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102. Preventing obesity in infants and toddlers in child care: results from a pilot randomized controlled trial

Author

Neelon, Sara E. Benjamin, Taveras, Elsie M., Ostbye, Truls, and Gillman, Matthew W.

Subjects
Obesity in children -- Risk factors -- Prevention -- Research, Infants -- Food and nutrition -- Health aspects -- Research, Toddlers -- Food and nutrition -- Health aspects -- Research, Health care industry
Abstract

Few interventions have focused on very young children for obesity prevention. This study evaluated a pilot intervention to improve the nutrition and physical activity environments of child care centers serving infants and toddlers. This randomized controlled trial took place in 32 centers in Boston, Massachusetts. The intervention aimed to improve policies and practices related to nutrition and physical activity within the center. For the outcome, observers assessed center environments using the Environment and Policy Assessment and Observation (EPAO) instrument (range 0-320 points) at baseline and the 6-month follow-up. We fit linear regression models with change in EPAO score from baseline to follow-up, controlling for potential confounders for total score, nutrition sub-score, and physical activity sub-score. Intervention centers had a mean (SD) of 98.2 (144.8) children enrolled, while control centers had 59.2 (34.5). In intervention centers, 47.5% of children were white, compared to 46.2% in controls. Fewer intervention centers had outdoor play areas on site (75 vs. 100%) but more had indoor play space (67 vs. 25%). At baseline, intervention centers had a mean (SD) EPAO score of 134.5 (7.0) points and controls had 146.8 (4.8) points. Compared with controls, intervention centers improved their EPAO scores at follow-up by 18.5 points (95% CI 0.1, 37.0; p = 0.049), chiefly through greater improvement in physical activity (12.2; 95% CI -1.6, 26.0; p = 0.075) and not nutrition (6.4; 95% CI -7.1, 19.8; p = 0.385). The pilot showed promise as an intervention to improve center environments, but future studies should include child-level outcomes. Keywords Child care * Infant * Nutrition * Physical activity * Toddler, Introduction Obesity presents a substantial health problem, even for very young children. In recent years, United States (US) data show that nearly one out of ten children ages 0-23 months [...]

Published
2014
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106. Issues In Reporting Epidemiological Studies

Author

Gillman, Matthew W., Blackburn, David F., Jöckel, Karl-Heinz, Stang, Andreas, Pocock, Stuart J., Collier, Timothy J., and Dandreo, Kimberley J.

Published
2005

116. Maternal Antibiotic Use During Pregnancy and Childhood Obesity at Age Five Years

Author

Heerman, William J., Daley, Matthew F., Boone-Heinonen, Janne, Rifas-Shiman, Sheryl L., Bailey, L. Charles, Forrest, Christopher B., Young, Jessica, Gillman, Matthew W., Horgan, Casie E., Janicke, David M., Jenter, Chelsea, Kharbanda, Elyse O., Lunsford, Doug, Messito, Mary Jo, Toh, Sengwee, and Block, Jason P.

Subjects
Adult, Male, Pediatric Obesity, Mothers, Article, Anti-Bacterial Agents, Body Mass Index, Pregnancy, Child, Preschool, Prenatal Exposure Delayed Effects, Humans, Female, Pregnancy Complications, Infectious, Retrospective Studies
Abstract

Objective: The benefits of antibiotic treatment during pregnancy are immediate, but there may be long-term risks to the developing child. Prior studies show an association between early life antibiotics and obesity, but few have examined this risk during pregnancy. Subjects: To evaluate the association of maternal antibiotic exposure during pregnancy on childhood BMI-z at five years, we conducted a retrospective cohort analysis. Using electronic health record data from seven health systems in PCORnet, a national distributed clinical research network, we included children with same-day height and weight measures who could be linked to mothers with vital measurements during pregnancy. The primary independent variable was maternal outpatient antibiotic prescriptions during pregnancy (any versus none). We examined dose response (number of antibiotic episodes), spectrum and class of antibiotics, and antibiotic episodes by trimester. The primary outcome was child age- and sex-specific BMI-z at age five years. Results: The final sample was 53 320 mother-child pairs. During pregnancy, 29.9% of mothers received antibiotics. In adjusted models, maternal outpatient antibiotic prescriptions during pregnancy were not associated with child BMI-z at age five years (β=0.00, 95% CI −0.03, 0.02). When evaluating timing during pregnancy, dose-response, spectrum and class of antibiotics, there were no associations of maternal antibiotics with child BMI-z at age five years. Conclusion: In this large observational cohort, provision of antibiotics during pregnancy was not associated with childhood BMI-z at five years.

Published
2019

122. Cohort Profile: Project Viva

Author

Oken, Emily, Baccarelli, Andrea A, Gold, Diane R, Kleinman, Ken P, Litonjua, Augusto A, De Meo, Dawn, Rich-Edwards, Janet W, Rifas-Shiman, Sheryl L, Sagiv, Sharon, Taveras, Elsie M, Weiss, Scott T, Belfort, Mandy B, Burris, Heather H, Camargo, Carlos A, Jr, Huh, Susanna Y, Mantzoros, Christos, Parker, Margaret G, and Gillman, Matthew W

Published
2015
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126. A qualitative study of gestational weight gain counseling and tracking

Author

Oken, Emily, Switkowski, Karen, Price, Sarah, Guthrie, Lauren, Taveras, Elsie M., Gillman, Matthew, Friedes, Jonathan, Callaghan, William, and Dietz, Patricia

Subjects
Weight gain -- Research -- Health aspects, Electronic records -- Usage, Health counseling -- Research -- Management, Company business management, Health care industry
Abstract

Excessive gestational weight gain (GWG) predicts adverse pregnancy outcomes and later obesity risk for both mother and child. Women who receive GWG advice from their obstetric clinicians are more likely to gain the recommended amount, but many clinicians do not counsel their patients on GWG, pointing to the need for new strategies. Electronic medical records (EMRs) are a useful tool for tracking weight and supporting guideline-concordant care, but their use for care related to GWG has not been evaluated. We performed in-depth interviews with 16 obstetric clinicians from a multi-site group practice in Massachusetts that uses an EMR. We recorded, transcribed, coded, and analyzed the interviews using immersion-crystallization. Many respondents believed that GWG had 'a lot' of influence on pregnancy and child health outcomes but that their patients did not consider it important. Most indicated that excessive GWG was a big or moderate problem in their practice, and that inadequate GWG was rarely a problem. All used an EMR feature that calculates total GWG at each visit. Many were enthusiastic about additional EMR-based supports, such as a reference for recommended GWG for each patient based on prepregnancy body mass index, a 'growth chart' to plot actual and recommended GWG, and an alert to identify out-of-range gains, features which many felt would remind them to counsel patients about excessive weight gain. Additional decision support tools within EMRs would be well received by many clinicians and may help improve the frequency and accuracy of GWG tracking and counseling. Keywords Gestational weight gain * Obstetrics * Electronic medical record * Counseling, Introduction Gestational weight gain (GWG) is an important predictor of short- and long-term outcomes of pregnancy for both mother and child [1]. Compared with adequate gain, mothers with excessive GWG [...]

Published
2013
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127. Estimation of Newborn Risk for Child or Adolescent Obesity

Author

Morandi, Anita, primary, Meyre, David, additional, Lobbens, Stéphane, additional, Kleinman, Ken, additional, Kaakinen, Marika, additional, Rifas-Shiman, Sheryl, additional, Vatin, Vincent, additional, Gaget, Stefan, additional, Pouta, Anneli, additional, Hartikainen, Anna-Liisa, additional, Laitinen, Jaana, additional, Ruokonen, Aimo, additional, Das, Shikta, additional, Khan, Anokhi, additional, Elliott, Paul, additional, Maffeis, Claudio, additional, Gillman, Matthew, additional, Järvelin, Marjo-Riitta, additional, and Froguel, Philippe, additional

Published
2013
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128. Medieval Glass and the Aesthetics of Simulation

Author

Gillman, Matthew Elliott

Subjects
Glassware, Medieval, Art, Iraqi, Abbasids, Precious stones, Art, Medieval
Abstract

Gemlike objects are a nearly ubiquitous phenomenon in the medium of glass, although culturally specific studies remain scarce. This dissertation considers the production of such works in the early medieval period, primarily in association with Abbasid rule. The first half attends to several accessory issues, including glass-related terminology, glass-coloring treatises, the lives of glassworkers, gemstone connoisseurship, and the legal status of such products. These demonstrate a range of coexisting attitudes, including the desirability of such works for their own sake rather than as surreptitious substitutes for “true” gemstones. The second half focuses on an exemplary object, an opaque turquoise glass bowl from the Treasury of San Marco in Venice, which I propose was produced in Baghdad for the caliph al-Mutawakkil just after the year 850. I then consider this work’s changing reception from late medieval Venice to modern scholarship, including ways in which “correct” interpretations of its material and/or origin have been repeatedly supplanted by false leads. The fundamental argument is that gemlike vessels like the San Marco turquoise were not deceptive stand-ins but rather intended to exercise complex discursive practices, both political and connoisseurial in nature, a function that ultimately remains in effect today.

Published
2021
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131. Age of achievement of gross motor milestones in infancy and adiposity at age 3 years

Author

Neelon, Sara E. Benjamin, Oken, Emily, Taveras, Elsie M., Rifas-Shiman, Sheryl L., and Gillman, Matthew W.

Subjects
Health care industry, World Health Organization
Abstract

Early life physical activity may help prevent obesity but is difficult to measure. The purpose of this study was to examine associations of age of achievement of gross motor milestones in infancy with adiposity at age 3 years. Seven forty one mother/infant dyads participated in a longitudinal study in Massachusetts. Exposures were age of attainment of 4 gross motor milestones-rolling over, sitting up, crawling, and walking. Outcomes were 3-year sum of subscapular and triceps skinfold thickness (SS + TR) for overall adiposity, their ratio (SS:TR) for central adiposity, and body mass index (BMI) z-score. We used linear regression models adjusted for confounders to examine motor milestone achievement and later adiposity. Rolling over (0.04, 95% CI: 0.008, 0.07) and sitting up (0.02, 95% CI: 0.001, 0.05) at [greater than or equal to] 6 months were associated with increased SS:TR compared with attainment before 6 months. Walking at [greater than or equal to] 15 months was associated with 0.98 mm higher SS + TR (95% CI: 0.05, 1.91) compared with walking before 12 months. Age at crawling was not associated with the outcomes. None of the milestones were associated with BMI z-score. Age of motor milestone achievement was only a modest predictor of adiposity. Later rolling over and sitting up were associated with greater central adiposity, and later age at walking was associated with greater overall adiposity at age 3 years. Although we controlled for birth weight and 6-month weight-for-length in our models, more detailed assessment of early adiposity prior to achievement of motor milestones is needed to help determine causality. Keywords Infant * Motor development * Obesity * Physical activity, Introduction The achievement of gross motor milestones in infancy is fairly universal, although age of attainment is influenced by both biology and the environment. Based on data from five countries, [...]

Published
2012
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140. Racial/ethnic differences in early-life risk factors for childhood obesity

Author

Taveras, Elsie M., Gillman, Matthew W., Kleinman, Ken, Rich-Edwards, Janet W., and Rifas-Shiman, Sheryl L.

Subjects
Company distribution practices, Obesity in children -- Risk factors, Obesity in children -- Demographic aspects, Obesity in children -- Distribution, Obesity in children -- Research, Race discrimination -- Research
Published
2010

141. Ambiente e obesidade no National Children's Study

Author

Trasande, Leonardo, Cronk, Chris, Durkin, Maureen, Weiss, Marianne, Schoeller, Dale, Gall, Elizabeth, Hewitt, Jeanne, Carrel, Aaron, Landrigan, Philip, and Gillman, Matthew

Published
2010

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