Maternal employment and childhood overweight in Germany

A widespread finding among studies from the US and the UK is that maternal employment is correlated with an increased risk of child overweight, even in a causal manner, whereas studies from other countries obtain less conclusive results. As evidence for Germany is still scarce, the purpose of this study is to identify the effect of maternal employment on childhood overweight in Germany using two sets of representative micro data. We further explore potential underlying mechanisms that might explain this relationship. In order to address the selection into maternal full-time employment, we use an instrumental variable strategy exploiting the number of younger siblings in the household as an instrument. While the OLS models suggest that maternal full-time employment is related to a 5 percentage point higher probability of the child to be overweight, IV estimates indicate a 25 percentage points higher overweight probability due to maternal full-time employment. Exploring various possible pathways, we find that maternal full-time employment promotes unhealthy dietary and activity behavior which might explain the positive effect of maternal employment on child overweight to some extent. Although there are limitations to our IV approach, several sensitivity analyses confirm the robustness of our findings.     

Understanding recent trends in childhood obesity in the United States

The prevalence of childhood obesity in the United States has more than tripled over the last four decades from 5 percent in 1978 to 18.5 percent in 2016. There is evidence for a break in trend in recent years: after growing from 0.4 to 0.7 percentage point per year between 1978 and 2004, the rate of increase has slowed to 0.1 percentage point per year from 2004 to 2016. To better understand these trends, in this paper we analyze a range of datasets that collect information on childhood obesity. We analyze the data overall, across the age distribution, across birth cohorts, and for subgroups of interest. We find steady increases in cohort-level obesity prevalence through approximately age 10, with levels unchanged thereafter, suggesting a need for additional interventions at early ages. We find that the prevalence of obesity has diverged by race and gender in recent years, especially among children entering kindergarten. Compared with 5-year-olds in 1997, 5-year-olds in 2010 were 2 percentage points more likely to be obese overall. Black and Hispanic 5-year-olds were 5 and 3 percentage points more likely to be obese, respectively, while whites had a 1 percentage point increase in obesity. However, overall and among all subgroups the rate of growth in obesity from kindergarten through 3rd grade has declined in recent years. Together, these findings can inform a future research literature that aims to target obesity interventions where they will be most impactful.     

儿童单纯性肥胖小鼠模型的制作

目的通过调整窝仔数的方法建立幼儿单纯性肥胖模型,并与高脂饲料制备模型进行比较。方法48只雌性KM小鼠产仔鼠后,一半仔鼠数目为14～16只,一半仔鼠调整为6只（雌雄各3只）。仔鼠离乳时或第9周时仔鼠分别饲喂普通饲料或高脂饲料。仔鼠在15周后处死,称重,测量体长、腰围,生殖器重、脂肪重（肾周和生殖器周脂肪）,计算体脂比。结果①BD2组常规饲料饲喂至15周结束后,无论雌雄仔鼠,其体重与BDl组比较差异均有显著性（P〈0．05）,且BD2组体重超过BD1组体重雌性为26．3％,雄性为20．0％。同一处理方式,雌性仔鼠体脂比均高于雄性。②不同时间饲喂高脂饲料,无论调整窝仔数与否,高脂饲料各组仔鼠,无论雌雄,其各组仔鼠体重均比BD1组高（P均〈0．05）;HFD4组雌性和雄性仔鼠体重与BD2组相比差异均存在显著性（P〈0．05）。结论通过调整窝仔数的方法可以成功制备儿童单纯性肥胖模型。在儿童早期肥胖的情况下,成年后过度高脂饮食会导致机体储存更多的脂肪。     

Maternal obesity programmes offspring development of non-alcoholic fatty pancreas disease

Background and aims

The prevalence of pancreatic adenocarcinoma (PAC) parallels rising rates of obesity and dysmetabolism, a possible link being non-alcoholic fatty pancreas disease (NAFPD). We have recently shown that maternal obesity programmes the development of a dysmetabolic and fatty liver (non-alcoholic fatty liver disease, NAFLD) phenotype in adult offspring. Since the pancreas and liver originate from the same embryonic bud, it is plausible that maternal obesity may similarly programme the development of NAFPD. Our objective was to determine the effect of maternal obesity on development of NAFPD in offspring and ascertain contributions of the intra/extra-uterine periods.

Methods

Female C57BL/6J mice were fed either a standard chow (3% fat, 7% sugar) or a hypercalorific diet (16% fat, 33% sugar) for six weeks prior to mating and throughout pregnancy and lactation. Female offspring were cross-fostered for suckling to dams on the same or opposite diet to yield four groups: offspring of lean suckled by lean dams (n = 6), offspring of obese suckled by obese dams (n = 6), offspring of lean suckled by obese dams (n = 5) and offspring of obese suckled by lean dams (n = 6). All offspring were weaned onto a standard chow diet at 21 days and sacrificed at 3 months post-partum for tissue collection.

Results

Offspring subjected to an adverse suckling environment showed significant increases in body weight, pancreatic triglyceride content, TGF-β, collagen gene expression and SBP at rest along with an enhanced restraint stress response, indicating a dysmetabolic and NAFPD phenotype.

Conclusions

Developmental programming is involved in the pathogenesis of NAFPD and appears to be largely dependent on an adverse extra-uterine environment.     

Decomposing socioeconomic inequalities in childhood obesity: Evidence from Ireland

The objective of this paper is to quantify and decompose the socioeconomic gradient in childhood obesity in the Republic of Ireland. The analysis is performed using data from the first wave of the Growing Up in Ireland survey, a nationally representative survey of 8568 nine-year-old children conducted in 2007 and 2008. We estimate concentration indices to quantify the extent of the socioeconomic gradient in childhood obesity and undertake a subsequent decomposition analysis to pinpoint the key factors underpinning the observed inequalities. Overall the results confirm a strong socioeconomic gradient in childhood obesity in the Republic of Ireland. Concentration indices of obesity (CI = −0.168) and overweight/obese (CI = −0.057) show that the gradient is more pronounced in obese children, while results from the decomposition analysis suggest that the majority of the inequality in childhood obesity is explained by parental level variables. Our findings suggest that addressing childhood obesity inequalities requires coordinated policy responses at both the child and parental level.     

Influence of adipose tissue immune dysfunction on childhood obesity

In recent decades, a dramatic rise has been observed in the prevalence of obesity in childhood and adolescence, along with an increase in fetal microsomia rates. The increased risk of obesity during this key period in development negatively affects the health of the individual later in life. Immune cells residing and recruited to white adipose tissue have been highlighted as important factors contributing to the pathogenesis of childhood obesity. Immune dysfunction in the context of obesity begins early in childhood, which is different from the pathological characteristics and influencing factors of adipose immunity in adults. Here, we explore the current understanding of the roles of childhood and early life events that result in high risks for obesity by influencing adipose tissue immune dysfunction under the pathological condition of obesity. Such knowledge will help in determining the mechanisms of childhood and early life obesity in efforts to ameliorate chronic inflammation-related metabolic diseases.     

Maternal employment and childhood obesity: A search for mechanisms in time use data

A substantial body of research documents that maternal employment is associated with childhood obesity. This paper explores possible mechanisms for that correlation in the American Time Use Survey (ATUS). We find that maternal employment is associated with working mothers spending, per day, 4 fewer minutes grocery shopping, 17 fewer minutes cooking, 10 fewer minutes eating with children, 12 fewer minutes playing with children, 4 fewer minutes supervising children, and 37 fewer minutes caring for children. The differences tend to be greatest for mothers with young children (age 0–5 years). We explore the extent to which these findings differ by day of the week, whether a partner or spouse is present in the household, whether the mother works non-standard hours, and socioeconomic status. Only a small percentage (about 15%) of the fewer minutes spent in these activities by working mothers appears to be offset by increases in time by husbands and partners. These findings suggest plausible mechanisms for the association between maternal employment and childhood obesity.     

肠道菌群与儿童肥胖的关系及其机制和治疗研究进展

随着人们生活水平的提高,儿童肥胖的发病率在世界各地大体呈现上升的趋势,中国儿童的超重和肥胖率更是接近了20%。儿童肥胖极易发展为成年肥胖,导致代谢紊乱,引发疾病。近年来,微生态学发展迅猛,肠道菌群作为人体最主要、最复杂的微生态系统,被认为是影响儿童肥胖的关键因子并加以研究。对肠道菌群与儿童肥胖关系的探索及为预防儿童肥胖寻找有效的方法成为许多研究者的研究目标。本文结合先前的研究成果和近期的相对权威的研究成果对肠道菌群与儿童肥胖的关系作一综述,主要内容包括其机制、影响因素、预防治疗方法和对未来研究方向的展望。     

Contingent valuation analysis of willingness to pay to reduce childhood obesity

Several recent surveys have asked Americans whether they support policies to reduce childhood obesity. There is reason for skepticism of such surveys because people are not confronted with the tax costs of such policies when they are asked whether they support them. This paper uses contingent valuation (CV), a method frequently used to estimate people's willingness to pay (WTP) for goods or services not transacted in markets, applied to unique survey data from New York State to estimate the willingness to pay to reduce childhood obesity. The willingness to pay data correlate in predictable ways with respondent characteristics. The mean WTP for a 50% reduction in childhood obesity is $46.41 (95% CI: $33.45, $59.15), which implies a total WTP by New York State residents of $690.6 million (95% CI: $497.7, $880.15), which is less than that implied by previous surveys that did not use CV methods but greater than current spending on policies to reduce childhood obesity and greater than the estimated savings in external costs. The findings provide policymakers with useful information about taxpayers' support for, and preferred budget for, anti-obesity policies.     

Maternal prenatal exposure to environmental factors and risk of childhood acute lymphocytic leukemia: A hospital-based case-control study in China

Objective: To investigate an association between maternal prenatal exposure to several environmental factors and risk of childhood acute lymphocytic leukemia (ALL), and the possible interactions in the Chinese population.Methods: 345 cases with ALL and their 1:1 age, gender, residence region matched controls aged 0–15 years were recruited from four hospitals in Henan Province from 2014 to 2016. Information was collected by interviews using a questionnaire. Unconditional logistic regression adjusted for age, gender, residence region and relevant confounders was carried out to generate the odds ratios (ORs) and 95% confidence intervals (CIs).Results: Our data indicate that maternal prenatal exposure to interior housing renovation (adjusted OR: 2.98, 95% CI: 1.51–5.86) or pesticides (adjusted OR: 1.48, 95% CI: 1.67–2.28) increased the risk of childhood ALL. Various subgroup analyses stratified by child's gender, age at diagnosis and other factors also supported these results. However, no interaction was detected between exposure to internal housing renovation and pesticides using an additive model. No significant links between maternal exposures to, environmental tobacco smoking (ETS), antipyretic analgesia intake, or viral infectious diseases with risk of ALL were detected.Conclusion: Findings in our study are in line with the existing literatures, which support the hypothesis that maternal prenatal exposure to interior housing renovation and pesticides are risk factors for childhood ALL. Notably, we found no interaction between these two risk factors, these findings may inform prevention and early detection strategies.     

Maternal stress during pregnancy and early childhood development

We estimate the impact of prenatal stress on early childhood development outcomes known as “middle years” or intermediate outcomes, which has not been studied previously. Using a unique measure of actual maternal stress induced by a large earthquake, we find that relative to children that were not exposed, in utero maternal stress reduces children’s cognitive skills and socio-emotional problems by age 3, and that the effects are heterogeneous. The negative impacts on cognitive skills occur during the first trimester of pregnancy and are found among both low and high-income children, and boys and girls. The harmful effects on socio-emotional behaviors occur when stress is experienced in the last trimester of pregnancy.     

Maternal BMI and country of birth as indicators of childhood obesity in children of Mexican origin

Objective: The goal of this study was to evaluate the relationship between maternal and childhood BMI at baseline in a group of 5‐ to 18‐year‐old children and their mothers, all of whom were of Mexican origin, low socioeconomic status, and enrolled in a cohort study in Houston, TX. Research Methods and Procedures: Using data from 438 mother‐child dyads residing in the same household, we completed logistic regression analyses to determine maternal factors associated with the child being overweight or at‐risk‐for‐overweight, after adjusting for the child's gender, age, and level of physical activity and other maternal confounders. Results: Almost one‐half of the boys and girls (47% and 44%, respectively) were either overweight or at‐risk‐for‐overweight. Obese mothers were twice as likely to have an overweight and/or at‐risk‐for‐overweight child compared with normal‐weight mothers. Women born in the U.S. were twice as likely to have an overweight and/or at‐risk‐for‐overweight child compared with women born in Mexico. In addition, women with less than a high school education were twice as likely to have an overweight child compared with their more educated peers. Discussion: The high prevalence of overweight or at‐risk‐for‐overweight among Mexican‐origin children of low socioeconomic status suggests a continued need to develop and implement culturally sensitive preventive interventions for this minority population. Our data also suggest a need to tailor such interventions particularly for children of obese mothers and those born in the U.S.     

Parental employment,family routines and childhood obesity

Using the Early Childhood Longitudinal Survey-Kindergarten Class of 1998–1999 (ECLS-K) data from kindergarten through eighth grade, this paper investigate the relationships among maternal employment, family routines and obesity. More hours worked by the mother tend to be negatively related to positive routines like eating meals as a family or at regular times, or having family rules about hours of television watched. Many of these same routines are significantly related to the probability of being obese, implying that family routines may be a mechanism by which maternal employment intensity affects children's obesity. However, inclusion of family routines in the obesity regression does not appreciably change the estimated effect of maternal employment hours. Thus, the commonly estimated deleterious effect of maternal employment on children's obesity cannot be explained by family routines, leaving the exact mechanisms an open question for further exploration.     

Determinants of obesity in transition economies: The case of Russia

This paper examines human obesity, measured as weight and body mass index (BMI), and its determinants in Russia. Obesity increased dramatically during transition from a planned to a market economy, by 38%. We determine the factors contributing to rising obesity using individual level data from the Russia Longitudinal Monitoring Survey for 1994 and 2004. We find a strong positive effect of diet/caloric intake and a strong negative effect of smoking on weight and BMI. Gender, education, and income are other major determinants of obesity. Our analysis provides information on dietary patterns and other determinants of obesity in Russia which is essential for formulation and implementation of effective policies designed to reduce the problem and improve the health of the population.     

Gene-diet interactions in childhood obesity

Childhood overweight and obesity have reached epidemic proportions worldwide, and the increase in weight-associated co-morbidities including premature type 2 diabetes mellitus (T2DM) and atherosclerotic cardiovascular disease will soon become major healthcare and economic problems. A number of studies now indicate that the childhood obesity epidemic which has emerged during the past 30 years is a complex multi-factorial disease resulting from interaction of susceptibility genes with an obesogenic environment. This review will focus on gene-diet interactions suspected of having a prominent role in promoting childhood obesity. In particular, the specific genes that will be presented (FTO, MC4R, and NPC1) have recently been associated with childhood obesity through a genome-wide association study (GWAS) and were shown to interact with nutritional components to increase weight gain. Although a fourth gene (APOA2) has not yet been associated with childhood obesity, this review will also present information on what now represents the best characterized gene-diet interaction in promoting weight gain.     

孕妇肥胖与死产关系的Meta分析

目的:探讨孕妇超重或肥胖与死产的关系。方法:采用RevMan4.2.10版本软件中的Meta分析,检索Pubmed文献数据库中1980年～2008年有关死产的孕妇超重或肥胖因素文献,并进行定量综合分析。结果:经检索、筛选后纳入的有关死产的孕妇超重或肥胖因素文献11篇;经异质性检验,采用固定效应模型、随机效应模型进行定量综合分析。综合结果表明孕妇超重、孕妇肥胖对死产的影响OR值分别为1.21(95%CI:1.05-1.40)、1.69(95%CI:1.51-1.90)。结论:孕妇因超重或肥胖的死产率明显高于正常体重孕妇。     

Maternal obesity and morbid obesity: The risk for birth defects in the offspring

BACKGROUND : The objective of this study was to assess, in a large data set from Swedish Medical Health Registries, whether maternal obesity and maternal morbid obesity were associated with an increased risk for various structural birth defects. METHODS : The study population consisted of 1,049,582 infants born in Sweden from January 1, 1995, through December 31, 2007, with known maternal weight and height data. Women were grouped in six categories of body mass index (BMI) according to World Health Organization classification. Infants with congenital birth defects were identified from three sources: the Swedish Medical Birth Registry, the Register of Birth Defects, and the National Patient Register. Maternal age, parity, smoking, and year of birth were thought to be potential confounders and were included as covariates in the adjusted odds ratio analyses. RESULTS : Ten percent of the study population was obese. Morbid obesity (BMI ≥ 40) occurred in 0.7%. The prevalence of congenital malformations was 4.7%, and the prevalence of relatively severe malformations was 3.2%. Maternal prepregnancy morbid obesity was associated with neural tube defects OR 4.08 (95% CI 1.87–7.75), cardiac defects OR 1.49 (95% CI 1.24–1.80), and orofacial clefts OR 1.90 (95% CI 1.27–2.86). Maternal obesity (BMI ≥ 30) significantly increased the risk of hydrocephaly, anal atresia, hypospadias, cystic kidney, pes equinovarus, omphalocele, and diaphragmatic hernia. CONCLUSION : The risk for a morbidly obese pregnant woman to have an infant with a congenital birth defect is small, but for society the association is important in the light of the ongoing obesity epidemic. Birth Defects Research (Part A), 2010. © 2009 Wiley‐Liss, Inc.