Abstract
Background
Obesity epidemic is one of the most serious public health challenges of the twenty-first century. Alcohol has been studied as a possible risk factor for obesity, but the evidence ...is discordant. This study examined the association between alcohol consumption and obesity in a sample of the Irish adult population.
Method
An analytical cross-sectional study was conducted using secondary data from the 2017 Healthy Ireland Survey. The primary survey recruited patients using a two-stage probability-based technique and a face-to-face-administered questionnaire to collect data. Descriptive and comparative data were analysed to identify associations between alcohol-related variables with waist circumference (WC) and body mass index (BMI). Regression analysis was performed to examine the associations between harmful alcohol consumption (AUDIT-C score ≥ 5) (exposure variable) and obesity indicators (WC and BMI), the primary outcomes of interest. Adjustments were made for sociodemographic, health-related, and other alcohol-related variables.
Results
Total of 6864 participants, aged 25 and older, took part in this survey (response rate = 60.4%). Most of the participants (81.9%) were alcohol drinkers, with the majority drinking less than three times per week (76.3%); 47.7% were considered harmful drinkers (AUDIT-C score ≥ 5). After controlling for possible confounders, positive associations of harmful alcohol consumption with WC (β = 1.72, 95% CI: 0.25, 3.19) and BMI (OR = 1.47, 95% CI: 1.10, 1.96) were observed. Binge drinking was positively associated with WC (β = 1.71, 95% CI: 0.50, 2.91), while alcohol consumption frequency was significantly and inversely associated with BMI (OR = 0.59, 95% CI: 0.44, 0.78).
Conclusion
Harmful alcohol consumption was associated with obesity (high BMI, large WC) after controlling for possible confounders. Frequent binge drinkers were more likely to have a large WC, while frequent alcohol consumers were less likely to have obesity. Further longitudinal studies to examine the exact association between alcohol consumption and obesity are warranted.
To review research on the influence of parent-related factors on children's dairy products consumption.
A search of electronic databases and a narrative synthesis of the literature were conducted. ...English-language articles were included if they reported data relating to parental influences on children's consumption of dairy products and if statistical significance was reported.
Studies were carried out in the USA (
8) and in a range of countries across Europe (
12) and Asia (
5).
The subjects of this research were children aged between 2 and 12 years of age, from a range of geographical locations.
Twenty-five studies met the inclusion criteria. The studies examined children's dairy products consumption in relation to parental socio-economic status (education level and income) (
12), home availability (
2), home food environment (
3), parental dairy products consumption (
4), parent feeding practices (
3), parents' beliefs and attitudes (
3) and parental nutrition knowledge (
3). Results on the association between socio-economic status and children's dairy products consumption varied; however, studies reporting a significant association generally observed a positive relationship. Fifteen studies reported children's total dairy products intake as an outcome measure, with the remaining studies reporting intake of milk or other dairy products as individual foods.
This review identified literature exploring a range of parental factors in relation to children's dairy products intake. However, there were limited numbers of studies published within each category of modifiable factors. Further research on the parent-related determinants of dairy products consumption in children is required in order to identify potential intervention targets in this age group.
Obesity and its measure of body mass index are strongly determined by parental body size. Debate continues as to whether both parents contribute equally to offspring body mass which is key to ...understanding the aetiology of the disease. The aim of this study was to use cohort data from three generations of one family to examine the relative maternal and paternal associations with offspring body mass index and how these associations compare with family height to demonstrate evidence of genetic or environmental cross-generational transmission.
669 of 1082 families were followed up in 2007/8 as part of the Lifeways study, a prospective observational cross-generation linkage cohort. Height and weight were measured in 529 Irish children aged 5 to 7 years and were self-reported by parents and grandparents. All adults provided information on self-rated health, education status, and indicators of income, diet and physical activity. Associations between the weight, height, and body mass index of family members were examined with mixed models and heritability estimates computed using linear regression analysis.
Self-rated health was associated with lower BMI for all family members, as was age for children. When these effects were accounted for evidence of familial associations of BMI from one generation to the next was more apparent in the maternal line. Heritability estimates were higher (h2 = 0.40) for mother-offspring pairs compared to father-offspring pairs (h2 = 0.22). In the previous generation, estimates were higher between mothers-parents (h2 = 0.54-0.60) but not between fathers-parents (h2 = -0.04-0.17). Correlations between mother and offspring across two generations remained significant when modelled with fixed variables of socioeconomic status, health, and lifestyle. A similar analysis of height showed strong familial associations from maternal and paternal lines across each generation.
This is the first family cohort study to report an enduring association between mother and offspring BMI over three generations. The evidence of BMI transmission over three generations through the maternal line in an observational study corroborates the findings of animal studies. A more detailed analysis of geno and phenotypic data over three generations is warranted to understand the nature of this maternal-offspring relationship.
Abstract
Context
There is limited evidence on strategies used to promote dietary behavior changes in socioeconomically disadvantaged urban adolescents and on their effectiveness.
Objective
A ...synthesis of nutrition interventions used in this group of adolescents is provided in this systematic review.
Data Sources
Five electronic databases (PubMed, Web of Science, CINAHL, PsycINFO, and ERIC) were searched until November 2020 to identify relevant studies.
Data Extraction
Forty-six manuscripts (n = 38 intervention studies) met the inclusion criteria. Quality was assessed with the Effective Public Health Practice Project Quality Assessment Tool. A qualitative synthesis summarizing data on study characteristics was conducted.
Data Analysis
Studies were classified by intervention type as those focusing on hedonic determinants of dietary intake (n = 1), environmental changes to promote a specific dietary intake (n = 3), cognitive determinants (n = 29), and multicomponent strategies (n = 13). The social cognitive theory was the most applied theoretical framework, either alone or combined with other frameworks. Most of the intervention studies targeted multiple dietary outcomes, and success was not always reported for each.
Conclusions
Despite the heterogeneity of the studies and lack of combination of dietary outcomes into dietary scores or patterns to evaluate changes on the individuals’ whole diets, long-term, theory-driven interventions targeting a single dietary factor seem promising in obtaining sustainable dietary behavior changes.
Systematic Review Registration
PROSPERO registration no. CRD42020188219.
Evidence available on the determinants of vegetable intake in young populations is inconsistent. Vegetable intake is particularly low in adolescents from less-affluent backgrounds, yet no systematic ...review of qualitative studies investigating determinants for vegetable intake specifically has been conducted to date in this group. This systematic review aimed to identify determinants of vegetable intake in adolescents from socioeconomically disadvantaged urban areas located in very high-income countries reported in qualitative studies.
Five electronic databases (PubMed, Web of Science, CINAHL, PsycINFO and ERIC) were searched until August 2022. The search strategy used combinations of synonyms for vegetable intake, adolescents, and qualitative methodologies. Main inclusion criteria were studies exploring views and experiences of motivators and barriers to vegetable intake in a sample of adolescents aged 12-18 years from socioeconomically disadvantaged urban areas in very high income countries. Study quality assessment was conducted using criteria established in a previous review.
Sixteen studies were included out of the 984 screened citations and 63 full texts. The synthesis of findings identified the following determinants of vegetable intake: sensory attributes of vegetables; psychosocial factors (nutrition knowledge, preferences/liking, self-efficacy, motivation); lifestyle factors (cost/price, time, convenience); fast food properties (taste, cost, satiety); home environment and parental influence; friends' influence; school food environment, nutrition education and teachers' support; and availability and accessibility of vegetables in the community and community nutrition practices. Studies attained between 18 and 49 out of 61 quality points, with eleven of 16 studies reaching ≥ 40 points. One main reason for lower scores was lack of data validation.
Multiple determinants of vegetable intake were identified complementing those investigated in quantitative studies. Future large scale quantitative studies should attempt to examine the relative importance of these determinants in order to guide the development of successful interventions in adolescents from socioeconomically disadvantaged backgrounds.
Asthma is the most common childhood chronic health condition. Maternal antenatal diet has been associated with offspring asthma risk, but studies investigating maternal whole diet quality and ...inflammatory potential with long-term offspring follow-up (>5 y) are rare.
We aimed to elucidate these associations in a prospective cohort study in Ireland.
Early pregnancy diets were assessed using a validated FFQ from which energy-adjusted Dietary Inflammatory Index (E-DII) and Healthy Eating Index (HEI)-2015 scores were computed. Doctor-diagnosed offspring asthma status (general practitioner or parent reports) for the first 10 y of life was collected at 3-y, 5-y, and 9-y follow-up. A total of 862 mother–child pairs with information on maternal diet and ≥1 offspring asthma data points were included. The longitudinal associations between maternal E-DII and HEI scores and offspring asthma status were assessed using generalized estimating equations.
Cumulative offspring asthma incidence was 21% over the 10-y period. In the main models, adjusted for maternal lifestyle and sociodemographic factors, a higher E-DII score, indicating a more proinflammatory diet, was associated with higher risk of offspring asthma (OR: 1.35; 95% CI: 1.10, 1.65; per 1-SD score increment), whereas a higher HEI-2015 score, indicating better dietary quality, was associated with lower risk (OR: 0.77; 95% CI: 0.64, 0.93) (both P < 0.01). Results persisted with further adjustment for childhood factors (e.g., breastfeeding, diet, and childcare attendance) and parental asthma history. Similar associations were observed when E-DII and HEI-2015 scores were modeled in quartiles (both P-trend < 0.05). Associations for HEI-2015 were attenuated after adjustment for E-DII, suggesting the importance of anti-inflammatory pathways.
Our results suggest that a proinflammatory and low-quality diet during pregnancy is associated with a higher risk of offspring asthma. Pending confirmation from other studies, optimizing these aspects of maternal diet can be a promising strategy for reducing childhood asthma risk. This prospective observational study was registered at the ISRCTN Registry as ISRCTN16537904.
Maternal caffeine intake is associated with adverse birth outcomes, but in most studies the primary caffeine source is coffee; the influence of tea caffeine remains unclear.
The aim of the study was ...to examine the association between maternal caffeine intake and birth outcomes in a population with tea as the predominant caffeine source.
Data from 941 Irish mother-child pairs of the Lifeways Cross Generation Cohort Study were examined. Maternal dietary intakes in early pregnancy were assessed using a validated food-frequency questionnaire. Caffeine intake was derived from coffee, tea, soft drinks, and cocoa-containing foods and beverages. Associations of maternal caffeine intake with continuous (birth weight, birth length, and gestational age) and binary low birth weight (LBW) (<2500 g) and preterm birth (PB) (<37 wk gestational age) birth outcomes were investigated using multiple linear and logistic regressions, respectively, with adjustment for potential confounders.
Tea was the predominant caffeine source (48%), followed by coffee (39%). In the fully adjusted model, maternal caffeine intake was associated with lower birth weight β (95% CI): −71.9 (−105.4, −38.4) g · 100 mg–1 · d–1 caffeine increment, shorter birth length −0.30 (−0.49, −0.11) cm, smaller head circumference −0.12 (−0.24, −0.01) cm, and shorter gestational age −0.13 (−0.25, −0.02) wk; higher risks for LBW OR (95% CI): 1.47 (1.14, 1.90) and PB 1.36 (1.07, 1.74) were also observed (all P < 0.05). The associations were robust to the exclusion of participants with pregnancy complications and in never smokers. Similar higher risks of adverse birth outcomes were observed for the highest caffeine intake categories from coffee ORLBW: 3.10 (1.08, 8.89); ORPB: 2.74 (1.05, 7.16) and tea ORLBW: 2.47 (1.02, 6.01); ORPB: 2.56 (1.14, 5.75), compared with the lowest intake categories (all P < 0.05).
Maternal caffeine intake from both coffee and tea is associated with adverse birth outcomes. This prospective observational study was registered at ISRCTN Registry as ISRCTN16537904.
The role of smoking from the paternal line during the pre-conception period on grand-child's overweight/obesity and associated underlying pathways are uncertain. We examined whether the smoking ...status from the paternal line was associated with the grand-child's higher weight at birth, and overweight or obesity at 5 and 9 years of age. The grandparental smoking effect from the maternal line was also explored.
Participants were fathers and grandparents and grand-children from the Lifeways Cross Generational Cohort (N = 1021 for the analysis at birth; N = 562 and N = 284 for the analysis at 5 and 9 years, respectively). Paternal and grandparental smoking was defined as smoking versus non-smoking. Children's weight categories compared were high versus normal weight at birth, and overweight/obesity versus normal weight (based on BMI and waist circumference) at age of five and nine years. Logistic regression models were used to estimate the crude and adjusted associations.
After adjustment for several child and parental factors, at age five there was an association between paternal smoking and offspring's overweight/obesity based on BMI (Adjusted Odds Ratio (AOR), and 95%CI: 1.76, 1.14-2.71, p-value: 0.010), most marked for boys (AOR: 2.05, 1.06-3.96, p-value: 0.032). These associations remained when confined to the children sample with biological fathers only (overall sample, AOR: 1.92, 1.22-3.02, p-value: 0.005; son, AOR: 2.09, 1.06-4.11, p-value: 0.033). At age 9, the paternal grandmothers' smoking was positively associated with their grandchild's overweight/obesity status based on waist circumference (AOR: 3.29, 1.29-8.37), and especially with that of her granddaughter (AOR: 3.44, 1.11-10.69). These associations remained when analysing only the children sample with biological fathers (overall sample, AOR: 3.22,1.25-8.29, p-value: 0.016; granddaughter, AOR: 3.55, 1.13-11.15, p-value: 0.030).
The smoking habit from the paternal line is associated with grand-children's adiposity measures during their early childhood, which might be epigenetically transmitted through male-germline cells.
Maternal dietary quality during pregnancy is associated with offspring outcomes. These associations have not been examined in three-generation families. We investigated associations between parental ...and grandparental dietary quality, determined by healthy eating index (HEI)-2015, and offspring birth outcomes and weight status at age 5. The Lifeways cohort study in the Republic of Ireland comprises 1082 index-child's mothers, 333 index-child's fathers, and 707 grandparents. HEI-2015 scores were generated for all adults from prenatal dietary information collected using a validated food frequency questionnaire. In an adjusted model, greater adherence to the maternal HEI was associated with lower likelihood of low birth weight (LBW) (OR: 0.72, 95% CI: 0.50-0.99,
= 0.04). Similarly, maternal grandmothers (MGM) with higher HEI scores were less likely to have grandchildren with LBW (OR: 0.87, 95% CI: 0.61-0.96,
= 0.04) and more likely to have macrosomia (OR: 1.10, 95% CI: 1.01-1.22,
= 0.03). Higher paternal and paternal grandmothers (PGM) HEI scores were associated with lower likelihood of childhood obesity (OR: 0.89, 95% CI: 0.30-0.94,
= 0.03) and overweight (OR: 0.83, 95% CI: 0.22-0.99,
= 0.04), respectively. Mediation analysis showed significant direct relationship of MGM and PGM HEI scores on grandchildren's birthweight and obesity, respectively. In conclusion, maternal line dietary quality appears to influence fetal growth whereas paternal line dietary quality appears to influence postnatal growth.
Maternal caffeine intake is associated with adverse birth outcomes, but its long-term influence on offspring adiposity outcomes is not well studied. Furthermore, few studies have investigated ...paternal and grandparental caffeine intake in relation to offspring outcomes.
To study the associations between maternal, paternal, and grandparental caffeine intake and offspring childhood adiposity.
The core study sample consists of 558 mother-child pairs from the Lifeways Study. Caffeine intake was derived from relevant food items in a self-administered validated food frequency questionnaire in early pregnancy. Children's body mass index (BMI) and waist circumference (WC) were measured at 5- and 9-y follow-up. Childhood overall and central obesity were defined as age- and sex-specific BMI z-score > International Obesity Task Force cut-off and WC z-score > 90th percentile, respectively. Multiple linear and logistic regressions were used to assess associations.
Study mothers had a mean age of 30.8 y and a mean prepregnancy BMI (kg/m2) of 23.7. In adjusted models, maternal caffeine intake was associated with a higher offspring BMI z-score β (95% CI): 0.13 (0.06, 0.21) for year 5 and 0.17 (0.04, 0.29) for year 9; per 100 mg/d increment in maternal caffeine intake, WC z-score β (95% CI): 0.09 (0.01, 0.17) for year 5 and 0.19 (0.05, 0.32) for year 9, and a higher risk of offspring overall obesity OR (95% CI): 1.32 (1.11, 1.57) for year 5 and 1.44 (1.10, 1.88) for year 9 and central obesity 1.28 (1.02, 1.60) for year 5 and 1.62 (1.12, 2.34) for year 9. The influence was stronger for coffee caffeine than tea caffeine. No consistent associations were observed for paternal and grandparental caffeine intake.
Maternal antenatal, but not paternal or grandparental, caffeine intake is associated with higher offspring adiposity and obesity risk at age 5 and 9 y, with stronger associations observed for coffee caffeine. This prospective observational study was registered at the ISRCTN Registry as ISRCTN16537904.
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