Aim
Obesity at the start of pregnancy has been rising worldwide, increasing the risk of maternal complications. We reviewed the independent effects of maternal obesity during pregnancy on neonatal ...adverse outcomes and the risk of childhood obesity and adverse cardio‐metabolic profiles.
Methods
We searched MEDLINE for papers published in English between December 2007 and November 2017, focusing primarily on human studies published in the last five years. However, we also chose to highlight examples derived from model animals that could bring mechanistic insight and preventive and therapeutic avenues.
Results
Our review showed that maternal obesity had independent effects on neonatal adverse outcomes such as macrosomia, perinatal mortality and birth defects. Maternal obesity alone increased the risks for adverse neonatal outcomes, including macrosomia, perinatal mortality, induced preterm birth and birth defects. In association with excess gestational weight gain, mainly early in pregnancy, increased the risks of childhood obesity, higher fat mass and, to a smaller extent, adverse cardio‐metabolic profiles. Animal models highlighted sexually dimorphic responses to maternal obesity.
Conclusion
Maternal obesity induced serious adverse neonatal effects and was associated with childhood obesity in their offspring. The peri‐conceptional period is critical for metabolic programming, and obese women need close monitoring from conception.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
This paper describes how eight London nurseries examined whether better use of bicycles would strengthen children's physical activity as a step to reducing child obesity. The nurseries are part of a ...social enterprise which offers one-third of the 4200 nursery places to children from poor and disadvantaged families/communities where rates of child obesity are high and increasing. The research was instigated because the nurseries built a partnership with Bikeworks which provided free bikes and staff wanted to ensure they were using them effectively to benefit children. Parents were involved but also asked a specific question about interest in a bike lending scheme. The paper concluded that staff became more observant of how they could enhance their practice using bikes to support children's physical and sociolinguistic development. It heightened the importance of observation of the children but also in identifying barriers such as poor cycling surface and state of bike repairs. Parents considered bikes to be a key part of their children's nursery life especially extending physical skills but were divided evenly about the value of introducing a bike lending scheme.
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BFBNIB, NUK, PILJ, SAZU, UL, UM, UPUK
This paper explores mothers' experiences of masculinity in the context of child obesity in Mexico. The paper draws on face to face interviews with 10 medical staff working at the child obesity clinic ...at Federico Gómez Children's Hospital in Mexico City and on interviews with 16 mothers and 1 grandmother of children diagnosed with obesity and morbid obesity. Through an analysis of medical discourses and practices the paper identifies a tendency to underestimate the extent to which fathers are involved in shaping the family diet and other health related practices. The paper argues that mothers' experiences of masculinity reflect ways of resisting the increased blame placed on them. Through their voices, mothers expose silenced family dynamics of food and other health-related habits and patterns. The invisibility of fathers in medical and academic discourse works to feed mother blaming and misleads medical practices and policies designed to address child obesity in Mexico.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Evolving animal studies and limited epidemiological data show that prenatal air pollution exposure is associated with childhood obesity. Timing of exposure and child sex may play an important role in ...these associations. We applied an innovative method to examine sex-specific sensitive prenatal windows of exposure to PM2.5 on anthropometric measures in preschool-aged children.
Analyses included 239 children born ≥ 37 weeks gestation in an ethnically-mixed lower-income urban birth cohort. Prenatal daily PM2.5 exposure was estimated using a validated satellite-based spatio-temporal model. Body mass index z-score (BMI-z), fat mass, % body fat, subscapular and triceps skinfold thickness, waist and hip circumferences and waist-to-hip ratio (WHR) were assessed at age 4.0 ± 0.7 years. Using Bayesian distributed lag interaction models (BDLIMs), we examined sex differences in sensitive windows of weekly averaged PM2.5 levels on these measures, adjusting for child age, maternal age, education, race/ethnicity, and pre-pregnancy BMI.
Mothers were primarily Hispanic (55%) or Black (26%), had ≤ 12 years of education (66%) and never smoked (80%). Increased PM2.5 exposure 8–17 and 15–22 weeks gestation was significantly associated with increased BMI z-scores and fat mass in boys, but not in girls. Higher PM2.5 exposure 10–29 weeks gestation was significantly associated with increased WHR in girls, but not in boys. Prenatal PM2.5 was not significantly associated with other measures of body composition. Estimated cumulative effects across pregnancy, accounting for sensitive windows and within-window effects, were 0.21 (95%CI = 0.01–0.37) for BMI-z and 0.36 (95%CI = 0.12–0.68) for fat mass (kg) in boys, and 0.02 (95%CI = 0.01–0.03) for WHR in girls, all per µg/m3 increase in PM2.5.
Increased prenatal PM2.5 exposure was more strongly associated with indices of increased whole body size in boys and with an indicator of body shape in girls. Methods to better characterize vulnerable windows may provide insight into underlying mechanisms contributing to sex-specific associations.
•Data-driven method to identify sensitive windows of prenatal PM2.5 on anthropometry.•Findings suggested time-dependent associations and effect modification by sex.•Sex-specific temporal associations may provide insights into underlying mechanisms.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
The relationships between parenting behaviors and child obesity or obesogenic eating behaviors (i.e., overeating unhealthy food) have been studied through the use of different parenting constructs; ...in particular, specific food parenting practices have been extensively investigated, but there is currently a need for a more comprehensive and integrative theoretical framework to guide future investigations. The present article argues for the use of Self-determination theory as a valuable framework to conceptually organize food parenting practices relevant to children's obesogenic eating behaviors. The three parenting dimensions of positive parental involvement, autonomy support and provision of structure - highlighted by Self-determination theory as closely linked to the process of internalization of healthy behaviors and values by the child - will be adopted as a framework to categorize food parenting practices into three types of practices: relatedness-enhancing, competence-enhancing and autonomy-enhancing.
Poverty-related disparities appear early in life in cognitive, language, and social-emotional development, and in growth, especially obesity, and have long-term consequences across the life course. ...It is essential to develop effective strategies to promote healthy behaviors in pregnancy and the early years of parenthood that can mitigate disparities. Primary preventive interventions within the pediatric primary care setting offer universal access, high engagement, and population-level impact at low cost. While many families in poverty or with low income would benefit from preventive services related to both development and growth, most successful interventions have tended to focus on only one of these domains. In this manuscript, we suggest that it may be possible to address both development and growth simultaneously and effectively. In particular, current theoretical models suggest alignment in mechanisms by which poverty can create barriers to parent-child early relational health (i.e., parenting practices, creating structure, and parent-child relationship quality), constituting a final common pathway for both domains. Based on these models and related empirical data, we propose a strength-based, whole child approach to target common antecedents through positive parenting and prevent disparities in both development and growth; we believe this approach has the potential to transform policy and practice. Achieving these goals will require new payment systems that make scaling of primary prevention in health care feasible, research funding to assess efficacy/effectiveness and inform implementation, and collaboration among early childhood stakeholders, including clinicians across specialties, scientists across academic disciplines, and policy makers.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, VSZLJ, ZAGLJ, ZRSKP
This report aims to evaluate the acceptability, appropriateness, feasibility, and adoption of a healthy lunchbox program (SWAP IT), from the parent perspective.
SWAP IT is an mobile health (m-Health) ...program aimed to support parents in swapping out discretionary foods for healthier alternatives. Following receipt of the program, parents completed validated scales assessing the Acceptability (AIM), Intervention Appropriateness (IAM), and Feasibility (FIM) via a computer-assisted telephone interview (CATI). Parents were asked about their awareness of strategies in SWAP IT and whether the program supported them to make lunchbox swaps from discretionary to everyday foods.
Of the 679 parents who consented, 413 completed the CATI (61% response rate). Parent’s mean AIM score (out of a total score of 5) was 4.22 (SD 0.48); FIM score was 4.27 (SD 0.54); and IAM score was 4.24 (SD 0.54). Most parents reported receiving the lunchbox messages (54%), with 45% reporting opening all 10 messages and 64% of parents reporting the program helped swap out discretionary foods.
The m-Health lunchbox program, SWAP IT, is highly acceptable, easy to adopt, appropriate, and feasible to parents.
Not only is SWAP IT effective, but favourable implementation factors highlight the potential scalability of the program in improving child nutrition.
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BFBNIB, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Early child weight gain predicts adolescent and adult obesity, underscoring the need to determine early risk factors affecting weight status and how risk factors might be mitigated. Socioeconomic ...status, food insecurity, caregiver depressive symptomology, single parenthood, and dysfunctional parenting each have been linked to early childhood weight status. However, the associations between these risk factors and children's weight status may be moderated by caregiver feeding styles (CFS). Examining modifiable factors buffering risk could provide key information to guide early obesity intervention efforts.
This analysis used baseline data from the Growing Healthy project that recruited caregivers/child dyads (N = 626) from Michigan Head Start programs. Caregivers were primarily non-Hispanic white (62%) and African American (30%). After using latent class analysis to identify classes of familial psychosocial risk, CFS was tested as a moderator of the association between familial psychosocial risk class and child body mass index (BMI) z-score.
Latent class analysis identified three familial psychosocial risk classes: (1) poor, food insecure and depressed families; (2) poor, single parent families; and (3) low risk families. Interactive effects for uninvolved feeding styles and risk group indicated that children in poor, food insecure, and depressed families had higher BMI z-scores compared to children in the low risk group. Authoritative feeding styles in low risk and poor, food insecure, and depressed families showed lower child BMI z-scores relative to poor, single parent families with authoritative feeding styles.
Uninvolved feeding styles intensified the risk and an authoritative feeding style muted the risk conferred by living in a poor, food-insecure, and depressed family. Interventions that promote responsive feeding practices could help decrease the associations of familial psychosocial risks with early child weight outcomes.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
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