Breastfeeding and risk of overweight and obesity at nine-years of age

Whether breastfeeding is protective against the development of childhood overweight and obesity remains the subject of considerable debate. Although a number of meta-analyses and syntheses of the literature have concluded that the greater preponderance of evidence indicates that breastfeeding reduces the risk of obesity, these findings are by no means conclusive. The present study used data from the Growing Up in Ireland study to examine the relationship between retrospectively recalled breastfeeding data and contemporaneously measured weight status for 7798 children at nine-years of age controlling for a wide range of variables including; socio-demographic factors, the child's own lifestyle-related behaviours, and parental BMI. The results of the multivariable analysis indicated that being breastfed for between 13 and 25 weeks was associated with a 38 percent (p < 0.05) reduction in the risk of obesity at nine-years of age, while being breastfed for 26 weeks or more was associated with a 51 percent (p < 0.01) reduction in the risk of obesity at nine-years of age. Moreover, results pointed towards a dose-response patterning in the data for those breastfed in excess of 4 weeks. Possible mechanisms conveying this health benefit include slower patterns of growth among breastfed children, which it is believed, are largely attributable to differences in the composition of human breast milk compared with synthesised formula. The suggestion that the choice of infant feeding method has important implications for health and development is tantalising as it identifies a modifiable health behaviour that is amenable to intervention in primary health care settings and has the potential to improve the health of the population.     

Social stratification and adolescent overweight in the United States: how income and educational resources matter across families and schools

The current study examines how poverty and education in both the family and school contexts influence adolescent weight. Prior research has produced an incomplete and often counterintuitive picture. We develop a framework to better understand how income and education operate alone and in conjunction with each other across families and schools. We test it by analyzing data from Wave 1 of the U.S.-based National Longitudinal Study of Adolescent Health (N = 16,133 in 132 schools) collected in 1994-1995. Using hierarchical logistic regression models and parallel indicators of family- and school-level poverty and educational resources, we find that at the family-level, parent's education, but not poverty status, is associated with adolescent overweight. At the school-level, the concentration of poverty within a school, but not the average level of parent's education, is associated with adolescent overweight. Further, increases in school poverty diminish the effectiveness of adolescents' own parents' education for protecting against the risks of overweight. The findings make a significant contribution by moving beyond the investigation of a single socioeconomic resource or social context. The findings push us to more fully consider when, where, and why money and education matter independently and jointly across health-related contexts.     

Feeding her children, but risking her health: the intersection of gender, household food insecurity and obesity

This paper investigates one explanation for the consistent observation of a strong, negative correlation in the United States between income and obesity among women, but not men. We argue that a key factor is the gendered expectation that mothers are responsible for feeding their children. When income is limited and households face food shortages, we predict that an enactment of these gendered norms places mothers at greater risk for obesity relative to child-free women and all men. We adopt an indirect approach to study these complex dynamics using data on men and women of childrearing age and who are household heads or partners in the 1999-2003 waves of the Panel Study of Income Dynamics (PSID). We find support for our prediction: Food insecure mothers are more likely than child-free men and women and food insecure fathers to be overweight or obese and to gain more weight over four years. The risks are greater for single mothers relative to mothers in married or cohabiting relationships. Supplemental models demonstrate that this pattern cannot be attributed to post-pregnancy biological changes that predispose mothers to weight gain or an evolutionary bias toward biological children. Further, results are unchanged with the inclusion of physical activity, smoking, drinking, receipt of food stamps, or Women, Infants and Children (WIC) nutritional program participation. Obesity, thus, offers a physical expression of the vulnerabilities that arise from the intersection of gendered childcare expectations and poverty.     

四川省20～69岁人群BMI及体重超重、肥胖流行现状

目的 研究四川省20～69岁人群BMI时间纵向变化,分析体重超重、肥胖流行现状.方法 取2000年和2010年四川省国民体质监测中成年、老年84 838人的BMI指数进行分类统计.结果 2010年BMI的均值在全体、男子、女子上高于2000年均值,差异有统计学意义(P＜ 0.01);2000年和2010年男子BMI均值高于女子均值,差异有统计学意义(P＜0.01).BMI分类统计,男子超重、肥胖比例2010年为33.77％、7.31％,比2000年增长5.24％、2.3％;女子超重、肥胖比例2010年为26.39％、6.82％,比2000年增长0.57％、1.3％.按2010年人口基数推算,样本人群体重超重者达到1 746万人,年增长16万人,肥胖者达到409万人,年增长10万人.结论 四川地区已进入体重超重和肥胖的突增阶段,应采取切实有力的肥胖防治措施.     

Parental perception of overweight and underweight in children and adolescents

Aims: To compare the parental perception of overweight and underweight in their children to objective criteria, based on body mass index (BMI), waist circumference and triceps skinfold thickness, and to explore the effects of potential determinants. Methods: Logistic regression of anthropometric measurements, socio‐demographic characteristics and self‐reported parental height and weight on the parental perception of their child’s weight status in 3770 children aged 2–19. Results: Seventy per cent of overweight/obese children and 40.8% of underweight children were perceived having normal weight by parents. In 2‐ to 5‐year‐old overweight children, 91.2% were considered to have normal weight. For a given BMI, primary school age children, adolescents and girls had a higher probability to be assigned as overweight, whereas adolescents and girls had a lower probability to be assigned as underweight. Overweight parents more readily assigned their children as underweight, but there was no effect of parental educational level or parental underweight. Conclusion: Parental ability to recognize overweight or underweight in their offspring was generally poor. The findings emphasize the need for objective criteria based on physical measurements in the routine follow up of children, as parental ability to recognize weight problems in their children is nonreliable.     

Female overweight is not associated with a higher embryo euploidy rate in first trimester miscarriages karyotyped by hysteroembryoscopy

Overweight women (body mass index ≥ 25 kg/m(2)) present an embryo euploidy rate in first trimester miscarriages similar to normoweight controls after a selective biopsy and karyotyping of embryo and/or chorion samples taken by hysteroembryoscopy.     

肥胖相关肿瘤发生机制和防治研究进展

超重、肥胖是包括心血管疾病、2 型糖尿病和代谢综合征等多种疾病的主要危险因素,并对恶性肿瘤风险和预后产 生负面影响。 肥胖已被证明是一些恶性肿瘤的独立危险因素,包括乳腺癌、子宫内膜癌、卵巢癌、胃癌、结直肠癌、肾癌、食管 腺癌、胰腺导管腺癌和肝癌等。 但关于肥胖促进肿瘤发生的机制知之甚少,目前主要集中在肥胖后的胰岛素抵抗、脂肪因子 失调、性激素失衡、全身炎症、免疫系统变化和肠道菌群失调。 这些机制并不是单独地在起作用,而是以炎症为基础,相互联 系、相互促进肿瘤的发生。 肥胖对恶性肿瘤的发展和死亡率的影响,大部分可以通过饮食结构的调整和增加体育锻炼来预 防。 以抗炎为基础的药物治疗可作为预防的优先策略,减重手术也为肥胖相关恶性肿瘤的预防和治疗提供更多选择。 本文 将综述超重和肥胖促进恶性肿瘤发生、发展的机制,并探讨未来肥胖患者的肿瘤预防和治疗措施。     

How safe is bariatric surgery in patients with class I obesity (body mass index 30–35 kg/m2)?

Background

The safety profile of bariatric surgery in patients with class I obesity, or body mass index ≥30 and <35 kg/m², is a matter of concern among patients and physicians.

新疆牧民超重和肥胖的现况调查

目的　了解新疆牧区以高脂饮食为特征的哈萨克人和蒙古人的体重指数水平。　方法　采用整群抽样的方法进行流行病学调查。　结果　 (1)BMI的平均值男性组为 (2 4.98± 3 .98)kg/m2 ,女性组为 (2 4.87± 4.5 1)kg/m2 ,总人群为 (2 4.91± 4.3 1)kg/m2 。 (2 )调查人群超重和肥胖的患病率为 5 1.66%。　结论　新疆牧区超重和肥胖的患病率处在全国较高的水平     

生育对妇女体质指数和肥胖发生率的影响

目的 本研究利用2002年中国居民营养与健康状况调查数据,分析了不同阶段女性体质指数和肥胖率,以探讨中国成年女性肥胖的预防措施.方法 采用多阶段分层整群随机抽样的方法 ,在全国31个省、自治区、直辖市进行调查.本研究抽取20～30岁育龄女性,分为3组,包括未婚(2474名)、已婚未育(10 816名)和已婚生育(4103名)的女性,共计17 393名.结果城市未婚女性、已婚未育和已婚生育的女性平均体重分别为(53.7±9.0)kg、(57.6±9.4)kg和(54.5±8.5)kg,其中未婚女性、已婚生育女性的平均体重显著高于已婚未育女性(t=12.25,P<0.0001;t=8.32,P<0.0001).城市未婚女性、已婚未育和已婚生育的女性平均体质指数分别为(21.1±3.3)kg/m2、(22.8±3.4)kg/m2和(22.0±2.9)ks/m2,其中已婚未育、已婚生育女性的平均体质指数显著高于未婚女性(t=14.88,P<0.0001;t=5.76,P<0.0001).农村未婚女性、已婚未育和已婚生育的女性平均体重分别为(52.3±7.8)kg、(55.3±8.6)kg和(52.8±8.1)kg,其中未婚女性、已婚生育女性的平均体重显著高于已婚未育女性(t=11.67,P<0.0001;t=14.15,P<0.0001);农村未婚女性、已婚未育和已婚生育的女性平均体质指数分别为(21.2±2.8)kg/m2、(22.5±3.1)kg/m2和(21.8±3.0)kg/m2,其中已婚未育、已婚生育女性的平均体质指数显著高于未婚女性(t=13.80,P<0.0001;t=5.34,P<0.0001);城市未婚女性的低体重率(18.1%)高于已婚未育、已婚生育女性(7.3%和9.1%)(与已婚未育比较χ2=113.69,P<0.0001;与已婚生育比较χ2=29.65,P<0.0001),而已婚未育女性超重肥胖率(32.7%)显著高于未婚女性(14.4%)(χ2=28.257,P<0.0001).农村未婚女性的低体重率(12.36%)显著高于已婚未育女性(6.73%)(χ2=50.040,P<0.0001);而已婚未育女性超重率(22.4%)显著高于未婚女性(12.3%)和已婚生育女性(15.4%)(与未婚比较χ2=69.119,P<0.0001;与已婚生育比较χ2=69.866,P<0.0001);已婚生育女性超重肥胖率随产后时间的延长呈下降趋势.结论 已婚生育女性体重滞留是产生成年女性肥胖的重要原因,然而已婚未育女性的体重变化值得重视.