Estimating overweight risk in childhood from predictors during infancy.

Pediatrics. 2013 Aug;132(2):e414-21. doi: 10.1542/peds.2012-3858.Epub 2013Jul15.

Weng SF, Redsell SA, Nathan D, Swift JA, Yang M, Glazebrook C.

OBJECTIVE: The aim of this study was to develop and validate a risk score
algorithm for childhood overweight based on a prediction model in infants.
METHODS: Analysis was conducted by using the UK Millennium Cohort Study. The
cohort was divided randomly by using 80% of the sample for derivation of the risk
algorithm and 20% of the sample for validation. Stepwise logistic regression
determined a prediction model for childhood overweight at 3 years defined by the 
International Obesity Task Force criteria. Predictive metrics R(2), area under
the receiver operating curve (AUROC), sensitivity, specificity, positive
predictive value (PPV), and negative predictive value (NPV) were calculated.
RESULTS: Seven predictors were found to be significantly associated with
overweight at 3 years in a mutually adjusted predictor model: gender, birth
weight, weight gain, maternal prepregnancy BMI, paternal BMI, maternal smoking in
pregnancy, and breastfeeding status. Risk scores ranged from 0 to 59
corresponding to a predicted risk from 4.1% to 73.8%. The model revealed
moderately good predictive ability in both the derivation cohort (R(2) = 0.92,
AUROC = 0.721, sensitivity = 0.699, specificity = 0.679, PPV = 38%, NPV = 87%)
and validation cohort (R(2) = 0.84, AUROC = 0.755, sensitivity = 0.769,
specificity = 0.665, PPV = 37%, NPV = 89%).
CONCLUSIONS: Using a prediction algorithm to identify at-risk infants could
reduce levels of child overweight and obesity by enabling health professionals to
target prevention more effectively. Further research needs to evaluate the
clinical validity, feasibility, and acceptability of communicating this risk.

Eating Frequency and Overweight and Obesity in Children and Adolescents: A Meta-analysis.

Pediatrics 2013;131:958–967

Panagiota Kaisari, MSc, Mary Yannakoulia, PhD, and Demosthenes B. Panagiotakos, PhD

Department of Nutrition and Dietetics, Harokopio University, Athens, Greece

OBJECTIVES: To determine the effect of eating frequency on body weight status in children and adolescents.

METHODS:In this meta-analysis, original observational studies published to October 2011 were selected through a literature search in the PubMed database. The reference list of the retrieved articles was also used to identify relevant articles; researchers were contacted when needed.

Selected studies were published in English, and they reported on the effect of eating frequency on overweight/obesity in children and adolescents. Pooled effect sizes were calculated using a random effects model.

RESULTS: Ten cross-sectional studies and 1 case-control study (21substudies in total), comprising 18 849 participants (aged 2–19 years),were included in the analysis. Their combined effect revealed that the highest category of eating frequency, as compared with the lowest,was associated with a beneficial effect regarding body weight status in children and adolescents (odds ratio [OR] = 0.78, log OR = –0.24,95% confidence interval [CI] –0.41 to –0.06). The observed beneficial effect remained significant in boys (OR = 0.76, log OR = –0.27, 95% CI–0.47 to –0.06), but not in girls (OR = 0.96, log OR = –0.04, 95% CI –0.40 to 0.32) (P for sex differences = 0.14).

CONCLUSIONS: Higher eating frequency was associated with lower body weight status in children and adolescents, mainly in boys. Clinical trials are warranted to confirm this inverse association, evaluate its clinical applicability, and support a public health recommendation; more studies are also needed to further investigate any sex-related differences, and most importantly, the biological mechanisms.