Weight Gain in Infancy and Vascular Risk Factors in Later Childhood

Michael R. Skilton, PhD^a,^b, 

Guy B. Marks, PhD^c, 

Julian G. Ayer, PhD^b,

Frances L. Garden, MBiostat^b,^c,^d, 

Sarah P. Garnett, PhD^b,^e,^f,

Jason A. Harmer, MBBS^b, 

Stephen R. Leeder, PhD^b,^d,^g, 

Brett G. Toelle, PhD^c, 

Karen Webb, PhD^h, 

Louise A. Baur, PhD^b,^d,^e, and

David S. Celermajer, PhD^b

PEDIATRICS Vol. 131 No. 6 June 1, 2013 pp. e1821 -e1828

(doi: 10.1542/peds.2012-2789)

1. ^aBoden Institute of Obesity, Nutrition, Exercise, and Eating Disorders,
2. ^bSydney Medical School;
3. ^dSydney School of Public Health;
4. ^eThe Children's Hospital at Westmead Clinical School; and
5. ^gMenzies Centre for Health Policy, University of Sydney, Sydney, Australia;
6. ^cWoolcock Institute of Medical Research, Glebe, Australia;
7. ^fInstitute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, Australia; and
8. ^hAtkins Center for Weight and Health, Department of Nutritional Sciences and Toxicology and School of Public Health, University of California, Berkeley, California

ABSTRACT

OBJECTIVE: We hypothesized that early weight gain would be associated with incident obesity, higher blood pressure, systemic inflammation, and arterial wall thickening in later childhood.

METHODS: A longitudinal birth cohort was recruited antenatally from 2 maternity hospitals in Sydney, Australia, between September 1997 and December 1999. Three hundred ninety-five nondiabetic children who were followed to age 8 years had complete data for early weight gain and arterial wall thickness.

RESULTS: Independent predictors of excess early weight gain (age 0–18 months; adjusted for height gain) included male gender (0.411 kg [SE: 0.103],P < .001), fewer weeks’ gestation (−0.121 kg [SE: 0.044] per week, P = .006), birth length (0.156 kg [SE: 0.024] per cm, P < .001), and failure to breastfeed to 6 months of age (0.498 kg [SE: 0.108], P < .001). Early height-adjusted weight gain was significantly associated with later childhood overweight (odds ratio [OR]: 1.67 [95% confidence interval (CI): 1.26 to 2.20] per kg) and obesity (OR: 2.07 [95% CI: 1.53 to 2.79] per kg), excess central adiposity (OR: 1.54 [95% CI: 1.20 to 1.98] per kg), higher systolic blood pressure (1.24 mm Hg [SE: 0.33] per kg, P < .001), higher C-reactive protein (0.17 mg/dL [SE: 0.06] per 100% increase in weight gain, P = .006), and greater carotid intima-media thickness (0.012 mm [SE: 0.004] per kg, P = .002).

CONCLUSIONS: Early postnatal weight gain from birth to age 18 months is significantly associated with later childhood overweight and obesity, excess central adiposity, and greater arterial wall thickness.

The variability of reported salt levels in fast foods across six countries: opportunities for salt reduction.

CMAJ. 2012 Jun 12;184(9):1023-8. Epub 2012 Apr 16.
Dunford E, Webster J, Woodward M, Czernichow S, Yuan WL, Jenner K, Ni Mhurchu C, Jacobson M, Campbell N, Neal B.

Abstract

BACKGROUND:

Several fast food companies have made commitments to reduce the levels of salt in the foods they serve, but technical issues are often cited as a barrier to achieving substantial reductions. Our objective was to examine the reported salt levels for products offered by leading multinational fast food chains.

METHODS:

Data on salt content for products served by six fast food chains operating in Australia, Canada, France, New Zealand, the United Kingdom and the United States were collected by survey in April 2010. Mean salt contents (and their ranges) were calculated and compared within and between countries and companies.

RESULTS:

We saw substantial variation in the mean salt content for different categories of products. For example, the salads we included in our survey contained 0.5 g of salt per 100 g, whereas the chicken products we included contained 1.6 g. We also saw variability between countries: chicken products from the UK contained 1.1 g of salt per 100 g, whereas chicken products from the US contained 1.8 g. Furthermore, the mean salt content of food categories varied between companies and between the same products in different countries (e.g., McDonald's Chicken McNuggets contain 0.6 g of salt per 100 g in the UK, but 1.6 g of salt per 100 g in the US).

INTERPRETATION:

The salt content of fast foods varies substantially, not only by type of food, but by company and country in which the food is produced. Although the reasons for this variation are not clear, the marked differences in salt content of very similar products suggest that technical reasons are not a primary explanation. In the right regulatory environment, it is likely that fast food companies could substantially reduce the salt in their products, translating to large gains for population health.

PMID:

 

22508978

 

[PubMed - indexed for MEDLINE] 

PMCID:

 

PMC3381762

 

Free PMC Article

Association between different growth curve definitions of overweight and obesity and cardiometabolic risk in children

CMAJ. 2012 Jul 10;184(10):E539-50. Epub 2012 Apr 30.
Kakinami L, Henderson M, Delvin EE, Levy E, O'Loughlin J, Lambert M, Paradis G.

Abstract

BACKGROUND:

Overweight and obesity in young people are assessed by comparing body mass index (BMI) with a reference population. However, two widely used reference standards, the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) growth curves, have different definitions of overweight and obesity, thus affecting estimates of prevalence. We compared the associations between overweight and obesity as defined by each of these curves and the presence of cardiometabolic risk factors.

METHODS:

We obtained data from a population-representative study involving 2466 boys and girls aged 9, 13 and 16 years in Quebec, Canada. We calculated BMI percentiles using the CDC and WHO growth curves and compared their abilities to detect unfavourable levels of fasting lipids, glucose and insulin, and systolic and diastolic blood pressure using receiver operating characteristic curves, sensitivity, specificity and kappa coefficients.

RESULTS:

The z scores for BMI using the WHO growth curves were higher than those using the CDC growth curves (0.35-0.43 v. 0.12-0.28, p < 0.001 for all comparisons). The WHO and CDC growth curves generated virtually identical receiver operating characteristic curves for individual or combined cardiometabolic risk factors. The definitions of overweight and obesity had low sensitivities but adequate specificities for cardiometabolic risk. Obesity as defined by the WHO or CDC growth curves discriminated cardiometabolic risk similarly, but overweight as defined by the WHO curves had marginally higher sensitivities (by 0.6%-8.6%) and lower specificities (by 2.6%-4.2%) than the CDC curves.

INTERPRETATION:

The WHO growth curves show no significant discriminatory advantage over the CDC growth curves in detecting cardiometabolic abnormalities in children aged 9-16 years.

PMID:

 

22546882

 

[PubMed - in process] 

PMCID:

 

PMC3394848

 

Free PMC Article