High Body Mass Index in Infancy May Predict Severe Obesity in Early Childhood

Smego, Allison; Woo, Jessica G.; Klein, Jillian A.; Suh, Christina; Bansal, Danesh; Bliss, Sherri; Daniels, Stephen R.; Bolling, Christopher; Crimmins, Nancy A.

doi:10.1016/j.jpeds.2016.11.020

Cited by 71 publications

(39 citation statements)

References 14 publications

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“…Accelerated growth during infancy and increased BMI in early life are known to enhance the risk for obesity [289,290,291], T2DM [292,293], allergy [294,295,296] and cancer later in life [297,298,299]. …”

Section: Milk-mediated Epigenetic Signaling and Diseases Of Civilmentioning

confidence: 99%

Milk’s Role as an Epigenetic Regulator in Health and Disease

2017

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Abstract:It is the intention of this review to characterize milk's role as an epigenetic regulator in health and disease. Based on translational research, we identify milk as a major epigenetic modulator of gene expression of the milk recipient. Milk is presented as an epigenetic "doping system" of mammalian development. Milk exosome-derived micro-ribonucleic acids (miRNAs) that target DNA methyltransferases are implicated to play the key role in the upregulation of developmental genes such as FTO, INS, and IGF1. In contrast to miRNA-deficient infant formula, breastfeeding via physiological miRNA transfer provides the appropriate signals for adequate epigenetic programming of the newborn infant. Whereas breastfeeding is restricted to the lactation period, continued consumption of cow's milk results in persistent epigenetic upregulation of genes critically involved in the development of diseases of civilization such as diabesity, neurodegeneration, and cancer. We hypothesize that the same miRNAs that epigenetically increase lactation, upregulate gene expression of the milk recipient via milk-derived miRNAs. It is of critical concern that persistent consumption of pasteurized cow's milk contaminates the human food chain with bovine miRNAs, that are identical to their human analogs. Commercial interest to enhance dairy lactation performance may further increase the epigenetic miRNA burden for the milk consumer.

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Section: Milk-mediated Epigenetic Signaling and Diseases Of Civilmentioning

confidence: 99%

Milk’s Role as an Epigenetic Regulator in Health and Disease

2017

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“…In children, the relation between body mass index (BMI) and adiposity varies with age and sex, so BMI thresholds are usually defined in terms of specific centiles on a growth reference curve [6]. Extremely high BMI values considerably increase children’s physical and mental health risks [7-11]. When compared with children with overweight or obesity, who often do not experience visible morbidities during childhood, children with severe obesity frequently have immediate health consequences, including a worse cardiometabolic risk profile, earlier signs of vascular dysfunction, and subclinical atherosclerosis [12-23].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Severe Obesity among Primary School Children in 21 European Countries

et al. 2019

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Background: The World Health Organization (WHO) European Childhood Obesity Surveillance Initiative (COSI) was established more than 10 years ago to estimate prevalence and monitor changes in overweight and obesity in children aged 6–9 years. Since then, there have been five rounds of data collection in more than 40 countries involving more than half a million children. To date, no comparative studies with data on severe childhood obesity from European countries have been published. Objectives: The aim of this work was to present the prevalence of severe obesity in school-aged children from 21 countries participating in COSI. Method: The data are from cross-sectional studies in 21 European WHO member states that took part in the first three COSI rounds of data collection (2007/2008, 2009/2010, 2012/2013). School-aged children were measured using standardized instruments and methodology. Children were classified as severely obese using the definitions provided by WHO and the International Obesity Task Force (IOTF). Analyses overtime, by child’s age and mother’s educational level, were performed in a select group of countries. Results:A total of 636,933 children were included in the analysis (323,648 boys and 313,285 girls). The prevalence of severe obesity varied greatly among countries, with higher values in Southern Europe. According to the WHO definition, severe obesity ranged from 1.0% in Swedish and Moldovan children (95% CI 0.7–1.3 and 0.7–1.5, respectively) to 5.5% (95% CI 4.9–6.1) in Maltese children. The prevalence was generally higher among boys compared to girls. The IOTF cut-offs lead to lower estimates, but confirm the differences among countries, and were more similar for both boys and girls. In many countries 1 in 4 obese children were severely obese. Applying the estimates of prevalence based on the WHO definition to the whole population of children aged 6–9 years in each country, around 398,000 children would be expected to be severely obese in the 21 European countries. The trend between 2007 and 2013 and the analysis by child’s age did not show a clear pattern. Severe obesity was more common among children whose mother’s educational level was lower. Conclusions: Severe obesity is a serious public health issue which affects a large number of children in Europe. Because of the impact on educational, health, social care, and economic systems, obesity needs to be addressed via a range of approaches from early prevention of overweight and obesity to treatment of those who need it.

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“…Although the report for the CDC growth charts (Kuczmarski et al, 2002) cautioned about extrapolating outside the 3rd and 97th percentiles of BMI, BMI z remains widely used in studies that include large numbers of children with very high BMIs (Hampl et al, 2016; Kreier et al, 2013; McCormick et al, 2014; Smego et al, 2017; Wang et al, 2015). We have shown that, among children with severe obesity, BMI z levels are only weakly associated with other measures of body size (Freedman et al, 2017a) and the current results highlight the drawbacks of attempting to assess longitudinal BMI z changes.…”

Section: Discussionmentioning

confidence: 99%

“…Extrapolated z -scores based on the CDC growth charts are widely used among children who have very high BMIs (Baughcum et al, 2015; Hampl et al, 2016; Kreier et al, 2013; Smego et al, 2017; Wang et al, 2015). However, BMI z values for extremely high BMIs can differ substantially from the empirical estimates (Flegal et al, 2009), have an effective upper limit (Woo, 2009) and are strongly influenced by sex and age.…”

Section: Discussionmentioning

confidence: 99%

“…Although investigators have emphasised the drawbacks of analysing changes in BMI z (Berkey & Colditz, 2007; Cole et al, 2005; Kakinami et al, 2014; Paluch et al, 2007), these changes continue to be widely used in longitudinal studies (Lo et al, 2014; McCormick et al, 2014; O’Connor et al, 2017; Smego et al, 2017) and it has been suggested that a BMI z -score reduction of more than 0.20–0.25 SDs may be clinically important (US Preventive Services Task Force, 2017). The limitations of the CDC BMI z values may be particularly relevant in longitudinal studies of children with very high BMIs, as the age-related changes in the L and S parameters could strongly influence observed changes in BMI z .…”

Section: Introductionmentioning

confidence: 99%

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Longitudinal changes in BMIz-scores among 45 414 2–4-year olds with severe obesity

Freedman

Butte

Taveras

et al. 2017

Annals of Human Biology

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Background BMI z-scores (BMIz) based on the Centers for Disease Control and Prevention (CDC) growth charts among children do not accurately characterise BMI levels among children with very high BMIs. These limitations may be particularly relevant in longitudinal and intervention studies, as the large changes in the L (normality) and S (dispersion) parameters with age can influence BMIz. Aim To compare longitudinal changes in BMIz with BMI expressed as a percentage of the 95th percentile (%BMIp95) and a modified z-score calculated as log(BMI/M)/S. Subjects and methods A total of 45 414 2–4-year-olds with severe obesity (%BMIp95 ≥ 120). Results Changes in very high BMIz levels differed from the other metrics. Among severely obese 2-year-old girls, for example, the mean BMIz decreased by 0.6 SD between examinations, but there were only small changes in BMIp95 and modified BMIz. Some 2-year-old girls had BMIz decreases of >1 SD, even though they had large increases in BMI, %BMIp95 and modified BMIz. Conclusions Among children with severe obesity, BMIz changes may be due to differences in the transformations used to estimate levels of BMIz rather than to changes in body size. The BMIs of these children could be expressed relative to the 95th percentile or as modified z-scores.

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High Body Mass Index in Infancy May Predict Severe Obesity in Early Childhood

Cited by 71 publications

References 14 publications

Milk’s Role as an Epigenetic Regulator in Health and Disease

Milk’s Role as an Epigenetic Regulator in Health and Disease

Prevalence of Severe Obesity among Primary School Children in 21 European Countries

Longitudinal changes in BMIz-scores among 45 414 2–4-year olds with severe obesity

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