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Find video protocols related to scientific articles indexed in Pubmed.
Associations Between Genetic Obesity Susceptibility and Early Postnatal Fat and Lean Mass: An Individual Participant Meta-analysis.
JAMA Pediatr
PUBLISHED: 10-21-2014
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Patterns of body size and body composition associated with genetic obesity susceptibility inform the mechanisms that increase obesity risk.
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Influences on adherence to diet and physical activity recommendations in women and children: insights from six European studies.
Ann. Nutr. Metab.
PUBLISHED: 10-02-2014
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Across Europe, poor health behaviours are associated with increased risks of non-communicable diseases. There is particular concern about young women, children and families, not least as health behaviours operating before and during pregnancy and in early postnatal life may have profound long-term consequences for children's health. Using findings drawn from 7 European countries, we aimed to identify barriers to the implementation and uptake of dietary and physical activity recommendations, and to consider how best to achieve changes in mothers' behaviours and thereby improve the adoption of health recommendations. Six studies across the 7 countries were used for this narrative synthesis of findings. Key Messages: A woman's education has a strong influence on her own and her children's health behaviours. Women's diets vary across ethnic groups and according to number of children, but psychological factors, such as self-efficacy and sense of control, which may be amenable to modification, are powerful, too, particularly in women with lower educational attainment. Maternal influences on children's behaviours are strong. Differences exist in infant feeding across countries, and there are apparent urban/rural differences in children's diets and physical activity.
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The effect of a behaviour change intervention on the diets and physical activity levels of women attending Sure Start Children's Centres: results from a complex public health intervention.
BMJ Open
PUBLISHED: 07-18-2014
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The UK government's response to the obesity epidemic calls for action in communities to improve people's health behaviour. This study evaluated the effects of a community intervention on dietary quality and levels of physical activity of women from disadvantaged backgrounds.
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Association of early childhood abdominal circumference and weight gain with blood pressure at 36?months of age: secondary analysis of data from a prospective cohort study.
BMJ Open
PUBLISHED: 07-05-2014
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To assess whether changes in measures of fat distribution and body size during early life are associated with blood pressure at 36?months of age.
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Maternal dietary glycemic index and glycemic load in early pregnancy are associated with offspring adiposity in childhood: the Southampton Women's Survey.
Am. J. Clin. Nutr.
PUBLISHED: 06-18-2014
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Maternal hyperglycemia in pregnancy is associated with greater adiposity in offspring. The glycemic index (GI) and glycemic load (GL) describe the glycemic response to carbohydrate ingestion. However, the influence of maternal dietary GI and GL in pregnancy on childhood adiposity is unknown.OBJECTIVE: We examined relations of maternal dietary GI and GL in early and late pregnancy with offspring body composition.DESIGN: A total of 906 mother-child pairs from the prospective cohort the Southampton Women's Survey were included. Children underwent dual-energy X-ray absorptiometry measurements of body composition at birth and 4 and 6 y of age. Log-transformed fat mass and lean mass were standardized with a mean (±SD) of 0 ± 1. Maternal dietary GI and GL were assessed at 11 and 34 wk of gestation by using an administered food-frequency questionnaire.RESULTS: After control for potential confounders, both maternal dietary GI and GL in early pregnancy were positively associated with fat mass at 4 and 6 y of age [fat mass SDs per 10-unit GI increase: ? = 0.43 (95% CI: 0.06, 0.80), P = 0.02 at 4 y of age; ? = 0.40 (95% CI: 0.10, 0.70), P = 0.01 at 6 y of age; fat mass SDs per 50-unit GL increase: ? = 0.43 (95% CI: 0.19, 0.67), P < 0.001 at 4 y of age; ? = 0.27 (95% CI: 0.07, 0.47), P = 0.007 at 6 y of age]. In contrast, there were no associations between maternal dietary GI or GL in late pregnancy and offspring fat mass at these ages. Maternal dietary GI and GL were not associated with fat mass at birth or offspring lean mass at any of the ages studied.CONCLUSION: Higher maternal dietary GI and GL in early pregnancy are associated with greater adiposity in childhood.
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Measuring the healthfulness of food retail stores: variations by store type and neighbourhood deprivation.
Int J Behav Nutr Phys Act
PUBLISHED: 05-13-2014
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The consumer nutrition environment has been conceptualised as in-store environmental factors that influence food shopping habits. More healthful in-store environments could be characterised as those which promote healthful food choices such as selling good quality healthy foods or placing them in prominent locations to prompt purchasing. Research measuring the full-range of in-store environmental factors concurrently is limited.
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'Making every contact count': Evaluation of the impact of an intervention to train health and social care practitioners in skills to support health behaviour change.
J Health Psychol
PUBLISHED: 04-10-2014
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A total of 148 health and social care practitioners were trained in skills to support behaviour change: creating opportunities to discuss health behaviours, using open discovery questions, listening, reflecting and goal-setting. At three time points post-training, use of the skills was evaluated and compared with use of skills by untrained practitioners. Trained practitioners demonstrated significantly greater use of these client-centred skills to support behaviour change compared to their untrained peers up to 1 year post-training. Because it uses existing services to deliver support for behaviour change, this training intervention has the potential to improve public health at relatively low cost.
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Adherence to nutritional guidelines in pregnancy: evidence from the Growing Up in New Zealand birth cohort study.
Public Health Nutr
PUBLISHED: 04-09-2014
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To determine adherence to nutritional guidelines by pregnant women in New Zealand and maternal characteristics associated with adherence.
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Prenatal development is linked to bronchial reactivity: epidemiological and animal model evidence.
Sci Rep
PUBLISHED: 03-25-2014
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Chronic cardiorespiratory disease is associated with low birthweight suggesting the importance of the developmental environment. Prenatal factors affecting fetal growth are believed important, but the underlying mechanisms are unknown. The influence of developmental programming on bronchial hyperreactivity is investigated in an animal model and evidence for comparable associations is sought in humans. Pregnant Wistar rats were fed either control or protein-restricted diets throughout pregnancy. Bronchoconstrictor responses were recorded from offspring bronchial segments. Morphometric analysis of paraffin-embedded lung sections was conducted. In a human mother-child cohort ultrasound measurements of fetal growth were related to bronchial hyperreactivity, measured at age six years using methacholine. Protein-restricted rats' offspring demonstrated greater bronchoconstriction than controls. Airway structure was not altered. Children with lesser abdominal circumference growth during 11-19 weeks' gestation had greater bronchial hyperreactivity than those with more rapid abdominal growth. Imbalanced maternal nutrition during pregnancy results in offspring bronchial hyperreactivity. Prenatal environmental influences might play a comparable role in humans.
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Activity levels in mothers and their preschool children.
Pediatrics
PUBLISHED: 03-24-2014
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To investigate the association between objectively measured maternal and preschool-aged children's physical activity, determine how this association differs by demographic and temporal factors, and identify factors associated with maternal activity levels.
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Objectively measured physical activity in four-year-old British children: a cross-sectional analysis of activity patterns segmented across the day.
Int J Behav Nutr Phys Act
PUBLISHED: 01-09-2014
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Little is known about preschool-aged children's levels of physical activity (PA) over the course of the day. Using time-stamped data, we describe the levels and patterns of PA in a population-based sample of four-year-old British children.
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Maternal Antenatal Vitamin D Status and Offspring Muscle Development: Findings From the Southampton Womens Survey.
J. Clin. Endocrinol. Metab.
PUBLISHED: 12-20-2013
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Context: Maternal 25-hydroxyvitamin D [25(OH)D] status in pregnancy has been associated with offspring bone development and adiposity. Vitamin D has also been implicated in postnatal muscle function, but little is known about a role for antenatal 25(OH)D exposure in programming muscle development. Objective: We investigated the associations between maternal plasma 25(OH)D status at 34 weeks of gestation and offspring lean mass and muscle strength at 4 years of age. Design and Setting: We studied a prospective UK population-based mother-offspring cohort: the Southampton Womens Survey (SWS). Participants: Initially, 12 583 nonpregnant women were recruited into the SWS, of whom 3159 had singleton pregnancies; 678 mother-child pairs were included in this analysis. Main Outcomes Measured: At 4 years of age, offspring assessments included hand grip strength and whole-body dual-energy x-ray absorptiometry, yielding lean mass and percent lean mass. Physical activity was assessed by 7-day accelerometry in a subset of children (n = 326). Results: The maternal serum 25(OH)D concentration in pregnancy was positively associated with offspring height-adjusted hand grip strength (? = 0.10 SD/SD, P = .013), which persisted after adjustment for maternal confounding factors, duration of breastfeeding, and childs physical activity at 4 years (? = 0.13 SD/SD, P = .014). Maternal 25(OH)D was also positively associated with offspring percent lean mass (? = 0.11 SD/SD, P = .006), but not total lean mass (? = 0.06 SD/SD, P = .15). However, this association did not persist after adjustment for confounding factors (? = 0.09 SD/SD, P = .11). Conclusions: This observational study suggests that intrauterine exposure to 25(OH)D during late pregnancy might influence offspring muscle development through an effect primarily on muscle strength rather than on muscle mass.
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Pregnancy and birth cohort resources in europe: a large opportunity for aetiological child health research.
Paediatr Perinat Epidemiol
PUBLISHED: 06-19-2013
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During the past 25 years, many pregnancy and birth cohorts have been established. Each cohort provides unique opportunities for examining associations of early-life exposures with child development and health. However, to fully exploit the large amount of available resources and to facilitate cross-cohort collaboration, it is necessary to have accessible information on each cohort and its individual characteristics. The aim of this work was to provide an overview of European pregnancy and birth cohorts registered in a freely accessible database located at http://www.birthcohorts.net.
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Assessing diets of 3-year-old children: evaluation of an FFQ.
Public Health Nutr
PUBLISHED: 05-01-2013
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OBJECTIVE: To evaluate the use of an administered eighty-item FFQ to assess nutrient intake and diet quality in 3-year-old children. DESIGN: Frequency of consumption and portion size of the foods listed on the FFQ during the 3 months preceding the interview were reported by the childs main caregiver; after the interview a 2 d prospective food diary (FD) was completed on behalf of the child. Nutrient intakes from the FFQ and FD were estimated using UK food composition data. Diet quality was assessed from the FFQ and FD according to the childs scores for a principal component analysis-defined dietary pattern (prudent pattern), characterised by high consumption of fruit, vegetables, water and wholemeal cereals. SETTING: Southampton, UK. SUBJECTS: Children (n 892) aged 3 years in the Southampton Womens Survey. RESULTS: Intakes of all nutrients assessed by the FFQ were higher than FD estimates, but there was reasonable agreement in terms of ranking of children (range of Spearman rank correlations for energy-adjusted nutrient intakes, r s = 0·41 to 0·59). Prudent diet scores estimated from the FFQ and FD were highly correlated (r = 0·72). Some family and child characteristics appeared to influence the ability of the FFQ to rank children, most notably the number of childs meals eaten away from home. CONCLUSIONS: The FFQ provides useful information to allow ranking of children at this age with respect to nutrient intake and quality of diet, but may overestimate absolute intakes. Dietary studies of young children need to consider family and child characteristics that may impact on reporting error associated with an FFQ.
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Increased Regional Deformation of the Left Ventricle in Normal Children With Increased Body Mass Index: Implications for Future Cardiovascular Health.
Pediatr Cardiol
PUBLISHED: 04-30-2013
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The prevalence of obesity continues to increase in the developing world. The effects of obesity on the cardiovascular system include changes in systolic and diastolic function. More recently obesity has been linked with impairment of longitudinal myocardial deformation properties in children. We sought to determine the effect of increased body mass index (BMI) on cardiac deformation in a group of children taking part in the population-based Southampton Womens Survey to detect early cardiovascular changes associated with increasing BMI before established obesity. Sixty-eight children at a mean age of 9.4 years old underwent assessment of longitudinal myocardial deformation in the basal septal segment of the left ventricle (LV) using two-dimensional speckle tracking echocardiography. Parameters of afterload and preload, which may influence deformation, were determined from cardiac magnetic resonance imaging. BMI was determined from the childs height and weight at the time of echocardiogram. Greater pediatric BMI was associated with greater longitudinal myocardial deformation or strain in the basal septal segment of the LV (? = 1.6, p < 0.001); however, this was not related to contractility or strain rate in this part of the heart (? = 0.001, p = 0.92). The end-diastolic volume of the LV increased with increasing BMI (? = 3.93, p < 0.01). In young children, regional deformation in the LV increases with increasing BMI, whilst normal contractility is maintained. This effect may be explained by the increased preload of the LV associated with increased somatic growth. The long-term implications of this altered physiology need to be followed-up.
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Physical activity intensity, sedentary time, and body composition in preschoolers.
Am. J. Clin. Nutr.
PUBLISHED: 04-03-2013
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Detailed associations between physical activity (PA) subcomponents, sedentary time, and body composition in preschoolers remain unclear.
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Correction of unexpected distributions of P values from analysis of whole genome arrays by rectifying violation of statistical assumptions.
BMC Genomics
PUBLISHED: 03-06-2013
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Statistical analysis of genome-wide microarrays can result in many thousands of identical statistical tests being performed as each probe is tested for an association with a phenotype of interest. If there were no association between any of the probes and the phenotype, the distribution of P values obtained from statistical tests would resemble a Uniform distribution. If a selection of probes were significantly associated with the phenotype we would expect to observe P values for these probes of less than the designated significance level, alpha, resulting in more P values of less than alpha than expected by chance.
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Fetal and infant growth predict hip geometry at 6 y old: findings from the Southampton Womens Survey.
Pediatr. Res.
PUBLISHED: 03-04-2013
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We investigated relationships between early growth and proximal femoral geometry at age 6 y in a prospective population-based cohort, the Southampton Womens Survey.
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Maternal awareness of young childrens physical activity: levels and cross-sectional correlates of overestimation.
BMC Public Health
PUBLISHED: 02-14-2013
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Factors associated with parental awareness of childrens physical activity (PA) levels have not been explored in preschool-aged children. This paper investigates maternal awareness of preschool-aged childrens PA levels and determined correlates associated with maternal overestimation of PA.
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Validation of novel wheeze phenotypes using longitudinal airway function and atopic sensitization data in the first 6 years of life: evidence from the Southampton Womens survey.
Pediatr. Pulmonol.
PUBLISHED: 02-08-2013
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In 1995 the Tucson Childrens Respiratory Study (TCRS) identified clinically distinct phenotypes amongst early wheezers; the Avon Longitudinal Study of Parents And Children (ALSPAC) has recently re-examined these.
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The relationship between maternal adiposity and infant weight gain, and childhood wheeze and atopy.
Thorax
PUBLISHED: 01-03-2013
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Obesity and asthma have increased in westernised countries. Maternal obesity may increase childhood asthma risk. If this relation is causal, it may be mediated through factors associated with maternal adiposity, such as fetal development, pregnancy complications or infant adiposity. We investigated the relationships of maternal body mass index (BMI) and fat mass with childhood wheeze, and examined the influences of infant weight gain and childhood obesity.
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Correlates of light and moderate-to-vigorous objectively measured physical activity in four-year-old children.
PLoS ONE
PUBLISHED: 01-01-2013
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Correlates of physical activity (PA) are hypothesized to be context and behaviour specific, but there is limited evidence of this in young children. The aim of the current study is to investigate associations between personal, social and environmental factors and objectively measured light and moderate-to-vigorous PA (LPA and MVPA, respectively) in four-year-old children.
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Associations between grip strength of parents and their 4-year-old children: findings from the Southampton Womens Survey.
Paediatr Perinat Epidemiol
PUBLISHED: 11-08-2011
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Relationships between birthweight and grip strength throughout the life course suggest that early influences on the growth and development of muscle are important for long-term muscle function. However, little is known about parental influences on childrens grip strength. We have explored this in the Southampton Womens Survey, a prospective general population cohort study from before conception through childhood. Grip strength was measured using a Jamar handgrip dynamometer in the mother at 19 weeks gestation and her partner, and in the child at age 4 years. Pre-pregnancy heights and weights were measured in the mothers; reported weights and measured heights were available for the fathers. Complete data on parents and children were available for 444 trios. In univariable analyses, both parents grip strengths were significantly associated with that of the child (r = 0.17, P < 0.001 for mothers; r = 0.15, P = 0.002 for fathers). These correlations were similar to that between the grip strength of the mothers and the fathers (r = 0.17, P < 0.001). In the multivariable model, after adjustment for childs height and physical activity, the correlations with the childs grip strength were attenuated, being 0.10 (P = 0.02) and 0.11 (P = 0.01) for mothers and fathers grip strength respectively. The findings show that grip strength of each parent is associated with that of the child, indicating that heritable influences and the shared family environment influence the development of muscle strength. This contributes to our understanding of the role of heritable and environmental factors on early muscle growth and development, which are important for muscle function across the life course.
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The long-term effects of prenatal development on growth and metabolism.
Semin. Reprod. Med.
PUBLISHED: 07-18-2011
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People who were small at birth and had poor infant growth have an increased risk of adult cardiovascular disease, osteoporosis, and type 2 diabetes, particularly if their restricted early growth was followed by increased childhood weight gain. These relations extend across the normal range of birth size in a graded manner, so reduced size is not a prerequisite. In addition, larger birth size is associated with risks of obesity and type 2 diabetes. The associations appear to reflect developmental plastic responses made by the fetus and infant based on cues about the environment, influenced by maternal characteristics including diet, body composition, stress, and exercise levels. These responses involve epigenetic processes that modify the offsprings phenotype. Vulnerability to ill health results if the environment in infancy, childhood, and later life is mismatched to the phenotype induced in development, informed by the developmental cues. This mismatch may arise through unbalanced diet or body composition of the mother or a change in lifestyle factors between generations. These insights offer new possibilities for the early diagnosis and prevention of chronic disease.
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Does living in a food insecure household impact on the diets and body composition of young children? Findings from the Southampton Womens Survey.
J Epidemiol Community Health
PUBLISHED: 06-07-2011
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Little is known about food insecurity in the UK. The aims of this study were to assess the prevalence and factors associated with food insecurity in a UK cohort and to examine whether the diets, reported health and anthropometry of young food insecure children differed from those of other children.
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Evaluation of methylation status of the eNOS promoter at birth in relation to childhood bone mineral content.
Calcif. Tissue Int.
PUBLISHED: 05-06-2011
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Our previous work has shown associations between childhood adiposity and perinatal methylation status of several genes in umbilical cord tissue, including endothelial nitric oxide synthase (eNOS). There is increasing evidence that eNOS is important in bone metabolism; we therefore related the methylation status of the eNOS gene promoter in stored umbilical cord to childhood bone size and density in a group of 9-year-old children. We used Sequenom MassARRAY to assess the methylation status of two CpGs in the eNOS promoter, identified from our previous study, in stored umbilical cords of 66 children who formed part of a Southampton birth cohort and who had measurements of bone size and density at age 9 years (Lunar DPXL DXA instrument). Percentage methylation varied greatly between subjects. For one of the two CpGs, eNOS chr7:150315553 + , after taking account of age and sex, there were strong positive associations between methylation status and the childs whole-body bone area (r = 0.28, P = 0.02), bone mineral content (r = 0.34, P = 0.005), and areal bone mineral density (r = 0.34, P = 0.005) at age 9 years. These associations were independent of previously documented maternal determinants of offspring bone mass. Our findings suggest an association between methylation status at birth of a specific CpG within the eNOS promoter and bone mineral content in childhood. This supports a role for eNOS in bone growth and metabolism and implies that its contribution may at least in part occur during early skeletal development.
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Epigenetic gene promoter methylation at birth is associated with childs later adiposity.
Diabetes
PUBLISHED: 04-06-2011
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Fixed genomic variation explains only a small proportion of the risk of adiposity. In animal models, maternal diet alters offspring body composition, accompanied by epigenetic changes in metabolic control genes. Little is known about whether such processes operate in humans.
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Breastfeeding and reported morbidity during infancy: findings from the Southampton Womens Survey.
Matern Child Nutr
PUBLISHED: 03-30-2011
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A number of studies in developed countries suggest that breastfeeding protects against infections in infancy. However, the choice to breastfeed is often related to maternal characteristics, and many of these studies are limited in the extent to which they can take account of confounding influences. In a prospective birth cohort study, we assessed the relationship between the duration of breastfeeding and the prevalence of lower respiratory tract infections, ear infections and gastrointestinal morbidity during the first year of life in 1764 infants. We considered the duration of all breastfeeding, including mixed feeding. Eighty-one per cent of the infants were breastfed initially, and 25% were breastfed up to 6 months. There were graded decreases in the prevalence of respiratory and gastrointestinal symptoms between birth and 6 months as breastfeeding duration increased; these were robust to adjustment for a number of confounding factors. The adjusted relative risks (95% confidence interval) for infants breastfed for six or more months compared with infants who were never breastfed were 0.72 (0.58-0.89), 0.43 (0.30-0.61) and 0.60 (0.39-0.92) for general respiratory morbidity, diarrhoea and vomiting, respectively. Duration of breastfeeding in the second half of infancy was less strongly related to diagnosed respiratory tract infections and gastrointestinal morbidity, although important benefits of breastfeeding were still seen. Our data provide strong support for a protective role of breastfeeding against respiratory and gastrointestinal infections in infancy. The graded inverse associations with breastfeeding duration suggest that current efforts to promote breastfeeding and increase duration will have important effects in reducing morbidity in infancy.
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Monitoring head size and growth using the new UK-WHO growth standard.
Arch. Dis. Child.
PUBLISHED: 02-01-2011
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In order to assess the extent to which children in the UK will follow the UK-WHO head circumference standard, the authors used head circumference data from the Southampton Womens Survey (n=3159) and the Avon Longitudinal Study of Parents and Children (n=15 208) in children aged 0-36 months, converted into z-scores using both the UK-WHO and UK1990 references. Rapid head growth was defined as crossing upwards through two major centile bands (1.33 SD). The UK-WHO standard identified many more infants with heads above the 98th centile than to the UK1990 reference (UK-WHO: 6-16% of infants at various ages; UK1990: 1-4%). Rapid head growth in the first 6-9 months was also much more common using the UK-WHO standard (UK-WHO: 14.6-15.3%; UK1990: 4.8-5.1%). Practitioners should be aware of these findings to avoid unnecessary referrals.
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Childhood socioeconomic position and objectively measured physical capability levels in adulthood: a systematic review and meta-analysis.
PLoS ONE
PUBLISHED: 01-26-2011
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Grip strength, walking speed, chair rising and standing balance time are objective measures of physical capability that characterise current health and predict survival in older populations. Socioeconomic position (SEP) in childhood may influence the peak level of physical capability achieved in early adulthood, thereby affecting levels in later adulthood. We have undertaken a systematic review with meta-analyses to test the hypothesis that adverse childhood SEP is associated with lower levels of objectively measured physical capability in adulthood.
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Patterns of fetal and infant growth are related to atopy and wheezing disorders at age 3 years.
Thorax
PUBLISHED: 10-18-2010
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Little is known about whether patterns of early growth are associated with altered respiratory and immune development. This study relates prenatal and infant growth patterns to wheeze and atopy at age 3 years.
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The Southampton Initiative for Health: a complex intervention to improve the diets and increase the physical activity levels of women from disadvantaged communities.
J Health Psychol
PUBLISHED: 08-13-2010
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The Southampton Initiative for Health is a training intervention with Sure Start Childrens Centre staff designed to improve the diets and physical activity levels of women of childbearing age. Training aims to help staff to support women in making changes to their lifestyles by improving three skills: reflection on current practice; asking open discovery questions; and goal-setting. The impact of the training on staff practice is being assessed. A before and after non-randomized controlled trial is being used to evaluate the effectiveness and cost-effectiveness of the intervention in improving womens diets and increasing their physical activity levels.
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Specific psychological variables predict quality of diet in women of lower, but not higher, educational attainment.
Appetite
PUBLISHED: 06-11-2010
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Our previous work found that perceived control over life was a significant predictor of the quality of diet of women of lower educational attainment. In this paper, we explore the influence on quality of diet of a range of psychological and social factors identified during focus group discussions, and specify the way this differs in women of lower and higher educational attainment. We assessed educational attainment, quality of diet, and psycho-social factors in 378 women attending Sure Start Childrens Centres and baby clinics in Southampton, UK. Multiple-group path analysis showed that in women of lower educational attainment, the effect of general self-efficacy on quality of diet was mediated through perceptions of control and through food involvement, but that there were also direct effects of social support for healthy eating and having positive outcome expectancies. There was no effect of self-efficacy, perceived control or outcome expectancies on the quality of diet of women of higher educational attainment, though having more social support and food involvement were associated with improved quality of diet in these women. Our analysis confirms our hypothesis that control-related factors are more important in determining dietary quality in women of lower educational attainment than in women of higher educational attainment.
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Different indices of fetal growth predict bone size and volumetric density at 4 years of age.
J. Bone Miner. Res.
PUBLISHED: 05-04-2010
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We have demonstrated previously that higher birth weight is associated with greater peak and later-life bone mineral content and that maternal body build, diet, and lifestyle influence prenatal bone mineral accrual. To examine prenatal influences on bone health further, we related ultrasound measures of fetal growth to childhood bone size and density. We derived Z-scores for fetal femur length and abdominal circumference and conditional growth velocity from 19 to 34 weeks gestation from ultrasound measurements in participants in the Southampton Womens Survey. A total of 380 of the offspring underwent dual-energy X-ray absorptiometry (DXA) at age 4 years [whole body minus head bone area (BA), bone mineral content (BMC), areal bone mineral density (aBMD), and estimated volumetric BMD (vBMD)]. Volumetric bone mineral density was estimated using BMC adjusted for BA, height, and weight. A higher velocity of 19- to 34-week fetal femur growth was strongly associated with greater childhood skeletal size (BA: r = 0.30, p < .0001) but not with volumetric density (vBMD: r = 0.03, p = .51). Conversely, a higher velocity of 19- to 34-week fetal abdominal growth was associated with greater childhood volumetric density (vBMD: r = 0.15, p = .004) but not with skeletal size (BA: r = 0.06, p = .21). Both fetal measurements were positively associated with BMC and aBMD, indices influenced by both size and density. The velocity of fetal femur length growth from 19 to 34 weeks gestation predicted childhood skeletal size at age 4 years, whereas the velocity of abdominal growth (a measure of liver volume and adiposity) predicted volumetric density. These results suggest a discordance between influences on skeletal size and volumetric density.
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Weight gain in pregnancy and childhood body composition: findings from the Southampton Womens Survey.
Am. J. Clin. Nutr.
PUBLISHED: 04-07-2010
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Intrauterine life may be a critical period for the programming of later obesity, but there is conflicting evidence about whether pregnancy weight gain is an important determinant of offspring adiposity.
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Breastfeeding, the use of docosahexaenoic acid-fortified formulas in infancy and neuropsychological function in childhood.
Arch. Dis. Child.
PUBLISHED: 02-04-2010
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To investigate the relation between breastfeeding, use of docosahexaenoic acid (DHA)-fortified formula and neuropsychological function in children.
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Twenty-five year mortality of a community cohort with schizophrenia.
Br J Psychiatry
PUBLISHED: 02-02-2010
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People with schizophrenia have significantly raised mortality but we do not know how these mortality patterns in the UK have changed since the 1990s.
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Why women of lower educational attainment struggle to make healthier food choices: the importance of psychological and social factors.
Psychol Health
PUBLISHED: 10-29-2009
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Women of lower educational attainment are more likely to eat unhealthy diets than women of higher educational attainment. To identify influences on the food choices of women with lower educational attainment, 11 focus groups (eight with women of lower, and three with women of higher educational attainment) were held. Using a semi-structured discussion guide, environmental, social, historical and psychological factors known to be associated with food choice were explored. Audio recordings were transcribed verbatim and thematically analysed. Compared to women of higher educational attainment, women of lower educational attainment had less control over their families food choices, less support for attempts to eat healthily, fewer opportunities to observe and learn good food-related practices, more negative affect, more perceived environmental constraints and more ambiguous beliefs about the consequences of eating a nutritious diet. These findings provide a starting point for taking forward the design of an intervention to improve the diets of young women.
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Womens dietary patterns change little from before to during pregnancy.
J. Nutr.
PUBLISHED: 08-26-2009
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Principal component analysis (PCA) is a popular method of dietary patterns analysis, but our understanding of its use to describe changes in dietary patterns over time is limited. Using a FFQ, we assessed the diets of 12,572 nonpregnant women aged 20-34 y from Southampton, UK, of whom 2270 and 2649 became pregnant and provided complete dietary data in early and late pregnancy, respectively. Intakes of white bread, breakfast cereals, cakes and biscuits, processed meat, crisps, fruit and fruit juices, sweet spreads, confectionery, hot chocolate drinks, puddings, cream, milk, cheese, full-fat spread, cooking fats and salad oils, red meat, and soft drinks increased in pregnancy. Intakes of rice and pasta, liver and kidney, vegetables, nuts, diet cola, tea and coffee, boiled potatoes, and crackers decreased in pregnancy. PCA at each time point produced 2 consistent dietary patterns, labeled prudent and high-energy. At each time point in pregnancy, and for both the prudent and high-energy patterns, we derived 2 dietary pattern scores for each woman: a natural score, based on the pattern defined at that time point, and an applied score, based on the pattern defined before pregnancy. Applied scores are preferred to natural scores to characterize changes in dietary patterns over time because the scale of measurement remains constant. Using applied scores, there was a very small mean decrease in prudent diet score in pregnancy and a very small mean increase in high-energy diet score in late pregnancy, indicating little overall change in dietary patterns in pregnancy.
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Do women change their health behaviours in pregnancy? Findings from the Southampton Womens Survey.
Paediatr Perinat Epidemiol
PUBLISHED: 08-20-2009
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A womans life style choices before and during pregnancy have important implications for her unborn child, but information on behaviour can be unreliable when data are collected retrospectively. In particular there are no large longitudinal datasets that include information collected prospectively before pregnancy to allow accurate description of changes in behaviour into pregnancy. The Southampton Womens Survey is a longitudinal study of women in Southampton, UK, characterised when they were not pregnant and again during pregnancy. The objective of the analyses presented here is to describe the degree to which women comply with diet and life style recommendations before and during pregnancy, and changes between these time points. The analyses are based on 1490 women who delivered between 1998 and 2003 and who provided information before pregnancy and at 11 and 34 weeks gestation. At each time point a trained research nurse ascertained smoking status and assessed food and drink consumption using a food frequency questionnaire. We derived the proportions of women who complied with recommendations not to smoke, to eat five portions of fruit and vegetables per day and to drink no more than four units of alcohol per week and 300 mg of caffeine per day. There was a notable reduction in smoking when women became pregnant: before pregnancy 27% of women smoked, whereas in early pregnancy 15% smoked. Similarly there were significant reductions in alcohol consumption and intake of caffeinated drinks: before pregnancy 54% of women drank more than four units of alcohol per week and 39% had estimated intakes of caffeine in drinks of >300 mg per day, whereas comparable figures for early pregnancy were 10% and 16% respectively. However, there was little change in fruit and vegetable intake; the percentages of women who did not achieve the recommendation to eat at least five portions of fruit and vegetables per week were 47% before pregnancy and 46% in early pregnancy. Younger women and those with fewer educational qualifications were less likely to comply with public health recommendations. Overall, 81% of women in early pregnancy complied with at least three of the recommendations. Although there is encouraging evidence of changed health behaviours in pregnancy, young women and those with few educational qualifications may particularly benefit from targeted health initiatives.
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What do babies eat? Evaluation of a food frequency questionnaire to assess the diets of infants aged 12 months.
Public Health Nutr
PUBLISHED: 07-25-2009
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To evaluate the relative validity of an FFQ for assessing nutrient intakes in 12-month-old infants.
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Cut-off points for anthropometric indices of adiposity: differential classification in a large population of young women.
Br. J. Nutr.
PUBLISHED: 06-12-2009
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Anthropometric indices of adiposity include BMI, waist circumference and waist:height ratio. In the recruitment phase of a prospective cohort study carried out between 1998 and 2002 we studied a population sample of 11 786 white Caucasian non-pregnant women in Southampton, UK aged 20-34 years, and explored the extent to which proposed cut-off points for the three indices identified the same or different women and how these indices related to adiposity. Height, weight and waist circumference were measured and fat mass was estimated from skinfold thicknesses; fat mass index was calculated as fat mass/height1.65. Of the subjects, 4869 (42 %) women were overweight (BMI > or = 25 kg/m2) and 1849 (16 %) were obese (BMI > or = 30 kg/m2). A total of 890 (8 %) subjects were not overweight but had a waist circumference > or = 80 cm and 748 (6 %) subjects were overweight but had a waist circumference < 80 cm (6 %). Of the women, 50 % had a BMI > or = 25 kg/m2 or a waist circumference > or = 80 cm or a waist:height ratio > or = 0.5. Of the variation in fat mass index, 85 % was explained by BMI, 76 % by waist circumference and 75 % by waist:height ratio. Our findings demonstrate that many women are differentially classified depending on which index of adiposity is used. As each index captures different aspects of size in terms of adiposity, there is the need to determine how the three indices relate to function and how they can be of use in defining risk of ill health in women.
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Variations in infant feeding practice are associated with body composition in childhood: a prospective cohort study.
J. Clin. Endocrinol. Metab.
PUBLISHED: 05-12-2009
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Most studies of infant diet and later body composition focus on milk feeding; few consider the influence of variations in the weaning diet.
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Infant sleep disturbance is associated with preconceptional psychological distress: findings from the Southampton Womens Survey.
Sleep
PUBLISHED: 05-06-2009
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To determine whether preconceptional psychological distress is associated with infant sleep disturbance.
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Breast-feeding and adherence to infant feeding guidelines do not influence bone mass at age 4 years.
Br. J. Nutr.
PUBLISHED: 04-02-2009
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The impact of variations in current infant feeding practice on bone mineral accrual is not known. We examined the associations between duration of breast-feeding and compliance with infant dietary guidelines and later bone size and density at age 4 years. At total of 599 (318 boys) mother-child pairs were recruited from the Southampton Womens Survey. Duration of breast-feeding was recorded and infant diet was assessed at 6 and 12 months using FFQ. At 6 and 12 months the most important dietary pattern, defined by principal component analysis, was characterised by high consumption of vegetables, fruits and home-prepared foods. As this was consistent with infant feeding recommendations, it was denoted the infant guidelines pattern. At age 4 years, children underwent assessment of whole-body bone size and density using a Hologic Discovery dual-energy X-ray absorptiometry instrument. Correlation methods were used to explore the relationships between infant dietary variables and bone mineral. There was no association between duration of breast-feeding in the first year of life and 4-year bone size or density. Infant guidelines pattern scores at 6 and 12 months were also unrelated to bone mass at age 4 years. We observed wide variations in current infant feeding practice, but these variations were not associated with differences in childhood bone mass at age 4 years.
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Womens compliance with nutrition and lifestyle recommendations before pregnancy: general population cohort study.
BMJ
PUBLISHED: 02-14-2009
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To examine the extent to which women planning a pregnancy comply with recommendations for nutrition and lifestyle.
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Validation of a maternal questionnaire on correlates of physical activity in preschool children.
Int J Behav Nutr Phys Act
PUBLISHED: 02-09-2009
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Valid measures of physical activity correlates in preschool children are lacking. This study aimed to assess the validity, factor structure and internal consistency of a maternal questionnaire on potential correlates of four-year-old childrens physical activity.
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Dietary patterns in infancy and cognitive and neuropsychological function in childhood.
J Child Psychol Psychiatry
PUBLISHED: 01-05-2009
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Trials in developing countries suggest that improving young childrens diet may benefit cognitive development. Whether dietary composition influences young childrens cognition in developed countries is unclear. Although many studies have examined the relation between type of milk received in infancy and subsequent cognition, there has been no investigation of the possible effect of variations in the weaning diet.
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Postpartum depressive symptoms: the B-vitamin link.
Ment Health Fam Med
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Objective This study examined longitudinal relationships between maternal red-cell folate status and dietary intakes of vitamins B(6), B(12) and folate before and during pregnancy and subsequent postpartum depressive symptoms.Study design and setting Within a cohort study of women aged 20-34 years (the Southampton Womens Survey) dietary data were obtained before pregnancy and at 11 and 34 weeks gestation. Red-cell folate was measured before pregnancy and at 11 weeks gestation. We derived relative risks of postpartum depressive symptoms using an Edinburgh Postnatal Depression Scale (EPDS) score of ? 13 administered from 6 months to 1 year postpartum.Results No significant differences were found between those with postpartum depressive symptoms (n = 905) and those without (n = 1951) in relation to red-cell folate concentration or dietary intake of folate, vitamin B(12) and vitamin B(6), before or during pregnancy. A prior history of mental illness (relative risk (RR) 1.83; 95% confidence interval (CI) 1.53-2.19) was associated with postpartum depressive symptoms, and women who breastfed until 6 months were less likely to experience postpartum depressive symptoms (RR 0.68; 95% CI 0.55-0.84).Conclusion This study suggests that folate status and dietary folate, B(6) and B(12) intakes before and during pregnancy are not associated with postpartum depressive symptoms. A history of mental illness, however, was a strong risk factor.
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New loci associated with birth weight identify genetic links between intrauterine growth and adult height and metabolism.
Momoko Horikoshi, Hanieh Yaghootkar, Dennis O Mook-Kanamori, Ulla Sovio, H Rob Taal, Branwen J Hennig, Jonathan P Bradfield, Beate St Pourcain, David M Evans, Pimphen Charoen, Marika Kaakinen, Diana L Cousminer, Terho Lehtimäki, Eskil Kreiner-Møller, Nicole M Warrington, Mariona Bustamante, Bjarke Feenstra, Diane J Berry, Elisabeth Thiering, Thiemo Pfab, Sheila J Barton, Beverley M Shields, Marjan Kerkhof, Elisabeth M van Leeuwen, Anthony J Fulford, Zoltan Kutalik, Jing Hua Zhao, Marcel den Hoed, Anubha Mahajan, Virpi Lindi, Liang-Kee Goh, Jouke-Jan Hottenga, Ying Wu, Olli T Raitakari, Marie N Harder, Aline Meirhaeghe, Ioanna Ntalla, Rany M Salem, Karen A Jameson, Kaixin Zhou, Dorota M Monies, Vasiliki Lagou, Mirna Kirin, Jani Heikkinen, Linda S Adair, Fowzan S Alkuraya, Ali Al-Odaib, Philippe Amouyel, Ehm Astrid Andersson, Amanda J Bennett, Alexandra I F Blakemore, Jessica L Buxton, Jean Dallongeville, Shikta Das, Eco J C de Geus, Xavier Estivill, Claudia Flexeder, Philippe Froguel, Frank Geller, Keith M Godfrey, Frederic Gottrand, Christopher J Groves, Torben Hansen, Joel N Hirschhorn, Albert Hofman, Mads V Hollegaard, David M Hougaard, Elina Hyppönen, Hazel M Inskip, Aaron Isaacs, Torben Jørgensen, Christina Kanaka-Gantenbein, John P Kemp, Wieland Kiess, Tuomas O Kilpeläinen, Norman Klopp, Bridget A Knight, Christopher W Kuzawa, George McMahon, John P Newnham, Harri Niinikoski, Ben A Oostra, Louise Pedersen, Dirkje S Postma, Susan M Ring, Fernando Rivadeneira, Neil R Robertson, Sylvain Sebert, Olli Simell, Torsten Slowinski, Carla M T Tiesler, Anke Tönjes, Allan Vaag, Jorma S Viikari, Jacqueline M Vink, Nadja Hawwa Vissing, Nicholas J Wareham, Gonneke Willemsen, Daniel R Witte, Haitao Zhang, Jianhua Zhao, , James F Wilson, Michael Stumvoll, Andrew M Prentice, Brian F Meyer, Ewan R Pearson, Colin A G Boreham, Cyrus Cooper, Matthew W Gillman, George V Dedoussis, Luis A Moreno, Oluf Pedersen, Maiju Saarinen, Karen L Mohlke, Dorret I Boomsma, Seang-Mei Saw, Timo A Lakka, Antje Körner, Ruth J F Loos, Ken K Ong, Peter Vollenweider, Cornelia M van Duijn, Gerard H Koppelman, Andrew T Hattersley, John W Holloway, Berthold Hocher, Joachim Heinrich, Chris Power, Mads Melbye, Mònica Guxens, Craig E Pennell, Klaus Bønnelykke, Hans Bisgaard, Johan G Eriksson, Elisabeth Widén, Hakon Hakonarson, André G Uitterlinden, Anneli Pouta, Debbie A Lawlor, George Davey Smith, Timothy M Frayling, Mark I McCarthy, Struan F A Grant, Vincent W V Jaddoe, Marjo-Riitta Järvelin, Nicholas J Timpson, Inga Prokopenko, Rachel M Freathy.
Nat. Genet.
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Birth weight within the normal range is associated with a variety of adult-onset diseases, but the mechanisms behind these associations are poorly understood. Previous genome-wide association studies of birth weight identified a variant in the ADCY5 gene associated both with birth weight and type 2 diabetes and a second variant, near CCNL1, with no obvious link to adult traits. In an expanded genome-wide association meta-analysis and follow-up study of birth weight (of up to 69,308 individuals of European descent from 43 studies), we have now extended the number of loci associated at genome-wide significance to 7, accounting for a similar proportion of variance as maternal smoking. Five of the loci are known to be associated with other phenotypes: ADCY5 and CDKAL1 with type 2 diabetes, ADRB1 with adult blood pressure and HMGA2 and LCORL with adult height. Our findings highlight genetic links between fetal growth and postnatal growth and metabolism.
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Variety and quality of healthy foods differ according to neighbourhood deprivation.
Health Place
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This study addresses a gap in the food environment literature by investigating spatial differences in the inter relationship of price, variety and quality of food in southern England. We conducted a survey of all grocery stores (n=195) in the city of Southampton, UK, and ranked neighbourhoods according to national quintiles of deprivation. We found no difference in availability or cheapest price across neighbourhoods. However, the poorest neighbourhoods had less variety of healthy products and poorer quality fruit and vegetables than more affluent neighbourhoods. Dietary inequalities may be exacerbated by differences in the variety and quality of healthy foods sold locally; these factors may influence whether or not consumers purchase healthy foods.
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Maternal plasma phosphatidylcholine fatty acids and atopy and wheeze in the offspring at age of 6 years.
Clin. Dev. Immunol.
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Variation in exposure to polyunsaturated fatty acids (PUFAs) might influence the development of atopy, asthma, and wheeze. This study aimed to determine whether differences in PUFA concentrations in maternal plasma phosphatidylcholine are associated with the risk of childhood wheeze or atopy. For 865 term-born children, we measured phosphatidylcholine fatty acid composition in maternal plasma collected at 34 weeks gestation. Wheezing was classified using questionnaires at 6, 12, 24, and 36 months and 6 years. At age of 6 years, the children underwent skin prick testing, fractional exhaled nitric oxide (FENO) measurement, and spirometry. Maternal n-6 fatty acids and the ratio of n-3 to n-6 fatty acids were not associated with childhood wheeze. However, higher maternal eicosapentaenoic acid, docosahexaenoic acid, and total n-3 fatty acids were associated with reduced risk of non-atopic persistent/late wheeze (RR 0.57, 0.67 and 0.69, resp. P = 0.01, 0.015, and 0.021, resp.). Maternal arachidonic acid was positively associated with FENO (P = 0.024). A higher ratio of linoleic acid to its unsaturated metabolic products was associated with reduced risk of skin sensitisation (RR 0.82, P = 0.013). These associations provide some support for the hypothesis that variation in exposure to n-6 and n-3 fatty acids during pregnancy influences the risk of childhood wheeze and atopy.
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Healthy conversation skills: increasing competence and confidence in front-line staff.
Public Health Nutr
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OBJECTIVE: (i) To assess change in confidence in having conversations that support parents with healthy eating and physical activity post-training. (ii) To assess change in staff competence in using open discovery questions (those generally beginning with how and what that help individuals reflect and identify barriers and solutions) post-training. (iii) To examine the relationship between confidence and competence post-training. DESIGN: A pre-post evaluation of Healthy Conversation Skills, a staff training intervention. SETTING: Sure Start Childrens Centres in Southampton, England. SUBJECTS: A total of 145 staff working in Sure Start Childrens Centres completed the training, including play workers (43 %) and community development or family support workers (35 %). RESULTS: We observed an increase in median confidence rating for having conversations about healthy eating and physical activity (both P < 0·001), and in using open discovery questions (P < 0·001), after staff attended the Healthy Conversation Skills training. We also found a positive relationship between the use of open discovery questions and confidence in having conversations about healthy eating post-training (r = 0·21, P = 0·01), but a non-significant trend was observed for having conversations about physical activity (r = 0·15, P = 0·06). CONCLUSIONS: The Healthy Conversation Skills training proved effective at increasing the confidence of staff working at Sure Start Childrens Centres to have more productive conversations with parents about healthy eating. Wider implementation of these skills may be a useful public health nutrition capacity building strategy to help community workers support families with young children to eat more healthy foods.
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Fetal liver blood flow distribution: role in human developmental strategy to prioritize fat deposition versus brain development.
PLoS ONE
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Among primates, human neonates have the largest brains but also the highest proportion of body fat. If placental nutrient supply is limited, the fetus faces a dilemma: should resources be allocated to brain growth, or to fat deposition for use as a potential postnatal energy reserve? We hypothesised that resolving this dilemma operates at the level of umbilical blood distribution entering the fetal liver. In 381 uncomplicated pregnancies in third trimester, we measured blood flow perfusing the fetal liver, or bypassing it via the ductus venosus to supply the brain and heart using ultrasound techniques. Across the range of fetal growth and independent of the mothers adiposity and parity, greater liver blood flow was associated with greater offspring fat mass measured by dual-energy X-ray absorptiometry, both in the infant at birth (r?=?0.43, P<0.001) and at age 4 years (r?=?0.16, P?=?0.02). In contrast, smaller placentas less able to meet fetal demand for essential nutrients were associated with a brain-sparing flow pattern (r?=?0.17, p?=?0.02). This flow pattern was also associated with a higher degree of shunting through ductus venosus (P?=?0.04). We propose that humans evolved a developmental strategy to prioritize nutrient allocation for prenatal fat deposition when the supply of conditionally essential nutrients requiring hepatic inter-conversion is limited, switching resource allocation to favour the brain if the supply of essential nutrients is limited. Facilitated placental transfer mechanisms for glucose and other nutrients evolved in environments less affluent than those now prevalent in developed populations, and we propose that in circumstances of maternal adiposity and nutrient excess these mechanisms now also lead to prenatal fat deposition. Prenatal developmental influences play important roles in the human propensity to deposit fat.
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Maternal late-pregnancy serum 25-hydroxyvitamin D in relation to childhood wheeze and atopic outcomes.
Thorax
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Studies exploring the relationship between prenatal vitamin D exposure and childhood asthma have yielded conflicting results. Higher vitamin D intake during pregnancy has been shown to lower the risk of childhood wheeze, yet a study of maternal late-pregnancy serum 25-hydroxyvitamin D suggested higher serum concentrations may be associated with increased childhood asthma.
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Maternal vitamin D status in pregnancy is associated with adiposity in the offspring: findings from the Southampton Womens Survey.
Am. J. Clin. Nutr.
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Low vitamin D status has been linked to adiposity, but little is known of the effects of low status in pregnancy on offspring body composition.
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Implementation of new Healthy Conversation Skills to support lifestyle changes - what helps and what hinders? Experiences of Sure Start Childrens Centre staff.
Health Soc Care Community
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Effective communication is necessary for good relationships between healthcare practitioners and clients. This study examined barriers and facilitators to implementing new communication skills. One hundred and ten Sure Start Childrens Centre staff attended one of 13 follow-up workshops in Southampton, UK between May 2009 and February 2011 to reflect on the use of new skills following a training course in communication, reflection and problem-solving. Barriers and facilitators were assessed with an adapted Problematic Experiences of Therapy scale (PETS). Staff reported frequency of skill use, and described what made it more difficult or easier to use the skills. Complete data were available for 101 trainees. The PETS indicated that staff had confidence in using the skills, but felt that there were practical barriers to using them, such as lack of time. Skills were used less often when staff perceived parents not to be engaging with them (Spearmans correlation r(s) = -0.42, P < 0.001), when staff felt less confident to use the skills (r(s) = -0.37, P < 0.001) and when there were more practical barriers (r(s) = -0.37, P < 0.001). In support of findings from the PETS, content analysis of free text responses suggested that the main barrier was a perceived lack of time to implement new skills. Facilitators included seeing the benefits of using the skills, finding opportunities and having good relationships with parents. Understanding the range of barriers and facilitators to implementation is essential when developing training to facilitate ongoing support and sustain skill use. Special attention should be given to exploring trainees perceptions of time, to be able to address this significant barrier to skill implementation. Staff training requires a multi-faceted approach to address the range of perceived barriers.
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Childhood bone mineral content is associated with methylation status of the RXRA promoter at birth.
J. Bone Miner. Res.
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Maternal vitamin D deficiency has been associated with reduced offspring bone mineral accrual. Retinoid-X Receptor-alpha (RXRA) is an essential cofactor in the action of 1,25(OH)2 -vitamin D, and RXRA methylation in umbilical cord DNA has been associated with later offspring adiposity. We tested the hypothesis that RXRA methylation in umbilical cord DNA collected at birth is associated with offspring skeletal development, assessed by dual-energy X-ray absorptiometry, in a population-based mother-offspring cohort (Southampton Womens Survey). Relationships between maternal plasma 25(OH)-vitamin D concentrations and cord RXRA methylation were also investigated. In 230 children aged 4 years, higher % methylation at 4 out of 6 RXRA CpG sites measured was correlated with lower offspring BMC corrected for body size (??=?-?2.1 to -3.4g/SD, p?=?0.002 to 0.047). In a second independent cohort (n?=?64), similar negative associations at two of these CpG sites, but positive associations at the two remaining sites, were observed; however none of the relationships in this replication cohort achieved statistical significance. Maternal free 25(OH)-vitamin D index was negatively associated with methylation at one of these RXRA CpG sites (??=?-?3.3 SD/unit, p?=?0.03). Thus, perinatal epigenetic marking at the RXRA promoter region in umbilical cord was inversely associated with offspring size-corrected bone mineral content in childhood. The potential mechanistic and functional significance of this finding remains a subject for further investigation.
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