Epigenetic Issues. The Link Between Microbiota and Gestational Diabetes.

Gestational diabetes (GDM) is considered a significant and increasing problem worldwide. The growing body of evidence points out that a hostile intrauterine environment in mothers with GDM via epigenetic mechanisms induces "diabetogenic" and "obesogenic" changes in an offspring's DNA. This sets in motion a vicious intergenerational cycle of metabolic diseases gradually deteriorating the health of the human population. One of the most important players in this process seems to be altered microbiota/microbiome. There is a chance that the identification of specific epigenetic marks may provide a key for future diagnostic, prognostic and therapeutic solutions/measures in the field of person-alized medicine. Given the reversibility of most epigenetic changes, an opportunity arises to improve the long-term health of the human population/race. In this manuscript, we aim to summarize available data on epigenetic changes among women suffering from GDM and their progeny in association with changes in microbiome.

Assessment of nutritional status and associated factors among adolescent girls in Afar, Northeastern Ethiopia: a cross-sectional study

Background A body of evidences showed that adolescent undernutrition is a serious public health problem in developing countries including Ethiopia. Adolescence period is the last chance for curbing the consequences of undernutrition and breaking the intergenerational cycle of malnutrition and poor health. Despite this fact, they have been considered as a low-risk group for poor health and nutrition problems than the young children or the very old. This study aimed to assess prevalence of nutritional status and associated factors among adolescent girls in Afar, Northeastern Ethiopia, 2017. Methods A school-based cross-sectional study design was conducted among 736 adolescent girls from February15 to March 05, 2017 in Afar, Northeastern Ethiopia, 2017. Multi-stage sampling technique was used to select study participants. A pretested and structured interviewer-administered questionnaire and anthropometric measurements was used to collect the data. The collected data were entered in to Epi Data version 3.1 and exported to SPSS version 20.0 for further statistical analysis. Body Mass Index for age (thinness) and height for age (stunting) was used to assess undernutrition of adolescent girls by using the new 2007 WHO Growth Reference. Data were analyzed using bivariate and multivariable logistic regression. The degree of association between dependent and independent variables were assessed using odds ratio with 95% confidence interval, and variables with p value < 0.05 were considered significant. Results The study revealed that the prevalence of thinness and stunting were 15.8% (95% CI 13.3–18.5%) and 26.6% (95% CI 23.5–29.9%), respectively. Being at an early adolescent age (AOR = 2.89, 95% CI 1.23–6.81) for thinness and being at an early adolescent age (AOR = 1.96, 95% CI 1.02–3.74), household food insecure (AOR = 2.88, 95% CI 1.15–7.21), menstruation status (AOR = 2.42, 95% CI 1.03–5.71), and availability of home latrine (AOR = 3.26, 95% CI 1.15–4.42) for stunting were the independent predictors among the adolescent girls. Conclusions The prevalence of thinness and stunting is above the public health importance threshold level. Thus, Multi-sector-centered nutrition interventions to improve nutritional status of disadvantaged adolescent girls through providing comprehensive nutritional assessment and counseling services at community, school, and health facility levels, and creating household’s income-generating activities are recommended before they reach conception to break the intergenerational cycle effect of malnutrition.

Genetic nurture effects on education: a systematic review and meta-analysis

Child educational development is associated with major psychological, social, economic and health milestones throughout the life course. Understanding the early origins of educational inequalities and their reproduction across generations is therefore crucial. Recent genomic studies provide novel insights in this regard, uncovering “genetic nurture” effects, whereby parental genotypes influence offspring’s educational development via environmental pathways rather than genetic transmission. These findings have yet to be systematically appraised. We conducted the first systematic review and meta-analysis to quantify genetic nurture effects on educational outcomes and investigate key moderators. Twelve studies comprising 38,654 distinct parent(s)-offspring pairs or trios from eight cohorts were included, from which we derived 22 estimates of genetic nurture effects. Multilevel random effects models showed that the effect of genetic nurture on offspring’s educational outcomes (βgenetic nurture = 0.08, 95% CI [0.07, 0.09]) was about half the size of direct genetic effects (βdirect genetic = 0.17, 95% CI [0.13, 0.20]). Maternal and paternal genetic nurture effects were similar in magnitude, suggesting comparable roles of mothers and fathers in determining their children’s educational outcomes. Genetic nurture effects were largely explained by parental educational level and family socioeconomic status, suggesting that genetically influenced environments play an important role in shaping child educational outcomes. Even after accounting for genetic transmission, we provide evidence that environmentally mediated parental genetic influences contribute to the intergenerational transmission of educational outcomes. Further exploring these downstream environmental pathways may inform educational policies aiming to break the intergenerational cycle of educational underachievement and foster social mobility.Public Significance StatementThis meta-analysis demonstrates that parents’ genetics influence their children’s educational outcomes through the rearing environments that parents provide. This “genetic nurture” effect is largely explained by family socioeconomic status and parental education level, is similar for mothers and fathers (suggesting that both parents equally shape their children’s educational outcomes) and is about half the size of direct genetic effects on children’s educational outcomes. Interventions targeting such environmental pathways could help to break the intergenerational cycle of educational underachievement and foster social mobility.

Nutrition Status of School Children in Punjab, India: Findings from School Health Surveys

Background School-going children and adolescents are rarely targeted in nutrition surveys, despite the significant impact of nutritional status on their health, cognition, educational achievements and future economic productivity. The present secondary data analysis evaluated the nutritional status of children and adolescents in the 5–18 years age group. Materials and methods The anthropometric measurements of children and adolescents studying in the government and government-aided schools were collected under the ‘Rashtriya Bal Swasthya Karyakram’ in the District Fatehgarh Sahib of Punjab, India between March and August 2018. It was analyzed using SPSS version 21. Mean and standard deviation for weight-for-age, height-for-age, body mass index (BMI) for age z-scores were calculated using World Health Organization’s Anthro-plus software. Results A total of 897 children’s data were included in the study. Out of 352 children in 5–9 years age group, mean weight, height and BMI were 15.7 ± 3.8 kg, 110.7 ± 10.6 cm and 12.7 ± 2.1 kg/m2. About 58.8%, 37.4% and 31.8% of the children were categorized as severely underweight, stunted and thin, respectively. In the 10–18 years age group, mean weight, height and BMI were 30.5 ± 9.5 kg, 140 ± 13.4 cm and 15.2 ± 2.6 kg/m2. Severe stunting was present in 19.4% of adolescents, while 26.9% were severely thin. Conclusion Our study depicts a high level of undernutrition in school-going children and adolescents. There is a need to strengthen the nutrition interventions for middle childhood and adolescence period that can help in a healthy transition from childhood to adulthood and break the intergenerational cycle of malnutrition. Lay summary National and state-level health-priorities focus mainly on improving the nutrition status of under-5-year children, while the school-going children and adolescents are usually neglected. The present secondary data analysis estimates the burden of malnutrition in school-going children and adolescents. These data were collected under one of India's national health programs that intend to tackle childhood illnesses. Our study depicts a high level of undernutrition in school-going children and adolescents. We found that girls were affected more by malnutrition in middle childhood, i.e. during 5–9 years (both by stunting and thinness) compared to boys. But in middle and late adolescence, males were more stunted and thin compared to females. Programs to support adolescents' nutrition interventions could provide an opportunity for a healthy transition from childhood to adulthood and could be an essential step in breaking the intergenerational cycle of malnutrition.

Using the ‘shit’ of the current COVID-19 crisis as fertiliser for the soil to lay the foundations of a new and sustainable era: lessons from past crises to improve the future

Studies of past crises have demonstrated that adverse experiences during critical periods of human development hamper the individual’s ability to reach its full potential and leaves lasting marks on health, behaviour, productivity and society as a whole. The COVID-19 crisis has severely worsened the environment in which we live and in which our future generations are being shaped, and will lead to loss of future human potential and capital. It is clear that the COVID-19 pandemic does not only harm the current world population, but also affects our future, as well as that of future generations. The science of transgenerational plasticity demonstrates that investments in early life hold the promise of having beneficial effects across multiple generations. As governments are reopening societies and prioritising policies, their overarching goal should be to improve the environment in which future generations grow and develop, learn and live. This will change the lifetime trajectories of children for the better and affect future health, school success, behaviour, productivity and well-being. This prioritisation will prove to be the most effective intervention to build sustainable futures but will also yield returns many times the original investment. It is a promising way to break the intergenerational cycle of adversity and accelerate progress on achieving the Sustainable Development Goals.

Parenting practices and intergenerational cycle of victimization in Peru

Existing research has suggested children of caregivers with histories of exposure to trauma are at heightened risk for victimization, but few studies have explored potential mechanisms that explain this intergenerational transmission of risk. With data from peri-urban households in Lima, Peru (N = 402), this study analyzes parenting behaviors in the relation between caregivers’ trauma history and child victimization for children aged 4–17. Results indicated caregivers’ trauma history and negative parenting behaviors related to child victimization, and negative parenting behaviors mediated this relation. Positive parenting behaviors did not have significant direct effects and were not mediators of risk transmission. Parenting behaviors did not moderate the relation between caregiver and child victimization, suggesting parenting behaviors may not buffer or exacerbate intergenerational transmission. Post-hoc analyses revealed family type (e.g., single, cohabitating/married) exerted significant direct and moderating effects on child risk, interacting with positive parenting. Families with married/cohabitating caregivers reported overall lower levels of child victimization; however, the relation between positive parenting and victimization was slightly stronger for children in single-parent families. Results highlight potential pathways of the intergenerational cycle of victimization and suggest high-risk families in Peru may benefit from parenting supports, especially pertaining to remediation of negative parenting behaviors.

Identifying Mediators Underlying the Intergenerational Cycle of Obesity: A Causal Mediation Analysis

Objectives To understand the mechanisms of the intergenerational cycle of obesity between women and offspring. Methods We recruited pregnant women into the Nurture study (North Carolina, US) and prospectively followed up their offspring until 1 year of age from 2013–2017. The exposure of this analysis was self-reported maternal pre-pregnancy body mass index (BMI) calculated using weight and height. The outcome was researcher-measured infant weight-for-length z-score (WFLZ) at 1 year, calculated based on the WHO Child Growth Standards. We conducted a causal mediation analysis to estimate the average mediation effect of each mediator, including gestational weight gain (GWG), delivery mode, infant birth weight-for-gestational age z-score, and duration of breastfeeding. We adjusted for maternal age, race, parity, smoking status prior to pregnancy, education, household income, food security, and gestational age (when not examining birth weight-for-gestational age z-score). Results We included 380 dyads. Among mothers, there were 65.5% black, 22.6% white, and 11.8% other/multiple race. Prior to pregnancy, 19.5% were overweight and 45.3% were obese. A 10 kg/m2 increment of pre-pregnancy BMI was associated with 0.16 (95% CI: 0.06, 0.27) higher infant WFLZ at 1 year. When examining mediators individually, birth weight-for-gestational age z-score had a statistically significant mediation effect (0.05, 95% CI: 0.02, 0.08), corresponding to 30.2% (95% CI: 20.0%, 62.9%) of the total effect of pre-pregnancy BMI on infant WFLZ. The average mediation effect by GWG was −0.04 (95% CI: −0.08, 0.00), by cesarean delivery was 0.01 (95% CI: −0.01, 0.04), and by breastfeeding duration was 0.02 (95% CI: −0.01, 0.06). Treating mediators as potential confounders for one another did not alter the results. Conclusions Infant birth weight-for-gestational age z-score mediated, in part (∼30%), the relation between maternal pre-pregnancy BMI and infant WFLZ at 1 year. In contrast, GWG, delivery mode, and breastfeeding were not mediators in our sample. This highlights the importance of primordial prevention of maternal obesity, ideally prior to conception, to mitigate the intergeneration cycle of obesity. Research exploring the potential mediating role of factors such as the gut microbiome is needed. Funding Sources The National Institutes of Health.