Maternal prompts to eat, child compliance, and mother and child weight status

OBJECTIVE: To determine if there is a relationship between maternal prompting to eat, child compliance, and mother and child weight. STUDY DESIGN: Seventy-one 3- to 6-year-old children and their mothers were videotaped tasting four foods (two familiar, two novel). Maternal prompts to eat and the child's compliance with the prompts were coded. Multiple logistic regression evaluated demographic, anthropometric, and food characteristics that predicted prompting and compliance; and demographic, behavioral, and food characteristics that predicted child body mass index Z score (BMIz) in the children of obese and non-obese mothers. RESULTS: Obese mothers did not prompt more than non-obese mothers, but children of obese mothers were more compliant (70.2% +/- 19.4 v 59.6% +/- 21.2, P = .04). Low maternal education, a novel food, and younger child age predicted prompting. Maternal obesity, a familiar food, and older child age predicted compliance. In children of obese mothers, low maternal education, more prompts to eat novel foods, fewer prompts to eat familiar foods, and fewer child bites of familiar foods predicted child BMIz (R(2) = 64%). In children of non-obese mothers, none of the covariates predicted child BMIz. CONCLUSIONS: Children of obese mothers may be more responsive to environmental cues to eat.     

Smoking and metabolic control in adolescents with type 1 diabetes

OBJECTIVE: To relate self-reported smoking frequency to metabolic control and other cardiovascular risk factors in adolescents with type 1 diabetes. STUDY DESIGN: In the multicenter Diabetes Patienten Verlaufsdokumentationssystem database from Germany and Austria, anonymized records on 27 561 patients < 20 years of age with documented smoking status were available for analysis. RESULTS: Self-reported smoking was negligible in patients younger than 11 years (0.1%), increasing to 5% in 11- to 15-year-old patients, and 28.4% in the 15- to 20-year-old age group. Multivariate analysis with adjustment for age, diabetes duration, sex, insulin therapy, and center differences, revealed that smokers had higher HbA1c-levels compared with non-smokers (9.1% vs 8.0%, P < .0001). Diastolic blood pressure was higher (68.2 vs 67.6 mm Hg, P < .0001), and the lipid profile was unfavorable in patients who smoke: Triglycerides and total cholesterol were higher and high-density lipoprotein-cholesterol was lower (all P < .0001). CONCLUSIONS: Smokers display significantly worse metabolic control and a higher cardiovascular risk profile. Although not attested in trials, we state that education about smoking, smoking prevention, and psychological help for smoking cessation should be an integral part of comprehensive pediatric care for adolescent patients with type 1 diabetes.     

Ex-premature infant boys with hypospadias are similar in size to age-matched, ex-premature infant boys without hypospadias

Objective

Studies have postulated that hypospadias, prematurity, and low birth weight are linked by defects in androgen signaling. To determine whether premature, hypospadiac boys are small and remain so, we compared their size at birth and at hypospadias repair to premature boys who underwent post-neonatal circumcision.

Methods

We identified premature boys admitted to Texas Children’s Hospital who underwent either hypospadias repair or circumcision after 4 months of age. Age, weight, and height at birth and surgery were recorded.

Results

Fifty-four boys had hypospadias and 34 did not. For hypospadiac boys, the mean birth weight and age, height, and weight at surgery were lower than for boys without hypospadias. More importantly, length-for-age and weight-for-age percentiles were also lower for hypospadiac boys. When subset analysis was performed on boys younger than 2 years at surgery, however, there were no significant differences in height or weight between hypospadiac and non-hypospadiac boys.

Conclusion

Our series suggests that premature, hypospadiac boys are born smaller than age-matched, non-hypospadiac controls. However, there were no age-corrected size differences between hypospadiac and non-hypospadiac boys at surgery. This implies that hypospadiac boys exhibit post-neonatal ‘rebound’ growth. Global growth deficits, if any, do not persist in hypospadiac boys.     

Cross-sectional and longitudinal associations between TV viewing and girls' body mass index, overweight status, and percentage of body fat

OBJECTIVE: To assess cross-sectional and longitudinal relations between television (TV) viewing and girls' body mass index (BMI), weight status, and percentage of body fat. STUDY DESIGN: Participants included 169 girls who were measured at ages 7, 9, and 11 years. Height and weight were measured and used to calculate girls' BMI and to classify their weight status. Girls' percentage of body fat was assessed with the use of dual-energy x-ray absorptiometry. Mothers reported the hours per day that girls watched TV on a typical day. RESULTS: No significant cross-sectional associations were identified. Results from longitudinal analyses showed that in comparison to girls who never exceeded the American Academy of Pediatrics TV viewing recommendations (ie, watched 相似文献   

Growth hormone deficiency, low levels of adiponectin, and unfavorable plasma lipid and lipoproteins

OBJECTIVE: To examine the impact of adolescent growth hormone deficiency (GHD) on circulating adiponectin levels and the relation between adiponectin, fasting insulin, plasma lipid, and lipoprotein levels. STUDY DESIGN: Twelve children with GHD on GH treatment with a chronological age (CA) of 14.4 +/- 2.0 years and 12 untreated adolescents with GHD with a CA of 14.9 +/- 2.3 years were studied. Adiponectin concentrations were measured in all patients, and the association of adiponectin with fasting insulin, total, LDL, and HDL cholesterol, triglycerides, apolipoprotein A-1, and apolipoprotein B was evaluated. Twelve healthy adolescents served as control subjects. RESULTS: Adiponectin levels were significantly lower in untreated GHD adolescents than in treated GHD subjects or in control subjects (P < .008). Total and LDL cholesterol, triglycerides, and Apo B concentrations were increased in untreated GHD adolescents, whereas HDL cholesterol levels were similar in all three groups. Insulin levels were significantly increased in treated GHD adolescents when compared with control subjects (P < .05) but similar to those with untreated GHD. Adiponectin was found to be negatively associated with body mass index, waist-to-hip ratio, and with Apo B, total cholesterol, triglycerides, and LDL cholesterol concentrations in untreated GHD adolescents, whereas a positive correlation between adiponectin and HDL cholesterol was noted in both untreated and treated GHD subjects. Adiponectin correlated inversely with fasting insulin levels in untreated and treated GHD adolescents. CONCLUSIONS: GHD in adolescence is associated with low levels of adiponectin and with an unfavorable plasma lipid and lipoprotein profile. Our data suggest that treatment with GH may improve the abnormalities seen.