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Objective This study examined the extent to which maternal immune activity during pregnancy is associated with childhood adiposity, and if so, whether associations at birth differ from those in infancy and childhood. Sex-specific associations were also examined. Methods Participants were 1,366 singleton pregnancies from the Collaborative Perinatal Project (1959-1966). Interleukin-1β (IL-1β), IL-6, TNF-α, IL-8, and IL-10 in maternal sera were assayed repeatedly during pregnancy. Children's BMI was calculated repeatedly from birth through age 8 and derived age- and sex-normalized BMI z scores (BMIz). Linear mixed models were used to estimate the cumulative concentration of each cytokine in the second and third trimesters and then related this concentration to child BMIz. Results Children exposed to higher IL-1β, IL-6, IL-8, and IL-10 concentrations had lower BMIz at birth but higher BMIz during childhood. Higher concentrations of IL-8 and IL-1β were also associated with higher BMIz during infancy (B per log increase in IL-8 = 0.04; 95% CI: 0.02 to 0.07; B per log increase in IL-1β = 0.03; 95% CI: 0.001 to 0.06). The associations between TNF-α and BMIz were in opposing directions in boys (B = -0.13; 95% CI: -0.31 to 0.04) and girls (B = 0.14; 95% CI: 0.02 to 0.26) during childhood. Conclusions Maternal prenatal inflammation contributes to the age- and sex-specific programming of obesity risk in childhood.

Infancy is a sensitive developmental period that presents both opportunities and challenges for caregivers to feed their infants in ways that support healthy growth and development. The capacity to eat in a way that supports energy (caloric) intake aligned with the body’s physiologic need for growth and development appear to diminish in the years following infancy, but the reasons for this and whether this is developmentally typical are unclear. Feeding interactions that undermine infants’ ability to regulate their intake in response to hunger and satiety are thought to confer risk for obesity in infancy and beyond. In this integrative review, we consider what we know about the emergence of self-regulation of behavior and emotion from both a behavioral and a physiological perspective. Then, we apply this information to our emerging understanding of how self-regulation of energy intake may be derailed through feeding interactions between caregivers and infants.

Emerging evidence indicates that industrially produced endocrine-disrupting chemicals (EDCs) may be as obesogenic as poor dietary patterns and should be considered in obesity prevention policies. The authors conducted two reviews: (a) a systematic search of four electronic databases for papers published since January 2010 to identify the policy recommendations contained in scientific reviews of EDC exposure and obesity risk and (b) a narrative review of obesity policy documents published since January 2012 to identify the recommendations of national and international agencies. A search of four electronic databases found 63 scientific reviews with policy recommendations, of which 26 suggested individual responsibility to avoid exposure, 11 suggested medical interventions to counter the effects of exposure, and 42 suggested regulatory control of hazardous chemicals. Of sixty policy documents examined, six mentioned pollutants as a possible risk factor for obesity, and only one made explicit reference to strategies for reducing exposure to EDCs. The UN Sustainable Development Goals include targets to prevent ill health from hazardous chemicals (Targets 3.9 and 12.4) and to remove unsafe industrial chemicals from the environment (Targets 6.3, 11.6, 12.4, and 14.1). The authors suggest these should be explicitly linked to World Health Assembly targets to halt the rise in obesity.

Background Few studies have examined the relationship between temperament and eating self-regulation in early childhood, despite emerging evidence for associations with pediatric obesity. Method The aim of this exploratory report was to examine the associations between three eating behaviors and three facets of temperament among 4- to 8-year-olds with or at risk for obesity. Results Among 28 participants in a family intervention to reduce eating speed, we found at baseline that slower child eating speed was associated with less surgency (r = -.39, p = .04) and higher food responsiveness was associated with higher negative affect (r = .40, p = .03). Conclusions These findings support the potential yield of integrating temperament with eating self-regulation assessments in studies of early obesity risk. A better understanding is needed regarding ways in which parents differentially feed in response to child temperament.

Background: Attending childcare is related to greater childhood obesity risk, but there are few long-term follow-up studies. We aimed to examine the associations of childcare type, age at start, and intensity with body mass index body mass index (BMI) trajectories from ages 10 to 42 years. Methods: The sample comprised 8234 individuals in the 1970 British Cohort Study, who had data on childcare attendance (no, yes), type (formal, informal), age at start (4-5, 3-3.99, 0-2.99 years old), and intensity (1, 2, 3, 4-5 days/week) reported at age 5 years and 32 563 BMI observations. Multilevel linear spline models were used to estimate the association of each exposure with the sample-average BMI trajectory, with covariate adjustment. A combined age at start and intensity exposure was also examined. Results: Attending vs not attending and the type of childcare (none vs formal/informal) were not strongly related to BMI trajectories. Among participants who attended childcare 1 to 2 days a week, those who started when 3 to 3.99 years old had a 0.197 (−0.004, 0.399) kg/m2 higher BMI at age 10 years than those who started when 4 to 5 years old, and those who started when 0 to 2.99 years old had a 0.289 (0.049, 0.529) kg/m2 higher BMI. A similar dose-response pattern for intensity was observed when holding age at start constant. By age 42 years, individuals who started childcare at age 0 to 2.99 years and attended 3 to 5 days/week had a 1.356 kg/m2 (0.637, 2.075) higher BMI than individuals who started at age 4 to 5 years and attended 1 to 2 days/week. Conclusions: Children who start childcare earlier and/or attend more frequently may have greater long-term obesity risk.

The potential for peers to influence obesity risk behavior increases in adolescence, yet there are knowledge gaps of how behaviors are modified in response to peers over time. This study examined how personal friendship network characteristics were associated with obesity-related behaviors from late childhood to early adolescence. Two waves of friendship, physical activity, screen time, and dietary recall data were collected from 11- to 13-year-old students (99% retention) in Australia (n = 308) over a five- to eight-month period. Regression models identified friendship network characteristics that predicted later health behaviors which varied by gender and behavior type, such as the number of friends positively associated with physical activity intensity (males) and screen time (females). The need for considering context to influence behavior change is discussed.

AIMS AND OBJECTIVES To describe obesity-risk behaviours (diet, physical activity and sedentary behaviour) and examine the relationships of the obesity-risk behaviours with body mass index (BMI) in school-aged Korean American children. BACKGROUND Korean American children have a risk of becoming overweight or obese and developing obesity-related complications; however, there is limited research about obesity-risk behaviours in Korean American children. DESIGN A cross-sectional study. METHODS Obesity-risk behaviours of children were assessed with well-validated self-report questionnaires (i.e., Elementary-level School-based Nutrition Monitoring Questionnaire) from children and their mothers. Height and weight of children were measured. Data were analysed with bivariate and multivariate analyses using mixed effects models to incorporate the correlation within siblings. RESULTS A total of 170 Korean American children (mean age 10.9 [2.0] years; 52.4% girls; mean BMI 19.3 [3.2]; 28.7% ≥85 percentiles) participated in the study. Only 38.3% of Korean American children met established recommendations of five fruits/vegetables per day; 56.5% met recommendations for more than 3 days per week of vigorous physical activity; and 40.8% met recommendations for

Summary Over 80% of preschool-aged children experience non-parental childcare. Childcare type has the potential to influence weight outcomes, but its impact on childhood overweight/obesity is not well established. This review aims to (i) systematically evaluate the effects of childcare type on childhood overweight/obesity risk and (ii) investigate the impact of childcare intensity and age at commencement. Five electronic databases were searched for observational studies quantifying an association between childcare type ≤5 years and weight outcomes

Summary Low adherence to guidelines for weight-related behaviours (e.g. dietary intake and physical activity) among US children underscores the need to better understand how parental factors may influence children's obesity risk. In addition to most often acting as primary caregiver to their children, women are also known to experience greater levels of stress than men. This study systematically reviewed associations between maternal stress and children's weight-related behaviours. Our search returned 14 eligible articles, representing 25 unique associations of maternal stress with a distinct child weight-related behaviour (i.e. healthy diet [n = 3], unhealthy diet [n = 6], physical activity [n = 7] and sedentary behaviour [n = 9]). Overall, findings for the relationship between maternal stress and children's weight-related behaviours were mixed, with no evidence for an association with children's healthy or unhealthy dietary intake, but fairly consistent evidence for the association of maternal stress with children's lower physical activity and higher sedentary behaviour. Recommendations for future research include prioritizing prospective designs, identifying moderators, and use of high-resolution, real-time data collection techniques to elucidate potential mechanisms.

SummaryObjectives Obesity has become a global epidemic and threat to public health. A good understanding of the causes can help attenuate the risk and spread. Environmental pollutants may have contributed to the rising global obesity rates. Some research reported associations between chemical pollutants and obesity, but findings are mixed. This study systematically examined associations between chemical pollutants and obesity in human subjects. Methods Systematic review of relevant studies published between 1 January 1995 and 1 June 2016 by searching PubMed and MEDLINE®. Results Thirty-five cross-sectional (n = 17) and cohort studies (n = 18) were identified that reported on associations between pollutants and obesity measures. Of them, 16 studies (45.71%) reported a positive association; none reported a sole inverse association; three (8.57%) reported a null association only; six (17.14%) reported both a positive and null association; seven (20.00%) reported a positive and inverse association; and three studies (8.57%) reported all associations (positive, inverse and null). Most studies examined the association between multiple different pollutants, different levels of concentration and in subsamples, which results in mixed results. Thirty-three studies reported at least one positive association between obesity and chemicals, such as polychlorinated biphenyls, biphenyl A, dichlorodiphenyltrichloroethane, dichlorodiphenyldichloroethylene and more. Certain chemicals, such as biphenyl A, were more likely to have high ORs ranging from 1.0 to 3.0, whereas highly chlorinated polychlorinated biphenyls were more likely to have negative ORs. Effects of chemicals on the endocrine system and obesity might vary by substance, exposure level, measure of adiposity and subject characteristics (e.g. sex and age). Conclusions Accumulated evidences show positive associations between pollutants and obesity in humans. Future large, long-term, follow-up studies are needed to assess impact of chemical pollutants on obesity risk and related mechanisms.

Purpose This study aims to examine adolescent level of knowledge concerning obesity risk. Design and Methods Qualitative and quantitative data were collected using a staged process. Data collected with (a) Obesity Risk Knowledge Scale (ORK-10), (b) focus groups, (c) scientific advisory group input, and (d) the Adolescent Obesity Risk Knowledge Scale (AORK). Results The AORK is tailored from the ORK-10 (α = .53) to capture adolescents' knowledge of obesity complications and/or risks (α = .68). Practice Implications The AORK integrates questions for assisting practitioners to initiate discussions about obesity and lifestyle choices with adolescents and their families.

Purpose To develop profiles of obesity risk behaviors for children and adolescents. Design and Methods Risk assessments were obtained from patients (n = 971) at a school-based health center. Latent class analysis was used to create subgroups based on seven indicators measuring diet, activity, and screen time. Results Four classes emerged, with 44% classified as the “Healthiest,” 8% as the “Least Healthy,” 37% as “Mixed Diet/Low Activity/Low Screen Time,” and 11% as “Mixed Diet/High Activity/High Screen Time.” Several demographic predictors distinguished the classes. Practice Implications Obesity risk factor profiles may help providers identify strengths and risks, tailor counseling, and plan interventions with families.

Purpose To evaluate the effects of web-based information on parental self-efficacy in managing obesity risk in preschoolers. Design and Methods The project included a literature review and the development and field testing of an information website that presented information on how to manage nine obesity risk factors for childhood obesity. Results Parents stated that they had no problems using the website, and 69% reported improved self-efficacy on at least two risk factors. Practice Implications Many parents access the Internet to obtain health information. A website that offers practical information on managing childhood obesity risk factors is a valuable resource for obesity prevention efforts.

Background The insulin-like growth factor 2 mRNA-binding protein 2 (IGF2BP2) and the cyclin-dependent kinase 5 regulatory subunit-associated protein 1-like 1 (CDKAL1) identified through genome-wide association (GWA) studies have been shown to be associated with Type 2 diabetes in various ethnic groups. In this study, we investigated the association of the rs7756992 of CDKAL1 and the rs4402960 of IGF2BP2 with Type 2 diabetes, diabetic complications (nephropathy, retinopathy and cardiovascular disease), obesity and hypertension in a Tunisian population. Methods A case-control association study including 200 Type 2 diabetes Tunisian patients (World Health Organization criteria) and 208 controls (age ≥40; fasting plasma glucose

Objective: While behavioral change is necessary to reverse the obesity epidemic, it can be difficult to achieve and sustain in unsupportive residential environments. This study hypothesized that environmental resources supporting walking and a healthy diet are associated with reduced obesity incidence. Design and Methods: Data came from 4,008 adults aged 45-84 at baseline who participated in a neighborhood ancillary study of the Multi-Ethnic Study of Atherosclerosis. Participants were enrolled at six study sites at baseline (2000-2002) and neighborhood scales were derived from a supplementary survey that asked community residents to rate availability of healthy foods and walking environments for a 1-mile buffer area. Obesity was defined as BMI ≥ 30 kg/m2. Associations between incident obesity and neighborhood exposure were examined using proportional hazards and generalized linear regression. Results: Among 4,008 nonobese participants, 406 new obesity cases occurred during 5 years of follow-up. Neighborhood healthy food environment was associated with 10% lower obesity incidence per s.d. increase in neighborhood score. The association persisted after adjustment for baseline BMI and individual-level covariates (hazard ratio (HR) 0.88, 95% confidence interval (CI): 0.79, 0.97), and for correlated features of the walking environment but CIs widened to include the null (HR 0.89, 95% CI: 0.77, 1.03). Associations between neighborhood walking environment and lower obesity were weaker and did not persist after adjustment for correlated neighborhood healthy eating amenities (HR 0.98, 95% CI: 0.84, 1.15). Conclusions: Altering the residential environment so that healthier behaviors and lifestyles can be easily chosen may be a precondition for sustaining existing healthy behaviors and for adopting new healthy behaviors.

In Uganda, 10.4% and 3.2% of adolescent girls and boys are considered overweight, even in the midst of malnutrition. However, few studies have explored risk factors associated with obesity among ad...

Anthropometric body dimensions are increasingly recognized as phenotypic markers of obesity risk. Available automated laser measurement systems provide accurate anthropometric dimensions but are co...

Adolescence is a critical period for acquisition of skeletal muscle mass (SMM) as well as the development of obesity. Prospective data on the effect of dietary protein on these outcomes are sparse....

My colleagues and I appreciate the thoughtful comments ofDr. Lanou regarding our recent report showing dairy accel-erationofweightandfatlosssecondarytoenergyrestriction(1) and are pleased to clarify the key points she has raised.First, with regard to diets and dietary compliance, asindicated in the paper, diets for all treatment arms wereconstructed to provide comparable levels of macronutrientand fiber content, and these were achieved; Table 2 of thepaper shows no significant differences in macronutrientdistribution across the three treatment arms. The Table doesnot include dietary fiber, but the target level was 8–12 g/d,and the actual level achieved averaged 9.4 g/d, with nosignificant differences among the groups. We regret theomissionofthisinformationfromthetextofthemanuscript.With regard to compliance with the dietary protocol, the 32subjects who completed the study were adherent with re-spect to maintaining the 500 100 kcal/d energy deficit asassessed by complete diet diaries throughout the study.Furthermore, all subjects were sedentary at study initiationand maintained this pattern throughout the study.Dr. Lanou has raised two important issues with regard tothe potential role of vitamin D in cows’ milk. One of theseis linked to the mechanism of action of calcium-rich foodsin suppressing adiposity: suppression of 1 ,25(OH)