Breast-feeding history and overweight in 11 to 13-year-old children in Iran

Background  The relationship between breast-feeding history and risk of overweight in pre-adolescent children was investigated. Methods  Children’s breast-feeding history and demographics were obtained in interviewer-administered questionnaires of a multistage cluster sample survey of 800 parents of children aged 11–13 years living in Yazd, Iran. Height and weight were measured in the children. Overweight was defined as body mass index ≥90th age- and sex-specific percentile of the 2000 Centers for Disease Control reference values. Results  One hundred and four (13.0%) of 800 children were overweight. A total of 783 (97.9%) of the children had been breast fed. There was a markedly lower overweight prevalence among breast-fed than non breast-fed children. Controlling for age and sex, children breast fed for at least 24 months were substantially less likely to be overweight than children breast fed for less than 12 months (OR 0.56, 95% CI 0.31–0.9). A longer overall duration and duration of exclusive breast-feeding were associated significantly with the decreasing prevalence of overweight. Conclusion  This sample of Iranian children shows high rates of overweight at young ages but also high rates of breast-feeding. The duration of breast-feeding is inversely related with the prevalence of overweight in pre-adolescent children.     

Breast-feeding and overweight in Singapore school children

Background:  Studies from developed Western countries have shown inconsistent associations between breast-feeding and overweight/obesity in children and adolescents. Few data are available from Asian populations. The purpose of the present study was therefore to evaluate the association between breast-feeding and overweight/obesity in a study of 10–12-year-old children in Singapore.
Methods:  A total of 797 school children (49% girls, 76% Chinese) who participated in the Singapore Cohort Study of the Risk Factors for Myopia (SCORM) were examined. Overweight/obesity ( n  = 179) was defined as age–sex-specific body mass index (BMI) cut-offs corresponding to BMI of 25 kg/m² for overweight and 30 kg/m² for obesity at age 18 based on the International Obesity Task Force (IOTF) reference.
Results:  The prevalence of overweight/obesity was 22.5%. Overall, breast-feeding was not found to be associated with overweight/obesity. After adjusting for potential confounders, the multivariable odds ratio (95% confidence interval) of overweight/obesity was 1.14 (0.80–1.63) for ever breast-fed compared with never breast-fed, 1.00 (0.57–1.72) for breast-fed for >3 months compared to ≤3 months and 0.79 (0.47–1.34) for exclusive/mostly breast-fed compared to partly breast-fed.
Conclusions:  No significant associations were detected among breast-feeding, its type, and duration with overweight/obesity in this Asian cohort of 10–12-year-old children.     

Television exposure and overweight risk in preschoolers

OBJECTIVE: To test the independent effect of television exposure in preschool-aged children on overweight risk. DESIGN: Cross-sectional and longitudinal analysis of the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development. SETTING: Ten US sites. PARTICIPANTS: One thousand sixteen children selected via conditional random sampling. MAIN EXPOSURE: Being awake in the room with the television on for 2 hours or more per day, by maternal report at age 36 months. MAIN OUTCOME MEASURES: Child overweight (body mass index [calculated as weight in kilograms divided by the square of height in meters] > or =95th percentile) calculated from measured anthropometrics at ages 36 and 54 months. Covariates tested included child sex and race; maternal marital status, education, age, and depressive symptoms; income-needs ratio, child behavior problems; Home Observation for Measurement of the Environment total score; hours per week in nonparental care; and proportion of television exposure that was educational. RESULTS: At age 36 months, 5.8% of children were overweight; at age 54 months, 10.0% were overweight. Exposure to 2 or more hours of television per day was associated with an increased risk of overweight at both age 36 months (odds ratio, 2.92; 95% confidence interval, 1.36-6.24) and age 54 months (odds ratio, 1.71; 95% confidence interval, 1.03-2.83) in unadjusted analyses. Only maternal age altered the concurrent relationship, and the effect of television remained significant (odds ratio, 2.61; 95% confidence interval, 1.21-5.62). Television exposure at age 36 months was no longer a significant predictor of overweight at age 54 months when controlling for covariates. CONCLUSION: Excessive television exposure is a risk factor for overweight in preschoolers independent of a number of potential confounders associated with the quality of the home environment.     

Predicting abdominal adipose tissue in overweight Latino youth.

OBJECTIVES: 1) Examine associations between visceral adipose tissue (VAT), subcutaneous abdominal adipose tissue (SAAT), and anthropometric and demographic variables; 2) generate and cross-validate prediction equations for estimating VAT and SAAT in overweight Latino children. STUDY DESIGN: Cross-sectional. PARTICIPANTS: 196 overweight 8-13-year-old Latino youth. Two-thirds (n = 131) were randomly assigned to a development group to generate prediction equations for VAT and SAAT; one-third (n = 65) was used as a cross-validation group. METHODS AND PROCEDURES: Anthropometric measurements (height, weight, skinfold thicknesses, and circumferences) were performed. VAT and SAAT were measured using magnetic resonance imaging (MRI). RESULTS: The strongest univariate correlate for VAT was waist circumference (WC) (r = 0.65, p < 0.01) while the strongest correlate for SAAT was hip circumference (r = 0.88, p < 0.001). Regression analyses showed approximately 50% of the variance in VAT was explained by WC (43.8%), Tanner stage (4.2%) and calf skinfold (1.7%). Variance in the SAAT model was explained by WC (77.8%), triceps skinfold (4.2%) and gender (2.3%). Residual analyses showed no bias in either equation. Though mean differences between measured and predicted VAT and SAAT were small, there was a large degree of variability at the individual level especially for VAT. CONCLUSIONS: Both VAT and SAAT prediction equations performed well at the group level, but the relatively high degree of variability suggests limited clinical utility of the VAT equation. MRI is currently required to derive an accurate measure of VAT at the individual level.     

Risk profiles for overweight/obesity among preschoolers

Background

The epidemic of overweight/obesity among U.S. children has led to an alarming increase in health-related consequences, including early-onset diabetes and cardiovascular disease. Recent research has identified the independent contribution of several maternal and child factors to the development of childhood overweight/obesity. Few studies, however, have examined risk profiles of childhood obesity.

Aim

This study used classification and regression tree (CART) analysis to examine the combined effect of maternal and child factors in generating risk profiles for overweight/obesity among preschoolers.

Study design

Data from the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B) study were used. The sample was comprised of preschool children. CART and logistic regression models were built and compared.

Results

Children who were overweight/obese at two years of age had an increased risk of being overweight/obese at four years of age. Children born to overweight/obese mothers were more likely to be overweight/obese by age four, even if their BMI at two years of age was normal. Children with high birth weight (≥ 4000 g.) were also more likely to be overweight/obese at age four years if they were born to mothers with a normal pregravid BMI, but were of a lower socioeconomic status. Among preschoolers whose mothers were black or white and who had a high pregravid BMI, breastfeeding duration and parity played an important role in determining their risk of being overweight/obese.

Conclusions

Classification tree analysis confirms and extends current knowledge of preschool overweight/obesity by providing preliminary risk profiles that are structured within the context of prenatal and postnatal maternal and child characteristics.     

Social influences on self-reported physical activity in overweight Latino children

Psychosocial variables influence physical activity for different age groups, sex, and ethnic groups. However, little is known about their influence on physical activity in preadolescent Latino children. The authors examined how a) confidence in one's ability to be physically active (self-efficacy); b) ideas about the consequences of being physically active (beliefs), and c) the influences of family and friends on physical activity (social influences) effect physical activity levels in overweight (body mass index >or=85%) Latino preadolescent children. One hundred and fourteen preadolescents participated in a larger intervention designed to improve healthy lifestyles for Latino families. The authors report baseline data collected at a community-based primary care clinic. Multivariate regression analyses showed that only social influences significantly predicted (P < .01) the metabolic equivalent adjusted self-reported baseline physical activity. Prevention and intervention strategies that augment social influences on physical activity are likely to result in more physical activity and improved health in these children.     

Insulin-like growth factor-I is inversely related to adiposity in overweight Latino children

The purpose of this study was to examine interrelationships between IGF-I, IGF binding proteins (IGFBPs) and adiposity in 178 overweight Hispanic adolescents (11.2 +/- 1.7 yr; body mass index: 28.2 +/- 5.4 kg/m2). Immunoradiometric assays were used to measure IGF-I, IGFBP-1 and IGFBP-3. Total fat and lean tissue mass were measured by DEXA and visceral and subcutaneous adipose tissue by MRI. IGF-I and IGFBP-3 remained inversely correlated with total body fat mass (r = -0.52, p < 0.001 and r = -0.25, p < 0.01, respectively) after controlling for covariates. IGFBP-1 was inversely correlated to total fat mass (r = -0.55, p < 0.001) in simple correlations; however, this relationship was eliminated after controlling for covariates (r = 0.02, p = 0.85). Correlations with visceral and subcutaneous adipose tissue yielded similar results. These results demonstrate that IGF-I, IGFBP-1 and IGFBP-3 are all inversely related to adiposity in Hispanic children.     

Breast-feeding. The roots

Although breast milk provides the best nutrition for the infant, breast-feeding has been decreasing with the growth in use of prepared milk formulas. This paper evaluates the available biblical literature dealing with breast-feeding. The research is unique in character, as it combines contemporary medical knowledge with presentation of cases taken from ancient history. We include no commentaries, but refer only to the words of the Bible exactly as written. Biblical texts relating to breast-feeding were examined and the cases of biblical characters who were breast-fed were studied. The great historical figures such as Isaac, Rebecca, Moses, Samuel, and Joash were breast-fed, openly or secretly. If the biological mother was unable to nurse her child, a wet nurse took over the feeding. Breast-feeding was the only way infants could survive at that time. Weaning day was very important and was celebrated. The wet nurse played an important role in family life, in some cases remaining to live with the infant after weaning, through childhood and even into adulthood. In spite of advanced technology that provides artificial infant formulas, contemporary mothers, just like biblical mothers, should be encouraged to breast-feed their infants.     

Breast-feeding and urinary tract infection.

A case-control study was conducted to study the association between breast-feeding and urinary tract infection. Case patients were 128 infants aged birth to 6 months with urinary tract infection. Control infants were 128 infants admitted to the same ward with an acute illness. The results support the hypothesis that breast-feeding protects infants against urinary tract infection.     

Family history and parental recognition of overweight in Croatian children

The aim of this study was to evaluate the perception of parents on the weight status of their offspring, particularly in relation to a family history of obesity and obesity-related illnesses. A cross-sectional study of 1,068 child-parent dyads sampled at school entry health examination was conducted (median age of the child 6.75 years, range 5.7-8.3 years, 50.3 % males). The parental perception of the weight status of their child was compared to the body mass index (BMI, kilogram per square meter), calculated from measured weight and height. Weight status (underweight, normal, overweight, and obese) was defined using the United States Centers for Disease Control and Prevention BMI for age reference charts. Backward multiple linear regression analysis was used to determine possible predictors of parental misclassification of overweight/obese children. Among this cohort of children, 12 % were overweight, 10.2 % obese, and 8.1 % were underweight. Only 24.8 % of obese children and 2.2 % of overweight children were considered "overweight" by their parents. A positive family history was not significantly associated with parental recognition of overweight. Parental misperception of overweight/obese children as being normal was related to the child BMI z-score (odds ratio (OR) 0.036; 0.012-0.111) and diabetes in family history (OR 3.187; 1.207-8.413). CONCLUSION: The majority of parents did not perceive their overweight/obese children as overweight. As having an obese family member or one who has suffered from an obesity-related illness does not increase the parental ability to recognize overweight in their children, strategies to increase public awareness about the importance of one's family medical history are needed.     

Breast-feeding: First thoughts.

Factors responsible for negative attitudes toward breast-feeding are discussed. These factors do not relate to the relative properties of bottle or breast milk, but to anxieties and conflicts women experience in relation to their breasts and sexuality. A review of factual data in the literature that can be brought to bear in the clinical management of these anxieties is presented. The impact of physician attitudes and physician intervention on breast-feeding trends is discussed.     

Breast-feeding and environmental tobacco smoke exposure.

BACKGROUND: Exposure to environmental tobacco smoke is associated with adverse effects in infants and children. OBJECTIVE: To explore whether an increase in urinary cotinine fumarate level is caused by ingested nicotine and cotinine in breast-feeding infants. METHODS: We studied newborns at risk for developing asthma and allergies based on a strong family history. We measured urinary cotinine levels in the infants as a measure of environmental tobacco smoke exposure and cotinine levels in the breast milk of breast-feeding mothers. RESULTS: Of 507 infants, urinary cotinine levels during the first 2 weeks of life were significantly increased in infants whose mothers smoked. Breast-fed infants had higher cotinine levels than non-breast-fed infants, but this was statistically significant (P<.05) only if mothers smoked. Urinary cotinine levels were 5 times higher in breast-fed infants whose mothers smoked than in those whose mothers smoked but did not breast-feed. CONCLUSIONS: Mothers should be encouraged to not smoke, and parents must be advised of the potential respiratory and systemic risks of environmental tobacco smoke exposure to their child, including the potential for future addiction to smoking.