48 results on '"Maguire, Jonathon L."'
Search Results
2. Late preterm birth and growth trajectories during childhood: a linked retrospective cohort study
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Yoshida-Montezuma, Yulika, Kirkwood, David, Sivapathasundaram, Branavan, Keown-Stoneman, Charles D. G., de Souza, Russell J., To, Teresa, Borkhoff, Cornelia M., Birken, Catherine S., Maguire, Jonathon L., Brown, Hilary K., and Anderson, Laura N.
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- 2023
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3. Changes in Pediatric Movement Behaviors During the COVID-19 Pandemic by Stages of Lockdown in Ontario, Canada: A Longitudinal Cohort Study.
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Patel, Priya, Li, Xuedi, Keown-Stoneman, Charles D.G., Vanderloo, Leigh M., Kinlin, Laura M., Maguire, Jonathon L., and Birken, Catherine S.
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COVID-19 pandemic ,STAY-at-home orders ,SCREEN time ,CHILD behavior ,COHORT analysis - Abstract
Background: Children's movement behaviors have been affected by the COVID-19 pandemic; however, little is known regarding movement behavior patterns over time by government-issued lockdowns. Our primary objective was to evaluate how children's movement behaviors changed by stages of lockdown/reopening in Ontario, Canada, from 2020 to 2021. Methods: A longitudinal cohort study with repeated measures of exposure and outcomes was conducted. The exposure variables were dates from before and during COVID-19 when child movement behavior questionnaires were completed. Lockdown/reopening dates were included as knot locations in the spline model. The outcomes were daily screen, physical activity, outdoor, and sleep time. Results: A total of 589 children with 4805 observations were included (53.1% boys, 5.9 [2.6] y). On average, screen time increased during the first and second lockdowns and decreased during the second reopening. Physical activity and outdoor time increased during the first lockdown, decreased during the first reopening, and increased during the second reopening. Younger children (<5 y) had greater increases in screen time and lower increases in physical activity and outdoor time than older children (≥5 y). Conclusions: Policy makers should consider the impact of lockdowns on child movement behaviors, especially in younger children. [ABSTRACT FROM AUTHOR]
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- 2023
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4. The social determinants of health as predictors of adherence to public health preventive measures among parents and young children during the COVID-19 pandemic: a longitudinal cohort study
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Yoshida-Montezuma, Yulika, Keown-Stoneman, Charles D. G., Wanigaratne, Susitha, Li, Xuedi, Vanderhout, Shelley M., Borkhoff, Cornelia M., Birken, Catherine S., Maguire, Jonathon L., and Anderson, Laura N.
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- 2021
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5. The mediation effect of breastfeeding duration on the relationship between maternal preconception BMI and childhood nutritional risk.
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Braddon, Kate E., Keown-Stoneman, Charles D. G., Dennis, Cindy-Lee, Li, Xuedi, Maguire, Jonathon L., O'Connor, Deborah L., Omand, Jessica A., Randall Simpson, Janis, and Birken, Catherine S.
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BREASTFEEDING ,BODY mass index ,FOOD consumption ,RESEARCH funding ,NUTRITIONAL assessment ,QUESTIONNAIRES ,DESCRIPTIVE statistics ,CHILD nutrition ,LONGITUDINAL method ,INFANT nutrition ,PSYCHOLOGY of mothers ,FOOD habits ,ECONOMIC impact ,NUTRITIONAL status ,FACTOR analysis ,CONFIDENCE intervals ,CHILDREN - Abstract
Background: Higher maternal preconception body mass index (BMI) is associated with lower breastfeeding duration, which may contribute to the development of poor child eating behaviours and dietary intake patterns (components of nutritional risk). A higher maternal preconception BMI has been found to be associated with higher child nutritional risk. This study aimed to determine whether breastfeeding duration mediated the association between maternal preconception BMI and child nutritional risk. Methods: In this longitudinal cohort study, children ages 18 months to 5 years were recruited from The Applied Research Group for Kids (TARGet Kids!) in Canada. The primary outcome was child nutritional risk, using The NutriSTEP
® , a validated, parent-reported questionnaire. Statistical mediation analysis was performed to assess whether total duration of any breastfeeding mediated the association between maternal preconception BMI and child nutritional risk. Results: This study included 4733 children with 8611 NutriSTEP® observations. The mean (SD) maternal preconception BMI was 23.6 (4.4) and the mean (SD) breastfeeding duration was 12.4 (8.0) months. Each 1-unit higher maternal preconception BMI was associated with a 0.081 unit higher nutritional risk (95% CI (0.051, 0.112); p < 0.001) (total effect), where 0.011(95% CI (0.006, 0.016); p < 0.001) of that total effect or 13.18% (95% CI: 7.13, 21.25) was mediated through breastfeeding duration. Conclusion: Total breastfeeding duration showed to mediate part of the association between maternal preconception BMI and child nutritional risk. Interventions to support breastfeeding in those with higher maternal preconception BMI should be evaluated for their potential effect in reducing nutritional risk in young children. [ABSTRACT FROM AUTHOR]- Published
- 2024
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6. Underweight in the first 2 years of life and nutrition risk in later childhood: a prospective cohort study.
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South, Courtney A., Keown‐Stoneman, Charles D. G., Birken, Catherine S., Malik, Vasanti, Zlotkin, Stanley H., and Maguire, Jonathon L.
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RISK assessment ,LEANNESS ,MALNUTRITION ,FOOD consumption ,RESEARCH funding ,BODY mass index ,BODY weight ,LONGITUDINAL method ,STATURE ,ODDS ratio ,FOOD habits ,CONFIDENCE intervals ,DISEASE risk factors ,CHILDREN - Abstract
Background: Children with underweight in the first 2 years have lower body mass index z‐score (zBMI) and height‐for‐age z‐score (HAZ) in later childhood. It is not known if underweight in the first 2 years is associated with nutrition risk in later childhood. Objective: (1) Determine the relationship between underweight (zBMI < −2) in the first 2 years and nutrition risk measured by the Nutrition Screening for Toddlers and Preschoolers (NutriSTEP) score from 18 months to 5 years. (2) Explore the relationship between underweight in the first 2 years and the NutriSTEP subscores for eating behaviours and dietary intake from 18 months to 5 years. Methods: This was a prospective study, including healthy full‐term children in Canada aged 0–5 years. zBMI was calculated using measured heights and weights and the WHO growth standards. NutriSTEP score was measured using a parent‐completed survey and ranged from 0 to 68. Nutrition risk was defined as a score ≥21. Linear mixed effects models were used. Results: Four thousand nine hundred twenty‐nine children were included in this study. At enrolment, 51.9% of participants were male. The prevalence of underweight children was 8.8%. Underweight in the first 2 years was associated with higher NutriSTEP (0.79, 95% CI: 0.29,1.29), higher eating behaviour subscore (0.24, 95% CI: 0.03, 0.46) at 3 years and higher odds of nutrition risk (OR: 1.39, 95% CI: 1.07,1.82) at 5 years. Conclusions: Children with underweight in the first 2 years had higher nutrition risk in later childhood. Further research is needed to understand the factors which influence these relationships. Key points: In this prospective cohort study of 4929 children aged 0–5 years, children with underweight in the first 2 years of life had higher odds of nutrition risk at 5 years of age compared to children without underweight in the first 2 years (p = 0.02). Further research is needed to understand the factors which influence these relationships. [ABSTRACT FROM AUTHOR]
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- 2024
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7. Forming a Parent And Clinician Team (PACT) in a cohort of healthy children
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Vanderhout, Shelley M., Birken, Catherine S., Zaccaria Cho, Maria, and Maguire, Jonathon L.
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- 2021
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8. Family perspectives of COVID-19 research
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Vanderhout, Shelley M., Birken, Catherine S., Wong, Peter, Kelleher, Sarah, Weir, Shannon, and Maguire, Jonathon L.
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- 2020
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9. Mandatory labeling requirements and over-the-counter cough and cold medication use in early childhood
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Degroot, Julie, Anderson, Laura N., Chen, Yang, Birken, Catherine S., Parkin, Patricia C., Carsley, Sarah, Khovratovich, Marina, Mamdani, Muhammad, and Maguire, Jonathon L.
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- 2015
10. Maternal BMI in the preconception period, and association with child zBMI growth rates.
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Deveci, Arin C., Keown‐Stoneman, Charles D. G., Maguire, Jonathon L., O'Connor, Deborah L., Anderson, Laura N., Dennis, Cindy‐Lee, and Birken, Catherine S.
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RISK of childhood obesity ,HUMAN growth ,STATURE ,BODY weight ,REGRESSION analysis ,SEX distribution ,RISK assessment ,RESEARCH funding ,DESCRIPTIVE statistics ,REPEATED measures design ,BODY mass index ,PRECONCEPTION care ,LONGITUDINAL method ,ADULTS ,CHILDREN - Abstract
Summary: Background: Elevated body mass index (BMI) and rapid growth in early childhood are important predictors of obesity risk. The association between maternal preconception BMI and child growth rates is unclear. Objectives: To assess the association between measured maternal preconception BMI and child age‐ and sex‐ standardized WHO BMI z‐score (zBMI) growth rates and mean zBMI, in children aged 0–10 years old. Methods: A longitudinal cohort study was conducted with children (n = 499) enrolled in The Applied Research Group for Kids (TARGet Kids!) primary care practice‐based research cohort. Maternal BMI was measured during the preconception period, defined as the 2 years prior to pregnancy. Repeated measures of child weight and height were obtained between 0 and 10 years of age. Linear mixed models were used to evaluate the association between maternal BMI and child zBMI growth rates and mean zBMI. Results: Maternal preconception BMI was associated with child zBMI growth rate during some growth periods, with the strongest association from age 0 to 4 months; a 5 kg/m2 higher maternal BMI was associated with 0.031 zBMI SD unit/mo higher growth rate (p = 0.004), and 0.186 SD unit higher mean child zBMI (p = 0.0002). Conclusions: Maternal preconception BMI was associated with growth rate and mean zBMI in early childhood. The preconception period may be an important target for health interventions to promote healthy child growth rate and weight outcomes. [ABSTRACT FROM AUTHOR]
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- 2023
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11. Low Serum 25-Hydroxyvitamin D Level and Risk of Upper Respiratory Tract Infection in Children and Adolescents
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Science, Michelle, Maguire, Jonathon L., Russell, Margaret L., Smieja, Marek, Walter, Stephen D., and Loeb, Mark
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- 2013
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12. Predictive Validity of the Infant Toddler Checklist in Primary Care at the 18-month Visit and School Readiness at 4 to 6 Years.
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Nurse, Kimberly M., Janus, Magdalena, Birken, Catherine S., Keown-Stoneman, Charles D. G., Omand, Jessica A., Maguire, Jonathon L., Reid-Westoby, Caroline, Duku, Eric, Mamdani, Muhammad, Tremblay, Mark S., Parkin, Patricia C., and Borkhoff, Cornelia M.
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DIAGNOSIS of child development deviations ,CONFIDENCE intervals ,RESEARCH methodology evaluation ,RESEARCH methodology ,MULTIVARIATE analysis ,MEDICAL screening ,REGRESSION analysis ,PRIMARY health care ,SCHOOLS ,DESCRIPTIVE statistics ,RESEARCH funding ,PREDICTIVE validity ,LOGISTIC regression analysis ,LONGITUDINAL method ,EVALUATION ,CHILDREN - Abstract
OBJECTIVE: The American Academy of Pediatrics recommends developmental surveillance and screening in early childhood in primary care. The 18-month visit may be an ideal time for identification of children with delays in language and communication, or symptoms of autism spectrum disorder (ASD). Little is known about the predictive validity of developmental screening tools administered at 18 months. Our objective was to examine the predictive validity of the Infant Toddler Checklist (ITC) at the 18-month health supervision visit, using school readiness at kindergarten age as the criterion measure. METHODS: We designed a prospective cohort study, recruiting in primary care in Toronto, Canada. Parents completed the ITC at the 18-month visit. Teachers completed the Early Development Instrument (EDI) when the children were in Kindergarten, age 4-6 years. We calculated screening test properties with 95% confidence intervals (CIs). We used multivariable logistic and linear regression analyses adjusted for important covariates. RESULTS: Of 293 children (mean age 18 months), 30 (10.2%) had a positive ITC including: concern for speech delay (n = 11, 3.8%), concern for other communication delay (n = 13, 4.4%), and concern for both (n = 6, 2.0%). At followup (mean age 5 years), 54 (18.4%) had overall EDI vulnerability, 19 (6.5%) had vulnerability on the 2 EDI communication domains. The ITC sensitivity ranged from 11% to 32%, speci- ficity from 91% to 96%, false positive rates from 4% to 9%, PPV from 16% to 35%, NPV from 83% to 95%. A positive ITC screen and ITC concern for speech delay were associated with lower scores in EDI communication skills and general knowledge (β = -1.08; 95% CI: -2.10, -0.17; β = -2.35; 95% CI: -3.63, -1.32) and EDI language and cognitive development (β = -0.62; 95% CI: -1.25, -0.18; β = -1.22; 95% CI: -2.11, -0.58). CONCLUSIONS: The ITC demonstrated high specificity suggesting that most children with a negative ITC screen will demonstrate school readiness at 4-6 years, and low false positive rates, minimizing over-diagnosis. The ITC had low sensitivity highlighting the importance of ongoing developmental surveillance and screening. [ABSTRACT FROM AUTHOR]
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- 2023
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13. Mealtime media use and cardiometabolic risk in children.
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Jamnik, Joseph, Keown-Stoneman, Charles, Eny, Karen M, Maguire, Jonathon L, Birken, Catherine S, and TARGet Kids! Collaboration
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REPEATED measures design ,SCHOOL children ,BREAKFASTS ,AGE groups ,HDL cholesterol ,LIPOPROTEINS ,RESEARCH ,RESEARCH methodology ,CARDIOVASCULAR diseases ,EVALUATION research ,COMPARATIVE studies ,MEALS ,CHOLESTEROL - Abstract
Objectives: To examine the association between mealtime media use and non-HDL-cholesterol as well as other markers of cardiometabolic risk (CMR) in children.Design: A repeated measures study design was used to examine the association between mealtime media use and CMR outcomes. Multivariable linear regression with generalised estimating equations was used to examine the association between mealtime media use and CMR outcomes. Analyses were stratified a priori by age groups (1-4 and 5-13 years).Setting: The TARGet Kids! Practice-based research network in Toronto, Canada.Participants: 2117 children aged 1-13 years were included in the analysis.Results: After adjusting for covariates, there was no evidence that total mealtime media use was associated with non-HDL-cholesterol in 1-4 year olds (P = 0·10) or 5-13 year olds (P = 0·29). Each additional meal with media per week was associated with decreased HDL-cholesterol in 5-13 year olds (-0·006 mmol/l; 95 % CI -0·009, -0·002; P = 0·003) and log-TAG in 1-4 year olds (β = -0·004; 95 % CI -0·008, -0·00009; P = 0·04). Media use during breakfast was associated with decreased HDL-cholesterol in 5-13 year olds (-0·012 mmol/l; 95 % CI -0·02, -0·004; P = 0·002), while media during lunch was associated with decreased log-TAG (-0·01 mmol/l; 95 % CI -0·03, -0·002; P = 0·03) in children aged 1-4 years. Total mealtime media use was not associated with total cholesterol, glucose or insulin in either age group.Conclusions: Mealtime media use may be associated with unfavourable lipid profiles through effects on HDL-cholesterol in school-aged children but likely not in pre-schoolers. [ABSTRACT FROM AUTHOR]- Published
- 2022
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14. Nutritional risk in early childhood and parent-reported school concerns.
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Omand, Jessica A, Janus, Magdalena, Maguire, Jonathon L, Parkin, Patricia C, Randall Simpson, Janis, Keown-Stoneman, Charles DG, Aglipay, Mary, and Birken, Catherine S
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DISEASE risk factors ,FOOD habits ,MOTOR ability ,FOOD consumption ,LOGISTIC regression analysis ,MOTOR learning - Abstract
Objective: To determine if nutritional risk in early childhood is associated with parent-reported school concerns. Design: A prospective cohort study conducted through the TARGet Kids! primary care research network (2011–2018). Nutritional risk was measured between 18 months and 5 years of age using validated parent-completed NutriSTEP
® questionnaires with eating behaviour and dietary intake subscores (0 = lowest and 68 = highest total nutritional risk score). Parent-reported school concerns were measured at school age (4–10 years of age) and included: speech and language; learning; attention; behaviour; social relationships; physical coordination; fine motor coordination and self-help skills and independence. The primary outcome was any parent-reported school concerns, and individual school concerns were used as secondary outcomes. Multiple logistic regression models were conducted adjusting for clinically relevant confounders to assess the relationship between nutritional risk and school concerns. Setting: Toronto, Canada. Participants: Children aged 18 months to 10 years. Results: The study included 3655 children, 52 % were male, mean NutriSTEP® score was 14·4 (sd 6·4). Each 1 sd increase in NutriSTEP® total score was associated with a 1·18 times increased odds of school concerns (adj OR: 1·18, 95 % CI 1·07, 1·28, P = 0·0004), and high nutritional risk was associated with a 1·42 times increased odds of school concerns (adj OR: 1·42, 95 % CI 1·13, 1·78, P = 0·002). Conclusions: Nutritional risk in early childhood was associated with school concerns. Nutritional interventions in early childhood may reveal opportunities to enhance school outcomes. [ABSTRACT FROM AUTHOR]- Published
- 2021
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15. Nutritional Risk in Early Childhood and School Readiness.
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Omand, Jessica A, Janus, Magdalena, Maguire, Jonathon L, Parkin, Patricia C, Aglipay, Mary, Randall Simpson, Janis, Keown-Stoneman, Charles D G, Duku, Eric, Reid-Westoby, Caroline, Birken, Catherine S, and Randall Simpson, Janis
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READINESS for school ,KINDERGARTEN children ,COGNITIVE development ,PRIMARY care ,FOOD consumption ,COMMUNICATIVE competence ,RESEARCH ,CHILD development ,COGNITION ,EVALUATION research ,COMPARATIVE studies ,SCHOOLS ,NUTRITIONAL status ,LONGITUDINAL method - Abstract
Background: Nutrition in early childhood is important for healthy growth and development. Achieving school readiness is considered one of the most important developmental milestones for young children.Objectives: The purpose of this study is to determine if nutritional risk in early childhood is associated with school readiness in kindergarten.Methods: A prospective cohort study was conducted through The Applied Research Group for Kids (TARGet Kids!) primary care research network in Toronto, Canada, 2015-2020. Nutritional risk was measured (18 mo to 5 y) using validated parent-completed questionnaires called Nutrition Screening for Toddlers and Preschoolers (NutriSTEP). High nutritional risk was categorized as scores ≥21. School readiness was measured using the validated teacher-completed Early Developmental Instrument (EDI), which measures 5 developmental domains in kindergarten (2 y of schooling, ages 4-6 y, before they enter grade 1). Vulnerability indicates scores lower than a population-based cutoff at the 10th percentile on at least 1 domain. Multiple logistic and linear regression models were conducted adjusting for relevant confounders.Results: The study included 896 children: 53% were male, 9% had high nutritional risk, and 17% were vulnerable on the EDI. A 1-SD increase in NutriSTEP total score was associated with 1.54 times increased odds of being vulnerable on the EDI among children in year 2 of kindergarten (P = 0.001). High nutritional risk cutoff was associated with 4.28 times increased odds of being vulnerable on the EDI among children in year 2 of kindergarten (P < 0.001). NutriSTEP total score and high nutritional risk were associated with lower scores on all 5 EDI domains, with the strongest association observed for the domains of language and cognitive development and communication skills and general knowledge.Conclusions: Higher nutritional risk in early childhood is associated with lower school readiness in year 2 of kindergarten. Nutritional interventions early in life may offer opportunities to enhance school readiness. This trial was registered www.clinicaltrials.gov as NCT01869530. [ABSTRACT FROM AUTHOR]- Published
- 2021
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16. Prospective cohort study of vitamin D and autism spectrum disorder diagnoses in early childhood.
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Ali, Yamna, Anderson, Laura N, Smile, Sharon, Chen, Yang, Borkhoff, Cornelia M, Koroshegyi, Christine, Lebovic, Gerald, Parkin, Patricia C, Birken, Catherine S, Szatmari, Peter, Maguire, Jonathon L, Birken, Catherine S., Maguire, Jonathon L., Lau, Eddy, Laupacis, Andreas, Parkin, Patricia C., Salter, Michael, Weir, Shannon, Anderson, Laura N., and Borkhoff, Cornelia M.
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DIAGNOSIS of autism ,THERAPEUTIC use of vitamin D ,AUTISM risk factors ,AGE distribution ,CONFIDENCE intervals ,DIETARY supplements ,ETHNIC groups ,INCOME ,LONGITUDINAL method ,MEDICAL records ,POISSON distribution ,SELF-evaluation ,SEX distribution ,VITAMIN D ,VITAMIN D deficiency ,RELATIVE medical risk ,ATTITUDES of mothers ,PARENT attitudes ,DISEASE incidence ,FAMILY history (Medicine) ,PHYSICIANS' attitudes ,DISEASE complications ,CHILDREN - Abstract
Several studies have suggested an association between vitamin D in childhood and autism spectrum disorder. No prospective studies have evaluated whether lower vitamin D levels precede ASD diagnoses – a necessary condition for causality. The objective of this study was to prospectively evaluate whether vitamin D serum levels in early childhood was associated with incident physician diagnosed ASD. A prospective cohort study was conducted using data from preschool-aged children in the TARGet Kids! practice-based research network in Toronto, Canada, from June 2008 to July 2015. 25-hydroxyvitamin D concentration was measured through blood samples and vitamin D supplementation from parent report. Autism spectrum disorder diagnosis was determined from medical records at follow-up visits. Covariates included age, sex, family history of autism spectrum disorder, maternal ethnicity, and neighborhood household income. Unadjusted and adjusted relative risks and 95% confidence intervals were estimated using Poisson regression with a robust error variance. In this study, 3852 children were included. Autism spectrum disorder diagnosis was identified in 41 children (incidence = 1.1%) over the observation period (average follow-up time = 2.5 years). An association between 25-hydroxyvitamin D concentration and autism spectrum disorder was not identified in the unadjusted (relative risk = 1.04, 95% confidence interval: 0.97, 1.11 per 10 nmol/L increase in 25-hydroxyvitamin D concentration) or adjusted models (adjusted relative risk = 1.06; 95% confidence interval: 0.95, 1.18). An association between vitamin D supplementation in early childhood and autism spectrum disorder was also not identified (adjusted relative risk = 0.86, 95% confidence interval: 0.46, 1.62). Vitamin D in early childhood may not be associated with incident physician diagnoses of autism spectrum disorder. [ABSTRACT FROM AUTHOR]
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- 2019
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17. E-cigarettes: A new hazard for children and adolescents.
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Richmond, Sarah A, Pike, Ian, Maguire, Jonathon L, and Macpherson, Alison
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CHILDREN'S injuries ,DRUG delivery systems ,NICOTINE ,QUESTIONNAIRES ,SURVEYS ,WOUNDS & injuries ,ELECTRONIC cigarettes ,INHALATION injuries ,ADOLESCENCE ,CHILDREN - Abstract
Objectives Electronic cigarettes and fluid (e-cigarettes, e-fluid) are hazardous materials that when inhaled or ingested may pose significant health risks to children and adolescents. The objective of this work was to explore the spectrum of injury related to e-cigarette exposure among Canadian children and adolescents. Methods A one-time survey was sent to all paediatricians in Canada. Information was collected on children and adolescents who presented with e-cigarette exposure (inhalation and ingestion cases) in the previous 12 months. Questions included the number of injuries and symptoms, in addition to age, sex, treatment setting, intentional e-cigarette use, and how the products were accessed. Results A total of 520 surveys were completed and returned, identifying 35 cases. Symptoms related to inhalation were present in 30 cases and in 5 ingestion cases (5 unintentional, 0 intentional). For inhalation cases, most were male, ages 15 to 19 years, who sought treatment for nausea/vomiting, cough, throat irritation, or acute nicotine toxicity in an outpatient clinic/office. Most inhalation cases reported e-cigarette use 2 to 3 days/week, and e-cigarettes purchases from a mall kiosk/store. For ingestion cases, most were male, ages 1 to 4 years presenting to an emergency department with nausea/vomiting, cough, or respiratory irritation. Younger cases accessed e-fluid at home, older cases purchased in a mall kiosk/store. E-fluid flavours reported consumed were fruit, candy, and tobacco. Conclusions E-cigarettes, recently introduced into the North American market are hazardous to children and adolescents. Given the low response rate to the survey, further investigation into the true burden of injury, as well as the risks that e-cigarettes pose, together with ways to reduce exposure, is needed. [ABSTRACT FROM AUTHOR]
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- 2020
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18. The association between body mass index trajectories and cardiometabolic risk in young children.
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Li, Xuedi, Keown‐Stoneman, Charles D.G., Lebovic, Gerald, Omand, Jessica A., Adeli, Khosrow, Hamilton, Jill K., Hanley, Anthony J., Mamdani, Muhammad, McCrindle, Brian W., Sievenpiper, John L., Tremblay, Mark S., Maguire, Jonathon L., Parkin, Patricia C., and Birken, Catherine S.
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BLOOD sugar analysis ,AGE distribution ,BLOOD pressure ,BODY weight ,CARDIOVASCULAR diseases risk factors ,CONFIDENCE intervals ,HIGH density lipoproteins ,HUMAN growth ,LONGITUDINAL method ,METABOLIC disorders ,CHILDHOOD obesity ,REGRESSION analysis ,RISK assessment ,SEX distribution ,STATURE ,TRIGLYCERIDES ,BODY mass index ,STRUCTURAL equation modeling ,WAIST circumference ,DISEASE complications ,DISEASE risk factors ,CHILDREN - Abstract
Summary: Background: Rapid growth is associated with increased cardiometabolic risk (CMR) in adolescence and adulthood. Little is known about whether the association between rapid growth and increased CMR originates in early childhood. Objectives: To identify age and sex standardized body mass index (zBMI) trajectories and to examine the association between zBMI trajectories and CMR outcomes in children 0 to 60 months. Study design A longitudinal cohort study was conducted through The Applied Research Group for Kids (TARGet Kids!) in Toronto, Canada. Participants had repeated measures of weight and length or height performed from birth to 60 months of age. Latent class mixed modelling was used to identify the zBMI trajectories. Linear regressions were performed to determine the association between zBMI trajectories and the primary outcome, a CMR score, quantified as the sum of age‐ and sex‐ standardized waist circumference, systolic blood pressure, glucose, log‐triglycerides and negative high‐density lipoprotein cholesterol (HDL‐C), divided by √5. Secondary outcomes were the individual components of the CMR formula as well as diastolic blood pressure and non‐HDL‐C. Results: Four BMI trajectories were identified among the 1166 children. After adjusting for all covariates, children in the rapidly accelerating trajectory had increased total CMR score (β = 1.38, 95% CI 0.77; 1.99, P <.001) and increased waist circumference score (β = 2.39, 95% CI 1.92; 2.86, P <.001) compared to the stable low group. Conclusions: Rapid growth during early childhood is associated with increased CMR in preschool children, largely driven by larger waist circumference. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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19. The association between screen time and cardiometabolic risk in young children.
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Sivanesan, Harunya, Vanderloo, Leigh M., Keown-Stoneman, Charles D. G., Parkin, Patricia C., Maguire, Jonathon L., and Birken, Catherine S.
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BLOOD sugar analysis ,BLOOD pressure ,BODY weight ,CARDIOVASCULAR diseases risk factors ,CONFIDENCE intervals ,HIGH density lipoproteins ,METABOLIC disorders ,RISK assessment ,TRIGLYCERIDES ,EVIDENCE-based medicine ,PROFESSIONAL practice ,MULTIPLE regression analysis ,SEDENTARY lifestyles ,PHYSICAL activity ,WAIST circumference ,SCREEN time ,DISEASE risk factors ,CHILDREN - Abstract
Objectives: While studies exist on the association between screen time and cardiometabolic risk among adolescents, research examining the effect of screen time on cardiometabolic risk in young children is lacking. The primary objective of this study was to examine the association between daily screen time and cardiometabolic risk (CMR) [sum of age- and sex-standardized z-scores of systolic blood pressure (SBP), glucose, log-triglycerides, waist circumference (WC), and negative high-density lipoprotein (HDL) cholesterol divided by the square root of five] in young children. Secondary objectives included examining individual CMR risk factors, including waist-to-height ratio and non high-density lipoprotein (non-HDL) cholesterol, as well as the individual cut-offs of these risk factors. Additional analyses include examining the association between screen time and CMR by handheld/non-handheld devices. Methods: A study was conducted among young children 3 to 6 years from the TARGet Kids! practice-based research network in Toronto and Montreal, Canada. Children with one or more measures of screen time and CMR were included in this study. Generalized estimating equation (GEE) multivariable linear regressions and multivariable logistic regressions, using published cut-offs, were conducted to evaluate these associations. Results: Data from 1317 children [mean age 52 months (SD = 13.36), 44.34% female] were included for analyses. There was no evidence of associations between screen time and total CMR score or individual risk factors (p > 0.05) after adjusting for confounders. A statistically significant, but small association between daily screen time and non-HDL cholesterol was found (B = 0.046; CI = [0.017 to 0.075]; p = 0.002. Conclusions: Though no relationship was reported between daily screen time and the majority of CMR factors in early childhood, there was an association between daily screen time and non-HDL cholesterol. As the relationship between daily screen time and CMR factors may not be apparent in early childhood, studies to evaluate longer-term cardiometabolic effects of screen time are needed. Although there is an evidence-based rationale to reduce screen time in early childhood, prevention of cardiometabolic risk may not be the primary driver. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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20. Whole milk compared with reduced-fat milk and childhood overweight: a systematic review and meta-analysis.
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Vanderhout, Shelley M, Aglipay, Mary, Torabi, Nazi, Jüni, Peter, da Costa, Bruno R, Birken, Catherine S, O'Connor, Deborah L, Thorpe, Kevin E, and Maguire, Jonathon L
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RISK of childhood obesity ,CATTLE ,CINAHL database ,FAT content of food ,INFORMATION storage & retrieval systems ,MEDICAL databases ,MEDICAL information storage & retrieval systems ,INGESTION ,MEDLINE ,META-analysis ,MILK ,SYSTEMATIC reviews - Abstract
Background The majority of children in North America consume cow-milk daily. Children aged >2 y are recommended to consume reduced-fat (0.1–2%) cow-milk to lower the risk of obesity. Objectives To evaluate the relation between cow-milk fat consumption and adiposity in children aged 1–18 y. Methods Embase (Excerpta Medica Database), CINAHL (Cumulative Index to Nursing and Allied Health Literature), MEDLINE, Scopus, and Cochrane Library databases from inception to August 2019 were used. The search included observational and interventional studies of healthy children aged 1–18 y that described the association between cow-milk fat consumption and adiposity. Two reviewers extracted data, using the Newcastle–Ottawa Scale to assess risk of bias. Meta-analysis was conducted using random effects to evaluate the relation between cow-milk fat and risk of overweight or obesity. Adiposity was assessed using BMI z -score (zBMI). Results Of 5862 reports identified by the search, 28 met the inclusion criteria: 20 were cross-sectional and 8 were prospective cohort. No clinical trials were identified. In 18 studies, higher cow-milk fat consumption was associated with lower child adiposity, and 10 studies did not identify an association. Meta-analysis included 14 of the 28 studies (n = 20,897) that measured the proportion of children who consumed whole milk compared with reduced-fat milk and direct measures of overweight or obesity. Among children who consumed whole (3.25% fat) compared with reduced-fat (0.1–2%) milk, the OR of overweight or obesity was 0.61 (95% CI: 0.52, 0.72; P < 0.0001), but heterogeneity between studies was high (I
2 = 73.8%). Conclusions Observational research suggests that higher cow-milk fat intake is associated with lower childhood adiposity. International guidelines that recommend reduced-fat milk for children might not lower the risk of childhood obesity. Randomized trials are needed to determine which cow-milk fat minimizes risk of excess adiposity. This systematic review and meta-analysis was registered with PROSPERO (registration number: CRD42018085075). [ABSTRACT FROM AUTHOR]- Published
- 2020
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21. Consumption of Cow's Milk in Early Childhood and Fracture Risk: A Prospective Cohort Study.
- Author
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Allison, Riley M, Birken, Catherine S, Lebovic, Gerald, Howard, Andrew W, L'Abbe, Mary R, Morency, Marie-Elssa, Maguire, Jonathon L, and Collaboration, The TARGet Kids!
- Subjects
MILK analysis ,CATTLE ,CONFIDENCE intervals ,DRINKING behavior ,FAT content of food ,BONE fractures ,LONGITUDINAL method ,MILK ,RISK assessment ,RELATIVE medical risk ,PARENT attitudes ,DESCRIPTIVE statistics ,DISEASE risk factors ,CHILDREN - Abstract
Cow's milk is consumed by most North American children, yet the relationships between the volume and fat content of cow's milk consumed and childhood fracture risk are unclear. Our primary objectives in this study were to evaluate whether the volume or fat content of cow's milk consumed at 1–3 years of age was associated with the risk of fracture between 3 and 10 years of age. This was a prospective cohort study of 2,466 children enrolled in Toronto, Ontario, Canada, between 2008 and 2016. The primary exposure was volume of cow's milk consumed between the ages of 1 and 3 years, and the secondary exposure was average percentage of milk fat consumed by each child during the same period. The primary outcome was a parental report of child fracture at ages 3–10 years. In the primary and secondary adjusted analyses, no association between milk volume and fracture risk (adjusted relative risk = 1.04, 95% confidence interval: 0.87, 1.26) or between milk-fat content and fracture risk (adjusted relative risk = 1.05, 95% confidence interval: 0.84, 1.31) was observed. In this study, we did not identify a protective association of early childhood cow's milk volume or fat consumption with fracture risk in later childhood. Future prospective research is needed to understand whether cow's milk is beneficial for fracture prevention through the life course. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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22. Total Breastfeeding Duration and Household Food Insecurity in Healthy Urban Children.
- Author
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Wong, Peter D., Parkin, Patricia C., Moodie, Rosemary G., Dai, David W.H., Maguire, Jonathon L., Birken, Catherine S., and Borkhoff, Cornelia M.
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AGE distribution ,BREASTFEEDING ,CHILDREN'S health ,CONFIDENCE intervals ,EMPLOYMENT ,ETHNIC groups ,FAMILIES ,INCOME ,QUESTIONNAIRES ,SEX distribution ,TIME ,URBAN health ,MULTIPLE regression analysis ,EDUCATIONAL attainment ,CROSS-sectional method ,FOOD security ,HEALTH & social status ,ODDS ratio ,CHILDREN - Abstract
Health care policy positions breastfeeding as an important part of the solution to household food insecurity; however, there are critical gaps in our knowledge of the relationship between breastfeeding duration (exposure variable) and household food insecurity (outcome variable). Our objective was to examine this relationship. A cross-sectional study was conducted from 2008 to 2016 of healthy urban children (N = 3838) who were 0 to 3 years old and recruited from The Applied Research Group for Kids (TARGet Kids!), a practice-based research network in Toronto, Canada. Total breastfeeding duration was collected from parent-reported questionnaires. Household food insecurity was measured using 1-item and 2-item food insecurity screens. Multivariable regression analysis was performed adjusting for prespecified covariates. The median total breastfeeding duration was 10.5 months (interquartile range, 6.0–14.0), and 14.7% of households were food insecure. After adjusting for child characteristics (age, sex), maternal characteristics (age, ethnicity, education, employment), and family characteristics (number of children, single parent family, neighborhood equity score), there was no significant association between total breastfeeding duration and household food insecurity (odds ratio, 0.99; 95% confidence interval, 0.98–1.01). Although low-income families had an increased odds of being household food insecure (P ≤.001), we found no significant association between total breastfeeding duration and household food insecurity at varying income levels. We found no association between breastfeeding duration and household food insecurity, regardless of family income. Although breastfeeding is associated with improved child health outcomes and considered to be part of the solution to household food insecurity, interventions focused on social determinants may provide more promising targets for the prevention of household food insecurity. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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23. A qualitative study to understand parent and physician perspectives about cow's milk fat for children.
- Author
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Vanderhout, Shelley M, Juando-Prats, Clara, Birken, Catherine S, Thorpe, Kevin E, and Maguire, Jonathon L
- Subjects
MILK ,MILKING ,MILKFAT ,PARENTS ,QUALITATIVE research ,PHYSICIANS ,THEMATIC analysis - Abstract
Objective: Consensus guidelines recommend that children consume reduced-fat (0·1-2 %) cow's milk at age 2 years to reduce the risk of obesity. Behaviours and perspectives of parents and physicians about cow's milk fat for children are unknown. Objectives were to: (i) understand what cow's milk fat recommendations physicians provide to 2-year-old children; (ii) assess the acceptability of reduced-fat v. whole cow's milk in children's diets by parents and physicians; and (iii) explore attitudes and perceptions about cow's milk fat for children.Design: Online questionnaires and individual interviews were conducted. Questionnaire data were analysed using descriptive statistics. Interview transcripts were analysed using a general inductive approach and thematic analysis.Setting: The TARGet Kids! practice-based research network in Toronto, Canada.Participants: Questionnaire respondents included fifty parents and fifteen physicians; individual interviews were conducted with with fourteen parents and twelve physicians.Results: Physicians provided various milk fat recommendations for 2-year-old children. Parents also provided different cow's milks: eighteen (36 %) provided whole milk and twenty-nine (58 %) provided reduced-fat milk. Analysis of qualitative interviews revealed three themes: (i) healthy eating behaviours, (ii) trustworthy nutrition information and (iii) importance of dietary fat for children.Conclusions: Parents provide, and physicians recommend, a variety of cow's milks for children and hold mixed interpretations of the role of cow's milk fat in children's diets. Clarity about its effect on child adiposity is needed to help make informed decisions about cow's milk fat for children. [ABSTRACT FROM AUTHOR]- Published
- 2019
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24. Breastfeeding duration, maternal body mass index, and birth weight are associated with differences in body mass index growth trajectories in early childhood.
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Eny, Karen M, Chen, Shiyi, Anderson, Laura N, Chen, Yang, Lebovic, Gerald, Pullenayegum, Eleanor, Parkin, Patricia C, Maguire, Jonathon L, Birken, Catherine S, and Collaboration, TARGet Kids!
- Subjects
OBESITY risk factors ,AGE distribution ,BIRTH weight ,BREASTFEEDING ,CHILD development ,LONGITUDINAL method ,REGRESSION analysis ,SEX distribution ,STATURE ,TIME ,BODY mass index ,REPEATED measures design - Abstract
Background: Accelerated postnatal growth is an important predictor for obesity risk. It is unknown whether early-life obesity-related risk factors affect body mass index (BMI) growth rates during distinct growth periods from early infancy through preschool years. Objective: We examined whether breastfeeding duration, maternal BMI, and birth weight are associated with growth trajectories of age- and sex-standardized WHO BMI z scores (zBMIs) in young children. Design: Children (n = 5905) in The Applied Research Group for Kids (TARGet Kids!) prospective cohort study underwent repeated measures of weight and length or height from birth to 10 y of age. Piecewise linear mixed models were used to determine whether zBMI growth rates differ for each risk factor during periods of growth between birth and 1, 3, 18, 36, and 72 mo of age. Results: Children who were breastfed <6 mo compared with >6 mo showed a higher growth rate between 1-3 and 3-18 mo, resulting in higher standardized BMIs (zBMIs) of +0.24, +0.12, and +0.19 at 18, 36, and 72 mo, respectively. Maternal BMI (in kg/m²) ≥30 compared with <30 resulted in higher growth rates between 1-3 and 36-72 mo and higher zBMIs of +0.22, +0.14, +0.18, and +0.41 at 3, 18, 36, and 72 mo, respectively. Infants weighing <2.5 kg at birth (compared with 2.5-4 kg) experienced higher growth rates between 1-3 and 3-18 mo but had lower zBMIs at all time points (zBMI: -1.45 to -0.21). Infants weighing ≥4 kg at birth (compared with 2.5-4 kg) had significantly lower growth rates in the first 3 mo but higher zBMIs at all time points (zBMI: +1.16 to +0.27). Conclusion: Differences in zBMI growth rates by breastfeeding duration, maternal BMI, and birth weight are seen in early infancy and contribute to differences in zBMI, which persist into midchildhood. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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25. Vitamin D status and functional health outcomes in children aged 2-8 y: a 6-mo vitamin D randomized controlled trial.
- Author
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Brett, Neil R, Parks, Colleen A, Lavery, Paula, Agellon, Sherry, Vanstone, Catherine A, Kaufmann, Martin, Jones, Glenville, Maguire, Jonathon L, Rauch, Frank, and Weiler, Hope A
- Subjects
ANTHROPOMETRY ,BIOMARKERS ,BODY composition ,COMPUTED tomography ,INGESTION ,LIFE skills ,LIQUID chromatography ,MASS spectrometry ,MUSCLE strength ,MUSCULOSKELETAL system physiology ,STATISTICAL sampling ,SURVEYS ,TIBIA ,VITAMIN D ,RANDOMIZED controlled trials ,PHYSICAL activity ,NUTRITIONAL status ,PHOTON absorptiometry - Abstract
Background: Most Canadian children do not meet the recommended dietary intake for vitamin D. Objectives: The aims were to test how much vitamin D from food is needed to maintain a healthy serum 25-hydroxyvitamin D
3 [25(OH)D3 ] status from fall to spring in young children and to examine musculoskeletal outcomes. Design: Healthy children aged 2-8 y (n = 51) living in Montreal, Canada, were randomly assigned to 1 of 2 dietary vitamin D groups (control or intervention to reach 400 lU/d by using vitamin D- fortified foods) for 6 mo, starting October 2014. At baseline and at 3 and 6 mo, anthropometric characteristics, vitamin D metabolites (liquid chromatography-tandem mass spectrometry), and bone biomarkers (IDS-iSYS, Immunodiagnositc Systems; Liaison; Diasorin) were measured and physical activity and food intakes surveyed. At baseline and at 6 mo, bone outcomes and body composition (dual-energy X-ray absorptiometry) were measured. Cross-sectional images of distal tibia geometry and muscle density were conducted with the use of peripheral quantitative computed tomography scans at 6 mo. Results: At baseline, participants were aged 5.2 ± 1.9 (mean ± SD) y and had a body mass index z score of 0.65 ± 0.12; 53% of participants were boys. There were no differences between groups in baseline serum 25(OH)D3 (66.4 ± 13.6 nmol/L) or vitamin D intake (225 ± 74 lU/d). Median (IQR) compliance was 96% (89-99%) for yogurt and 84% (71-97%) for cheese. At 3 mo, serum 25(OH)D3 was higher in the intervention group (P < 0.05) but was not different between groups by 6 mo. Although lean mass accretion was higher in the intervention group (P < 0.05), no differences in muscle density or bone outcomes were observed. Conclusions: The consumption of 400 IU vitamin D/d from fall to spring did not maintain serum 25(OH)D3 concentration or improve bone outcomes. Further work with lean mass accretion as the primary outcome is needed to confirm if vitamin D enhances lean accretion in healthy young children. This trial was registered at www.clinicaltrials.gov as NCT02387892. [ABSTRACT FROM AUTHOR]- Published
- 2018
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26. DHA and EPA in red blood cell membranes are associated with dietary intakes of omega-3-rich fish in healthy children.
- Author
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Parks, Colleen A., Brett, Neil R., Agellon, Sherry, Lavery, Paula, Vanstone, Catherine A., Maguire, Jonathon L., Rauch, Frank, and Weiler, Hope A.
- Abstract
Omega-3 long-chain polyunsaturated fatty acids (n-3 LCPUFA) are important in child development. The primary objective of this study was to investigate the associations between dietary intakes of n-3 LCPUFA and red blood cell (RBC) n-3 LCPUFA in young children. Healthy children, (2–8 y) underwent RBC fatty acid profiling. Dietary intakes were parent-reported over 6 mo using three 24 h dietary intake assessments and three 30 d food frequency questionnaires (FFQ). Participants (n = 49, 5.6 ± 1.9 y), were 59% male, and had a body mass index (BMI) z-score of 0.65 ± 0.84. Dietary n-3 LCPUFA intakes were not different over time. RBC docosahexaenoic acid (DHA) positively correlated with average DHA from the 24 h recalls. RBC DHA and eicosapentaenoic acid (EPA) positively correlated with average n-3 LCPUFA-rich fish intake from the FFQ. RBC appear to reflect long-term stable intakes of n-3 LCPUFA during growth in healthy young children. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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27. Association between noncow milk beverage consumption and childhood height.
- Author
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Morency, Marie-Elssa, Birken, Catherine S., Lebovic, Gerald, Yang Chen, L'Abbé, Mary, Lee, Grace J., and Maguire, Jonathon L.
- Subjects
MILK consumption ,STATURE ,CHILD nutrition ,SOYMILK ,PROTEIN content of milk ,ALMOND milk ,CHILDREN ,FAT content of milk ,HEALTH ,PHYSIOLOGY ,NUTRITION ,CONFIDENCE intervals ,DOSE-response relationship in biochemistry ,DRINKING (Physiology) ,LONGITUDINAL method ,MILK ,MULTIVARIATE analysis ,PROBABILITY theory ,REGRESSION analysis ,CROSS-sectional method - Abstract
Background: Cow milk consumption in childhood has been associated with increased height, which is an important measure of children's growth and development. Many parents are choosing noncow milk beverages such as soy and almond milk because of perceived health benefits. However, noncow milk contains less protein and fat than cow milk and may not have the same effect on height. Objective: We sought to determine whether there is an association between noncow milk consumption and lower height in childhood and assess whether cow milk consumption mediates the relation between noncow milk consumption and height. Design: This was a cross-sectional study of 5034 healthy Canadian children aged 24-72 mo enrolled in the Applied Research Group for Kids cohort. The primary exposure was the volume of noncow milk consumption (number of 250-mL cups per day). The primary outcome was height, which was measured as height-for-age z score. Multivariable linear regression was used to determine the association between noncow milk consumption and height. A mediation analysis was conducted to explore whether cow milk consumption mediated the association between noncow milk consumption and height. Results: There was a dose-dependent association between higher noncow milk consumption and lower height (P < 0.0001). For each daily cup of noncow milk consumed, children were 0.4 cm (95% CI: 0.2, 0.8 cm) shorter. In the mediation analysis, lower cow milk consumption only partially mediated the association between noncow milk consumption and lower height. The height difference for a child aged 3 y consuming 3 cups noncow milk/d relative to 3 cups cow milk/d was 1.5 cm (95% CI: 0.8, 2.0 cm). Conclusions: Noncow milk consumption was associated with lower childhood height. Future research is needed to understand the causal relations between noncow milk consumption and height. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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28. Temperament and fracture in preschool-aged children.
- Author
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Ryckman, Kandace, Richmond, Sarah A., Anderson, Laura N., Birken, Catherine S., Parkin, Patricia C., Macarthur, Colin, Maguire, Jonathon L., and Howard, Andrew W.
- Subjects
PREVENTION of injury ,RISK factors of fractures ,CONFIDENCE intervals ,QUESTIONNAIRES ,TEMPERAMENT ,LOGISTIC regression analysis ,RETROSPECTIVE studies ,CASE-control method ,DESCRIPTIVE statistics ,ODDS ratio ,CHILDREN - Abstract
Objectives: Approximately one-half of all children will sustain a fracture before adulthood. Understanding the factors that place a child at increased risk of fracture is necessary to inform effective injury prevention strategies. The purpose of this study was to examine the association between temperament and fracture risk in preschool-aged children. Methods: Children aged 3 to 6 years who were diagnosed with a fracture were recruited from the Hospital for Sick Children Fracture Clinic. Using a retrospective case -- control study design, the 148 cases were frequency-matched by age and sex to 426 controls from the TARGet Kids primary care paediatric cohort. The Childhood Behaviour Questionnaire, a 36-item caregiver response questionnaire was used to assess three of the following temperament factors: surgency (e.g., high activity level), negative affect (e.g., anger, fear, discomfort) and effortful control (e.g., attentional focusing). Results: Unadjusted logistic models demonstrated no association between children with previous fracture and higher scores of surgency (unadjusted odds ratio [OR]=1.06, 95% confidence interval [CI]: 0.84, 1.34), negative affect (unadjusted OR=1.15, 95% CI: 0.93, 1.42) or effortful control (unadjusted OR=0.80, 95% CI: 0.63, 1.03). Further, models adjusted for covariates also demonstrated no significant association with surgency (1.00, 95% CI: 0.78, 1.29), negative affect (1.09, 95% CI: 0.86, 1.37) and effortful control (0.80, 95% CI: 0.61, 1.05). Conclusion: None of the three main temperament types identified by the Childhood Behaviour Questionnaire were associated with an increase in fracture risk. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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29. Vitamin D and Fracture Risk in Early Childhood: A Case-Control Study.
- Author
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Anderson, Laura N., Sze Wing Heong, Yang Chen, Thorpe, Kevin E., Adeli, Khosrow, Howard, Andrew, Sochett, Etienne, Birken, Catherine S., Parkin, Patricia C., and Maguire, Jonathon L.
- Subjects
RISK factors of fractures ,ANTHROPOMETRY ,CHILDREN'S hospitals ,CONFIDENCE intervals ,DIET ,DIETARY supplements ,DRINKING (Physiology) ,MILK ,VITAMIN D ,LOGISTIC regression analysis ,STATISTICAL significance ,CASE-control method ,ODDS ratio ,CHILDREN - Abstract
The objective of this study was to evaluate the association of vitamin D intake and serum levels with fracture risk in children under 6 years of age. A case-control study was conducted in Toronto, Ontario, Canada. Cases were recruited from the fracture clinic at the Hospital for Sick Children, and matched controls were obtained from the TARGet Kids! primary-care research network. Controls were matched to cases on age, sex, height, and season. Fracture risk was estimated from conditional logistic regression, with adjustment for skin type, fracture history, waist circumference, outdoor free play, neighborhood income, soda consumption, and child's birth weight. A total of 206 cases were recruited during May 2009--April 2013 and matched to 343 controls. Serum 25-hydroxyvitamin D concentration (per 10-nmol/L increment: adjusted odds ratio (aOR) = 0.95, 95% confidence interval (CI): 0.88, 1.03) and intake of cow's milk (<2 cups/day vs. 2 cups/day: aOR = 0.95 (95% CI: 0.60, 1.52); >2 cups/day vs. 2 cups/day: aOR = 1.39 (95% CI: 0.85, 2.23)) were not significantly associated with reduced odds of fracture. A statistically significant association was observed between child use of vitamin D supplements and decreased odds of fracture (yes vs. no: aOR = 0.42, 95% CI: 0.25,0.69). Vitamin D supplementation, but not serum 25-hydroxyvitamin D level or milk intake, was associated with reduced fracture risk among these healthy young children. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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30. Relation between milk-fat percentage, vitamin D, and BMI z score in early childhood.
- Author
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Vanderhout, Shelley M., Birken, Catherine S., Parkin, Patricia C., Lebovic, Gerald, Yang Chen, O'Connor, Deborah L., and Maguire, Jonathon L.
- Subjects
CHILDREN'S health ,CHILD nutrition ,CLINICAL trials ,COMPARATIVE studies ,CONFIDENCE intervals ,DRINKING (Physiology) ,FAT content of food ,INFANT nutrition ,METROPOLITAN areas ,MILK ,MULTIVARIATE analysis ,PARENTS ,PROBABILITY theory ,QUESTIONNAIRES ,REGRESSION analysis ,RESEARCH funding ,STATISTICS ,VITAMIN D ,BODY mass index ,CROSS-sectional method ,DATA analysis software ,DESCRIPTIVE statistics ,CHILDREN - Abstract
Background: Fortified cow milk is a material contributor of vitamin D and dietary fat in children. Recommendations for children >2 y of age advise reduced milk-fat consumption to reduce childhood obesity, yet the relation between lower milk fat, vitamin D stores, and body mass index (BMI) is unclear. Objectives: The primary objective was to explore the association between milk-fat percentage and both BMI z score (zBMI) and venous 25-hydroxyvitamin D [25(OH)D]; the secondary objective was to assess whether milk volume consumed modified this relation. Design: This was a cross-sectional analysis. Healthy urban children aged 12-72 mo were recruited from 9 primary health care practices within The Applied Research Group for Kids (TARGet Kids!) research group in Toronto, Canada. We used adjusted bivariate linear regression to examine the relation between milk-fat percentage and child 25(OH)D and zBMI concurrently. Effect modification by milk volume consumed on the evaluated relations was explored with the use of an interaction term in the statistical model. Results: Among the 2745 included children there was a positive association between milk-fat percentage and 25(OH)D (P = 0.006) and a negative association between milk-fat percentage and zBMI (P < 0.0001). Participants who drank whole milk had a 5.4-nmol/L (95% CI: 4.32, 6.54) higher median 25(OH)D concentration and a 0.72 lower (95% CI: 0.68, 0.76) zBMI score than children who drank 1% milk. Milk volume consumed modified the effect of milk-fat percentage on 25(OH)D (P = 0.003) but not on zBMI (P = 0.77). Conclusions: Whole milk consumption among healthy young children was associated with higher vitamin D stores and lower BMI. Longitudinal and interventional studies are needed to confirm these findings. TARGet Kids! was registered at clinicaltrials.gov as NCT01869530. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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31. Total Duration of Breastfeeding, Vitamin D Supplementation, and Serum Levels of 25-Hydroxyvitamin D.
- Author
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Darmawikarta, Denise, Chen, Yang, Lebovic, Gerald, Birken, Catherine S., Parkin, Patricia C., and Maguire, Jonathon L.
- Subjects
THERAPEUTIC use of vitamin D ,BREASTFEEDING ,CONFIDENCE intervals ,DIETARY supplements ,RESEARCH funding ,VITAMIN D deficiency ,CROSS-sectional method ,DATA analysis software ,CALCITRIOL ,DESCRIPTIVE statistics ,ODDS ratio ,CHILDREN - Abstract
Objectives. To determine the association between total breastfeeding duration and serum 25-hydroxyvitamin D (25-OHD) and to explore whether vitamin D supplementation influences this association. Methods. We conducted a cross-sectional study of healthy children between September 2011 and August 2013 through the TARGet Kids! primary health care research network. Of the 4533 eligible children, we included only the 2508 who had 25-OHD measured. We assessed adjusted associations of total breastfeeding duration (in months) with serum 25-OHD and in supplemented versus nonsupplemented children, with the odds of 25-OHD less than 20 nanograms per milliliter. Results. Each 1-month increase in total breastfeeding duration was associated with a 0.12 nanograms per milliliter lower median serum 25-OHD (95% confidence interval [CI] =-0.21 ng/mL, -0.02 ng/mL) among children who were not supplemented. The odds of serum 25-OHD less than 20 nanograms per milliliter increased by 6% (odds ratio [OR] = 1.06; 95% CI = 1.03, 1.10) for every 1-month increase in total breastfeeding duration among nonsupplemented children. The interaction between vitamin D supplementation, duration of breastfeeding, and median serum 25-OHD was statistically significant (P=.04). Conclusions. Breastfed children who were not supplemented, particularly those breastfed more than 1 year, appear to have lower vitamin D status. Vitamin D supplementation may mitigate this risk. These findings support recommendations for supplementation during breastfeeding of any duration. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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32. Severe iron-deficiency anaemia and feeding practices in young children.
- Author
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Parkin, Patricia C., DeGroot, Julie, Maguire, Jonathon L., Birken, Catherine S., and Zlotkin, Stanley
- Subjects
IRON deficiency anemia ,CHILD nutrition ,IRON deficiency diseases in infants ,BOTTLE feeding ,IRON deficiency anemia in children ,CHILDREN ,AGE distribution ,ANIMAL experimentation ,BREASTFEEDING ,COMPARATIVE studies ,HOSPITAL care ,INFANT formulas ,IRON ,LONGITUDINAL method ,RESEARCH methodology ,MEDICAL cooperation ,MILK ,RESEARCH ,EVALUATION research ,SEVERITY of illness index ,ODDS ratio - Abstract
Objectives: Fe-deficiency anaemia (IDA) occurs in 1-2 % of infants in developed countries, peaks at 1-3 years of age and is associated with later cognitive deficits. The objectives of the present study were to describe the characteristics of young children with severe IDA and examine modifiable risk factors in a developed-country setting.Design: Two prospective samples: a national surveillance programme sample and a regional longitudinal study sample.Setting: Canada, 2009-2011.Subjects: Two samples of young children recruited from community-based health-care practices: a national sample with severe anaemia (Hb<80 g/l) due to Fe deficiency and a regional sample with non-anaemic Fe sufficiency.Results: Children with severe IDA (n 201, mean Hb 55·1 g/l) experienced substantial morbidity (including developmental delay, heart failure, cerebral thrombosis) and health-care utilization (including a 42 % hospitalization rate). Compared with children with Fe sufficiency (n 597, mean Hb 122·4 g/l), children with severe IDA consumed a larger volume of cow's milk daily (median 1065 ml v. 500 ml, P<0·001) and were more likely to be using a bottle during the day (78 % v. 43 %, OR=6·0; 95 % CI 4·0, 8·9) and also in bed (60 % v. 21 %, OR=6·5; 95 % CI 4·4, 9·5).Conclusions: Severe IDA is associated with substantial morbidity and may be preventable. Three potentially modifiable feeding practices are associated with IDA: (i) cow's milk consumption greater than 500 ml/d; (ii) daytime bottle use beyond 12 months of age; and (iii) bottle use in bed. These feeding practices should be highlighted in future recommendations for public health and primary-care practitioners. [ABSTRACT FROM AUTHOR]- Published
- 2016
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33. Dietary vitamin D dose-response in healthy children 2 to 8 y of age: a 12-wk randomized controlled trial using fortified foods.
- Author
-
Brett, Neil R., Lavery, Paula, Agellon, Sherry, Vanstone, Catherine A., Maguire, Jonathon L., Rauch, Frank, and Weiler, Hope A.
- Subjects
ENRICHED foods ,ANALYSIS of variance ,ANTHROPOMETRY ,BODY composition ,CALCIUM ,CHEESE ,CHI-squared test ,CHILDREN'S health ,CHILD nutrition ,CLINICAL trials ,HUMAN skin color ,DAIRY products ,DOSE-response relationship in biochemistry ,FISHER exact test ,LONGITUDINAL method ,NUTRITIONAL assessment ,NUTRITION policy ,NUTRITIONAL requirements ,PARATHYROID hormone ,PROBABILITY theory ,QUESTIONNAIRES ,REGRESSION analysis ,RESEARCH funding ,STATISTICAL sampling ,SEASONS ,STATISTICS ,SUNSHINE ,VITAMIN D ,YOGURT ,STATISTICAL power analysis ,DATA analysis ,ENVIRONMENTAL exposure ,SOCIOECONOMIC factors ,STATISTICAL significance ,BODY mass index ,RANDOMIZED controlled trials ,BLIND experiment ,DATA analysis software ,DESCRIPTIVE statistics ,NUTRITIONAL status ,PHOTON absorptiometry ,CHILDREN - Abstract
Background: Vitamin D is fundamental for bone health. A high proportion of Canadian 2- to 8-y-olds do not meet the Estimated Average Requirement (EAR) of 400 IU/d. Objective: The objective was to determine whether vitamin D intakes consistent with the EAR or Recommended Dietary Allowance (RDA), through fortification of additional dairy products, would result in higher vitamin D status in young children. Design: Participants aged 2-8 y (n = 77; Montreal, Canada) were randomly assigned to 1 of 3 dietary vitamin D targets (control; EAR: 400 IU/d; or RDA: 600 IU/d) for 12 wk (January to April 2014). Anthropometric measurements, demographic characteristics, dietary intakes, fasting serum parathyroid hormone, 25-hydroxyvitamin D [25(OH)D], and ionized calcium were compared by using mixed-model ANOVA. Results: Participants' mean ± SD age was 5.1 ± 1.9 y; 54.5% were boys with body mass index z scores of 0.50 ± 0.85. Compliance was 85% overall. No differences were observed in baseline dietary vitamin D intakes or serum 25(OH)D. At 12 wk, the EAR and RDA groups had significantly higher vitamin D intakes [median (IQR): control, 227 (184-305) IU/d; EAR, 410 (363-516) IU/d; and RDA, 554 (493-653) IU/d; P < 0.05] and serum 25(OH)D concentrations (control: 55.8 ± 12.3 nmol/L; EAR: 64.1 ± 10.0 nmol/L; and RDA: 63.7 ± 12.4 nmol/L; P < 0.05) than the control group. Ninety-six percent of children in the EAR and RDA groups and 67% of the control group had 25(OH)D concentrations ≥50 nmol/L. Conclusion: Increasing the vitamin D intakes of young children through fortification of alternative dairy products results in significantly higher serum concentrations of 25(OH)D and a significantly greater proportion of children with serum 25(OH)D ≥50 nmol/L during periods of minimal ultraviolet B radiation exposure. This trial was registered at clinicaltrials.gov as NCT02097160 and had Health Canada Temporary Marketing Authorization Letters for both products (TM-13-0432 and TM-13-0433). [ABSTRACT FROM AUTHOR]
- Published
- 2016
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34. Risk factors, practice variation and hematological outcomes of children identified with non-anemic iron deficiency following screening in primary care setting.
- Author
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Abdullah, Kawsari, Thorpe, Kevin E., Maguire, Jonathon L., Birken, Catherine S., Fehlings, Darcy, Hanley, Anthony J., and Parkin, Patricia C
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DIAGNOSIS of deficiency diseases ,C-reactive protein ,CONFIDENCE intervals ,IRON compounds ,LONGITUDINAL method ,MEDICAL screening ,EVIDENCE-based medicine ,SOCIOECONOMIC factors ,DATA analysis software ,DESCRIPTIVE statistics ,ODDS ratio ,CHILDREN - Abstract
Copyright of Paediatrics & Child Health (1205-7088) is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2015
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35. 22 Mealtime Media Use And Non-High-Density Lipoprotein Cholesterol in Children.
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Jamnik, Joseph, Keown-Stoneman, Charles, Eny, Karen M, Maguire, Jonathon L, and Birken, Catherine S
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CARDIOVASCULAR diseases risk factors ,CONFERENCES & conventions ,HIGH density lipoproteins ,TELEVISION ,CHILDREN - Published
- 2019
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36. RE: "VITAMIN D AND FRACTURE RISK IN EARLY CHILDHOOD: A CASE-CONTROL STUDY".
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Sugiyama, T., Anderson, Laura N., and Maguire, Jonathon L.
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RISK factors of fractures ,BIRTH weight ,BONE growth ,DIETARY supplements ,BONE fractures ,SPRAINS ,VITAMIN D ,PHYSICAL activity ,WAIST circumference ,CHILDREN ,PREGNANCY - Published
- 2018
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37. Dietary fat restrictions in young children and the later risk of obesity.
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Rolland-Cachera, Marie Françoise, Briend, André, Michaelsen, Kim F., Vanderhout, Shelley M., Birken, Catherine S., and Maguire, Jonathon L.
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FAT content of milk ,RISK of childhood obesity ,AGE factors in human body composition ,FAT content of food ,MILK ,VITAMIN D ,BODY mass index ,CHILDREN - Published
- 2017
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38. 32 The Association Between Maternal Ethnicity and Iron Deficiency in Early Childhood.
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Gunaseelan, Vinusha, Parkin, Patricia C, Wahi, Gita, Birken, Catherine S, Maguire, Jonathon L, Macarthur, Colin, and Borkhoff, Cornelia M
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CONFERENCES & conventions ,ETHNIC groups ,INFANT nutrition ,IRON ,IRON metabolism disorders ,MOTHERS ,DISEASE risk factors ,CHILDREN - Published
- 2019
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39. 28 The effect of screen time on cardiometabolic risk in young children: A longitudinal cohort study.
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Sivanesan, Harunya, Vanderloo, Leigh M, Parkin, Patricia C, Maguire, Jonathon L, Keown-Stoneman, Charles D G, and Birken, Catherine S
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METABOLIC disorders ,CARDIOVASCULAR diseases risk factors ,CONFERENCES & conventions ,SCREEN time ,CHILDREN ,DISEASE risk factors - Published
- 2019
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40. Iron deficiency among low income Canadian toddlers: a cross-sectional feasibility study in a Community Health Centre and non-Community Health Centre sites.
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Bayoumi, Imaan, Parkin, Patricia C., Lebovic, Gerald, Patel, Rupa, Link, Kendra, Birken, Catherine S., Maguire, Jonathon L., and Borkhoff, Cornelia M.
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NUTRITION disorders ,POVERTY areas ,BREASTFEEDING ,COMMUNITY health services ,CONFIDENCE intervals ,FERRITIN ,INFLAMMATION ,IRON ,MILK ,PEDIATRICS ,PRIMARY health care ,TIME ,PILOT projects ,MULTIPLE regression analysis ,SOCIOECONOMIC factors ,EDUCATIONAL attainment ,DISEASE prevalence ,CROSS-sectional method ,ODDS ratio ,CHILDREN ,DISEASE risk factors - Abstract
Background: Iron deficiency in early childhood has been associated with poor developmental outcomes. Little is known about the nutritional health of young children receiving care at Canadian Community Health Centres (CHCs). Our objectives were to describe iron deficiency among toddlers at an Ontario CHC, to compare young children attending CHCs and non-CHCs, and assess the feasibility of conducting research on children in CHC settings. Methods: One CHC, Kingston Community Health Centres (CHC) with two clinical sites and one community programming site was added to the nine non-CHC pediatric and primary care clinics in the existing TARGet Kids! research network. A cross-sectional feasibilitystudy was conducted.and. Healthy children, ages 12–36 months were Enrolled. iron deficiency without inflammation (ferritin< 14 μg/L and CRP < 10 mg/L) and serum ferritin were assessed. Adjusted multivariable regression analyses were used to evaluate an association between CHC enrolment and iron status. Results: The CHC cohort (n = 31) was older, had lower household income, lower maternal education, higher nutrition risk scores, higher cow's milk intake, shorter breastfeeding duration and higher prevalence of unhealthy weights compared with the non-CHC cohort (n = 875). There was no association between CHC status and serum ferritin (difference in median serum ferritin 4.78 μg/L, 95% confidence interval [CI] -2.5, 14.3, p = 0.22) or iron deficiency (OR 0.55, 95% CI 0.11, − 2.73, p = 0.46) using multivariable linear and logistic regression, respectively. Conclusion: Despite differences in sociodemographic variables, we did not detect a difference in iron status between toddlers enrolled at CHCs compared to non-CHC settings. Further research is needed to understand the health effects of poverty generally, and iron deficiency specifically among children receiving care at CHCs. [ABSTRACT FROM AUTHOR]
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- 2018
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41. Chronic Iron Deficiency and Cognitive Function in Early Childhood.
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Gingoyon, Argie, Borkhoff, Cornelia M., Koroshegyi, Christine, Mamak, Eva, Birken, Catherine S., Maguire, Jonathon L., Fehlings, Darcy, Macarthur, Colin, and Parkin, Patricia C.
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C-reactive protein , *SCIENTIFIC observation , *HEMOGLOBINS , *CONFIDENCE intervals , *MULTIVARIATE analysis , *FERRITIN , *ANTHROPOMETRY , *COGNITION , *HEALTH outcome assessment , *CONCEPTUAL structures , *QUESTIONNAIRES , *DESCRIPTIVE statistics , *IRON deficiency anemia , *LONGITUDINAL method , *DISEASE complications , *CHILDREN - Abstract
Background and objectives: A landmark longitudinal study, conducted in Costa Rica in the 1980s, found that children with chronic iron deficiency compared with good iron status in infancy had 8 to 9 points lower cognitive scores, up to 19 years of age. Our objective was to examine this association in a contemporary, high-resource setting. Methods: This was a prospective observational study of children aged 12 to 40 months screened with hemoglobin and serum ferritin. All parents received diet advice; children received oral iron according to iron status. After 4 months, children were grouped as: chronic iron deficiency (iron deficiency anemia at baseline or persistent nonanemic iron deficiency) or iron sufficiency (IS) (IS at baseline or resolved nonanemic iron deficiency). Outcomes measured at 4 and 12 months included the Early Learning Composite (from the Mullen Scales of Early Learning) and serum ferritin. Results: Of 1478 children screened, 116 were included (41 chronic, 75 sufficient). Using multivariable analyses, the mean between-group differences in the Early Learning Composite at 4 months was -6.4 points (95% confidence interval [CI]: -12.4 to -0.3, P = .04) and at 12 months was -7.4 points (95% CI: -14.0 to -0.8, P = .03). The mean between-group differences in serum ferritin at 4 months was 14.3 μg/L (95% CI: 1.3-27.4, P = .03) and was not significantly different at 12 months. Conclusions: Children with chronic iron deficiency, compared with children with IS, demonstrated improved iron status, but cognitive scores 6 to 7 points lower 4 and 12 months after intervention. Future research may examine outcomes of a screening strategy on the basis of early detection of iron deficiency using serum ferritin. [ABSTRACT FROM AUTHOR]
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- 2022
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42. Sleep Duration and Internalizing Symptoms in Children.
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Wu, Liliana C., Hattangadi, Nayantara, Keown-Stoneman, Charles D. G., Maguire, Jonathon L., Birken, Catherine S., Stremler, Robyn, Constantin, Evelyn, and Charach, Alice
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INTERNALIZING behavior , *SLEEP , *CHILDREN , *SLEEP hygiene , *MEDICAL offices - Abstract
Objective: Emotional problems such as anxiety and low mood have been associated with sleep problems in children. The study's objectives were to 1) assess the association between sleep duration and internalizing symptoms (anxiety and low mood) in children aged 5-12 years (y), and 2) evaluate whether insufficient sleep according to the National Sleep Foundation (NSF) guidelines is associated with internalizing symptoms. Methods: A cross-sectional study of N =796 children aged 5-12y, recruited from primary care physicians' offices in Toronto, Canada was conducted through the TARGet Kids! research network. Using linear regression, we investigated 1) the cross-sectional association between parent reported 24-hour sleep duration (hours) and parent reported symptoms using the Strengths and Difficulties Questionnaire (SDQ), controlling for child age, sex, family income, maternal education, family composition, and standardized body-mass index (zBMI). The analysis was repeated using insufficient sleep per NSF guideline as the independent variable. Results: Sleep duration was inversely associated with internalizing symptoms, B estimate = -0.33 (95%CI -0.57, -0.07), p=0.012. Twentyeight (14%) children aged 5 y, and 36 (6%) of those aged 6-12y, experienced insufficient sleep. There was a trend toward association between insufficient sleep and internalizing symptoms, B estimate = 0.64 (-0.09, 1.38), p=0.086. Conclusion: The relationship between insufficient sleep and internalizing symptoms among children requires further elucidation. Children who show internalizing symptoms may benefit from interventions supporting sleep. [ABSTRACT FROM AUTHOR]
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- 2022
43. Screening for Iron Deficiency in Early Childhood Using Serum Ferritin in the Primary Care Setting.
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Oatley, Hannah, Borkhoff, Cornelia M., Shiyi Chen, Macarthur, Colin, Persaud, Navindra, Birken, Catherine S., Maguire, Jonathon L., and Parkin, Patricia C.
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IRON deficiency anemia diagnosis , *C-reactive protein , *CONFIDENCE intervals , *FERRITIN , *HEMOGLOBINS , *MEDICAL screening , *PRIMARY health care , *REGRESSION analysis , *EARLY intervention (Education) , *CROSS-sectional method , *CHILDREN - Abstract
OBJECTIVES: The American Academy of Pediatrics recommends universal screening for anemia using hemoglobin at 12 months. However, hemoglobin lacks diagnostic accuracy for iron deficiency, and the optimal age for screening has not been determined. Our objective was to assess a screening strategy for iron deficiency using serum ferritin. METHODS: We conducted a cross-sectional study of children 1 to 3 years old attending a health supervision visit. We examined the relationship between child age and serum ferritin, age and hemoglobin, hemoglobin and serum ferritin, and the prevalence of elevated C-reactive protein (CRP). RESULTS: Restricted cubic spline analysis (n = 1735) revealed a nonlinear relationship between age and serum ferritin (P < .0001). A linear spline model revealed that from 12 to 15 months, for each 1-month increase in age, serum ferritin levels decreased by 9% (95% confidence interval [CI]: 5 to 13). From 15 to 24 months, the rate of change was nonsignificant. From 24 to 38 months, for each month increase in age, serum ferritin increased by 2% (95% CI: 1 to 2). For hemoglobin, from 12 to 24 months, the rate of change was nonsignificant. From 24 to 38 months, for each 1-month increase in age, hemoglobin increased by 20% (95% CI: 9 to 32). Compared with the serum ferritin cutoff of <12 ^g/L, the hemoglobin cutoff of <110 g/L had a sensitivity of 25% (95% CI: 19 to 32) and a specificity of 89% (95% CI: 87 to 91). Elevated CRP >10 mg/L occurred in 3.3% (95% CI: 2.5 to 4.2). CONCLUSIONS: Screening for iron deficiency using serum ferritin at 15 or 18 months may be a promising strategy. For children at low risk for acute inflammation, concurrent measurement of CRP may not be necessary. [ABSTRACT FROM AUTHOR]
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- 2018
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44. Evaluation of ethnic differences in cardiometabolic risk in children.
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Tinajero, Maria G., Keown-Stoneman, Charles DG, Anderson, Laura, Maguire, Jonathon L., Hanley, Anthony J., Sievenpiper, John L., Johnson, Kassia, Birken, Catherine, and Malik, Vasanti S.
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ETHNICITY , *ETHNIC differences , *SOUTH Asians , *HDL cholesterol , *SYSTOLIC blood pressure , *WAIST circumference - Abstract
In adults, cardiometabolic conditions manifest differently by ethnicity with South Asians particularly predisposed. Whether these differences arise in childhood remains narrowly explored. To address this evidence gap, we examined whether children of different ethnicities display differences in cardiometabolic risk (CMR). A cross-sectional analysis was conducted among 5557 children (3–11 years). Multivariable linear regression models adjusted for age, sex, z-body mass index, and demographic factors were used to estimate differences in CMR outcomes between children with parents that self-reported European ancestry (reference group) and one of 13 other ethnicities (African, Arab, East Asian, Latin American, South Asian, Southeast Asian, Mixed Ethnicities, and Other). The primary outcome was a CMR score, calculated as the sum of age- and sex-standardized waist circumference, systolic blood pressure (SBP), glucose, log-triglycerides, and inverse high-density lipoprotein cholesterol (HDL-C), divided by √5. Lower mean CMR scores were observed among children with African (β = −0.62, 95% CI: −0.92; −0.32) and East Asian (β = −0.41, 95% CI: −0.68, −0.15) ancestry compared to children with European ancestry. Children with South Asian ancestry had higher SBP (β = 2.25, 95% CI: 1.27, 3.22) and non-HDL-C (β = 0.17, 95% CI: 0.07, 0.26) than children with European ancestry. Ethnic differences in CMR were observed in early and middle childhood. [ABSTRACT FROM AUTHOR]
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- 2023
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45. A novel systematic pipeline for increased predictability and explainability of growth patterns in children using trajectory features.
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Massara, Paraskevi, Lopez-Dominguez, Lorena, Bourdon, Celine, Bassani, Diego G., Keown-Stoneman, Charles D.G., Birken, Catherine S., Maguire, Jonathon L., Santos, Iná S., Matijasevich, Alicia, Bandsma, Robert H.J., and Comelli, Elena M.
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- 2023
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46. A Core Outcome Set for Children With Feeding Tubes and Neurologic Impairment: A Systematic Review.
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Kapadia, Mufiza Z., Joachim, Kariym C., Balasingham, Chrinna, Cohen, Eyal, Mahant, Sanjay, Nelson, Katherine, Maguire, Jonathon L., Guttmann, Astrid, and Offringa, Martin
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MALNUTRITION , *ANTHROPOMETRY , *BODY composition , *CALORIMETRY , *CAREGIVERS , *CHILD development , *CHRONIC diseases in children , *ENTERAL feeding , *GASTROESOPHAGEAL reflux , *NUTRITION for people with disabilities , *HEALTH status indicators , *HOSPITAL care , *LENGTH of stay in hospitals , *HUMAN growth , *INFORMATION storage & retrieval systems , *MEDICAL databases , *MEDICAL information storage & retrieval systems , *RESEARCH methodology , *MEDICAL care , *EVALUATION of medical care , *MEDICAL care use , *MEDLINE , *MORTALITY , *NEUROLOGICAL disorders , *CHILDHOOD obesity , *PATIENT satisfaction , *QUALITY of life , *RESEARCH funding , *WEIGHT gain , *SYSTEMATIC reviews , *QUALITATIVE research , *COST analysis , *CHILDREN with disabilities , *FAMILY relations , *BURDEN of care , *FOOD diaries , *FEEDING tubes , *DESCRIPTIVE statistics , *META-synthesis , *SYMPTOMS , *CHILDREN - Abstract
CONTEXT: Uncertainty exists about the impacts of feeding tubes on neurologically impaired children. Core outcome sets (COS) standardize outcome selection, definition, measurement, and reporting. OBJECTIVE: To synthesize an evidence base of qualitative data on all outcomes selected and/or reported for neurologically impaired children 0 to 18 years living with gastrostomy/gastrojejunostomy tubes. DATA SOURCES: Medline, Embase, and Cochrane Register databases searched from inception to March 2014. STUDY SELECTION: Articles examining health outcomes of neurologically impaired children living with feeding tubes. DATA EXTRACTION: Outcomes were extracted and assigned to modified Outcome Measures in Rheumatology 2.0 Filter core areas; death, life impact, resource use, pathophysiological manifestations, growth and development. RESULTS: We identified 120 unique outcomes with substantial heterogeneity in definition, measurement, and frequency of selection and/or reporting: "pathophysiological manifestation" outcomes (n = 83) in 79% of articles; "growth and development" outcomes (n = 13) in 55% of articles; "death" outcomes (n = 3) and "life impact" outcomes (n = 17) in 39% and 37% of articles, respectively; "resource use" outcomes (n = 4) in 14%. Weight (50%), gastroesophageal reflux (35%), and site infection (25%) were the most frequently reported outcomes. LIMITATIONS: We were unable to investigate effect size of outcomes because quantitative data were not collected. CONCLUSIONS: The paucity of outcomes assessed for life impact, resource use and death hinders meaningful evidence synthesis. A COS could help overcome the current wide heterogeneity in selection and definition. These results will form the basis of a consensus process to produce a final COS. [ABSTRACT FROM AUTHOR]
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- 2016
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47. BMI-for-Age and Weight-for-Length in Children 0 to 2 Years.
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Furlong, Kayla R., Anderson, Laura N., Huiying Kang, Lebovic, Gerald, Parkin, Patricia C., Maguire, Jonathon L., O'Connor, Deborah L., and Birken, Catherine S.
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BODY weight , *CHI-squared test , *CHILDREN'S hospitals , *STATISTICAL correlation , *ETHNIC groups , *FAMILY medicine , *INFANT development , *RESEARCH methodology , *MEDICAL appointments , *PEDIATRICS , *PRIMARY health care , *PROBABILITY theory , *RESEARCH funding , *STATISTICAL hypothesis testing , *STATURE , *DATA analysis , *SECONDARY analysis , *SOCIOECONOMIC factors , *BODY mass index , *PREDICTIVE tests , *CROSS-sectional method , *DESCRIPTIVE statistics , *CHILDREN - Abstract
OBJECTIVES: To determine the agreement between weight-for-length and BMI-for-age in children 0 to <2 years by using research-collected data, examine factors that may affect agreement, and determine if agreement differs between research- and routinely collected data. METHODS: Cross-sectional data on healthy, term-born children (n = 1632) aged 0 to <2 years attending the TARGet Kids! practice-based research network in Toronto, Canada (December 2008-October 2014) were collected. Multiple visits for each child were included. Length (cm) and weight (kg) measurements were obtained by trained research assistants during research visits, and by nonresearch staff during all other visits. BMI-for-age z-scores were compared with weight-for-length z-scores (the criterion measure). RESULTS: The correlation between weight-for-length and BMI-for-age was strong (r = 0.986, P < .0001) and Bland-Altman plots revealed good agreement (difference = -0.08, SD = 0.20, P = .91). A small proportion (6.3%) of observations were misclassified and most misclassifications occurred near the percentile cutoffs. There were no differences by age and sex. Agreement was similar between research- and routinely collected data (r = 0.99, P < .001; mean difference -0.84, SD = 0.20, P = .67). CONCLUSIONS: Weight-for-length and BMI-for-age demonstrated high agreement with low misclassification. BMI-for-age may be an appropriate indicator of growth in the first 2 years of life and has the potential to be used from birth to adulthood. Additional investigation is needed to determine if BMI-for-age in children <2 years is associated with future health outcomes. [ABSTRACT FROM AUTHOR]
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- 2016
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48. Evaluating the accuracy of a geographic closed-ended approach to ethnicity measurement, a practical alternative.
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Omand, Jessica A., Carsley, Sarah, Darling, Pauline B., Parkin, Patricia C., Birken, Catherine S., Urquia, Marcelo L., Khovratovich, Marina, and Maguire, Jonathon L.
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ETHNICITY , *DEMOGRAPHIC characteristics , *MOTHER-child relationship , *PUBLIC health , *DISEASE risk factors , *HEALTH - Abstract
Abstract: Purpose: Measuring ethnicity accurately is important for identifying ethnicity variations in disease risk. We evaluated the degree of agreement and accuracy of maternal ethnicity measured using the new standardized closed-ended geographically based ethnicity question and geographic reclassification of open-ended ethnicity questions from the Canadian census. Methods: A prospectively designed study of respondent agreement of mothers of healthy children aged 1–5 years recruited through the TARGet Kids! practice-based research network. For the primary analysis, the degree of agreement between geographic reclassification of the Canadian census maternal ethnicity variables and the new geographically based closed-ended maternal ethnicity variable completed by the same respondent was evaluated using a kappa analysis. Results: Eight hundred sixty-two mothers who completed both measures of ethnicity were included in the analysis. The kappa agreement statistic for the two definitions of maternal ethnicity was 0.87 (95% confidence interval, 0.84–0.90) indicating good agreement. Overall accuracy of the measurement was 93%. Sensitivity and specificity ranged from 83% to 100% and 96% to 100%, respectively. Conclusions: The new standardized closed-ended geographically based ethnicity question represents a practical alternative to widely used open-ended ethnicity questions. It may reduce risk of misinterpretation of ethnicity by respondents, simplify analysis, and improve the accuracy of ethnicity measurement. [Copyright &y& Elsevier]
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- 2014
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