Prospective Association of Maternal Educational Level with Child’s Physical Activity, Screen Time, and Diet Quality

Evidence has identified unhealthy lifestyle behaviors as the main contributors to obesity in children, so it is essential to identify factors that could influence children’s lifestyles. The objective of the present study was to analyze the association of baseline maternal educational level with child’s physical activity, screen time, and dietary habits at follow-up. This community-based cohort study was carried out between 2012 and 2014 and included 1405 children aged 8 to 10 years old. Maternal educational level was used as an indicator of child’s socioeconomic status. Physical activity, screen time, and dietary habits were assessed by validated questionnaires. The odds of having commercially baked goods for breakfast [OR 1.47 (95% CI 1.03 to 2.10)], going more than once a week to a fast-food restaurant [OR 1.64 (95% CI 1.20 to 2.26)], and taking sweets and candys several times a day [OR 3.23 (95% CI 2.14 to 4.87) were significantly higher among children whose mothers had a lower educational level compared to their peers whose mothers had a higher level. These associations held for taking sweets and candy several times a day after additional adjustment for the corresponding dietary behavior at baseline. Maternal educational level was inversely associated (p < 0.001) with child’s screen time at follow up and being in the lowest maternal educational category was associated with an increased odds of surpassing the maximum recommended time of screen time of 120 min per day (OR (95% CI) 1.43 (1.07 to 1.90), p = 0.016). Maternal education is a predictor for unhealthy dietary habits and high screen time in children.

Effects of the augmented reality game Pokémon GO on fitness and fatness in secondary school students

Objective: The aim of this study was to analyse the effect of 8 weeks of Pokémon GO on physical fitness (cardiorespiratory fitness [CRF], Speed/Agility [S/A], and muscular strength [MS]) and fatness (body mass index [BMI], percentage of body fat [%BF], and waist-hip index), as well as possible differences between weekly physical activity (PA) levels, in Spanish adolescents between 12 and 15 years of age. Design, setting and method: Comparative design, with a control group ( n = 86) that did not participate in Pokémon GO, and an intervention group ( n = 78) which did so over an 8-week period. Age, sex, number of home computers, and maternal educational level were controlled for as possible confounding variables. Results: Results show that players walked a total of 52 km in 8 weeks. Moreover, they played the game for a mean of 40 min/day. Pokémon GO players showed improvements in CRF and BMI ( p < .05). Inactive young people showed a 22.2% increase in CRF and an 11.3% decrease in their %BF compared to non-players. Despite these results, less than half of the participants considered that Pokémon GO had improved their overall fitness and felt more encouraged to engage in PA. Conclusion: Pokémon GO increased PA and CRF levels and decreased BMI and %BF after 8 weeks of practice independently of age, sex, number of computers at home, and maternal education. The Pokémon GO app could be used in school and family contexts to increase the daily amount of MVPA, improve CRF, and to take advantage of the effects of loss of body fat.

1232Relationship between leucine metabolism and executive function development: the GUSTO cohort

Background Molecular biomarkers for cognitive function have also been widely investigated. However, few investigated early development of executive function (EF) comprehensively, which is a higher-level of cognitive function responsible for coordinating other cognitive ability. Methods We investigated the metabolomic biomarkers for EF in a multi-ethnicity birth cohort in Singapore. Circulating level of 165 metabolites were quantified using a nuclear magnetic resonance (NMR)-based metabolomics platform in 457 and 524 children at age 6 and 8 years. EF was assessed in 495 children (∼7 years) using parent-reported Behavior Rating Inventory of Executive Function, Second Edition. We incorporated genetic data and performed mediation analysis to investigate the role of rs1260326 (GCKR) in the relationship between leucine metabolism and EF. Results Higher circulating level of leucine was consistently associated with poorer EFs (Initiate, Working Memory, Plan/Organize, Task-Monitor, and Organization of Materials) after adjusting for age, sex, maternal ethnicity, maternal educational level, household income at recruitment, and child body-mass index (BMI). Comparing to CT genotype, CC genotype in rs1260326 is potentially associated with poorer EFs. But these associations were not mediated via circulating leucine level or BMI. Higher circulating leucine exerts effect on EFs and part of the effect may be via impact on BMI. Leucine-BMI interaction may exist in CT subgroup. Conclusions Our analysis suggested that leucine exerts harmful effect on EF, but at a lower level, leucine-BMI interaction may counteract with the effect of leucine. Key messages Higher level of circulating leucine was associated with poorer EF. Leucine-BMI interaction influences the leucine-EF association.

Dental caries in children and adolescents with juvenile idiopathic arthritis and controls: a multilevel analysis

Background Optimal utilization of dental caries data is crucial in epidemiological research of individuals with juvenile idiopathic arthritis (JIA). The aims were to: explore whether caries is more prevalent among children and adolescents with JIA compared to controls; examine presence of caries according to JIA group, socio-behavioral and intraoral characteristics, and the extent to which surface-specific caries varies between and within individuals; assess whether surface-specific caries varies according to JIA group and dentition; and investigate whether disease-specific clinical features of JIA are associated with presence of caries. Methods In this comparative cross-sectional study, calibrated dentists examined index teeth (primary 2. molars, 1. permanent molars) of 4–16-year-olds with JIA (n = 219) and matched controls (n = 224), using a detailed caries diagnosis system (including enamel caries). JIA-specific characteristics were assessed by pediatric rheumatologists and socio-behavioral information collected by questionnaires. Multilevel mixed-effect logistic regressions reporting odds ratios (OR) with 95% confidence interval (CI) were applied (caries at surface level as outcome variable). Potential confounders were adjusted for, and the effect of dependency of surface-specific caries data was estimated by calculating intra-class correlation coefficients (ICC). Results At individual level, no significant difference in caries prevalence was found between individuals with JIA and controls, regardless of inclusion of enamel caries. Proportion of enamel lesions exceeded dentine lesions. JIA was not associated with presence of caries, but in both groups, low maternal educational level was associated with presence of caries (OR: 2.07, 95% CI: 1.24–3.46). Occlusal and mesial surfaces, compared to buccal surfaces, had generally higher OR according to presence of caries than distal and lingual surfaces (ICC = 0.56). Surface-specific caries in the permanent dentition differed significantly according to group affiliation. Some JIA disease-specific variables were suggested to associate with presence of caries. Conclusions No overall difference in caries prevalence between individuals with JIA and controls was observed, but for both groups, low maternal educational level and tooth surface associated with presence of caries. Associations between JIA disease-specific variables and presence of caries cannot be excluded. Due to predominance of enamel lesions, the potential of preventative dental strategies is considerable.

Vitamin E deficiency and associated factors among Brazilian school children

Objective: Brazilian national data show a significant deficiency in pediatric vitamin E consumption, but there are very few studies evaluating laboratory-proven nutritional deficiency. The present study aimed to settle the prevalence of vitamin E deficiency (VED) and factors associated among school-aged children attended at a primary health unit in Ribeirão Preto (SP). Methods: A cross-sectional study that included 94 children between 6 and 11 years old. All subjects were submitted to vitamin E status analysis. To investigate the presence of factors associated with VED, socioeconomic and anthropometric evaluation, determination of serum hemoglobin and zinc levels, and parasitological stool exam were performed. The associations were performed using Fisher's exact test. Results: VED (α-tocopherol concentrations <7 μmol/L) was observed in seven subjects (7.4%). None of them had zinc deficiency. Of the total of children, three (3.2%) were malnourished, 12 (12.7%) were anemic, and 11 (13.5%) presented some pathogenic intestinal parasite. These possible risk factors, in addition to maternal-work, maternal educational level, and monthly income, were not associated with VED. Conclusions: The prevalence of VED among school-aged children attended at a primary health unit was low. Zinc deficiency, malnutrition, anemia, pathogenic intestinal parasite, maternal-work, maternal educational level, and monthly income were not a risk factor for VED.

Early school leaving: obstetrical and neonatal risks

Introduction: Maternal mortality remains very high in Madagascar. In addition, women's education level is low. The aim of this study is to determine the impact of the maternal educational level on the obstetrical and neonatal outcomes.Methods: This is a retrospective analytical study of primiparae with seven years of study or less to patients with more than seven years of study at Zafisaona Gabriel Mahajanga university hospital center.Results: Prematurity was higher in low-grade patients (RR=2.6 (1.04-6.51)), and low birth weight was the leading cause of neonatal morbidity (RR=3.52). Pregnancy screening, maternal morbimortality, caesarean section, neonatal death and fetal intrauterine death were identical between the two groups.Conclusions: Education has a positive impact on maternal health. An education on pregnancy outcomes should be done at school.

Maternal Education and Child Mortality Differentials: An Upshot From the National Family Health Survey 2015–2016, India

Child mortality is a sociodemographical problem in India. Although nationally representative survey (National Family Health Survey) showed child mortality was gradually declining, that was not satisfactory, and child mortality differentials prevailed all over India. The study intended to identify the effect of maternal educational level along with some sociodemographical determinants on the mortality of their children. The study was run through bivariate association and logistic regression using the data from National Family Health Survey-4 (2015–2016). Findings declared that maternal education had significantly high influence (odds ratio: no education 3.9, primary 2.9, secondary 1.8; adjusted odds ratio: no education 2.9, primary 2.3, secondary 1.6) on child mortality in the Indian context.

PREDICTORS OF UNDER–FIVE CHILD MORTALITY IN ZIMBABWE

The study examines the role of socio-economic and maternal factors on under–five child mortality in Zimbabwe. The research is based on the analysis of the 2012 population census data. A logistic regression model was employed to determine factors that significantly affect under-five child mortality. The results revealed that maternal educational level, age at first birth, marital status, sanitation and provincial location were significant determinants of under–five child mortality. Public health interventions should focus on mothers; single, formerly married, had early childbearing, uneducated, use unsafe drinking water and toilets.

Identifying patterns of lifestyle behaviours among children of 3 years old

Background To identify the patterns of lifestyle behaviours in children aged 3 years, to investigate the parental and child characteristics associated with the lifestyle patterns, and to examine whether the identified lifestyle patterns are associated with child BMI and weight status. Methods Cross-sectional data of 2090 children 3 years old participating in the Dutch BeeBOFT study were used. Child dietary intakes, screen times and physical activity were assessed by parental questionnaire, and child weight and height were measured by trained professionals according to a standardized protocol. Latent class analysis was applied to identify patterns of lifestyle behaviours among children. Results Three subgroups of children with distinct patterns of lifestyle behaviours were identified: the ‘unhealthy lifestyle’ pattern (36%), the ‘low snacking and low screen time’ pattern (48%) and the ‘active, high fruit and vegetable, high snacking and high screen time’ pattern (16%). Children with low maternal educational level, those raised with permissive parenting style (compared those with authoritative parents), and boys were more likely be allocated to the ‘unhealthy lifestyle’ pattern and the ‘active, high fruit and vegetable, high snacking and high screen time’ pattern (P &lt; 0.05). No association was found between the identified lifestyle patterns and child BMI z-score at age 3 years. Conclusions Three different lifestyle patterns were observed among children aged 3 years. Low maternal educational level, permissive parenting style and male gender of the child were associated with having unhealthy lifestyle patterns for the child.

Child, family, and school factors in bilingual preschoolers’ vocabulary development in heritage languages

Child characteristics, family factors, and preschool factors are all found to affect the rate of bilingual children's vocabulary development in heritage language (HL). However, what remains unknown is the relative importance of these three sets of factors in HL vocabulary growth. The current study explored the complex issue with 457 Singaporean preschool children who are speaking either Mandarin, Malay, or Tamil as their HL. A series of internal factors (e.g., non-verbal intelligence) and external factors (e.g., maternal educational level) were used to predict children's HL vocabulary growth over a year at preschool with linear mixed effects models.The results demonstrated that external factors (i.e., family and preschool factors) are relatively more important than child characteristics in enhancing bilingual children's HL vocabulary growth. Specifically, children's language input quantity (i.e., home language dominance), input quality (e.g., number of books in HL), and HL input quantity at school (i.e., the time between two waves of tests at preschool) predict the participants’ HL vocabulary growth, with initial vocabulary controlled. The relative importance of external factors in bilingual children's HL vocabulary development is attributed to the general bilingual setting in Singapore, where HL is taken as a subject to learn at preschool and children have fairly limited exposure to HL in general. The limited amount of input might not suffice to trigger the full expression of internal resources. Our findings suggest the crucial roles that caregivers and preschools play in early HL education, and the necessity of more parental involvement in early HL learning in particular.