Studies in high-income countries show that despite the positive association of weight with socioeconomic position at birth, an inverse socioeconomic gradient in overweight (OW) appears later in ...childhood. The objectives were to understand the natural history of socioeconomic inequalities in weight, height and body mass index (BMI), by investigating their associations with maternal educational level between birth and 5 years, separately in boys and girls.
A published work of growth modelling between birth and 5 years allowed us to calculate predicted weight, height and BMI at 1 month, 6 months, 1, 3 and 5 years for 1735 children from the French EDEN mother-child cohort. Associations between maternal education and predicted measures of body size were analysed with marginal linear and logistic models, stratified by sex.
In girls, despite a positive association between maternal education and birthweight, an inverse socioeconomic gradient was observed as early as 1 month for BMI. Girls whose mothers had low education levels were shorter on the whole than their counterparts with better-educated mothers, despite their similar weights. In boys, no socioeconomic gradient in BMI was observed at any age, including birth, but positive associations were found as early as 1 month for both weight and height.
The emergence of an inverse socioeconomic gradient in BMI and OW apparently results from a complex pattern of socioeconomic inequalities in weight and height from 1 month onwards. The very start of life thus appears to be an important window of opportunity for addressing socioeconomic inequalities in growth.
Pregnant women and their unborn child are exposed to a large number of substances during pregnancy. Some of these substances may cross the placenta, resulting in exposure of the foetus. There is ...growing evidence that certain substances could interact to produce a mixture effect. It is therefore essential to identify the main mixtures mothers are exposed to.
This study aimed to identify the major mixtures French pregnant women included in EDEN and ELFE cohorts were exposed to, on the basis of the 441 substances analysed in the second French total diet study. Exposure systems and the composition of substances were identified from co-exposures using sparse non-negative matrix under-approximation to generate the main mixtures. Individuals were clustered to define clusters with similar co-exposure profiles.
Six clusters associated with eight mixtures were identified. For example in ELFE, cluster 2 comprising 10% of the population was characterised by mixtures “Pest-1” mainly contains pesticides and ”TE-F-PAH″ contains trace elements, furans and polycyclic aromatic hydrocarbons. Five other clusters were also described with their associated mixtures. Similar results were observed for EDEN.
This study helps to prioritise mixtures for which it is crucial to investigate possible toxicological effects and to recommend epidemiological studies concerning health effects.
•Exposures to 200 substances were assessed for French women before and during their pregnancy.•Co-exposure data was reduced into two matrices using SNMU method: exposure systems and individuals' coefficients.•Eight main mixtures were defined from exposure systems and six of them were common.•Six clusters of mothers with similar pattern of contaminant intake were identified.
To study the relationship between pre-pregnancy body mass index (BMI) and weight gain during pregnancy with pregnancy and birth outcomes, with a focus on gestational diabetes and hypertension and ...their role in the association with fetal growth. We studied 1,884 mothers and offspring from the Eden mother–child cohort. Weight before pregnancy (W1) and weight after delivery (W2) were collected and we calculated BMI and net gestational weight gain (netGWG = (W2 − W1)/(weeks of gestation)). Gestational diabetes, hypertension gestational age and birth weight were collected. We used multivariate linear or logistic models to study the association between BMI, netGWG and pregnancy and birth outcomes, adjusting for center, maternal age and height, parity and average number of cigarettes smoked per day during pregnancy. High BMI was more strongly related to the risk of giving birth to a large-for-gestational-age (LGA) baby than high netGWG (odds ratio OR 95% CI of 3.23 1.86–5.60 and 1.61 0.91–2.85, respectively). However, after excluding mothers with gestational diabetes or hypertension the ORs for LGA, respectively weakened (OR 2.57 1.29–5.13) for obese women and strengthened for high netGWG (OR 2.08 1.14–3.80). Low in comparison to normal netGWG had an OR of 2.18 1.20–3.99 for pre-term birth, which became stronger after accounting for blood pressure and glucose disorders (OR 2.70 1.37–5.34). Higher net gestational weight gain was significantly associated with an increased risk of LGA only after accounting for blood pressure and glucose disorders. High gestational weight gain should not be neglected in regard to risk of LGA in women without apparent risk factors.
Sedentary behavior, physical activity and dietary behavior are formed early during childhood and tend to remain relatively stable into later life. No longitudinal studies have assessed the ...independent influence of these three energy balance-related behaviors during toddlerhood on later adiposity. We aimed to analyze the associations between TV/DVD watching time, outdoor play time and dietary patterns at the age of 2 years and child adiposity at the age of 5 years, in boys and girls separately.
This study included 883 children from the French EDEN mother-child cohort. TV/DVD watching time, outdoor play time and dietary intakes were reported by parents in questionnaires when the child was aged 2 years. Two dietary patterns, labeled 'Guidelines' and 'Processed, fast foods', were identified in a previous study. The percentage of body fat (%BF) based on bioelectrical impedance analysis and body mass index were measured at the age of 5 years.
In boys, TV/DVD watching time at the age of 2 years was positively associated with %BF at the age of 5 years (β=0.50 (95% confidence interval: 0.001, 1.00) for those boys with ⩾60 min per day of TV/DVD watching time vs those with ⩽15 min per day, P-value for trend 0.05). In girls, outdoor play was inversely associated with %BF (β=-0.96 (95% confidence interval: -1.60, -0.32) for those in the highest tertile of outdoor play time vs those in the lowest tertile, P=0.001). Overall, at the age of 2 years, dietary patterns were associated with both TV/DVD watching time and outdoor play time, but no significant and independent association was observed between dietary patterns and later adiposity.
This study shows longitudinal and gender-differentiated relations between both TV/DVD watching time and outdoor play time in toddlerhood and later adiposity, whereas evidence for a relation between dietary patterns and subsequent fat development was less conclusive. Early childhood-by the age of 2 years-should be targeted as a critical time for promoting healthy energy balance-related behaviors.
Early eating patterns and behaviors can determine later eating habits and food preferences and they have been related to the development of childhood overweight and obesity. We aimed to identify ...patterns of feeding in the first year of life and to examine their associations with family characteristics.
Our analysis included 1004 infants from the EDEN mother-child cohort. Feeding practices were assessed through maternal self-report at birth, 4, 8 and 12 months. Principal component analysis was applied to derive patterns from breastfeeding duration, age at complementary food (CF) introduction and type of food used at 1 year. Associations between patterns and family characteristics were analyzed by linear regressions.
The main source of variability in infant feeding was characterized by a pattern labeled 'late CF introduction and use of ready-prepared baby foods'. Older, more educated, primiparous women with high monthly income ranked high on this pattern. The second pattern, labeled 'longer breastfeeding, late CF introduction and use of home-made foods' was the closest to infant feeding guidelines. Mothers ranking high on this pattern were older and more educated. The third pattern, labeled 'use of adults' foods' suggests a less age-specific diet for the infants. Mothers ranking high on this pattern were often younger and multiparous. Recruitment center was related to all patterns.
Not only maternal education level and age, but also parity and region are important contributors to the variability in patterns. Further studies are needed to describe associations between these patterns and infant growth and later food preferences.
Acrylamide is a contaminant formed in a wide variety of carbohydrate-containing foods during frying or baking at high temperatures. Recent studies have suggested reduced foetal growth after exposure ...to high levels of acrylamide during pregnancy.
To study the relationship between maternal dietary acrylamide intake during pregnancy and their offspring’s anthropometry at birth.
In our population of 1471 mother-child pairs from two French cities, Nancy and Poitiers, dietary acrylamide intake during pregnancy was assessed by combining maternal food frequency questionnaires with data on food contamination at the national level, provided by the second “French Total Diet Study”. Newborns weighing less than the 10th percentile, according to a customised definition, were defined as small for gestational age (SGA). Linear and logistic regression models were used to study continuous and binary outcomes respectively, adjusting for the study centre, maternal age at delivery, height, education, parity, smoking during pregnancy, the newborn’s gestational age at birth and sex.
The median and interquartile range of dietary acrylamide intake were 19.2μg/day (IQR, 11.8;30.3). Each 10μg/day increase in acrylamide intake was associated with an odds-ratio for SGA of 1.11 (95% Confidence Interval: 1.03,1.21), birth length change of −0.05cm (95% CI: −0.11,0.00) and birth weight change of −9.8g (95% CI: −21.3,1.7).
Our results, consistent with both experimental and epidemiological studies, add to the evidence of an effect of acrylamide exposure on the risk of SGA and suggest an effect on foetal growth, for both weight and length.
•Acrylamide arises in carbohydrate-containing foods during cooking at high temperatures.•Food frequency questionnaire and Total Diet Study were linked to estimate exposure.•Dietary acrylamide increased the risk of being small for gestational age (SGA).•Results pointed out to a global effect affecting both birth weight and length.•Animal studies and two epidemiological studies have shown consistent results.
Summary
Background
Beyond pre‐pregnancy BMI, maternal weight change before and during pregnancy may also affect offspring adiposity.
Objective
To investigate the relationship between maternal weight ...history before and during pregnancy with children's adiposity at 5–6 years.
Methods
In 1069 mother–child dyads from the EDEN Cohort, we examined by linear regression the associations of children's BMI, fat mass and abdominal adiposity at 5–6 years with maternal pre‐pregnancy BMI, pre‐pregnancy average yearly weight change from age 20 and gestational weight gain. The shapes of relationships were investigated using splines and polynomial functions were tested.
Results
Children's BMI and adiposity parameters were positively associated with maternal pre‐pregnancy BMI, but these relationships were mainly seen in thin mothers, with no substantial variation for maternal BMI ranging from 22 to 35 kg/m2. Gestational weight gain was positively associated with children's BMI Z‐score, but again more so in thin mothers. We found no association with pre‐pregnancy weight change.
Conclusions
Before the adiposity rebound, maternal pre‐pregnancy thinness explains most of the relationship with children's BMI. The relationship may emerge at older ages in children of overweight and obese mothers, and this latency may be an obstacle to early prevention.
Few studies have examined the factors explaining the variability in fat and carbohydrate intake during infancy. We aimed to describe infants' fat and carbohydrate intake and analyse the associations ...with infant and maternal characteristics and feeding practices.
This study included 1275 infants aged 8 months from the French EDEN mother-child cohort. Carbohydrate intake, fat intake, added fat (vegetable oils and animal fats) and added sugar (honey, white sugar, brown sugar, jam and sweetened beverages) consumption were calculated at 8 and 12 months. Associations between these variables and infant and maternal characteristics as well as maternal dietary patterns during pregnancy, breast-feeding duration and age at complementary feeding introduction were analysed using multivariable linear and logistic regressions.
Less than 5% of non-breast-fed infants reached the recommendation of consuming at least 40% of total energy from fat, whereas more than 95% of them reached 45% of energy from carbohydrates. Overall, infant and maternal characteristics and maternal diet during pregnancy were marginally associated with both carbohydrate/added sugar and fat/added fat intake. Nevertheless, age at complementary feeding introduction was associated with all outcomes.
Our results suggest that only a small proportion of non-breast-fed infants at 8 and 12 months reached the recommendations for fat intake, whereas a majority of them reached the recommendations for carbohydrate intake. As subgroups of infants with a higher risk of inadequate diet were not identified, the present results call for an improved dissemination of information regarding infant-specific dietary fat needs in the entire population.
Objective
To estimate the prevalence of flatus‐only and faecal incontinence, to describe their risk factors and to analyse the association between anal incontinence and psychological distress over ...the first year postpartum.
Design
Cohort study from pregnancy to 12 months postpartum.
Setting
Two university hospital maternity wards in France.
Population
A total of 2002 pregnant women were recruited between 2003 and 2006. Data on anal incontinence were available for the 1632 women who comprise the sample for analysis.
Methods
Women were enrolled during pregnancy. A postal questionnaire was sent at 4 and 12 months postpartum.
Main outcome measures
Anal (flatus‐only and faecal) incontinence was assessed at 4 months postpartum. Mental health was assessed at 4 and 12 months postpartum by the Edinburgh Postpartum Depression Scale (EPDS) and use of antidepressant drugs as well as by self‐rated mental health.
Results
At 4 months postpartum, the prevalence for flatus‐only incontinence was 14.4% and for faecal incontinence 1.7%; multivariate analysis, restricted to women reporting no anal incontinence before the index pregnancy, showed that continuing breastfeeding at 4 months was related to a higher risk of de novo postpartum anal incontinence (OR = 2.23). Women who reported anal incontinence at 4 months were more frequently depressed (EPDS ≥10 or antidepressant use) at 12 months postpartum: 36.0% of those with faecal incontinence were depressed, 23.3% of those with flatus‐only incontinence and only 14.8% of the continent women.
Conclusion
Postnatal faecal incontinence was rare but associated with poorer maternal mental health. Postnatal screening should be encouraged, and psychological support offered.
Tweetable
Postnatal faecal incontinence was associated with depression; postnatal screening should be encouraged and psychological support offered.
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Postnatal faecal incontinence was associated with depression; postnatal screening should be encouraged and psychological support offered.
Chronic heart failure (CHF) is characterized by heightened sympathetic nervous activity, carotid chemoreceptor (CC) sensitivity, marked exercise intolerance and an exaggerated ventilatory response to ...exercise. The purpose of this study was to determine the effect of CC inhibition on exercise cardiovascular and ventilatory function, and exercise tolerance in health and CHF.
Twelve clinically stable, optimally treated patients with CHF (mean ejection fraction: 43 ± 2.5%) and 12 age- and sex-matched healthy controls were recruited. Participants completed two time-to-symptom-limitation (TLIM) constant load cycling exercise tests at 75% peak power output with either intravenous saline or low-dose dopamine (2 μg⋅kg
⋅min
; order randomized). Ventilation was measured using expired gas data and operating lung volume data were determined during exercise by inspiratory capacity maneuvers. Cardiac output was estimated using impedance cardiography, and vascular conductance was calculated as cardiac output/mean arterial pressure.
There was no change in TLIM in either group with dopamine (CHF: saline 13.1 ± 2.4 vs. dopamine 13.5 ± 1.6 min,
= 0.78; Control: saline 10.3 ± 1.2 vs. dopamine 11.5 ± 1.3 min,
= 0.16). In CHF patients, dopamine increased cardiac output (
= 0.03), vascular conductance (
= 0.01) and oxygen delivery (
= 0.04) at TLIM, while ventilatory parameters were unaffected (
= 0.76). In controls, dopamine improved vascular conductance at TLIM (
= 0.03), but no other effects were observed.
Our findings suggest that the CC contributes to cardiovascular regulation during full-body exercise in patients with CHF, however, CC inhibition does not improve exercise tolerance.
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