To evaluate the association of sleep habits with the weight status of children aged 4–6 years.
Data were obtained from the PREDI Study, a Brazilian birth cohort study. The current study was carried ...out in the homes of the participants during two follow-ups: 2016/17 and 2018. The participants were submitted to anthropometric assessment and demographic, socioeconomic and sleep data were obtained. The child's sleep habits were self-reported by the mother or caregiver on the day of the visit and included information on the following sleep habits during the past week: bedtime routine, rhythmicity, and separation affect determined with the Sleep Habits Inventory for Preschool Children and the Sleep Habits Inventory. Logistic regression and gamma-log regression analyses were used to examine the association of sleep habits with excess body weight of children in the two follow-ups according to sex.
Of the 217 and 185 children included in 2016/17 and 2018, respectively, 66 (30.6%) and 48 (25.9%) had a BMI >85th percentile at 4–6 years, respectively. The median rhythmicity score was higher in children with excess body weight (p = 0.05). Adjusted analysis showed that rhythmicity was associated with excess body weight of girls at ages 4–5 years (OR = 1.42, 95% CI: 1.09–1.86, p = 0.009) and 6 years (OR = 1.32, 95% CI: 1.06–1.65, p = 0.015), even after adjustment for other important covariates. Additionally, the sleep habit “separation affect” was inversely associated with the child's BMI in boys (β = −0.005, 95% CI: −0.010–0.000, p = 0.037).
In the present study, rhythmicity problems were associated with increased odds of girls aged 4–6 years having excess body weight. These results are important from a public health perspective since strategies aimed at preventing excess body weight in children need to consider the child's sleep quality as a potential risk factor, especially rhythmicity.
•Children with altered sleep habits are more likely to have excess body weight in the early years of school.•Changes in rhythmicity in children were associated with excess body weight.•The higher the rhythmicity scores, the greater the child's BMI, especially in girls.•The higher the separation affect scores, the lower the child's BMI in boys.
To examine the association between breast-feeding duration and the risk of excess body weight (children >85th percentile, mothers BMI≥25·0 kg/m2) concurrently in mother-child pairs two years after ...delivery.
Prospective cohort study in Joinville, Brazil. Multivariable logistic regression was used to examine the independent relationship between breast-feeding duration and risk of excess body weight.
Brazilian public maternity hospital.
Three hundred and five mother-child pairs.
At 2-year follow-up, 23·6 % of mother-child pairs had excess body weight. Children breast-fed for <2 months were more likely to have excess body weight than children breast-fed for ≥6 months (OR=2·4; 95 % CI 1·1, 5·1). Breast-feeding for <2 months was also associated with a greater likelihood of maternal excess body weight compared with those who breast-fed for ≥6 months (OR=2·9; 95 % CI 1·1, 8·1). There was a progressive increase in the likelihood of mother-child pairs having excess body weight as breast-feeding duration decreased. In addition to breast-feeding duration, other independent determinants of excess body weight were pre-pregnancy weight, gestational weight gain and number of pregnancies in mothers, and birth weight in children.
Breast-feeding for a longer duration has a parallel protective effect on the risk of excess body weight in mother-child pairs two years after birth. Since members of the same family could be influenced by the same risk factors, continued promotion and support of breast-feeding may help to attenuate the rising prevalence of overweight in mother-child pairs.
To describe the main predictors for excess birth weight in Brazilian children.
Systematic review carried out in the bibliographic databases: PubMed/MEDLINE, Cochrane, Scopus, Web of Science, and ...LILACS. The research in the gray literature was performed using the Google Scholar database. The bias risk analysis was adapted from the Downs and Black scale, used to evaluate the methodology of the included studies.
Using the classifications of fetal macrosomia (>4.000g or ≥4.000g) and large for gestational age (above the 90th percentile), 64 risk factors for excess birth weight were found in 33 scientific articles in the five regions of the country. Of the 64 risk factors, 31 were significantly associated with excess birth weight, with excess gestational weight gain, pre-gestational body mass index ≥25kg/m2, and gestational diabetes mellitus being the most prevalent.
The main predictors for excess birth weight in Brazil are modifiable risk factors. The implementation of adequate nutritional status in the gestational period and even after childbirth appears to be due to the quality and frequency of the follow-up of the mothers and their children by public health agencies.
Descrever os principais preditores para o excesso de peso ao nascer em crianças brasileiras.
Revisão sistemática realizada nos bancos de dados bibliográficos: PubMed/MEDLINE, Cochrane, Scopus, Web of Science e LILACS. A pesquisa na literatura cinzenta foi realizada na base de dados Google Acadêmico. A análise do risco de viés foi adaptada da escala de Downs and Black, utilizada para avaliar a metodologia dos estudos incluídos.
Utilizando-se as classificações macrossomia fetal (>4.000g ou ≥4.000g) e grande para idade gestacional acima do percentil 90, foram encontrados 64 fatores de risco para excesso de peso ao nascer em 33 artigos científicos nas cinco regiões do país. Dos 64 fatores de risco, 31 foram significativamente associados a excesso de peso ao nascer, sendo ganho de peso gestacional excessivo, índice de massa corporal pré-gestacional ≥25kg/m2 e diabetes mellitus gestacional os mais prevalentes.
Os principais preditores para o excesso de peso ao nascer no Brasil são fatores de risco modificáveis. O estabelecimento de um estado nutricional adequado no período gestacional e mesmo após o parto parece ser a qualidade e a frequência do acompanhamento dos órgãos de saúde junto às mães e seus filhos.
To identify which anthropometric measurement would be the best predictor of metabolic syndrome (MetS) in Brazilian adolescents.
Cross-sectional study conducted on 222 adolescents (15-17 years) from a ...city in southern Brazil. Anthropometric, physical activity, blood pressure and biochemical parameters were investigated. MetS criteria were transformed into a continuous variable (MetS score). Linear regression analyses were performed to assess the associations of BMI, hip circumference, neck circumference (NC), triceps skinfold, subscapular skinfold and body fat percentage with MetS score. ROC curves were constructed to determine the cutoff for each anthropometric measurement.
The prevalence of MetS was 7.2%. Each anthropometric measurement was significantly (p < 0.001) associated with MetS score. After adjusting for potential confounding variables (age, sex, physical activity, and maternal education), the standardized coefficients of NC and body fat percentage appeared to have the strongest association (beta = 0.69 standard deviation) with MetS score. The regression of BMI provided the best model fit (adjusted R2 = 0.31). BMI predicted MetS with high sensitivity (100.0%) and specificity (86.4%).
Our results suggest that BMI and NC are effective screening tools for MetS in adolescents. The early diagnosis of MetS combined with targeted lifestyle interventions in adolescence may help reduce the burden of cardiovascular diseases and diabetes in adulthood.
This study aimed to analyze the effect of type of breastfeeding on the nutritional status of children between 12-24 months of age. This cohort study included 435 children born in 2012 in a public ...hospital in Joinville, Santa Catarina State, Brazil. Two years after delivery the mothers and their children were contacted in their homes for a new investigation of demographic, economic, nutritional, and anthropometric data. In the unadjusted analysis, children who were not exclusively breastfed were more likely to be overweight (including obesity) at 2 years of age (OR = 1.6; p = 0.049) than exclusively breastfed children. After adjusting for several covariates, children who were not exclusively breastfed had a 12% higher risk of overweight including obesity compared to unadjusted analysis (OR = 2.6 vs. OR = 1.8; p = 0.043). In addition, birthweight was also an independent determinant of overweight including obesity (OR = 2.5; p = 0.002). The practice of exclusive breastfeeding can reduce the risk of overweight in children from developing countries such as Brazil.
To describe the main predictors for excess birth weight in Brazilian children.
Systematic review carried out in the bibliographic databases: PubMed/Medline, Cochrane, Scopus, Web of Science, and ...LILACS. The research in the gray literature was performed using the Google Scholar database. The bias risk analysis was adapted from the Downs and Black scale, used to evaluate the methodology of the included studies.
Using the classifications of fetal macrosomia (>4.000g or ≥4.000g) and large for gestational age (above the 90th percentile), 64 risk factors for excess birth weight were found in 33 scientific articles in the five regions of the country. Of the 64 risk factors, 31 were significantly associated with excess birth weight, with excess gestational weight gain, pre‐gestational body mass index ≥25kg/m2, and gestational diabetes mellitus being the most prevalent.
The main predictors for excess birth weight in Brazil are modifiable risk factors. The implementation of adequate nutritional status in the gestational period and even after childbirth appears to be due to the quality and frequency of the follow‐up of the mothers and their children by public health agencies.
Descrever os principais preditores para o excesso de peso ao nascer em crianças brasileiras.
Revisão sistemática feita nos bancos de dados bibliográficos: PubMed/Medline, Cochrane, Scopus, Web of Science e Lilacs. A pesquisa na literatura cinzenta foi feita na base de dados Google Acadêmico. A análise do risco de viés foi adaptada da escala de Downs e Black, usada para avaliar a metodologia dos estudos incluídos.
Com o uso das classificações macrossomia fetal (> 4.000g ou ≥ 4.000g) e grande para idade gestacional acima do percentil 90, foram encontrados 64 fatores de risco para excesso de peso ao nascer em 33 artigos científicos nas cinco regiões do país. Dos 64 fatores de risco, 31 foram significativamente associados a excesso de peso ao nascer, os mais prevalentes foram ganho de peso gestacional excessivo, índice de massa corporal pré‐gestacional ≥25kg/m2 e diabetes mellitus gestacional.
Os principais preditores para o excesso de peso ao nascer no Brasil são fatores de risco modificáveis. O estabelecimento de um estado nutricional adequado no período gestacional e mesmo após o parto parece ser a qualidade e a frequência do acompanhamento dos órgãos de saúde junto às mães e seus filhos.
Objectives:to analyze the accuracy of neck circumference (NC) as a measure for assessing excess body weight in children aged 13-24 months of life, according to gender.Methods:this is a ...cross-sectional study comparing the neck circumferences in relation to body mass index (BMI) and other anthropometric measures. The best cut-off point for identifying excess body weight was determined using the Receiver Operating Characteristics curve (ROC curve), according to gender and age groups 13-15 months, 16-19 months and 20-24 months.Results:NC waspositively correlated (p<0.001) with body weight and BMI in both genders, and length in girls (p<0.001). Positive correlations were found between NC and BMI in the three age groups (13-15, 16-19 and 20-24 months) in both boys and girls. The NC cut-off points for boys were 23.6, 23.9 and 24.0 cm, and 23.4, 23.5 and 23.6 cm for girls, for the 1315, 16-19 and 20-24 age groups respectively.Conclusions:NC can be used to screen for excess body weight in children aged 13-24 months. However, further studies with a larger sample will be required in order to complement these results.
Pooled data analysis in the field of maternal and child nutrition rarely incorporates data from low- and middle-income countries and existing studies lack a description of the methods used to ...harmonize the data and to assess heterogeneity. We describe the creation of the Brazilian Maternal and Child Nutrition Consortium dataset, from multiple pooled longitudinal studies, having gestational weight gain (GWG) as an example. Investigators of the eligible studies published from 1990 to 2018 were invited to participate. We conducted consistency analysis, identified outliers, and assessed heterogeneity for GWG. Outliers identification considered the longitudinal nature of the data. Heterogeneity was performed adjusting multilevel models. We identified 68 studies and invited 59 for this initiative. Data from 29 studies were received, 21 were retained for analysis, resulting in a final sample of 17,344 women with 72,616 weight measurements. Fewer than 1% of all weight measurements were flagged as outliers. Women with pre-pregnancy obesity had lower values for GWG throughout pregnancy. GWG, birth length and weight were similar across the studies and remarkably similar to a Brazilian nationwide study. Pooled data analyses can increase the potential of addressing important questions regarding maternal and child health, especially in countries where research investment is limited.
Excess body weight leads to a variety of metabolic changes and increases the risk for cardiovascular diseases (CVD) in adulthood. The objective of this study was to investigate the presence of risk ...markers for CVD among Brazilian adolescents of normal weight and with excess body weight. The markers included blood pressure, C-reactive protein, homocysteine, tumor necrosis factor alpha, fibrinogen, fasting insulin and glucose, homeostasis model assessment of insulin resistance (HOMA-IR), leptin, total cholesterol, low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), and triglycerides. We calculated odds ratios (OR) using logistic regression and adjusted for potential confounders such as age, sex, physical activity, and socioeconomic background. Compared with normal weight subjects, overweight/obese adolescents were more likely to have higher systolic blood pressure (OR = 3.49, p < 0.001), fasting insulin (OR = 8.03, p < 0.001), HOMA-IR (OR = 8.03, p < 0.001), leptin (OR = 5.55, p < 0.001), and LDL-c (OR = 5.50, p < 0.001) and lower serum HDL-c concentrations (OR = 2.76, p = 0.004). After adjustment for confounders, the estimates did not change substantially, except for leptin for which the risk associated with overweight increased to 11.09 (95% CI: 4.05–30.35). In conclusion, excess body weight in adolescents exhibits strong associations with several markers that are established as causes of CVD in adults. This observation stresses the importance of primary prevention and of maintaining a healthy body weight throughout adolescence to reduce the global burden of CVD.
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