母亲孕前体质量指数孕期增重与子代学龄前期体成分的关系

  目的  探索孕前体质量指数、孕期增重与子代学龄前期肥胖和体成分的关系,为指导母亲从孕前开始合理控制体重和预防儿童肥胖提供依据。  方法  于2020年9—12月在天津市3所幼儿园招募1 333名学龄前儿童。结构化问卷收集儿童生活方式信息;检测儿童身高、体重、体脂肪组织质量,计算体脂肪百分比(FM%)、脂肪质量指数(FMI)、非脂肪质量指数(FFMI)。获取儿童母亲孕产期医疗记录,将母亲按孕前体重状态和孕期增重分组。采用χ2检验、t检验、线性回归模型及Logistic回归方法分析不同组间儿童肥胖及体成分差异。  结果  纳入研究的学龄前儿童超重及肥胖检出率为12.7%和7.7%。调整母亲分娩年龄及产次,儿童出生孕周、性别及年龄和生活方式后,母亲孕前BMI、孕期增重与子代学龄前期的肥胖及体成分指标的相关性均有统计学意义(P值均 < 0.05)。孕前正常体重母亲孕期增重过多会增加子代高FM%及高FMI的风险(OR值分别为1.81,1.68,P值均 < 0.05);孕前超重肥胖母亲,子代肥胖风险及体成分与母亲孕期增重相关性均无统计学意义。  结论  母亲孕前体重状态、孕期增重与子代学龄前期肥胖及体成分均存在关联。建议母亲孕前及孕产期合理控制体重。     

孕前BMI、妊娠期糖尿病与儿童4岁时肥胖相关指标关联的出生队列研究

目的 探讨孕前BMI、妊娠期糖尿病（GDM）与儿童4岁时肥胖相关指标的关联。方法 基于已经建立的“马鞍山市优生优育队列”,对2013年10月至2015年4月出生的单胎活产儿,随访至4岁。在孕期首次填写问卷调查孕前身高、体重,在24～28周接受75 g口服糖耐量试验进行GDM诊断。在儿童4岁时测量身高、体重、腰围和体成分。组间比较采用χ²检验、方差分析或t检验,采用logistic回归模型与广义线性模型分析孕前超重/肥胖、孕前患有GDM与儿童肥胖相关特征的关系。结果 儿童4岁时超重、肥胖率分别为13.08%、6.03%。控制孕期和儿童人口统计学变量后,孕前母亲超重/肥胖者儿童在4岁时发生肥胖、腰围超标、腰围身高比超标的风险要高,其OR值（95% CI）分别为3.27（2.15～4.98）、2.32（1.72～3.14）和2.29（1.73～3.02）;且与体成分指标（骨骼肌、体脂肪、体脂百分比）相关（P<0.05）。孕期母亲患有GDM者,儿童4岁时肥胖发生风险要比母亲未患有GDM者高1.78倍（OR=1.78,95% CI：1.14～2.79）;但是孕期母亲患有GDM对4岁儿童腰围超标、腰围身高比超标发生风险并无影响,与体成分指标（骨骼肌、体脂肪、体脂百分比）无统计学关联。结论 孕前母亲超重/肥胖、孕期患有GDM是4岁儿童肥胖的独立危险因素,且孕前BMI与儿童体成分的各项指标相关。     

Body Size Perception Among African American Women

ObjectiveTo assess body size perception among African American women using cultural definitions of body size terms.MethodsSixty-nine African American women classified Body Image Scale figures as overweight, obese, and too fat, and independently selected the figure they considered closest to their current body size.ResultsBody size classifications of figures did not vary by participant weight status. Overweight figures were not considered too fat. For 86% of overweight (body mass index [BMI], 25–29.9) women and 40% of obese (BMI > 30) women, the self figure was not defined as overweight, obese, or too fat. Among participants with BMI ≥ 35, 65% did not classify their self figure as obese and 29% did not classify their self figure as overweight.Conclusions and ImplicationsThe difference between cultural (folk) and medical definitions of body size terms may serve as a barrier to effective communication between patients and providers about health effects of excess adiposity.     

Association of Cesarean Delivery with Trajectories of Growth and Body Composition in Preschool Children

This study aimed to examine the association of cesarean delivery with trajectories of growth and body composition in preschool children. This ambidirectional cohort study was conducted between 2017 and 2020 in China. Information on the delivery mode, weight, and length/height of the children measured at routine healthcare visits was obtained from maternal and child health records. For three years while in kindergarten, children’s body mass index (BMI), fat mass index (FMI), fat-free mass index (FFMI), and percentage of body fat (FM%) were repeatedly measured. A BMI z score (zBMI) was calculated and standardized to WHO measures, and overweight and obesity were defined using the WHO reference. After adjustment for maternal age, maternal education, annual family income, prepregnancy BMI, gestational weight gain, gravidity, parity, gestational age, child sex, birthweight, breastfeeding duration, and the parent-reported dietary intake of the children, children born via cesarean delivery (n = 1992) versus those born vaginally (n = 1578) had higher zBMI growth rates beyond 36 months (β: 0.003; 95% CI: 0.001, 0.005 SD units/month) and elevated levels of FMI (β: 0.097; 95% CI: 0.026, 0.168 kg/m²), FM% (β: 0.402; 95% CI: 0.058, 0.745%) and zBMI (β: 0.073; 95% CI: 0.012, 0.133 units), but not FFMI (β: 0.022; 95% CI: −0.022, 0.066 kg/m²). The adjusted OR of overweight and obesity was 1.21 (95% CI: 1.04, 1.40). Cesarean delivery likely elevated zBMI growth rates and increased the risk of overweight and obesity in preschool children, with the elevation of fat mass but not fat-free mass.     

母亲孕前体质指数及孕期增重与学龄前儿童超重肥胖的关系研究

目的 探讨母亲孕前BMI及孕期增重与学龄前儿童超重肥胖的关系。方法 2016年6-11月,以广州市4 303名3~5岁学龄前儿童为研究对象,根据WHO标准和中国成人肥胖标准分别判断儿童和母亲孕前体重状态,参照美国医学研究所孕期增重推荐值判断母亲孕期增重情况。应用多因素二分类非条件logistic回归模型和协方差分析母亲孕前BMI和孕期增重与学龄前儿童超重肥胖的关系。结果 矫正混杂因素后,logistic回归分析显示,母亲孕前超重肥胖的儿童发生超重肥胖的风险是母亲孕前体重正常儿童的1.820倍（OR=1.820,95% CI：1.368~2.422）;与母亲孕期增重适宜的儿童相比,母亲孕期增重过度的儿童超重肥胖发生风险增加（OR=1.296,95% CI：1.007~1.667）。协方差分析结果也显示,母亲孕前体重超重肥胖和母亲孕期增重过度均增加儿童BMI Z值。根据母亲孕前BMI分为3组进行分层分析,结果显示,不同孕期增重组间儿童超重肥胖发生风险差异无统计学意义（P>0.05）。但与母亲孕前BMI适宜且孕期增重适宜组相比,母亲孕前超重肥胖且孕期增重过度组的儿童发生超重肥胖的风险增加（OR=1.574,95% CI：1.029~2.409）。结论 母亲孕前超重和孕期增重过度均增加学龄前儿童超重肥胖的风险,且母亲孕前超重较孕期增重过度对学龄前儿童超重肥胖发生的影响更大。     

A prospective study of maternal prenatal weight and offspring cardiometabolic health in midchildhood

PurposeTo examine the relations of maternal prepregnancy body mass index (ppBMI) and gestational weight gain (GWG) with offspring cardiometabolic health.DesignWe studied 1090 mother–child pairs in Project Viva, a Boston-area prebirth cohort. We measured overall (dual x-ray absorptiometry total fat; body mass index z-score) and central adiposity (dual x-ray absorptiometry trunk fat), and systolic blood pressure in offspring at 6 to 10 years. Fasting bloods (n = 687) were assayed for insulin and glucose (for calculation of homeostatic model assessment of insulin resistance), triglycerides, leptin, adiponectin, high sensitivity C-reactive protein, and interleukin 6. Using multivariable linear regression, we examined differences in offspring outcomes per 1 SD maternal ppBMI and GWG.ResultsAfter adjustment for confounders, each 5 kg/m² higher ppBMI corresponded with 0.92 kg (95% confidence interval, 0.70–1.14) higher total fat, 0.27 BMI z-score (0.21–0.32), and 0.39 kg (0.29–0.49) trunk fat. ppBMI was also positively associated with homeostatic model assessment of insulin resistance, leptin, high sensitivity C-reactive protein, interleukin 6, and systolic blood pressure; and lower adiponectin. Each 5 kg of GWG predicted greater adiposity (0.33 kg [0.11–0.54] total fat; 0.14 kg [0.04–0.23] trunk fat) and higher leptin (6% [0%–13%]) in offspring after accounting for confounders and ppBMI.ConclusionsChildren born to heavier mothers have more overall and central fat and greater cardiometabolic risk. Offspring of women with higher GWG had greater adiposity and higher leptin.     

Does maternal smoking during pregnancy have a direct effect on future offspring obesity? Evidence from a prospective birth cohort study

The authors used a population-based birth cohort of 3,253 children (52% males) born in Brisbane, Australia, between 1981 and 1984 to prospectively examine whether maternal smoking during pregnancy was associated with offspring overweight and obesity. The authors compared mean body mass indexes (weight (kg)/height (m)2) and levels of overweight and obesity at age 14 years among offspring by patterns of maternal smoking (never smoked, smoked before and/or after pregnancy but not during pregnancy, or smoked during pregnancy). Adolescent body mass index and prevalences of overweight and obesity were greater in offspring whose mothers had smoked during pregnancy than in those whose mothers had never smoked. Body mass index and levels of overweight and obesity among adolescent offspring whose mothers stopped smoking during pregnancy but smoked at other times in the child's life were similar to those among offspring whose mothers had never smoked. These results were independent of a range of potentially confounding factors and suggest a direct effect of maternal smoking during pregnancy on adolescent overweight and obesity. They provide yet another incentive for pregnant women to be persuaded not to smoke and for young women to be encouraged to never take up smoking.     

Change in maternal body mass index is associated with offspring body mass index: a 21-year prospective study

Purpose

To examine whether changes in maternal overweight and obesity from pre-pregnancy to two decades postpartum predict the body mass index (BMI) of adult offspring.

Methods

We used a subsample of 1997 mother–offspring pairs from the 7,223 original cohorts of women who gave birth in Brisbane, Australia, between 1981 and 1984. Multiple linear regression and multinomial logistic regression were used to examine the relationship between change in maternal BMI from pre-pregnancy to 21-year postpartum, and offspring BMI at 21-year, adjusting for potential confounding factors.

Results

At 21-year postpartum, 31.15 % mothers were overweight and a further 30.80 % were obese. Mothers gained a mean weight of 16.07 kg over the 21 year. We found that the offspring of mothers who became overweight or remained overweight at 21-year postpartum were at greater risk of being overweight and obese at 21 years. In the adjusted model, offspring of mothers who had normal BMI before pregnancy but became overweight by 21-year postpartum were (odds ratio) 1.72 (95 % CI = 1.20, 2.47) times more likely to be overweight. Compared to offspring of mothers who maintained normal weight over two decades, offspring of mothers who remained persistently overweight were (odds ratio) 5.39 (95 % CI = 3.50, 8.30) times more likely to be obese by age 21 year.

Conclusions

The findings of this study suggest that long-term changes in maternal BMI from pre-pregnancy to 21-year postpartum are independently associated with BMI in their young adult offspring.     

Higher prepregnancy body mass index is a risk factor for developing preeclampsia in Maya-Mestizo women: a cohort study

Aim: Preeclampsia and obesity are two closely related syndromes. The high maternal prepregnancy body mass index (BMI) is a risk factor for present preeclampsia, independently of the ethnic background of the studied population. The aim of this study was to analyse in a prospective cohort study the relation between prepregnancy BMI and development of preeclampsia in Maya-Mestizo women.

Design: This is a prospective cohort study of 642 pregnant women that were included in the first trimester of the pregnancy (gestational age ≤12 weeks at the first antenatal visit) and all of them were of Maya-Mestizo ethnic origin from the state of Yucatán, México. We assessed the potential risk factors for preeclampsia and documented the prepregnancy BMI (kg/m²) that was based on measured height and maternal self-report of prepregnancy weight at the initial visit. Besides, in the antenatal visit we documented if the pregnant women developed preeclampsia.

Results: Of the 642 pregnant Maya-Mestizo women, 49 developed preeclampsia, with an incidence of 7.6% (44.9% had severe and 55% mild). The prepregnancy BMI was higher in women with developed preeclampsia than in those with normal pregnancies. Women with overweight or obesity in comparison with normal weight presented a RR?=?2.82 (95% CI: 1.32–6.03; P?=?0.008) and RR=?4.22 (95% CI: 2.07–8.61; P?=?0.001), respectively.

Conclusions: Our findings expand the previous studies to show that the higher prepregnancy BMI is a strong, independent risk factor for preeclampsia.     

Additive interactions of maternal prepregnancy BMI and breast-feeding on childhood overweight

OBJECTIVE: To examine the interactions of maternal prepregnancy BMI and breast-feeding on the risk of overweight among children 2 to 14 years of age. RESEARCH METHODS AND PROCEDURES: The 1996 National Longitudinal Survey of Youth, Child and Young Adult data in the United States were analyzed (n = 2636). The weighted sample represented 51.3% boys, 78.0% whites, 15.0% blacks, and 7.0% Hispanics. Childhood overweight was defined as BMI >/=95th percentile for age and sex. Maternal prepregnancy obesity was determined as BMI >/=30 kg/m(2). The duration of breast-feeding was measured as the weeks of age from birth when breast-feeding ended. RESULTS: After adjusting for potential confounders, children whose mothers were obese before pregnancy were at a greater risk of becoming overweight [adjusted odds ratio (OR), 4.1; 95% confidence interval (CI), 2.6, 6.4] than children whose mothers had normal BMI (<25 kg/m(2); p < 0.001 for linear trend). Breast-feeding for >/=4 months was associated with a lower risk of childhood overweight (OR, 0.6; 95% CI, 0.4, 1.0; p = 0.06 for linear trend). The additive interaction between maternal prepregnancy obesity and lack of breast-feeding was detected (p < 0.05), such that children whose mothers were obese and who were never breast-fed had the greatest risk of becoming overweight (OR, 6.1; 95% CI, 2.9, 13.1). DISCUSSION: The combination of maternal prepregnancy obesity and lack of breast-feeding may be associated with a greater risk of childhood overweight. Special attention may be needed for children with obese mothers and lack of breast-feeding in developing childhood obesity intervention programs.     

Maternal smoking during pregnancy and childhood growth trajectory: a random effects regression analysis

Background

Although maternal smoking during pregnancy has been reported to have an effect on childhood overweight/obesity, the impact of maternal smoking on the trajectory of the body mass of their offspring is not very clear. Previously, we investigated this effect by using a fixed-effect model. However, this analysis was limited because it rounded and categorized the age of the children. Therefore, we used a random-effects hierarchical linear regression model in the present study.

Methods

The study population comprised children born between 1 April 1991 and 31 March 1999 in Koshu City, Japan and their mothers. Maternal smoking during early pregnancy was the exposure studied. The body mass index (BMI) z-score trajectory of children born to smoking and non-smoking mothers, by gender, was used as the outcome. We modeled BMI trajectory using a 2-level random intercept and slope regression.

Results

The participating mothers delivered 1619 babies during the study period. For male children, there was very strong evidence that the effect of age in months on the increase in BMI z-score was enhanced by maternal smoking during pregnancy (P < 0.0001). In contrast, for female children, there was only weak evidence for an interaction between age in months and maternal smoking during pregnancy (P = 0.054), which suggests that the effect of maternal smoking during pregnancy on the early-life BMI trajectory of offspring differed by gender.

Conclusions

These results may be valuable for exploring the mechanism of fetal programming and might therefore be clinically important.Key words: body mass index, childhood growth, gender, multi-level analysis, pregnancy, smoking     

College athletes with an elevated body mass index often have a high upper arm muscle area, but not elevated triceps and subscapular skinfolds

Body mass index (BMI, calculated as kg/m²) is increased by high amounts of both lean and fat tissue. Therefore, a very muscular individual with low body fat could be classified as overweight by BMI. To evaluate this problem, the relationship between BMI, body fat as indicated by the sum of triceps and subscapular skinfolds, and muscle mass as indicated by upper arm muscle area (UAMA) was studied in 107 male and 106 female National Collegiate Athletic Association Division III athletes. Sex, the sum of triceps and subscapular skinfolds, and UAMA were significantly related to BMI (overall P<.0001, R²=0.617), although the relationship was nonlinear and more complex in females than in males. Thirty-eight athletes had a BMI of 25 or higher, indicating overweight or obesity. Of these, only four had excess body fat, as indicated by a sum of triceps and subscapular skinfolds greater than the 85th percentile, but 27 had high muscle mass, indicated by a UAMA greater than the 85th percentile. In the nonrandom sample of athletes we studied, BMI frequently classified muscular individuals who did not have high skinfold measurements as overweight.     

Do childhood sleeping problems predict obesity in young adulthood? Evidence from a prospective birth cohort study

It has been suggested that sleeping problems are causally associated with obesity in early life, but most studies examining this association have been cross-sectional. The authors used a population-based birth cohort of 2,494 children who were born between 1981 and 1983 in Brisbane, Australia, to examine the prospective association between early-life sleeping problems (at ages 6 months and 2-4 years) and obesity at age 21 years. The authors compared mean body mass indices (BMIs; weight (kg)/height (m)2) and persons in the categories of overweight (BMI 25.0-29.9) and obesity (BMI > or =30) among offspring at age 21 years according to maternally reported childhood sleeping problems. They found that young adult BMI and the prevalence of obesity were greater in offspring who had had sleeping problems at ages 2-4 years than in with those who had not had sleeping problems. These associations were robust to adjustment for a variety of potential confounders, including offspring sex, maternal mental health, and BMI, and several mediators, including adolescent dietary patterns and television-watching. These findings provide some evidence for a long-term impact of childhood sleeping problems on the later development of obesity.     

Growth of children at high risk of obesity during the first 6 y of life: implications for prevention

BACKGROUND: The contribution of familial factors to adiposity in children is poorly understood. OBJECTIVE: The objective was to assess differences in growth in the first 6 y of life in children born to either overweight or lean mothers. DESIGN: The body size and composition of 33 children at high risk and 37 children at low risk of obesity on the basis of the mother's overweight [body mass index (BMI; in kg/m(2)) of 30.2 +/- 4.2 and 19.5 +/- 1.1, respectively] were measured repeatedly from 3 mo to 6 y of age at the Children's Hospital of Philadelphia. RESULTS: At year 2, no significant differences in any measure were observed between the high- and low-risk groups. By year 4, weight, BMI, and lean body mass were greater in the high-risk than in the low-risk children. By year 6, weight was even greater in the high-risk than in the low-risk children (23.4 +/- 6.4 compared with 20.4 +/- 2.1 kg; P < 0.02), and, for the first time, fat mass was greater in the high-risk than in the low-risk children (6.7 +/- 5.7 compared with 3.8 +/- 1.2 kg; P < 0.02). Ten of 33 high-risk children exceeded the 85th percentile of BMI at year 6 compared with 1 of 37 low-risk children (odds ratio = 15.7). Accelerated weight gain was predicted by high-risk group status, greater weight at year 2, and lower family income. CONCLUSION: Anthropometric measures were not significantly different between groups at year 2; weight and lean body mass were greater at years 4 and 6, and fat mass was greater at year 6 in high-risk children.     

Body Mass Index and Birth Defects: Texas, 2005–2008

Texas ranks 12th nationally in the proportion of adult residents who are obese; approximately 67 % of Texans are overweight or obese. Studies indicate that obesity is related to an increased risk for birth defects; however, small sample sizes have limited the scope of birth defects investigated, and only four levels of body mass index (BMI) are typically explored. Using six BMI levels, we evaluated the association between maternal BMI and birth defects in a population-based registry covering ~1.6 million births. Texas birth defect cases were linked to 2005–2008 vital records. Maternal BMI was calculated using self-reported prepregnancy weight and height from the vital record and categorized as follows: underweight (BMI <18.5), normal weight (BMI 18.5–24.9), overweight (BMI 25–29.9), class I obese (BMI 30–34.9), class II obese (BMI 35–39.9) and class III obese (BMI ≥40). Prevalence ratios for specific birth defects for maternal BMI categories were estimated by using normal weight as the referent, adjusted for maternal age and race/ethnicity, and stratified by maternal diabetes status. Risk for certain birth defects increased with increasing BMI (i.e., atrial and ventricular septal defects, pulmonary valve atresia, patent ductus arteriosus, and clubfoot). Risk for birth defects was substantially increased among some obese mothers (BMI ≥30) (e.g., spina bifida, tetralogy of Fallot, cleft lip with or without cleft palate, hypospadias, and epispadias). Conversely, mothers with higher BMI had a lower risk for having an infant or fetus with gastroschisis (aPR = 0.35; 95 % CI = 0.12, 0.80). Given the increased risk for birth defects associated with obesity, preconception counseling should emphasize the importance of maintaining normal weight.     

Joint Effect of Obesity and Teenage Pregnancy on the Risk of Preeclampsia: A Population-Based Study

PurposeTo determine the joint effect of young maternal age and obesity status on the risk of preeclampsia and eclampsia among a large cohort of singleton pregnancies.MethodsData were obtained from birth cohort files recorded in the state of Florida during the years 2004–2007. The study sample consisted of mothers aged 13–24 (n = 290,807), divided into four obesity categories on the basis of prepregnancy body mass index (BMI): nonobese (BMI < 30), Class I obese (30.0 ≤ BMI ≥ 34.9), Class II obese (35.0 ≤ BMI ≥ 39.9), and extreme obesity (BMI ≥ 40). Nonobese mothers (BMI < 30) between the ages of 20 and 24 years were the reference group. Logistic regression models were generated to adjust for the association between preeclampsia, obesity, and maternal age with sociodemographic variables and pregnancy complications as covariates.ResultsThe overall prevalence of preeclampsia in the study population was 5.0%. The risk of preeclampsia and eclampsia increased significantly with increasing BMI and decreasing age. Extremely obese teenagers were almost four times as likely to develop preeclampsia and eclampsia compared with nonobese women aged 20–24 years (adjusted odds ratio [95% confidence interval] = 3.79 [3.15–4.55]). Whereas obesity elevated the risk for preeclampsia and eclampsia among all women in the study, teenagers were most at risk because of the combined effects of young age and obesity.ConclusionEffective obesity prevention strategies should continue to be advocated for all teenagers, in addition to innovative approaches to teenage pregnancy prevention.     

Mode of delivery and adiposity: Hong Kong's “Children of 1997” birth cohort

PurposeTo examine whether mode of delivery was associated with childhood adiposity in a developed non-Western context.MethodsWe used generalized estimating equations to estimate the association of mode of delivery (vaginal or cesarean) with body mass index (BMI) z-score and overweight (including obesity) from 3 months to 13 years, in 7809 term birth (94% follow-up) from a population-representative Chinese birth cohort, “Children of 1997.” We used multiple imputation for missing data.ResultsThe cesarean section rate (26%) was higher for children born in private hospitals, with lower gestational age, lower birth order, higher maternal age, higher maternal BMI, and higher family socioeconomic position. Cesarean section was not associated with BMI z-score from 3 months to 13 years (mean difference, 0.03; 95% confidence interval, ?0.02 to 0.09) or overweight from 3 years to 13 years (odds ratio, 0.98; 95% confidence interval, 0.77 to 1.25) after adjusting for infant and maternal characteristics and family socioeconomic position.ConclusionsIn a non-Western developed setting, mode of delivery was not clearly associated with BMI or overweight (including obesity) into late childhood. From a public health perspective, the role of mode of delivery and its mechanistic pathway in the current burgeoning epidemic of obesity needs to be clarified.     

Vascular structure and function in women: relationship with body mass index

BACKGROUND: The purpose of the present study was to compare endothelial function in lean (body mass index [BMI]=18.0-24.9 kg/m2); overweight (BMI=25-29.9 kg/m2); and obese (BMI>30 kg/m2), healthy, eumenorrheic women. METHODS: Eighteen lean, 22 overweight, and 19 obese eumenorrheic middle-aged women were studied. Vascular structure and function were assessed via non-invasive ultrasound imaging of the carotid and brachial arteries. Body composition, blood pressure, fasting blood lipids, glucose, and insulin also were measured. RESULTS: The groups demonstrated significantly (p<0.001) different mean values for total body, lean body, and fat masses. The obese group demonstrated significantly (p<0.05) elevated fasting glucose and insulin levels and lower high-density lipoprotein levels as compared to the lean group. The overweight group also demonstrated elevated fasting glucose levels as compared to the lean group (p<0.05) with no significant difference from the obese group. Only systolic blood pressure differed among the three groups, being elevated in the obese group compared to the lean group (p<0.05). The obese group demonstrated significantly (p<0.05) elevated carotid artery lumen diameter, carotid artery wall cross-sectional area, and brachial artery lumen diameter with significantly (p<0.05) lower flow-mediated dilation as compared to the lean group. The overweight group demonstrated elevated carotid artery wall cross-sectional area and brachial artery lumen diameter as well as lower flow-mediated dilation as compared to the lean group (p<0.05). CONCLUSIONS: The results of this study support the hypothesis that carotid artery wall cross-sectional area is elevated and flow-mediated dilation reduced in overweight and obese eumennorheic women as compared to lean counterparts in relation to BMI classification.     

Does Early School Entry Prevent Obesity Among Adolescent Girls?

PurposeTo examine the relationship between early school entry and body weight status among adolescent girls.MethodsUsing nationally representative data from the 1997 cohort of the National Longitudinal Survey of Youth, we exploited state-specific first-grade entrance policy as a quasi-experimental research design to examine the effect of early school entry on the body weight status of adolescent girls. Fixed-effects models were used to compare the body mass index (BMI), BMI z-score, and likelihood of overweight and obesity between teenage girls born before school cut-off dates and those born after, while controlling for age, race/ethnicity, maternal education status, and maternal body weight status.ResultsLate starters had higher BMIs and a higher prevalence of overweight and obesity and the results were found to be consistent across age groups. Among girls whose birthdays were within 1 month of the cut-off dates, the coefficient of late starting was significantly positive (β = .311; p = .02), indicating that it might be correlated with weight gain in adolescence.ConclusionsEarly admission to a school environment might have a long-term protective effect in terms of adolescent girls' propensity to obesity. Future studies are needed to examine the effect of early school entry on the eating behavior and physical activities of adolescent girls.