiometabolic risk factors in a national sample of children and adolescents: The CASPIAN III Study

ObjectivesAlthough sleep duration is one of the most important health-related factors, its association with risk factors for chronic diseases has not been completely clarified, especially among children and adolescents. The aim of this study was to evaluate the association between sleep duration and CVD risk factors among a nationally representative sample of Iranian children and adolescents.MethodsThis cross-sectional national study was performed on a representative sample of 5528 Iranian students, ages 10 to 18 y living in central cities of 27 provinces of Iran. Physical examinations and laboratory tests were performed using standard protocols. To determine the association between sleep duration and cardiometabolic risk factors, multivariable logistic regression was used and odds ratios (OR; with 95% confidence intervals) are reported.ResultsThe mean ± SD age was not significantly different among boys (14.69 ± 2.45 y) and girls (14.7 ± 2.38 y). In a crude model, boys who slept > 8 h and 5 to 8 h had lower OR for abdominal obesity compared with those who had slept <5 h in a crude model (ORs, 0.70, 0.80, 1.0, respectively; P = 0.008). A similar result was observed in an age- adjusted model for the prevalence of abdominal obesity (ORs, 0.69, 0.76, 1.0, respectively; P = 0.011). Girls who had slept > 8 h per day had lower OR for high serum low-density lipoprotein levels compared with those who slept < 5 h per day (P = 0.002). These differences remained significant even in the fully adjusted model for all the confounding variables (P = 0.008). Moreover, among boys ages 10 to 14 y, longer sleep duration increased the risk for high total cholesterol in all models.ConclusionShorter sleep duration increased the risk for some cardiometabolic risk factors among adolescents. The clinical significance of our findings should be determined in longitudinal studies.     

Quality of life of children and adolescents with clinical obesity,perspectives of children and parents

Background/objectivesChildhood obesity can have important psychological impacts. The objective of this study was to evaluate the Health Related Quality of Life (HRQoL) of children and adolescents with overweight and obesity. The participants were referred to an outpatient hospital-based obesity treatment. Additionally, we investigated the differences between parent- and self-reported HRQoL.Subjects/methodsChildren and adolescents aged 3−18 years with overweight or obesity, referred by their general practitioner or youth health care physician to the pediatric outpatient clinic of Hospital Gelderse Vallei (Ede, the Netherlands) for multidisciplinary obesity treatment, were enrolled in this cross-sectional study (n = 119).Interventions/methodsParent-proxy reported HRQoL was assessed using the Child Health Questionnaire Parental Form 50 (CHQ-PF50, n = 119) and the Infant Toddler Quality of Life Questionnaire 97 (ITQOL-97). Adolescents completed CHQ Child Form 87 (CHQ-CF87, n = 45) and Impact of Weight on Quality of Life-Kids (IWQOL-Kids, n = 38) to assess self-reported HRQoL.ResultsThe mean age of the children was 9.6 years (SD 4.3). Both parent-proxy reports and child self-reports showed lower HRQoL in children with a higher degree of obesity, especially in the physical domains of HRQoL (p < 0.05). Child self-reported scores were significantly lower than parent-proxy scores on the subscales ‘bodily pain/discomfort’ and ‘general health perceptions’, and significantly higher on ‘behavior’ and ‘family cohesion’ (p < 0.05).ConclusionsChildhood obesity has a negative effect on HRQoL, especially on the physical aspects. The discordance between parent and child reports underscores the importance of using a combination of parent-proxy and child self-reports to assess HRQoL.     

Short sleep duration and obesity among Australian children

Background  

There is limited information on sleep duration and obesity among Australian children. The objective of the study is to cross-sectionally examine the relationship between sleep duration and obesity in Australian children aged 5 to 15 years.     

Picky eating in preschool children: The predictive role of the child's temperament and mother's negative affectivity

ObjectiveThe objective of this study is to describe the development and examine predictors of picky eating from 1.5 to 4.5 years of age in a community sample of children.MethodsMothers completed a questionnaire, assessing picky eating and a range of child and maternal factors, when their children were aged 1.5 (n = 913), 2.5 (n = 777), and 4.5 (n = 727) years.ResultsPicky eating increased significantly from 1.5 to 4.5 years. Lower maternal age, higher levels of child emotionality, and maternal negative affectivity at the child's age 1.5 predicted an increase in picky eating from 1.5 years to 2.5 and 4.5 years. Having siblings protected against the development of picky eating.ConclusionChild and maternal temperament at a very early stage in the child's life increase the risk for picky eating later on.     

Association of Snacking Frequency,Size, and Energy Density with Weight Status among Preschool-Aged Children in the United States

BackgroundSnacking (ie, eating between meals) is common among US preschool-aged children, but associations with weight status are unclear.ObjectiveThis research evaluated associations of snack frequency, size, and energy density as well as the percent of daily energy from snacking with weight status and sociodemographic characteristics among US children aged 2 to 5 years.DesignCross-sectional analysis of 2007-2018 National Health and Nutrition Examination Survey data using two, caregiver proxy, 24-hour dietary recalls.Participants/settingUS children aged 2 to 5 years (n = 3,313) with at least one snack occasion over 2 days of intake.Main outcome measuresSnacking parameters included frequency (number of occasions per day), size (kilocalories per occasion), and energy density (kilocalories per gram per occasion) as well as percent of daily energy from snacking.Statistical analysesGeneralized linear regression models evaluated associations of snacking with child weight status (ie, normal weight and overweight/obesity), adjusting for survey weights, energy misreporting, mean meal size, and sociodemographic covariates.ResultsChildren with overweight/obesity consumed more frequent snacks (2.8 [0.06] vs 2.5 [0.03] snacks/day, respectively; P < 0.001), larger snacks (188 [4] vs 162 [23] kcal/occasion, respectively; P < 0.001), and a greater percent of daily energy from snacking (29.80% [1.00%] vs 26.09% [0.40%], respectively; P < 0.001) than children with normal weight. Mean snack frequency and size as well as percentage of daily energy from snacking varied with child age, gender, and head of household education. Associations of snacking with child race and ethnicity were less consistent.ConclusionsThese nationally representative findings provide evidence that the consumption of larger, more frequent snacks is associated with overweight/obesity among US children aged 2 to 5 years and snacking varies by sociodemographic characteristics.     

Initial investigation of associations between feeding practices,eating behaviours,and weight status in Vietnamese children using modified questionnaires

AimsThis cross-sectional study aims to extend the preliminary validation of the Feeding Practices and Structure Questionnaire (FPSQ) and Children’s Eating Behaviour Questionnaire (CEBQ) in the Vietnamese context by examining associations between maternal feeding practices, child eating behaviours, and child weight status.MethodsModified versions of the FPSQ and CEBQ were used to measure maternal feeding practices and child eating behaviours, respectively, in a sample of Vietnamese mothers of children within the age range of two to five years (n = 100). Children’s weight-for-height z-scores (WHZs) were calculated using weight and height measurements obtained by clinicians. Pearson’s correlation coefficients were used to examine bivariate associations between maternal feeding practices, child eating behaviours, and child WHZs. Significant variables were then entered into a multivariable regression model.ResultsChild WHZs were associated with maternal persuasive feeding, and child slowness in eating, enjoyment of food/food responsiveness, and emotional undereating, but in multivariable regression analysis, only persuasive feeding (β = ?0.44, p = 0.027) and slowness in eating (β = ?0.39, p = 0.036) contributed significantly to the model.ConclusionsThe findings provide some evidence of construct validity for the modified questionnaires. Potential implications of dietary-related behaviours on weight status in preschool-aged children in Viet Nam are evident. However, further validation and analysis in larger datasets must be undertaken in order to examine these associations with increased certainty.     

Skipping Breakfast and Subsequent Overweight/Obesity in Children: A Nationwide Prospective Study of 2.5- to 13-year-old Children in Japan

BackgroundFew longitudinal studies have examined the association between skipping breakfast and overweight/obesity in pre-elementary school children. Furthermore, this association may differ between boys and girls. The main objective of this study was to assess whether skipping breakfast in early childhood was associated with later incidence of overweight/obesity, with stratification by gender, using data on children aged 2.5 to 13 years old in The Longitudinal Survey of Newborns in the 21^st century.MethodsWe examined the associations between skipping breakfast at 2.5 years old and overweight/obesity at 2.5 (n = 34,649), 4.5 (n = 35,472), 7 (n = 31,266), 10 (n = 31,211), and 13 (n = 28,772) years old. To estimate adjusted odds ratios (ORs) with 95% confidence intervals (CIs) of overweight/obesity by each age (2.5, 4.5, 7, 10, and 13 years), a multivariate logistic regression was used adjusting for time-invariant and time-varying covariates.ResultsAt the age of 2.5 years, 11.0% of boys and 12.2% of girls were skipping breakfast. In fully adjusted models, skipping breakfast at 2.5 years old was not significantly associated with overweight/obesity at 2.5 and 4.5 years old, but was significantly associated with overweight/obesity at 7 and 10 years old, in both sexes. Skipping breakfast at 2.5 years old was significantly associated with overweight/obesity at 13 years old in boys (OR 1.38; 95% CI, 1.17–1.62), but not in girls (OR 1.21; 95% CI, 0.98–1.49).ConclusionsSkipping breakfast in early childhood increased overweight/obesity in later childhood, but there may be gender differences in the association.Key words: skipping breakfast, longitudinal study, children, overweight/obesity     

Linking cohort data and Welsh routine health records to investigate children at risk of delayed primary vaccination

BackgroundDelayed primary vaccination is one of the strongest predictors of subsequent incomplete immunisation. Identifying children at risk of such delay may enable targeting of interventions, thus decreasing vaccine-preventable illness.ObjectivesTo explore socio-demographic factors associated with delayed receipt of the Diphtheria, Tetanus and Pertussis (DTP) vaccine.MethodsWe included 1,782 children, born between 2000 and 2001, participating in the Millennium Cohort Study (MCS) and resident in Wales, whose parents gave consent for linkage to National Community Child Health Database records at the age seven years contact. We examined child, maternal, family and area characteristics associated with delayed receipt of the first dose of the DTP vaccine.Results98.6% received the first dose of DTP. The majority, 79.6% (n = 1,429) received it on time (between 8 and 12 weeks of age), 14.2% (n = 251) received it early (prior to 8 weeks of age) and 4.8% (n = 79) were delayed (after 12 weeks of age); 1.4% (n = 23) never received it. Delayed primary vaccination was more likely among children with older natural siblings (risk ratio 3.82, 95% confidence interval (1.97, 7.38)), children admitted to special/intensive care (3.15, (1.65, 5.99)), those whose birth weight was > 4Kg (2.02, (1.09, 3.73)) and boys (1.53, (1.01, 2.31)). There was a reduced risk of delayed vaccination with increasing maternal age (0.73, (0.53, 1.00) per 5 year increase) and for babies born to graduate mothers (0.27, (0.08, 0.90)).ConclusionsAlthough the majority of infants were vaccinated in a timely manner, identification of infants at increased risk of early or delayed vaccination will enable targeting of interventions to facilitate timely immunisation. This is to our knowledge the first study exploring individual level socio-demographic factors associated with delayed primary vaccination in the UK and demonstrates the benefits of linking cohort data to routinely-collected child health data.     

Trends in effectiveness of inactivated influenza vaccine in children by age groups in seven seasons immediately before the COVID-19 era

BackgroundWe have reported the vaccine effectiveness of inactivated influenza vaccine in children aged 6 months to 15 years between the 2013/14 and 2018/19 seasons. Younger (6–11 months) and older (6–15 years old) children tended to have lower vaccine effectiveness. The purpose of this study is to investigate whether the recent vaccine can be recommended to all age groups.MethodsThe overall adjusted vaccine effectiveness was assessed from the 2013/14 until the 2020/21 season using a test-negative case-control design based on rapid influenza diagnostic test results. Vaccine effectiveness was calculated by influenza type and by age group (6–11 months, 1–2, 3–5, 6–12, and 13–15 years old) with adjustments including influenza seasons.ResultsA total of 29,400 children (9347, 4435, and 15,618 for influenza A and B, and test-negatives, respectively) were enrolled. The overall vaccine effectiveness against influenza A, A(H1N1)pdm09, and B was significant (44% [95% confidence interval (CI), 41–47], 63% [95 %CI, 51–72], and 37% [95 %CI, 32–42], respectively). The vaccine was significantly effective against influenza A and B, except among children 6 to 11 months against influenza B. The age group with the highest vaccine effectiveness was 1 to 2 years old with both influenza A and B (60% [95 %CI, 55–65] and 52% [95 %CI, 41–61], respectively). Analysis for the 2020/21 season was not performed because no cases were reported.ConclusionsThis is the first report showing influenza vaccine effectiveness by age group in children for several seasons, including immediately before the coronavirus disease (COVID-19) era. The fact that significant vaccine effectiveness was observed in nearly every age group and every season shows that the recent vaccine can still be recommended to children for the upcoming influenza seasons, during and after the COVID-19 era.     

中国6~17岁儿童青少年超重肥胖流行特征

目的 分析我国6~17岁儿童青少年超重肥胖流行情况,为制定肥胖防治策略提供科学依据。方法 利用"2010-2012年中国居民营养与健康状况监测"中6~17岁儿童青少年调查资料,分析我国儿童青少年超重肥胖现状。6岁儿童采用WHO 2007年推荐的分年龄性别BMI超重肥胖判定标准判定超重肥胖,7~17岁儿童青少年采用《中国学龄儿童青少年超重和肥胖预防与控制指南》中的分年龄、性别的BMI超重肥胖判定标准进行判定。结果 6~17岁儿童青少年超重率和肥胖率分别为9.6%和6.4%,其中城市儿童青少年超重率和肥胖率分别为11.0%（男生：12.8%,女生：9.0%）和7.7%（男生：9.7%,女生：5.5%）,农村儿童青少年超重率和肥胖率分别为8.4%（男生：9.3%,女生：7.4%）和5.2%（男生：6.2%,女生：4.1%）。按家庭经济收入水平分,高、中和低家庭收入儿童青少年的超重率分别为12.3%、10.7%和8.2%,肥胖率分别为8.6%、7.2%和5.7%。结论 2012年,我国6~17岁儿童青少年超重肥胖表现为城市高于农村,男生高于女生;患病率与家庭经济收入水平有关。     

Sugar-Sweetened Beverage Consumption and Sleep Duration and Quality Among Pregnant Women

ObjectiveTo examine sugar-sweetened beverage (SSB) consumption, sleep duration, and quality during pregnancy.MethodsPregnant women completed 3 24-hour dietary recalls and the Pittsburgh Sleep Quality Index. Logistic regression models estimated odds of short sleep duration (< 7 h/night) and poor sleep quality (Pittsburgh Sleep Quality Index score > 5) by SSB consumption (servings/d averaged across 3 days).ResultsParticipants (n = 108) were a median age of 30 years old (interquartile range [IQR], 26–33) and at 23.9 weeks gestation (IQR, 18.9–30.6). Participants consumed a median of 0.4 servings of SSBs per day on average (IQR, 0–1.1; range, 0–4.6). Fifty-two percent reported poor quality sleep and 38% short sleep. Each additional serving of SSB was associated with higher odds of short sleep (adjusted odds ratio, 1.6; 95% confidence interval, 1.1–2.5) and poor sleep quality (adjusted odds ratio, 2.1; 95% confidence interval, 1.2–3.6).Conclusions and ImplicationsSSB consumption may be a modifiable risk factor for short/poor sleep during pregnancy. Longitudinal research is needed to explore the interplay between SSB consumption and sleep.     

睡眠状况与儿童青少年心理行为问题关联研究

目的 分析儿童青少年睡眠不足、周末睡眠社会时差等睡眠问题与心理行为问题之间的相关性,为预防和改善儿童青少年心理行为问题提供参考依据。方法 2019年4-5月采用立意抽样按照街道—学校类型—学校3个阶段在深圳市宝安区辖区内6个街道选取14所学校,对30 188名1~12年级儿童青少年进行问卷调查。心理行为问题评定采用父母版与学生版困难与长处问卷进行,夜间睡眠时间、周末上床和起床推迟时间、午睡情况等采用自编的《中小学生成长轨迹及健康指数调查问卷》。调整性别、年龄、父母文化程度、学习成绩、学习负担和噪声等混杂因素,采用多因素logistic回归分析睡眠问题与心理行为问题之间的关联强度（OR值）及其95％CI。结果 小学低年级、小学高年级、初中和高中学生睡眠不足分别占90.4％、90.1％、98.2％和98.4％,有19.9％的学生不午睡,19.6％的学生周末推迟起床时间≥2 h,35.1％的学生晚上不固定时间睡觉,15.5％的学生每天不固定时间起床。与夜间睡眠时长8~9 h相比,小学低年级学生夜间睡眠时长≤7 h、7~8 h增加心理行为问题发生风险,睡眠时间>9 h与心理行为问题呈负向关联;小学高年级学生夜间睡眠时长≤7 h增加心理行为问题发生风险;初、高中生夜间睡眠≤6 h者心理行为问题增加,OR值（95％CI）分别为2.53（1.85~3.47）、2.41（1.11~5.25）,而夜间睡眠>9 h者心理行为问题也增加,OR值（95％CI）分别为2.37（1.40~4.01）、5.38（1.79~16.1）。与午睡时间0.5~1 h相比,不午睡及午睡时间<0.5 h都是中小学生出现心理行为问题的危险因素,午睡时间1~2 h还是高中生出现心理行为问题的危险因素。早上不固定时间起床、晚上不固定时间睡觉、周末推迟起床≥2 h是中小学生出现心理行为问题的危险因素。周末夜间推迟入睡≥2 h,小学低年级和高年级、初中、高中学生出现心理行为问题的OR值（95％CI）分别为2.07（1.45~2.97）、1.57（1.09~2.26）、2.66（2.06~3.44）、2.48（1.96~3.15）。结论 儿童青少年夜间睡眠不足、不午睡以及睡觉与起床时间不固定与心理行为问题呈正向关联,但夜间睡眠长也是中学生心理行为问题的危险因素。同时,睡眠的社会时差增加了儿童青少年心理行为问题发生风险,小学低年级学生周末入睡推迟0.5 h即与不良心理行为增加有关联。     

The predicted persistence and kinetics of antibody decline 9 years after pre-school booster vaccination in UK children

BackgroundLong term follow-up of vaccine trials is essential to establish the duration of protection. In the context of worldwide concern about rising pertussis incidence, estimates of antibody persistence after vaccination, which do not account for the rise in antibody due to natural boosting or infection, may overestimate the degree of protection afforded by pertussis vaccines.MethodsThis was a 5 year follow up study of a randomised controlled trial of diphtheria, tetanus, pertussis and polio booster vaccines in UK children aged 3.5–5 years. Antibody persistence was measured at 1 month, 1, 3, and 5 years after vaccination and the kinetics of antibody decline were modelled longitudinally. Estimates of predicted antibody persistence 9 years after the pre-school booster were derived from model parameters.ResultsAntibody levels 9 years after vaccination were predicted to be above accepted thresholds for protection for diphtheria, tetanus and polio. Antibody responses to pertussis toxoid were undetectable in 49% of children at the 5 year follow up visit, and responses were predicted to be undetectable in 69% (95% CI 45–88%) of children by the time of their teenage booster at 13–14 years of age.ConclusionsThere is no defined correlate of protection for pertussis. However, the large proportion of participants in this study with undetectable pertussis antibody levels at both measured and predicted timepoints suggests sub-optimal immunity in adolescence. Adding pertussis to the teenage booster for UK children as is done in other countries, would enhance immunity in adolescence.     

Change in adiposity is associated with change in glycoprotein acetyls but not hsCRP in adolescents with severe obesity

BackgroundObesity-associated chronic inflammation mediates the development of adverse cardiometabolic outcomes. There are sparse data on associations between severe obesity and inflammatory biomarkers in adolescence; most are cross-sectional and limited to acute phase reactants. Here, we investigate associations between adiposity measures and inflammatory biomarkers in children and adolescents with severe obesity both cross-sectionally and longitudinally.MethodsFrom the Childhood Overweight Biorepository of Australia (COBRA) study, a total of n = 262 participants, mean age 11.5 years (SD 3.5) with obesity had measures of adiposity (body mass index, BMI; % above the 95th BMI-centile, %>95th BMI-centile; waist circumference, WC; waist/height ratio, WtH; % total body fat, %BF; % truncal body fat, %TF) and inflammation biomarkers (glycoprotein acetyls, GlycA; high-sensitivity C-Reactive Protein, hsCRP; white blood cell count, WBC; and neutrophil/lymphocyte ratio, NLR) assessed at baseline. Ninety-eight individuals at mean age of 15.9 years (3.7) participated in a follow-up study 5.6 (2.1) years later. Sixty-two individuals had longitudinal data. Linear regression models, adjusted for age and sex for cross-sectional analyses were applied. To estimate longitudinal associations between change in adiposity measures with inflammation biomarkers, models were adjusted for baseline measures of adiposity and inflammation.ResultsAll adiposity measures were cross-sectionally associated with GlycA, hsCRP and WBC at both time points. Change in BMI, %>95th BMI-centile, WC, WtH and %TF were associated with concomitant change in GlycA and WBC, but not in hsCRP and NLR.ConclusionGlycA and WBC but not hsCRP and NLR may be useful in assessing adiposity-related severity of chronic inflammation over time.