Summary
What is already known about this subject
Parents of children with overweight and obesity tend to underestimate their children's weight.
Most studies show no association between parental ...education level and accurate parental perception of a child's weight category.
Studies show no consistent relationship between parental weight perception and the child's gender.
What this study adds
Parental underestimation of children's weight category for children in the overweight and obesity categories was found across eight European countries.
Regional differences indicated a more accurate parental weight perception in Northern and Central Europe.
A high proportion of parents in Southern Europe were concerned about future underweight or overweight in their children.
Objectives
To evaluate parental perceptions of and concern about child's body weight and general health in children in a European cohort.
Design
Cross‐sectional multi‐centre study in eight European countries.
Participants
16 220 children, ages 2–9 years.
Methods
Parents completed a questionnaire regarding children's health and weight and concern about overweight and underweight. Objective children's weight categories from the International Obesity Task Force were used. Logistic regression models were utilized to identify predictors of accurate weight perception.
Results
Parental weight perception corresponded overall to children's mean body mass index (BMI) z‐scores, with important exceptions. About one‐third of the total indicated concern about underweight, paradoxically most often parents of children in the overweight or obesity categories. In 63%, parents of children in the overweight category marked ‘proper weight’. The strongest predictor for accurate parental weight perception for children with overweight and obesity was BMI z‐score (odds ratio OR = 7.2, 95% confidence interval CI 6.1–8.7). Compared to Southern Europe, ORs for accurate parental weight perception were 4.4 (95% CI 3.3–6.0) in Northern Europe and 3.4 (95% CI 2.7–4.2) in Central Europe.
Conclusion
Parents of children categorized as being overweight or obese systematically underestimated weight. Parents differed regionally regarding accurate weight perception and concern about overweight and underweight.
To compare different field methods for estimating body fat mass with a reference value derived by a three-component (3C) model in pre-school and school children across Europe.
Multicentre validation ...study.
Seventy-eight preschool/school children aged 4-10 years from four different European countries.
A standard measurement protocol was carried out in all children by trained field workers. A 3C model was used as the reference method. The field methods included height and weight measurement, circumferences measured at four sites, skinfold measured at two-six sites and foot-to-foot bioelectrical resistance (BIA) via TANITA scales.
With the exception of height and neck circumference, all single measurements were able to explain at least 74% of the fat-mass variance in the sample. In combination, circumference models were superior to skinfold models and height-weight models. The best predictions were given by trunk models (combining skinfold and circumference measurements) that explained 91% of the observed fat-mass variance. The optimal data-driven model for our sample includes hip circumference, triceps skinfold and total body mass minus resistance index, and explains 94% of the fat-mass variance with 2.44 kg fat mass limits of agreement. In all investigated models, prediction errors were associated with fat mass, although to a lesser degree in the investigated skinfold models, arm models and the data-driven models.
When studying total body fat in childhood populations, anthropometric measurements will give biased estimations as compared to gold standard measurements. Nevertheless, our study shows that when combining circumference and skinfold measurements, estimations of fat mass can be obtained with a limit of agreement of 1.91 kg in normal weight children and of 2.94 kg in overweight or obese children.
Objective: To describe the design, measurements and fieldwork of the IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) physical activity ...and body composition validation study, and to determine the potential and limitations of the data obtained. Design: Multicentre validation study. Subjects: A total of 98 children from four different European countries (age: 4–10 years). Methods: An 8-day measurement protocol was carried out in all children using a collaborative protocol. Reference methods were the doubly labelled water method for physical activity, and a three- and a four-compartment model for body composition. Investigated field methods were accelerometers, a physical activity questionnaire and various anthropometric measurements. Results: For the validation of physical activity field methods, it was possible to gather data from 83 to 89 children, laying the basis for age- and sex-specific results. The validation of body composition field methods is possible in 64–80 children and allows sex-specific analyses but has only limited statistical power in the youngest age group (<6 years). The amount of activity energy expenditure (AEE) varied between centres, sexes and age groups, with boys and older children having higher estimates of AEE. After normalisation of AEE by body weight, most group-specific differences diminished, except for country-specific differences. Conclusion: The IDEFICS validation study will allow age- and sex-specific investigation of questions pertaining to the validity of several field methods of body composition and physical activity, using established reference methods in four different European countries. From the participant analyses it can be concluded that the compliance for the investigated field methods was higher than that for the reference methods used in this validation study.
Summary
What is already known about this subject
The expression of specific genes in peripheral blood cells (PBCs) may be used as biomarkers of the metabolic status.
High levels of expression of ...CPT1A, SLC27A2, INSR, LEPR, FASN and PPARα in PBCs are indicative of a lower risk for the insulin resistant or dyslipidaemic state associated with obesity in children.
Breastfeeding seems to confer protective effects against obesity and its related metabolic problems.
What this study adds
Children who had been breastfed showed higher expression levels of SLC27A2, FASN, PPARα and INSR in PBCs compared with formula‐fed subjects.
The relationship of the PBC transcript levels of SLC27A2, INSR, FASN and PPARα with insulin resistance and dyslipidaemia may be dependent on the type of infant feeding (breast vs. formula).
The transcript levels of the mentioned biomarkers could be useful to distinguish the formula‐fed children who are at higher risk of metabolic alterations.
Background
Blood‐cell transcripts have showed to be good biomarkers of metabolic alterations and their use in early detection and prevention of future disorders is promising.
Objective
This study aimed to examine the relation between previously proposed transcriptional biomarkers of metabolic health (SLC27A2, CPT1A, FASN, PPARα, INSR, LEPR) in peripheral blood cells and the type of infant feeding in a subset of children from the IDEFICS (Identification and Prevention of Dietary‐ and Lifestyle‐Induced Health Effects in Children and Infants) cohort.
Subjects
A total of 237 children aged 2–9 years from eight European countries were studied.
Results
Breastfed children showed higher expression levels of SLC27A2, FASN, PPARα and INSR, and lower risk of being overweight and of having high plasma triglyceride levels vs. formula‐fed children. Besides, overweight formula‐fed children presented higher HOMA‐index than overweight breastfed children (1.90 vs. 1.62); however, this negative effect was absent in formula‐fed children with high expression of SLC27A2. Moreover, formula‐fed children with low expression of SLC27A2, FASN, PPARα and INSR presented higher triglyceride levels than subjects with high expression of these genes (77.7 mg dL−1 vs. 44.8 mg dL−1). This difference was absent in breastfed children.
Conclusions
Protective effects of breastfeeding are reflected in higher expression levels of SLC27A2, FASN, PPARα and INSR in blood cells. These biomarkers may also serve to discriminate the formula‐fed children that are at higher risk of metabolic alterations.
The aim of this study was to compare the prevalence of overweight in only children to those with siblings and to explore potential behavioral mediating factors. This study relies upon cross-sectional ...data collected at survey centers in eight European countries participating in Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS (IDEFICS). The present analysis is based on measured anthropometry and parent or guardian-reported socio-demographic characteristics. Subjects include 12 720 children aged 2-9 years for whom number of siblings was known. Singletons were more likely (odds ratio 1.52, 95% confidence interval (CI):1.34-1.72) to be overweight than their peers with siblings when controlling for factors related to childhood overweight, including survey country, parental education, parental weight, maternal age, child's age, birth weight and gender. The three southernmost countries have over threefold risk of overweight, dominated by Italy, compared with the north-central countries, which is not explained by the prevalence of singleton children. The excess risk of overweight among children without siblings was robustly observed even when considering behavioral mediating factors (playtime, screen time per day, dietary propensities for sugar or fat, parental attitudes towards food rewards and television in the child's bedroom). Among singletons aged 6-9 years, the excess risk of overweight was 1.70 (95% CI: 1.44-2.01) compared with 1.32 (95% CI: 1.10-1.60) in younger singletons.
Objective: To investigate the repeatability of maternal self-reported prenatal, perinatal and early postnatal factors within the IDEFICS (Identification and prevention of dietary- and ...lifestyle-induced health effects in children and infants) study. Design: Data are from the baseline survey of the longitudinal cohort study IDEFICS in eight European countries. Subjects: A total of 420 parents from eight countries (43–61 per country) were asked to complete the parental questionnaire (PQ) twice at least 1 month apart. Measurements: The PQ assesses prenatal (maternal weight gain), perinatal (child's birth weight and length, Caesarean (C)-section, week of delivery) and early postnatal factors (exclusive breastfeeding, breastfeeding, introduction of solid food). Intra-class correlation coefficients (ICCs) were calculated to compare maternal reports on prenatal, perinatal and early postnatal factors between the first and second PQ. Results: In total, 249 data sets were considered for the analyses. Overall, maternal reports for prenatal and perinatal factors showed higher repeatability (ICC=0.81–1.00, P0.05 for all) than those for early infant nutrition (ICC=0.33–0.88, P0.05 for all). Perfect agreement was found for parental reports on C-section (ICCall=1.00, P0.05). There was stronger agreement for duration of breastfeeding (ICC=0.71, P0.05) compared with exclusive breastfeeding (ICC=0.33, P0.05). Maternal reports showed moderate correlation for the introduction of several types of food (cereals ICC=0.64, P0.05; fruits ICC=0.70, P0.05; meat ICC=0.83, P0.05; vegetables ICC=0.75, P0.05), and high correlation (ICC=0.88, P0.05) for cow's milk. Conclusion: Maternal reports on pregnancy and birth were highly reproducible, but parental recall of early infant nutrition was weaker and should be interpreted more cautiously.
Genetische Ursachen der Adipositas Hebebrand, J.; Bammann, K.; Hinney, A.
Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz,
07/2010, Letnik:
53, Številka:
7
Journal Article
Recenzirano
Zusammenfassung
Eine kleine Anzahl bestätigter Hauptgene für menschliche Adipositas sind durch molekulargenetische Studien identifiziert worden; Mutationen in ihnen haben einen starken Einfluss auf ...die Entwicklung von übermäßigem Körpergewicht. Allerdings sind diese Mutationen selten und erklären nicht die vorliegende Adipositasepidemie in den Industrienationen. Die genetische Prädisposition für eine idiopathische Adipositas hat höchstwahrscheinlich in den meisten Fällen eine polygene Basis; hierbei hat jede einzelne Genvariante nur einen kleinen Einfluss auf das Körpergewicht. Die Einführung genomweiter Assoziationsstudien (GWAS) bietet erstmals die Gelegenheit, systematisch und in größerer Anzahl Risiko-Genvarianten zu identifizieren, die zu komplexen Erkrankungen prädisponieren. Die Rezeptorvariante mit der Aminosäure Isoleucin (Wildtyp: Valin) an Position 103 des Melanokortin-4-Rezeptors (MC4R) bildete die erste bestätigte Variante mit einem kleinen Einfluss auf den Body-Mass-Index (BMI). Zusätzlich konnten weitere Polymorphismen in unmittelbarer Nähe des MC4R-Gens nachgewiesen werden, die ebenfalls einen kleinen Effekt auf das Körpergewicht ausüben. Varianten im ersten Intron des „Fat-Mass-and-Obesity-Associated“-Gens (FTO) haben den stärksten polygenen Effekt auf den BMI (+0,4 kg/m
2
pro Allel). Kürzlich wurden in drei großen GWAS weitere Einzelnukleotid-Polymorphismen (SNPs) mit einem jeweils kleinen Effekt auf Adipositas beziehungsweise auf das Körpergewicht identifiziert. Bis Dezember 2009 wurden 17 solide bestätigte Polygene für die Gewichtsregulierung berichtet.
A small number of confirmed major genes for human obesity has been identified by molecular genetic studies; mutations of these have a strong influence on the development of excessive body weight. ...However, the underlying mutations are rare and do not explain the current obesity epidemic. The genetic predisposition to common obesity most likely has a polygenic basis, and each single gene variant has only a small influence on body weight. The introduction of genome-wide association scans (GWAS) offers new opportunities for the study of complex diseases. The receptor variant with the amino acid isoleucin (wildtype: valine) at position 103 of the melanocortin-4 receptor (MC4R) represents the first confirmed polygenic variant with an influence on body mass index; additional polymorphisms located 188 kb at the 3' end of the MC4R have also been shown to have an effect on body weight. Variants in the first intron of the "fat mass and obesity associated" gene (FTO) confer the most pronounced polygenic effect on obesity (+0.4 kg/m(2) per allele); these variants were originally detected in 2007 in GWAS pertaining to type 2 diabetes mellitus. Recently, additional SNPs with a polygenic effect on obesity have been identified in three large GWAS. By December 2009, 17 solidly confirmed polygenes for body weight regulation have been reported.
To assess the relationship between parental education level and the consumption frequency of obesity-related foods in European children.
The analysis was based on data from the cross-sectional ...baseline survey of a prospective cohort study. The effects of parental education on food consumption were explored using analysis of covariance and logistic regression.
Primary schools and pre-schools of selected regions in Italy, Estonia, Cyprus, Belgium, Sweden, Hungary, Germany and Spain.
Participants (n 14,426) of the IDEFICS baseline cohort study aged 2 to 9 years.
Parental education level affected the intake of obesity-related foods in children. Children in the low and medium parental education level groups had lower odds of more frequently eating low-sugar and low-fat foods (vegetables, fruits, pasta/noodles/rice and wholemeal bread) and higher odds of more frequently eating high-sugar and high-fat foods (fried potatoes, fruits with sugar and nuts, snacks/desserts and sugared beverages; P < 0.001). The largest odds ratio differences were found in the low category (reference category: high) for vegetables (OR = 0.56; 95 % CI 0.47, 0.65), fruits (OR = 0.56; 95% CI 0.48, 0.65), fruits with sugar and nuts (OR = 2.23; 95% CI 1.92, 2.59) and sugared beverages (OR = 2.01; 95% CI 1.77, 2.37).
Low parental education level was associated with intakes of sugar-rich and fatty foods among children, while high parental education level was associated with intakes of low-sugar and low-fat foods. These findings should be taken into account in public health interventions, with more targeted policies aiming at an improvement of children's diet.
Socioeconomic disadvantages during childhood are hypothesised to have negative implications for health. We aimed to investigate the association between socioeconomic disadvantages and children's ...total metabolic syndrome (MetS) score at baseline and follow-up and the extent to which socioeconomic disadvantages over time and the accumulation of these socioeconomic disadvantages can affect children's MetS risk.
The two-year longitudinal IDEFICS study included 2401 European children (aged 2.0–9.9) with complete information of the 16,229 participating at baseline. Sociodemographic variables, psychosocial factors and lifestyle were proxy-reported via questionnaires. Socioeconomically disadvantaged groups included children from families with low income, low education, migrant origin, unemployed parents, parents who lacked a social network, and from non-traditional families. MetS risk score was calculated as the sum of z-scores of waist circumference, blood pressure, lipids and insulin resistance. Linear mixed-effects models were used to study the association between social disadvantages and MetS risk. Models were adjusted for sex, age, well-being and lifestyle (fruit and vegetables consumption, physical activity, screen time).
At both time points, children from low-income families (0.20 0.03–0.37); (β estimate and 99% confidence interval), children from non-traditional families (0.14 0.02–0.26), children whose parents were unemployed (0.31 0.05–0.57) and children who accumulated >3 disadvantages (0.21 0.04–0.37) showed a higher MetS score compared to non-socioeconomically disadvantaged groups.
Children from socioeconomically disadvantaged families are at high metabolic risk independently of diet, physical activity, sedentary behaviours and well-being. Interventions focusing on these socioeconomically disadvantaged groups should be developed to tackle health disparities.
•Disadvantages in childhood were related to higher metabolic syndrome (MetS) risk.•Non-traditional families and unemployment contributed most to MetS risk.•Insulin resistance, systolic blood pressure and waist circumference were affected.•Lifestyle factors and children's well-being are significant mediators.
PDF
