Longitudinal Associations Between Child Weight Change, the Home Food Environment, and Child Feeding Practices During COVID-19

Objectives Lifestyle changes during the coronavirus 2019 (COVID-19) pandemic may result in child weight gain thus increasing obesity risk. Weight gain during COVID-19 may be, in part, be due to changes in the home food environment and child feeding practices; yet longitudinal studies have not examined these relations. This study describes patterns of child weight change, the home food environment, and child feeding practices across two timepoints during COVID-19. Methods Parents (N = 433; 95% female) in the US with a child aged 5–18 years completed two online surveys in May (T1) and September (T2) 2020. Parents reported on child feeding practices (e.g., concern for child overweight, restriction, pressure, monitoring) using the Child Feeding Questionnaire, perceived child weight status, and the home food environment before COVID-19 (i.e., baseline; retrospective report) and at twice during COVID-19 (T1 and T2). Child weight change was categorized as having gained weight vs. not. Repeated measures and chi square analyses examined differences in changes in child feeding practices and the home food environment by child weight change. Results About 30% of parents reported child weight gain from T1 to T2 (average +9.6 ± 7.1 lbs). Interactions between parents’ concern for child overweight, monitoring, and restriction, by child weight change, were observed (ps ≤ 0.02): families with child weight gain reported baseline to T1 increases in these feeding practices, that were sustained at T2; for families without child weight gain, concern, monitoring, and restriction increased at T1, but returned to baseline at T2. Overall, pressure feeding practices increased from baseline to T1, and returned to baseline at T2. No clear patterns regarding home food environment changes and child weight change were observed. Conclusions Almost one-third of parents reported child weight gain during COVID-19, which was related to sustained concern for overweight and some feeding practices, yet not home food environment changes. Further research is needed to investigate different behavioral, societal, environmental, and psychosocial factors contributing to child weight gain during COVID-19, in order to identify the most salient intervention targets to mitigate the potential long-term health consequences. Funding Sources Virginia Commonwealth University, National Cancer Institute

Association Between Breastfeeding and Child Overweight in Mexico

Background: Globally, the prevalence of child overweight has increased over the past few decades. The largest burden of child overweight is identified among upper-middle-income countries, such as Mexico. Breastfeeding has been identified as one of the key affordable and modifiable maternal health behaviors protecting against child overweight. Objective: To examine the association between breastfeeding and child overweight while sequentially controlling for individual, household, and area factors in Mexican children. Methods: Secondary data analysis using the 2012 Mexican National Health and Nutrition Survey which included risk factors for overweight on 2089 children aged 6 to 35 months and analyzed data to estimate fixed- and mixed-effects logistic regression models. Results: Overall, 9.0% of children were overweight and 71.1% of mothers reported any breastfeeding for ≥6 months. We found no evidence for a protective effect of any breastfeeding for ≥6 months on child overweight when compared to children who were never breastfed in the fully adjusted model and across all models (model 4, adjusted odds ratio [AOR] [95% CI] = 0.76 [0.31-1.86]). We identified risk factors for child overweight at the individual and area levels, with maternal obesity and offspring high birthweight being significant in the fully adjusted model and across all models (model 4, AOR [95% CI] = 2.26 [1.32-3.85] and 2.83 [1.44-5.56], correspondingly). Conclusions: Our results suggest shared obesogenic environment influences from which the overweight-obese maternal-child dyads are emerging in Mexican households. More research is needed to better understand these obesogenic environments grounded on the particular contexts among upper-middle-income countries.

Do genetic risk scores for childhood adiposity operate independent of BMI of their mothers?

Objectives Genetic predisposition and maternal body mass index (BMI) are risk factors for childhood adiposity, defined by either BMI or overweight. We aimed to investigate whether childhood-specific genetic risk scores (GRSs) for adiposity-related traits are associated with childhood adiposity independent of maternal BMI, or whether the associations are modified by maternal BMI. Methods We constructed a weighted 26-SNP child BMI-GRS and a weighted 17-SNP child obesity-GRS in overall 1674 genotyped children within the Danish National Birth Cohort. We applied a case-cohort (N = 1261) and exposure-based cohort (N = 912) sampling design. Using logistic regression models we estimated associations of the GRSs and child overweight at age 7 years and examined if the GRSs influence child adiposity independent of maternal BMI (per standard deviation units). Results In the case-cohort design analysis, maternal BMI and the child GRSs were associated with increased odds for childhood overweight [OR for maternal BMI: 2.01 (95% CI: 1.86; 2.17), OR for child BMI-GRS: 1.56 (95% CI: 1.47; 1.66), and OR for child obesity-GRS 1.46 (95% CI: 1.37; 1.54)]. Adjustment for maternal BMI did not change the results, and there were no significant interactions between the GRSs and maternal BMI. However, in the exposure-based cohort design analysis, significant interactions between the child GRSs and maternal BMI on child overweight were observed, suggesting 0.85–0.87-fold attenuation on ORs of child overweight at higher values of maternal BMI and child GRS. Conclusion GRSs for childhood adiposity are strongly associated with childhood adiposity even when adjusted for maternal BMI, suggesting that the child-specific GRSs and maternal BMI contribute to childhood overweight independent of each other. However, high maternal BMI may attenuate the effects of child GRSs in children.

Changes in Child Undernutrition and Overweight in India from 2006 to 2019: An Analysis of 22 States

Objectives: India has historically displayed high levels of child stunting and low levels of child overweight. Using newly released data, we evaluated changes in priority indicators of child growth from 2006 to 2019 and examined the role of human development measures in these changes. Methods: We estimated cumulative and annualized changes in state- and district-level child growth indicators using three rounds of National Family Health Surveys (2005-06, 2015-16, 2019-20) in 22 states. Outcomes included stunting, underweight, wasting, and overweight. Human development was measured using a principal components analysis of nine survey-based items. We contrasted expected versus observed changes in district-level growth indicators between 2015 and 2019 based on changes in development measures using two-way Blinder Oaxaca decomposition. Results: From 2006 to 2019, the prevalence of stunting and underweight decreased by 10.9 percentage points (pp) and 7.1 pp, respectively, while the prevalence of wasting and overweight increased by 2.8 pp and 2.2 pp, respectively. Annualized rates of change for stunting, wasting, and underweight were lower from 2015 to 2020 compared with the 2006 to 2015 period, while rates of change in overweight were higher. Simultaneously, all nine human development indicators improved between 2006 and 2020. A unit increase between 2015 and 2020 in the human development score predicted a -4.7 pp (95% CI: - 5.7, -3.6) change in stunting, yet stunting declined by just -0.3 pp. Conclusions: Population-level reductions in child undernutrition have stalled and the rise in child overweight has accelerated between 2015 and 2020 relative to the 10 years preceding this period.

Las secuelas del terremoto: el problema de la malnutrición infantil en Manabí

La malnutrición infantil es un tema preocupante en Ecuador, donde sus prevalencias resultan muy superiores al promedio de América Latina; para el año 2018, la desnutrición infantil en el país alcanza el 23%, superando ampliamente el promedio regional que bordea el 9%, y el sobrepeso infantil en el país alcanzó el 16%, superando el promedio regional de alrededor de 8%. En este contexto, esta investigación tiene el objetivo de analizar la malnutrición infantil en la provincia de Manabí, su evolución y características. Para ello se desarrolla una metodología cuantitativa, usando datos de las Encuestas de Condiciones de Vida y las Encuestas Nacionales de Salud y Nutrición, y emplea modelos de regresión probabilística. Entre los principales resultados se encuentra que la desnutrición y el sobrepeso infantil se asocian con factores diversos, donde ha existido una reducción de la desnutrición entre 1999 y 2014; sin embargo, los problemas nutricionales para el año 2018 se han agudizado, lo cual se presenta como una secuela del terremoto del año 2016. Palabras clave: desnutrición; sobrepeso; Ecuador; análisis de regresión. ABSTRACT Child malnutrition is an alarming issue in Ecuador, where its prevalence is much higher than the Latin American average; by 2018, child malnutrition in the country reaches 23%, far exceeding the regional average bordering 9%, and child overweight in the country reaches 16%, exceeding the regional average of around 8%. In this context, this research aims to analyze child malnutrition in the province of Manabí, its evolution and characteristics. This article develops a quantitative methodology, using data from the Living Conditions Surveys and the National Health and Nutrition Surveys, and uses probabilistic regression models. Among the main results are that child malnutrition and overweight are associated with various factors, where there has been a reduction in malnutrition between 1999 and 2014; however, nutritional problems for 2018 have become more acute, which is presented as a sequel to the 2016 earthquake. Keywords: malnutrition; overweight; Ecuador; regression analysis.

A aplicação da escala KTK para a análise do desenvolvimento motor grosso em crianças

Introdução: A escala Körperkoordinations test für Kinder (KTK) destaca-se por ser uma forma indireta e eficaz de mapear a coordenação motora grossa entre crianças de 5 a 14 anos de idade. O teste é constituído por quatro etapas, nas quais avaliam-se: 1) equilíbrio em marcha para trás; 2) saltos laterais; 3) saltos monopedais e 4) transferência sobre plataformas. Objetivo: Buscar através de revisão narrativa a aplicabilidade da escala KTK na pesquisa do desenvolvimento motor grosso com crianças sobrepeso/obesas e eutróficas. Métodos: Foi realizada uma revisão narrativa da literatura nacional e internacional através das bases de dados Lilacs, PubMed, Scielo e Bireme e por meio do cruzamento das palavras-chave: Child, Overweight, Obesity, Motor skills, Körperkoordinationstest für Kinder (KTK) e os seus correspondentes em português. Os artigos de observação e experimentação realizados no período de 2003 até o presente momento foram incluídos desde que atendessem aos critérios de inclusão. Conclusão: A bateria de testes KTK mostrou-se eficiente para pesquisa do desenvolvimento motor grosso de menores sobrepeso/obesos e eutróficos.Palavras-chave: criança, sobrepeso, obesidade, destreza motora.