Influence of maternal excess weight before pregnancy on breastfeeding and weaning: pooled analyses of four population-based cohorts born between 1982-2015

Purpose: To investigate the associations of maternal excess weight before pregnancy with (1) weaning at age 3mo, (2) duration of exclusive breastfeeding at age 6mo, (3) duration of any breastfeeding at age 12mo; and (4) to compare the magnitude of these associations over four decades. Methods: Data were from participants in the Pelotas (Brazil) Birth Cohorts born in 1982 (N=5,334), 1993 (N=1,442), 2004 (N=4,092) and 2015 (N=4,102). Maternal pre-pregnancy weight was collected after the delivery and breastfeeding status was assessed when children were three and 12 months old. Results: Only in the most recent cohort (2015), women with excess weight [body mass index (BMI) ≥ 25 kg/m2) before pregnancy had higher risk of discontinuing exclusive breastfeeding within the first six months post-partum than women with normal weight [HR= 1.22 (95%CI 1.15; 1.30)]. Duration of any type of breastfeeding until 12 months of age was not affected by pre-pregnancy weight. Conclusion: Excess weight before pregnancy is associated with exclusive breastfeeding only in the most recent birth cohort coinciding with increases in weight excess and breastfeeding over time.

Prevalence of Overweight, Obesity, Abdominal Obesity, and Obesity-Related Risk Factors in Polish Preschool Children: A Cross-Sectional Study

The aim of this study was to assess the prevalence of overweight, obesity, abdominal obesity (AO), and obesity-related risk factors in children aged 5–6 years from Poland. The study was conducted at 22 randomly selected kindergartens representing each city district. A cross-sectional study of 1172 children aged 5–6 years was conducted using questionnaire forms and physical measurements. The physical measurements included body height, weight, waist circumference (WC), and body fat percentage (BFP). A univariate and multivariate logistic regressions were performed to evaluate the risk factors for excess weight, excess adiposity, and abdominal obesity (AO). The prevalence of excess weight (BMI ≥ 85th percentile) was 11.0%. The prevalence of excess adiposity (BFP ≥ 85th percentile) was 42.3%. Prevalence of AO (WC ≥ 90th percentile) was higher in girls compared to boys (14.9% vs. 10.7%, respectively). Multivariate logistic regression analysis indicated that children whose both parents were obese had significantly higher risk of excess weight, excess adiposity, and AO. Lower education level of fathers was associated with higher risk of excess weight and excess adiposity in children, while a lower level of maternal education was associated with higher risk of AO in children. Screen time over 120 min per day, participating less than once a week in at least 60 min of moderate-to-vigorous physical activity (MVPA) and birth weight over 4000 g were associated with excess weight, excess adiposity and AO. Moreover, cesarean delivery was associated with higher risk of excess weight and excess adiposity, and lower socio-economic status with higher risk of AO. This study revealed that excess adiposity and AO differed by gender. Parental obesity, screen time, MVPA, and birth weight could be significant determinants of excess weight, excess adiposity and AO in Polish preschool children.

FOOD ADDICTION SYMPTOMS AND METABOLIC CHANGES IN CHILDREN AND ADOLESCENTS WITH THE DOUBLE BURDEN OF MALNUTRITION

The double burden of malnutrition (DBM) has been described in many low/middle-income countries. We investigated food addiction, thyroid hormones, leptin, the lipid/glucose profile, and body composition in DBM children/adolescents. Subjects were allocated into groups according nutritional status: control (C, n=28), weight excess (WE, n=23), and DBM (weight excess plus mild stunting, n=22). Both the DBM and WE groups showed higher insulin concentrations than the control (mean pmol/l [CI]: DBM=57.95 [47.88-70.14], WE=74.41 [61.72-89.80], C=40.03 [34.04-47.83], P<0.001). WE and DBM showed more food addiction symptoms than the control (3.11 [2.33–3.89], 3.41 [2.61-4.20] and 1.66 [0.95-2.37]). In DBM individuals addiction symptoms were correlated with higher body fat and higher insulin and leptin levels. These data provide preliminary evidence consistent with the suggestion that DBM individuals have a persistent desire to eat, but further studies are required to confirm these results in a larger study. These hormonal changes and high body fat contribute to development of diabetes in long-term.

Reasons for smoking among English-speaking adults in Leicester - a pilot study

Cigarette smoke contains around 7000 chemicals that are harmful to health and cause premature death. Most smokers acknowledge the harm they are doing to them yet continue to smoke. This pilot study was designed to understand the impact of cigarette smoking, the addictive effect of nicotine, and also hypothesize a recommendation for smoking cessation. Methods: This study recruited English speaking adult participants who were either current, occasional, and ex-smokers from NHS stop smoking clinics in Leicester, United Kingdom, using a self-completed questionnaire. Results: Out of 32 participants, White British were thirteen & Asian were nine with majority of males. Stress, boredom, nervousness, and just like it, were the main reasons quoted for cigarette smoking. Irritation & mood swings were the top reasons for craving. The visual stimuli and smell of smoking were reported as the top two strong cues. Majority of the participants reported having several effects due to cigarette smoking such as respiratory cough, feel like tightening of lungs, asthma, high blood pressure, difficulty in losing weight, excess fat accumulation near the waist, poor appetite, fatigue, sleep disturbances, darkened teeth as well as an inability to differentiate between taste. Conclusion: Our study suggested that cigarette smoking may be more like a habit than an addiction, therefore unable to relieve stress or boredom, but keep smokers hooked to the habit.

Obesity in Pregnant Adolescents: Clinical Correlates, Maternal and Fetal Outcomes

Objective: To evaluate the relationship between pregestational obesity and maternal and fetal outcomes in pregnant adolescents. Methods: Cross-sectional study conducted among puerperal teenagers of a university hospital in Southern Brazil. Structured questionnaires on sociodemographic and obstetric data were applied. Results: We evaluated 500 puerperal adolescents with a mean age of 17.77± 1.36. Of these, 31.2% (n=156) had pregestational weight excess. Pregestational weight excess was significantly associated with gestational hypertension (p=0.037) and diabetes (p=0.045), cesarean delivery (p=0.040),and lower adherence to prenatal care (24.7%, p=0.007).

Menarca y estado nutricional en niñas del periurbano de la ciudad de La Plata, Argentina

La menarca constituye un hito madurativo importante. A escala mundial ocurre, en promedio, a los 12,5 años y está sujeta a factores genéticos y/o ambientales. El objetivo fue analizar, en niñas residentes en la periferia urbana de La Plata: a) la edad mediana de menarca y b) si el estado nutricional y la distribución adiposa influyen en la edad de ocurrencia de menarca. Se evaluaron, durante los ciclos 2014-2017, en 657 niñas de 10-14 años: presencia(P)/ausencia(A) de menarca, peso, talla y pliegues subcutáneos tricipital y subescapular. Se determinaron: edad mediana de menarca (EM) según método status quo y regresión logística; estado nutricional -desnutrición, exceso ponderal y normonutrición- empleando como referencia y puntos de corte a la OMS; y distribución de adiposidad según índice subescapular/tricipital, considerando valores >1 indicativos de adiposidad centralizada. Se calcularon en general y por estado nutricional la EM y las prevalencias de ocurrencia comparándose mediante Chi2. La menarca estuvo presente en el 44,10% de las niñas con EM de 12,13 años. Alrededor del 54% de las niñas se mantuvo dentro de los límites normales (P: 41,20%; EM: 12,28 años) y el 45,70% estaban desnutridas; de estas 4,90% mostraron desnutrición debido a la baja estatura (P: 25,00%; MS: 13,40 años) y 40,80% tenían exceso de peso (P: 50,40%; MS: 11,78 años). El 32,72% de las niñas tenían adiposidad centralizada (P: 59,10%; EM: 11,79 años). Los resultados permiten concluir que el estado nutricional influye en la edad mediana de ocurrencia de la menarca, la cual es mayor en las niñas desnutridas y menor en las niñas con exceso ponderal. La disposición centralizada de la adiposidad favorece la presencia de menarca. Menarche is an important maturation milestone. It normally occurs at an average age of 12.5 years and is influenced by genetic and/or environmental factors. The aim of this study was to analyze in girls residing at suburbs of La Plata city a) the median age of menarche; b) if nutritional status and fat distribution have any influence in the age of menarche. During years 2014 to 2017, 657 girls aged between 10 and 14 years(y) were surveyed, determining: presence(P)/absence(A) of menarche, weight, height, and tricipital and subscapular skinfolds. It was measured: median age of menarche (MA) according to the status quo method and logistic regression; nutritional status -undernutrition, excess weight, and normonutrition- using WHO as a reference and their cut-off points; and the distribution of adiposity through the use of subscapular/tricipital index, considering values >1 an indicative of centralized adiposity. The median age of menarche was calculated both in the general sample and by nutritional status; general and age-prevalence of menarche were compared by Chi2. Menarche was present in 44.10% of the girls with MS of 12.13 years. About 54% of the population stayed within normal limits (P: 41.20%; MS: 12.28 years) and 45.70% were malnourished; of these 4.90% showed malnutrition due to short stature (P: 25.00 %; MS: 13.40 years) and 40.80% had weight excess (P: 50.40%; MS: 11.78 years). 32.72% of the girls had centralized adiposity (P: 59.10%; MS: 11.79 years). These results allow us to conclude that nutritional status influences the median age of menarche: it is higher in undernourished girls and lower in those with weight excess. Centralized disposition of adiposity promotes the presence of menarche.

Considering BMI, Body Image and Desired Weight Change for Suitable Obesity Management Options

With prevalence of obesity increasing worldwide, understanding body image in individuals with excessive weight is important, as unawareness of weight excess can prevent weight loss attempts. We explored the associations among measured and self-reported body mass index (BMI), body image and body satisfaction among Spanish females and males with overweight or obesity, with a special focus in discriminating individuals who are and are not satisfied with their body and wish or not to change their appearance. Just unifying all individuals with excessive weight may lead to uncover or deny different realities and to develop unfitted clinical management options. Updating findings for the Spanish population, we found that most participants correctly estimated their weight, but 3 in 10 underestimated it. Similarly, their body images corresponded to adults with overweight or obesity who desired to be thinner, but in average they reported a perceived body just slightly overweight and a moderate satisfaction with their body. Complementing the existing evidence, BMI and sex-gender interacted for influencing body weight estimation and desired weight change. In addition, three different subgroups were found for desired change of weight and size, depending on their BMI and body satisfaction. Discovering and considering different subjective realities and corporeal experiences among individuals with weight excess will help professionals to develop appropriate therapeutic interventions. Thus, the personal experiences that individuals have with obesity, instead of obesity itself, should be considered for disentangling management efforts.

Extended composite index of anthropometric failure in Argentinean preschool and school children

Objective:The Composite Index of Anthropometric Failure (CIAF) can only be applied to children under 5 years of age and does not contemplate obesity. The aim of this study was to propose an Extended CIAF (ECIAF) that combines the characterization of malnutrition due to undernutrition and excess weight, and apply it in six Argentine provinces.Design:ECIAF excludes children not in anthropometric failure (group A) and was calculated from a percentage of children included in malnutrition categories B: wasting only; C: wasting and underweight; D: wasting, stunting and underweight; E: stunting and underweight; F: stunting only; Y: underweight only; G: only weight excess; and H: stunting and weight excess.Setting:Cross-sectional study conducted in Buenos Aires, Catamarca, Chubut, Jujuy, Mendoza and Misiones (Argentina).Participants:10 879 children of both sexes aged between 3 and 13·99.Results:ECIAF in preschool children (3 to 4·99 years) was 15·1 %. The highest prevalence was registered in Mendoza (16·7 %) and the lowest in Misiones (12·0 %). In school children (5 to 13·99 years) ECIAF was 28·6 %. Mendoza also recorded the highest rate (30·7 %), while Catamarca and Chubut had the lowest values (27·0 %). In the whole sample, about 25 % of the malnutrition was caused by undernutrition and 75 % by excess weight.Conclusions:The ECIAF summarizes anthropometric failure by both deficiency and excess weight and it highlights that a quarter of the malnutrition in the Argentine population was caused by undernutrition, although there are differences between Provinces (P < 0·05). ECIAF estimates are higher than those of CIAF or under-nutrition.