Obesity and Blood Pressure in children

Estimates of relationships between blood pressures and anthropometric structure or body composition were made on a total sample of 414 children, taking age and sex into account. A subsample of 250 children was formed from obese (or slightly obese) subjects. A different pattern in anthropometric structure and body composition resulted in relation to a different degree of obesity. A canonical correlation analysis was carried out for each sex, in which a multivariate measure of the linear association between heart-circulatory functionality parameters, on the one hand, and all the anthropometric traits and body composition parameters, on the other, was computed. This association resulted statistically significant in both sexes, also if a difference was observed as concerns the traits that most heavily contributed to the relation-ships between sets of variables, with an evident sexual dimorphism also in infancy. The necessity of preventive measures and sanitary screening also during infancy was pointed out.     

Genetic and Environmental Influences on the Tracking of Body Size from Birth to Early Adulthood

Objective: This study identified genetic and environmental influences on the tracking of body size from birth to 16 to 18.5 years of age. Research Methods and Procedures: Longitudinal information was collected from a nationally representative sample of Finnish twin adolescents (birth cohorts 1975 to 1979) and their parents through questionnaires mailed when the twins were ages 16 and 18.5 years old. The sample included 702 monozygotic, 724 same‐sex dizygotic, and 762 opposite‐sex dizygotic sets of twins. The measures used were length, weight, ponderal index (kilograms per cubic meters), and gestational age at birth, and height, weight, and body mass index (kilograms per square meters) at 16 to 18.5 years of age. The changes in genetic and environmental influences on body size from birth to early adulthood were analyzed by quantitative genetic modeling. Results: The twins who had a higher weight or ponderal index at birth were taller and heavier in early adulthood, whereas those who were longer at birth were taller, but not heavier, later in life. Adult height was affected more by the birth size than body mass index. In the genetic modeling analyses, the genetic factors accounting for the variation of body size became more apparent with age, and both genetic and environmental influences on stature had a sizable carry‐over effect from birth to late adolescence, whereas for relative weight, the influences were more age‐specific. Discussion: The genetic and environmental architecture of body size changes from birth to adulthood. Even in monozygotic twins who share their genetic background, the initially larger twin tended to remain larger, demonstrating the long‐lasting effects of fetal environment on final body size.     

The Semantic Organization of Subjective Experience in Adolescence and Early Adulthood

To discover the laws of development of subjective experience, we must study the relationships between affective and intellectual processes in that experience (Vygotsky, 1981). Changes in this relationship and the formation of new interfunctional interactions during the course of emotional development shape the dynamic of such experiences and give rise to qualitatively new types.     

Birth Weight,Adulthood BMI,and Subsequent Weight Gain in Relation to Leptin Levels in Swedish Women

LISSNER, LAUREN, CECILIA KARLSSON, ANNA KARIN LINDROOS, LARS SJOSTROM, BJORN CARLSSON, LENA CARLSSON, AND CALLE BENGTSSON. Birth weight, adulthood BMI, and subsequent weight gain in relation to leptin levels in Swedish women. Obes Res. Objective Leptin seems to be involved in the regulation of energy balance, although little is known about the epidemiology of leptin with respect to prediction of weight gain and incidence of obesity-related diseases. The dual aim of this study is to document characteristics of leptin after long-term storage, and to describe its relation to body weight, from birth to old age, in an ongoing prospective study. Research Methods and Procedures A population-based sample of Swedish women was first examined at the ages of 38 to 60 and re-examined 24 years later. This study used 1358 frozen serum samples that had been stored 29 years for analysis of leptin concentrations and their relation to body weight history. Results Leptin values obtained from stored samples showed the same correlation with relative weight as that seen in a contemporary sample with similar demographic characteristics. Lower self-reported birth weight was associated with higher leptin levels in adulthood (p = 0.01), controlling for age and adult BMI. Prospective analyses revealed that high leptin in 38 to 46-year-olds predicted subsequent long-term weight gain (p = 0.003), although no significant associations were seen in women initially aged 50 or older. Discussion: It is feasible to use frozen serum for studying leptin in relation to obesity and related developments many years later. High leptin level was a risk factor for subsequent weight gain in 38- and 46-year-old women. Retrospective analyses involving birth weight suggest that leptin resistance in adulthood might have fetal origins.     

Body Size at Birth Is Associated with Food and Nutrient Intake in Adulthood

Background

Small body size at birth is associated with an increased risk of cardiovascular disease and type 2 diabetes. Dietary habits are tightly linked with these disorders, but the association between body size at birth and adult diet has been little studied. We examined the association between body size at birth and intake of foods and macronutrients in adulthood.

Methodology/Principal Findings

We studied 1797 participants, aged 56 to 70, of the Helsinki Birth Cohort Study, whose birth weight and length were recorded. Preterm births were excluded. During a clinical study, diet was assessed with a validated food-frequency questionnaire. A linear regression model adjusted for potential confounders was used to assess the associations. Intake of fruits and berries was 13.26 g (95% confidence interval [CI]: 0.56, 25.96) higher per 1 kg/m³ increase in ponderal index (PI) at birth, and 83.16 g (95% CI: 17.76, 148.56) higher per 1 kg higher birth weight. One unit higher PI at birth was associated with 0.14% of energy (E%) lower intake of fat (95% CI: -0.26, -0.03) and 0.18 E% higher intake of carbohydrates (95% CI: 0.04, 0.32) as well as 0.08 E% higher sucrose (95% CI: 0.00, 0.15), 0.05 E% higher fructose (95% CI: 0.01, 0.09), and 0.18 g higher fiber (95% CI: 0.02, 0.34) intake in adulthood. Similar associations were observed between birth weight and macronutrient intake.

Conclusions

Prenatal growth may modify later life food and macronutrient intake. Altered dietary habits could potentially explain an increased risk of chronic disease in individuals born with small body size.     

Obesity in Adolescence Predicts Lower Educational Attainment and Income in Adulthood: The Project EAT Longitudinal Study

Objective

Prospective associations between obesity in adolescence and adult socioeconomic outcomes, and potential mediators, were examined in a contemporary cohort.

Methods

Longitudinal data collected in 1998 to 1999 (Project EAT‐I) and 2015 to 2016 (EAT‐IV) were analyzed for 1,796 participants who provided data at both time points. Adolescents (mean age = 14.8 years) self‐reported demographic and psychosocial variables (EAT‐I) and follow‐up outcomes (EAT‐IV). Body weight and height were directly measured. Bachelor's degree or more education, income ≥ US $50,000, and partnered status at follow‐up were examined by baseline obesity (>95th BMI percentile) using logistic regression. Self‐esteem, depression, and weight‐related teasing were examined as mediators using multivariate probit regressions. All analyses were adjusted for race, baseline age, and parent socioeconomic status.

Results

Girls with obesity were significantly less likely to have achieved a bachelor’s degree (OR 0.32, 95% CI [0.18, 0.58]; P < 0.001), earn ≥ $50,000 annually (OR 0.57, 95% CI [0.33, 0.99]; P < 0.04), or be partnered (OR 0.45, 95% CI [0.27, 0.75]; P < 0.002) in adulthood. No associations were observed among boys. Among girls, depression mediated 8.5% and 23.6% of the association between adolescent obesity and adult education and income, respectively.

Conclusions

Adolescent girls with obesity have lower educational attainment and income and are less likely to be partnered in later adulthood. Depression may partly mediate the associations.

     

Differential Impact of Obesity in Related Populations

To search for genetic and environmental determinants of obesity, we compared the prevalences and the impact of obesity in three populations from two cities: Mexican Amcricans (n=820) and non-Hispanic whites (n=1112)from San Antonio, Texas, and Mexicans from Mexico City (n= 1878). In the age range examined, 35–64 years, only Mexican men and women showed a significant increase in the prevalence of obesity with age. On the other hand, genetic ancestry, especially in women, made significant differences in the rates of obesity. Mexican Americans showed relatively high, and non-Hispanic whites low, rates of obesity. To discriminate between genetic and environmental influences mediating the impact of obesity on a set of hemodynamic and metabolic variables, we compared this impact between Mexican Americans and both non-Hispanic whites (same macro-environment, different gene pools), and Mexicans (same gene pool, different environments). We found that obesity always worsens the hemodynamic and metabolic profiles of individuals, but the magnitude of the effects may be variable. We showed that the levels of insulin concentrations for a given level of obesity were similar in Mexicans and Mexican Americans, suggesting that genetic influences predominate in determining insulin levels; the levels of triglycerides and HDL for a given level of obesity were similar in Mexican Americans and non-Hispanic whites, suggesting predominant environmental influences on lipid levels. On the other hand, the levels of glucose and systolic blood pressure for a given level of obesity were usually different between Mexican Americans and either of the other two populations, suggesting that these levels may result from genotype-by-environment interactions.     

Birth Weight in Relation to Leisure Time Physical Activity in Adolescence and Adulthood: Meta-Analysis of Results from 13 Nordic Cohorts

Background

Prenatal life exposures, potentially manifested as altered birth size, may influence the later risk of major chronic diseases through direct biologic effects on disease processes, but also by modifying adult behaviors such as physical activity that may influence later disease risk.

Methods/Principal Findings

We investigated the association between birth weight and leisure time physical activity (LTPA) in 43,482 adolescents and adults from 13 Nordic cohorts. Random effects meta-analyses were performed on categorical estimates from cohort-, age-, sex- and birth weight specific analyses. Birth weight showed a reverse U-shaped association with later LTPA; within the range of normal weight the association was negligible but weights below and above this range were associated with a lower probability of undertaking LTPA. Compared with the reference category (3.26–3.75 kg), the birth weight categories of 1.26–1.75, 1.76–2.25, 2.26–2.75, and 4.76–5.25 kg, had odds ratios of 0.67 (95% confidence interval: 0.47, 0.94), 0.72 (0.59, 0.88), 0.89 (0.79, 0.99), and 0.65 (0.50, 0.86), respectively. The shape and strength of the birth weight-LTPA association was virtually independent of sex, age, gestational age, educational level, concurrent body mass index, and smoking.

Conclusions/Significance

The association between birth weight and undertaking LTPA is very weak within the normal birth weight range, but both low and high birth weights are associated with a lower probability of undertaking LTPA, which hence may be a mediator between prenatal influences and later disease risk.     

Effect of Birth Year on Birth Weight and Obesity in Adulthood: Comparison between Subjects Born Prior to and during the Great Depression in Iceland

Background

Many epidemiological studies have linked small size at birth to adverse adult health outcomes but the relative influence of environmental exposures is less well established.

Methods

The authors investigated the impact of prenatal environmental exposure by comparing 2750 participants born before (1925–1929) and during (1930–1934) the Great Depression in Reykjavik, Iceland. Calendar year served as proxy for environmental effects. Anthropometric measurements at birth and school-age (8–13 years) were collected from national registries. Participants were medically examined as adults (33–65 years).

Results

Mean birth weight, adjusted for maternal age and parity, decreased by 97 g (95% confidence interval (CI): 39, 156) for men and 70 g (95% CI: 11, 129) for women from 1925 to 1934; growth at school-age was significantly reduced for participants growing during the Depression. As adults, women prenatally exposed to the Depression had higher body mass index (Δ0.6 kg/m², 95% CI: 0.2, 1.1), higher fasting blood glucose levels (Δ0.16 mmol/L, 95% CI: 0.07, 0.23) and greater odds of being obese 1.43 (95% CI: 1.01, 2.02) compared to unexposed counterparts. Non-significant associations were observed in men.

Conclusion

Reduction in birth weight due to rapid shifts in the economic environment appears to have a modest but significant association with later obesity for women while male offspring appear to be less affected by these conditions.     

Birth Weight and Its Relationship to Size Attained and Relative Fat Distribution at 7 to 12 Years of Age

The relationship between birth weight and relative subcutaneous fat distribution at school age was considered in 131 boys and 106 girls 7 to 12 years of age. Relative fat distribution at school age was estimated with the ratio of the subscapular to triceps skinfolds (S/T) for the total sample, and with the ratio of the sum of two trunk (subscapular, midaxillary) to the sum of two extremity (triceps, medial calf) skinfolds (T/E) for subsamples of 102 boys and 63 girls. There were no sex differences in the S/T ratio (mm/mm), boys 0.62 ± 0.15, girls 0.63 ± 0.18; T/E ratio (mm/mm), boys 0.58 ± 0.13, girls 0.59 ± 0.16; and BMI (kg/m²), boys 17.1 ± 2.4, girls 16.9 ± 2.2. Second order partial correlations, controlling for age and the BMI or age and sum of skinfolds, between birth weight and the skinfold ratios are, respectively, ?0.22 and ?0.20 (p<0.01) for S/T and ?0.29 and ?032 (p<0.01) for T/E in girls, and ?0.18 and ?0.17 (p<0.05) for S/T and ?0.06 and ?0.6 for T/E in boys. Though low, the correlations suggest that as birth weight decreases proportionally more subcutaneous fat is accumulated on the trunk than on the extremities, more so in females than in males. Results of stepwise multiple regression analyses indicate that birth weight accounts for from 2% to 8% of the variance in relative subcutaneous fat distribution at school age.     

Obesity, white blood cell counts, and platelet counts among police officers

Objective: To determine the association between several obesity indices (BMI, waist circumference, waist‐to‐hip and waist‐to‐height ratios, and abdominal height) and hematologic parameters [white blood cell (WBC) and platelet counts] among police officers. Research Methods and Procedures: The authors conducted this cross‐sectional study among 104 randomly selected officers (41 women and 63 men) from the Buffalo, NY, Police Department. Anthropometric measures were performed by clinic staff, and fasting blood samples were drawn for complete blood counts. Pearson's correlation, Student's t tests, ANOVA, analysis of covariance, and linear regression were used to assess the associations. Results: Officers ranged in age from 26 to 61 years old and were predominantly white. Among women, current smokers had significantly higher WBC counts (7.4 × 10³ cells/µL ± 1.4) than former (5.2 × 10³ cells/µL ± 1.4) or never smokers (5.6 × 10³ cells/µL ± 1.5) (p = 0.002). Women had similar WBC counts but higher mean platelet counts than men (p = 0.005). Among women, abdominal height was positively associated with platelet count after adjustment for depression (p for trend = 0.039). Among women and men, a non‐significant step‐wise trend was observed between abdominal height and mean WBC counts before and after adjustment for smoking, race, and physical activity. No association was observed between obesity and platelet count among men. Discussion: Abdominal height was significantly associated with increased platelet counts among female officers. No significant associations were observed between obesity and WBC or platelet counts among male officers.     

Weight Status in Childhood as a Predictor of Becoming Overweight or Hypertensive in Early Adulthood**

Objective: To assess the extent to which weight status in childhood or adolescence predicts becoming overweight or hypertensive by young adulthood. Research Methods and Procedures: We conducted a prospective study of 314 children, who were 8 to 15 years old at baseline, and were followed up 8 to 12 years later. Weight, height, and blood pressure were measured by trained research staff. Incident overweight was defined as BMI ≥ 25 kg/m² among participants who had not been overweight as children. Results: More male subjects (48.3%) than female subjects (23.5%) became overweight or obese between their first childhood visit and the young adult follow‐up (p < 0.001). Being in the upper one half of the normal weight range (i.e., BMI between the 50th and 84th percentiles for age and gender in childhood) was a good predictor of becoming overweight as a young adult. Compared with children with a BMI <50th percentile, girls and boys between the 50th and 74th percentiles of BMI were ～5 times more likely [boys, odds ratio (OR) = 5.3, p = 0.002; girls, OR = 4.8, p = 0.07] and those with a BMI between the 75th and 84th percentiles were up to 20 times more likely (boys, OR = 4.3, p = 0.02; girls, OR = 20.2, p = 0.001) to become overweight. The incidence of high blood pressure was greater among the male subjects (12.3% vs. 1.9%). Compared with boys who had childhood BMI below the 75th percentile, boys between the 75th and 85th percentiles of BMI as children were four times more likely (OR = 3.6) and those at above the 85th percentile were five times more likely (OR = 5.1) to become hypertensive. Discussion: High normal weight status in childhood predicted becoming overweight or obese as an adult. Also, among the boys, elevated BMI in childhood predicted risk of hypertension in young adulthood.     

Measuring Left Ventricular Pressure in Late Embryonic and Neonatal Mice

Blood pressure increases significantly during embryonic and postnatal development in vertebrate animals. In the mouse, blood flow is first detectable around embryonic day (E) 8.5¹. Systolic left ventricular (LV) pressure is 2 mmHg at E9.5 and 11 mmHg at E14.5². At these mid-embryonic stages, the LV is clearly visible through the chest wall for invasive pressure measurements because the ribs and skin are not fully developed. Between E14.5 and birth (approximately E21) imaging methods must be used to view the LV. After birth, mean arterial pressure increases from 30 - 70 mmHg from postnatal day (P) 2 - 35³. Beyond P20, arterial pressure can be measured with solid-state catheters (i.e. Millar or Scisense). Before P20, these catheters are too big for developing mouse arteries and arterial pressure must be measured with custom pulled plastic catheters attached to fluid-filled pressure transducers³ or glass micropipettes attached to servo null pressure transducers⁴.Our recent work has shown that the greatest increase in blood pressure occurs during the late embryonic to early postnatal period in mice^5-7. This large increase in blood pressure may influence smooth muscle cell (SMC) phenotype in developing arteries and trigger important mechanotransduction events. In human disease, where the mechanical properties of developing arteries are compromised by defects in extracellular matrix proteins (i.e. Marfan''s Syndrome⁸ and Supravalvular Aortic Stenosis⁹) the rapid changes in blood pressure during this period may contribute to disease phenotype and severity through alterations in mechanotransduction signals. Therefore, it is important to be able to measure blood pressure changes during late embryonic and neonatal periods in mouse models of human disease.We describe a method for measuring LV pressure in late embryonic (E18) and early postnatal (P1 - 20) mice. A needle attached to a fluid-filled pressure transducer is inserted into the LV under ultrasound guidance. Care is taken to maintain normal cardiac function during the experimental protocol, especially for the embryonic mice. Representative data are presented and limitations of the protocol are discussed.     

Stability of the Association between Birth Weight and Childhood Overweight during the Development of the Obesity Epidemic

Objective: To assess whether changes in the birth weight distribution or changes in the association of birth weight with the later risk of childhood overweight have contributed to the development of the obesity epidemic. Research Methods and Procedures: A Danish population‐based cohort study of 124,615 girls and 128,346 boys (ages 6 to 13 years), born between 1936 and 1983, were studied. Birth weight and annual measurements of height and weight were obtained from school health records. Overweight was defined by BMI in relation to internationally accepted criteria. The relative risk of being overweight by birth weight was calculated separately for each age, sex, and time period. Results: The birth weight distribution remained relatively stable over time. Compared with children with a birth weight of 3.0 to 3.5 kg, the risk of overweight increased consistently with each increase in birth weight category among girls and boys and at all ages between 6 and 13 years. Furthermore, the association between birth weight and increased risk of overweight in childhood remained stable across a 48‐year period. Discussion: The increase in the prevalence of overweight could not be explained by time trends in the distribution of birth weight or by changes in the association between birth weight and the later risk of overweight over time. This implies that, unless the prenatal environment influences the later risk of overweight without increasing birth weight, the environmental influences contributing to the obesity epidemic in children of school age operate in the early postnatal period.     

A Study of Normal Heart Sounds,Heart Size,Arterial Pressure and Electrocardiograms From Infancy to Early Adulthood in One Male and One Female

This study forms part of a project to define the range of normal for heart sounds and murmurs. Using the method of writing quantitative symbol phonocardiograms, data were collected on one female and one male subject from earliest infancy to adulthood (aged 27 and 25). Serial measurements of heart size, arterial pressure and records of electrocardiograms and electrophonocardiograms were made. The heart sounds are shorter and somewhat less loud under the age of two years than later. Physiologic splitting of the first and second sounds, a physiologic systolic murmur, the appearance and disappearance of a third sound are shown in the illustrations which epitomize this study. These longitudinal studies of age period changes in the electrocardiogram reveal what has been learned from the horizontal studies. The shape of the cardiac silhouette as recorded between the ages of 5 and 8 years seems to predict the adult shape. The adult type of arterial pressure became established in the early teens.     

Overweight in Childhood,Adolescence and Adulthood and Cardiovascular Risk in Later Life: Pooled Analysis of Three British Birth Cohorts

Background

Overweight and obesity in adulthood are established risk factors for adverse cardiovascular outcomes, but the contribution of overweight in childhood to later cardiovascular risk is less clear. Evidence for a direct effect of childhood overweight would highlight early life as an important target for cardiovascular disease prevention. The aim of this study was to assess whether overweight and obesity in childhood and adolescence contribute to excess cardiovascular risk in adults.

Methods and findings

Data from three British birth cohorts, born in 1946, 1958 and 1970, were pooled for analysis (n = 11,447). Individuals were categorised, based on body mass index (BMI), as being of normal weight or overweight/obese in childhood, adolescence and adulthood. Eight patterns of overweight were defined according to weight status at these three stages. Logistic regression models were fitted to assess the associations of patterns of overweight with self-reported type 2 diabetes, hypertension, and coronary heart disease (CHD) in adulthood (34–53 years). Compared to cohort members who were never overweight, those who were obese in adulthood had increased risk of all outcomes. For type 2 diabetes, the odds ratio was higher for obese adults who were also overweight or obese in childhood and adolescence (OR 12.6; 95% CI 6.6 to 24.0) than for those who were obese in adulthood only (OR 5.5; 95% CI 3.4 to 8.8). There was no such effect of child or adolescent overweight on hypertension. For CHD, there was weak evidence of increased risk among those with overweight in childhood. The main limitations of this study concern the use of self-reported outcomes and the generalisability of findings to contemporary child populations.

Conclusions

Type 2 diabetes and to a lesser extent CHD risk may be affected by overweight at all stages of life, while hypertension risk is associated more strongly with weight status in adulthood.     

Associations of Aging and Birth Cohort with Body Mass Index in a Biethnic Cohort

Objective: To examine associations of aging and birth cohort with body mass index (BMI) in a biethnic cohort. Research Methods and Procedures: This was a longitudinal closed cohort study of 14, 500 white and African‐American men and women, 45 to 64 years of age, followed for 9 years. Aging was defined as the length of the interval in years between baseline and following visits. Birth cohort was defined by the year in which participants were born. Mixed model analyses were used to examine associations of aging, birth cohort, and BMI in four ethnicity‐gender groups. Results: We found that aging was associated with an increase in BMI in white and African‐American men and women. The associations between aging and BMI were stronger in the younger birth cohorts. Except for white women, younger birth cohort was associated with a higher BMI. After adjusting for aging, birth cohort was associated with an increase in BMI of 0.1 kg/m² [95% confidence interval (95% CI): ?0.1, 0.3] among white women. The corresponding values for African‐American women, white men, and African‐American men are 0.5 kg/m² (95% CI: 0.1, 0.9), 0.6 kg/m² (95% CI: 0.4, 0.8), and 0.6 kg/m² (95% CI: 0.2, 1.0), respectively. Discussion: Our analyses show that, in all except white women, people in this age range who were born later have a higher BMI at the same attained age. In all groups, people who are born later gained more weight as they aged. In general, subjects ages 45 to 64 years gained weight as they aged 9 years.