Infant feeding modifies the relationship between rapid weight gain in infancy and childhood obesity

PURPOSE: The purpose of this investigation is to examine the relationship between forced sedentariness attributed to the management of a lower extremity injury and change in BMI in pediatric patients. INTRODUCTION: Over the past 30 years, childhood obesity has significantly increased. Lack of physical activity and rising levels of sedentary living are associated with rising childhood obesity. As the effects of childhood obesity are long lasting, it is important to characterize childhood conditions that lead to increases in BMI. Traumatic lower extremity injuries in children commonly result in casting and forced immobilization. Children and adolescents who cease physical activity at a younger age are at a higher risk for weight gain and inactive lifestyles as adults. Presently, the data examining short term and longitudinal effects of injury on weight changes are lacking. Therefore, the purpose of this investigation is to examine the relationship between forced sedentariness attributed to the management of a lower extremity injury and change in BMI in pediatric patients. METHODS: Eighty eight subjects aged 5 to 18 with lower extremity fractures managed with non-weight bearing for a minimum of 6 weeks were identified. This group was compared to a cohort of controls, who presented to the pediatric orthopaedic clinic for upper extremity injuries. For each subject, BMI was calculated from height and weight data obtained at each clinic visit for which the data were available for a minimum of 6 months. Percent change in BMI was then calculated and compared between the lower extremity injury group and controls utilizing ANOVA. Logistic regression was then performed to determine if age, gender, and undergoing surgery were correleated with a BMI change of greater than 10%. RESULTS: The results of initial ANOVA analysis demonstrated no difference in BMI trends between children with lower extremity injuries and controls. On average, both groups showed a modest increase in BMI over time (lower extremity injuries = 3.40%, controls = 3.23%). Logistic analysis of the lower extremity revealed male gender to be associated with a 10% increase in BMI during the study period, though this was not significant (p = 0.153) CONCLUSIONS: Our investigation yielded a negative result. As there is limited literature on BMI trends in children, our power calculation may have underestimated the subjects needed to demonstrate a statistically significant difference between groups. SIGNIFICANCE: The increases observed in both groups may indicate that the experience of being injured is associated with increases in BMI regardless of the location of injury. Further investigation would involve assessing BMI trends prospectively to identify opportunities to obviate possible weight gain with injury.

Download Full-text

Amount, Preparation and Type of Formula Consumed and Its Association with Weight Gain in Infants Participating in the WIC Program in Hawaii and Puerto Rico

Nutrients ◽

10.3390/nu11030695 ◽

2019 ◽

Vol 11 (3) ◽

pp. 695 ◽

Cited By ~ 3

Author(s):

Rafael Graulau ◽

Jinan Banna ◽

Maribel Campos ◽

Cheryl Gibby ◽

Cristina Palacios

Keyword(s):

Puerto Rico ◽

Weight Gain ◽

Nutrition Education ◽

Infant Feeding ◽

Secondary Analysis ◽

Infant Food ◽

Wic Program ◽

Rapid Weight Gain ◽

Z Scores

The aim of this study was to assess the association between amount (below or above recommendations), preparation (liquid vs. powder), and type (regular vs. hydrolysate) of infant formula consumed and weight in infants participating in the Women, Infant and Children (WIC) Program in Hawaii (HI) and Puerto Rico (PR). This was a secondary analysis of 162 caregivers with healthy term 0–2-month-old infants. Socio-demographics, infant food frequency questionnaires, and weight and length were assessed at baseline and after four months. Infant feeding practices were associated with weight-for-length z-scores using multivariable logistic regression. In total, 37.7% were exclusively breastfed and 27.2% were exclusively formula-fed. Among formula users, regular (63.6%) and powder (87.0%) formula were the most common; 43.2% consumed formula above recommendations. Most infants had rapid weight gain (61.1%). Infants fed regular formula had higher odds of overweight after four months (adjusted OR = 8.77, 95% CI: 1.81–42.6) and higher odds of rapid weight gain (adjusted OR = 3.10, 95% CI: 1.12, 8.61). Those exclusively formula fed had higher odds of slow weight gain (adjusted OR = 4.07, 95% CI: 1.17–14.2). Formula preparation and amount of formula were not associated with weight. These results could inform the WIC program’s nutrition education messages on infant feeding. Studies with longer follow-up are needed to confirm these results.

Download Full-text

The Q223R Polymorphism of the Leptin Receptor Gene as a Predictor of Weight Gain in Childhood Obesity and the Identification of Possible Factors Involved

Genes ◽

10.3390/genes11050560 ◽

2020 ◽

Vol 11 (5) ◽

pp. 560

Author(s):

Helena Marcos-Pasero ◽

Elena Aguilar-Aguilar ◽

Gonzalo Colmenarejo ◽

Ana Ramírez de Molina ◽

Guillermo Reglero ◽

...

Keyword(s):

Weight Gain ◽

Childhood Obesity ◽

Leptin Receptor ◽

Linear Models ◽

Receptor Gene ◽

Lifestyle Factors ◽

Nucleotide Polymorphisms ◽

Rapid Weight Gain ◽

Activity Data ◽

Weight Growth

(1) Background: Childhood rapid weight gain during development has been postulated as a predictor of obesity. The objective of this study was to investigate the effect of single nucleotide polymorphisms (SNPs) on the annual weight gain and height growth, as well as identifying possible lifestyle factors involved. (2) Methods: As part of the GENYAL study, 221 children (6–8 years old) of Madrid (Spain) were enrolled. A total of 11 SNPs associated with high childhood body mass indexes (BMIs) were assessed. Anthropometric measurements, dietary and physical activity data, were collected in 2017 and 2018. Bonferroni-corrected linear models were used to fit the data. (3) Results: A significant association between the Q223R LEPR and the weight growth was found, showing a different behavior between GA and GG genotypes (p = 0.001). Regarding lifestyle factors, an interaction between Q223R genotypes and total active weekly hours/week to predict the weight growth (kg/year) was observed (p = 0.023). In all the genotypes, a beneficial effect against rapid weight growth was observed, but the effect size of the interaction was much more significant in homozygous (GG) minor homozygous (β = −0.61 (−0.95, −0.26) versus heterozygous (AG) and wild-type homozygous (AA) genotypes (β = −0.07 (−0.24, 0.09) and β = −0.12 (−0.32, 0.08), respectively). (4) Conclusions: These results may contribute to more personalized recommendations to prevent childhood obesity.

Download Full-text

Childhood obesity: rapid weight gain in early childhood and subsequent cardiometabolic risk

Clinical Pediatric Endocrinology ◽

10.1297/cpe.29.135 ◽

2020 ◽

Vol 29 (4) ◽

pp. 135-142 ◽

Cited By ~ 1

Author(s):

Osamu Arisaka ◽

Go Ichikawa ◽

Satomi Koyama ◽

Toshimi Sairenchi

Keyword(s):

Early Childhood ◽

Weight Gain ◽

Childhood Obesity ◽

Cardiometabolic Risk ◽

Rapid Weight Gain

Download Full-text

Rapid Weight Gain, Infant Feeding Practices, and Subsequent Body Mass Index Trajectories: The CALINA Study

Nutrients ◽

10.3390/nu12103178 ◽

2020 ◽

Vol 12 (10) ◽

pp. 3178

Author(s):

Paloma Flores-Barrantes ◽

Isabel Iguacel ◽

Iris Iglesia-Altaba ◽

Luis A. Moreno ◽

Gerardo Rodríguez

Keyword(s):

Body Mass Index ◽

Weight Gain ◽

Infant Feeding ◽

Body Mass ◽

Feeding Practices ◽

Growth Patterns ◽

Growth Trajectories ◽

Infant Feeding Practices ◽

Z Score ◽

Rapid Weight Gain

We aimed to study growth patterns according to rapid weight gain (RWG) and infant feeding practices during the first 120 days and whether infant feeding practices mediated the association between RWG in the first semester of life and subsequent body mass index (BMI) z-score in children from age 1 to 6. (1) Methods: 862 children from the Growth and Feeding during Lactation and Early Childhood in Children of Aragon study (CALINA in Spanish) were examined. Repeated-measures ANOVA analyses were conducted to assess growth trajectories according to RWG and type of feeding practice. The product of coefficients mediation method was used to assess the potential contribution of infant feeding practices to the association between RWG and BMI z-score. Mediation models were conducted using IBM SPSS-PROCESS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp. (2) Results: BMI and weight z-score trajectories were significantly higher in the RWG group and the formula-fed group. No significant differences were found regarding height. Infant feeding practices did not mediate the association between RWG and BMI z-score but were associated with BMI at 6 years. (3) Conclusions: Infant feeding practices and RWG determine different growth trajectories of BMI and weight during childhood. Although infant feeding practices did not mediate the association between early RWG and BMI later in life, formula feeding is independently related to higher BMI growth patterns later in childhood.

Download Full-text

The Relationship of Rapid Weight Gain in Infancy to Obesity and Skeletal Maturity in Childhood

Obesity Research ◽

10.1038/oby.2003.62 ◽

2003 ◽

Vol 11 (3) ◽

pp. 457-460 ◽

Cited By ~ 56

Author(s):

Noël Cameron ◽

John Pettifor ◽

Thea De Wet ◽

Shane Norris

Keyword(s):

Weight Gain ◽

Skeletal Maturity ◽

Rapid Weight Gain ◽

Relationship Of ◽

The Relationship

Download Full-text

Protocol of the Snuggle Bug/Acurrucadito Study: a longitudinal study investigating the influences of sleep-wake patterns and gut microbiome development in infancy on rapid weight gain, an early risk factor for obesity

BMC Pediatrics ◽

10.1186/s12887-021-02832-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Megan E. Petrov ◽

Nana Jiao ◽

Sarada S. Panchanathan ◽

Elizabeth Reifsnider ◽

Dean V. Coonrod ◽

...

Keyword(s):

Weight Gain ◽

Longitudinal Study ◽

Childhood Obesity ◽

Low Income ◽

Objective Assessment ◽

Infant Growth ◽

Infant Sleep ◽

Rapid Weight Gain ◽

Modifiable Factors ◽

Wake Patterns

Abstract Background Overweight, obesity, and associated comorbidities are a pressing global issue among children of all ages, particularly among low-income populations. Rapid weight gain (RWG) in the first 6 months of infancy contributes to childhood obesity. Suboptimal sleep-wake patterns and gut microbiota (GM) have also been associated with childhood obesity, but little is known about their influences on early infant RWG. Sleep may alter the GM and infant metabolism, and ultimately impact obesity; however, data on the interaction between sleep-wake patterns and GM development on infant growth are scarce. In this study, we aim to investigate associations of infant sleep-wake patterns and GM development with RWG at 6 months and weight gain at 12 months. We also aim to evaluate whether temporal interactions exist between infant sleep-wake patterns and GM, and if these relations influence RWG. Methods The Snuggle Bug/ Acurrucadito study is an observational, longitudinal study investigating whether 24-h, actigraphy-assessed, sleep-wake patterns and GM development are associated with RWG among infants in their first year. Based on the Ecological Model of Growth, we propose a novel conceptual framework to incorporate sleep-wake patterns and the GM as metabolic contributors for RWG in the context of maternal-infant interactions, and familial and socio-physical environments. In total, 192 mother-infant pairs will be recruited, and sleep-wake patterns and GM development assessed at 3 and 8 weeks, and 3, 6, 9, and 12 months postpartum. Covariates including maternal and child characteristics, family and environmental factors, feeding practices and dietary intake of infants and mothers, and stool-derived metabolome and exfoliome data will be assessed. The study will apply machine learning techniques combined with logistic time-varying effect models to capture infant growth and aid in elucidating the dynamic associations between study variables and RWG. Discussion Repeated, valid, and objective assessment at clinically and developmentally meaningful intervals will provide robust measures of longitudinal sleep, GM, and growth. Project findings will provide evidence for future interventions to prevent RWG in infancy and subsequent obesity. The work also may spur the development of evidence-based guidelines to address modifiable factors that influence sleep-wake and GM development and prevent childhood obesity.

Download Full-text

ROHHAD syndrome – A still unrecognized cause of childhood obesity: report of three cases

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2020-0111 ◽

2020 ◽

Vol 33 (10) ◽

pp. 1341-1348

Author(s):

Maria Filippidou ◽

Theoni Petropoulou ◽

Evanthia Botsa ◽

Ioannis – Anargyros Vasilakis ◽

Penelope Smyrnaki ◽

...

Keyword(s):

Weight Gain ◽

Childhood Obesity ◽

Diagnostic Tests ◽

Rapid Onset ◽

Autonomic Dysregulation ◽

Rapid Weight Gain ◽

Hypothalamic Dysfunction ◽

Alveolar Hypoventilation ◽

Case Presentations

AbstractObjectivesRapid-onset obesity with hypoventilation, hypothalamic dysfunction, and autonomic dysregulation (ROHHAD) is a rare, potentially fatal, pediatric syndrome.Case presentationsWe describe three cases of ROHHAD-syndrome in Greece. The main and earliest symptom was the excessive and rapid weight gain at 5, 2, and 3 years of age. Years after the onset of obesity, the patients developed hypothalamic dysfunction with various endocrinological abnormalities (at 9, 8, and 6.8 years, respectively), autonomic dysregulation and finally, alveolar hypoventilation (at 14.6, 8, and 7.8 years, respectively), leading to the diagnosis of ROHHAD-syndrome.ConclusionsThe rarity of the syndrome, the variable symptoms’ presentation, and the lack of specific diagnostic tests could explain why no previous cases have been reported from our country. The rapid onset of obesity was underestimated, and the patients were misdiagnosed with other more common obesity syndromes. Therefore, we propose a questionnaire to help physicians identify patients with ROHHAD-syndrome.

Download Full-text