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1. Understanding income-related differences in distribution of child growth, behaviour and development using a cross-sectional sample of a clinical cohort study

Author

Michael Peer, Tara Kiran, Mary Beth Derocher, Margarita Lam-Antoniades, Peter Szatmari, Gerald Lebovic, Vincent Hildebrand, Arjumand Siddiqi, Peter Jüni, Christopher Allen, Julia Thompson, Charlie Guiang, Kevin Thorpe, Marty Perlmutar, Douglas Campbell, Andreas Laupacis, Curtis Handford, Suzanne Turner, Christine Koroshegyi, Jonathon L Maguire, Eric Duku, Caroline Reid-Westoby, Magdalena Janus, Catherine S. Birken, Jonathon L. Maguire, Ronald Cohn, Eddy Lau, Patricia C. Parkin, Michael Salter, Laura N. Anderson, Cornelia M. Borkhoff, Charles Keown-Stoneman, Christine Kowal, Dalah Mason, Murtala Abdurrahman, Kelly Anderson, Gordon Arbess, Jillian Baker, Tony Barozzino, Sylvie Bergeron, Dimple Bhagat, Gary Bloch, Joey Bonifacio, Ashna Bowry, Caroline Calpin, Sohail Cheema, Elaine Cheng, Brian Chisamore, Evelyn Constantin, Karoon Danayan, Paul Das, Anh Do, Kathleen Doukas, Anne Egger, Allison Farber, Amy Freedman, Sloane Freeman, Sharon Gazeley, Dan Ha, Laura Hanson, Lukasz Jagiello, Gwen Jansz, Paul Kadar, Florence Kim, Holly Knowles, Bruce Kwok, Sheila Lakhoo, Denis Leduc, Fok-Han Leung, Alan Li, Patricia Li, Jessica Malach, Roy Male, Vashti Mascoll, Aleks Meret, Maya Nader, Katherine Nash, Sharon Naymark, James Owen, Kifi Pena, Navindra Persaud, Andrew Pinto, Michelle Porepa, Vikky Qi, Danyaal Raza, Alana Rosenthal, Katherine Rouleau, Caroline Ruderman, Michael Sgro, Hafiz Shuja, Susan Shepherd, Barbara Smiltnieks, Stephen Treherne, Fatima Uddin, Meta van den Heuvel, Joanne Vaughan, Thea Weisdorf, Sheila Wijayasinghe, Peter Wong, John Yaremko, Ethel Ying, Elizabeth Young, Michael Zajdman, Farnaz Bazeghi, Vincent Bouchard, Marivic Bustos, Charmaine Camacho, Dharma Dalwadi, Tarandeep Malhi, Sharon Thadani, Laurie Thompson, Mary Aglipay, Imaan Bayoumi, Sarah Carsley, Katherine Cost, Karen Eny, Laura Kinlin, Jessica Omand, Shelley Vanderhout, Leigh Vanderloo, Bryan Boodhoo, Olivia Chan, David W.H. Dai, Judith Hall, Rita Kandel, Michelle Rodrigues, Hilde Vandenberghe, Patricia Raso, Amanda Offord, Faraz V Shahidi, Anne Fuller, Laura N Anderson, Catherine Birken, Charles D G Keown-Stoneman, Gurpreet Lakhanpal, Shannon Weir-Seeley, Sheila Jacobson LeahHarrington, Rosemary Moodie EliseMok, Noor Ramji NasreenRamji, Vanna Schiralli JanetSaunderson, Carolyn Taylor CinnthaSrikanthan, Pamela Ruth Flores, Mateenah Jaleel, Ataat Malick, Michelle Mitchell, Martin Ogwuru, Frank Ong, Rejina Rajendran, and Audra Stitt KarenPope

Subjects
Medicine
Published
2022
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2. Maternal ethnicity and iron status in early childhood in Toronto, Canada: a cross-sectional study

Author

Michael Peer, Tara Kiran, Noor Ramji, Mary Beth Derocher, Margarita Lam-Antoniades, Peter Szatmari, Gerald Lebovic, Peter Jüni, Colin Macarthur, Christopher Allen, Julia Thompson, Charlie Guiang, Kevin Thorpe, Marty Perlmutar, Douglas Campbell, Andreas Laupacis, Elise Mok, Curtis Handford, Suzanne Turner, Christine Koroshegyi, Catherine S. Birken, Jonathon L. Maguire, Ronald Cohn, Eddy Lau, Patricia C. Parkin, Michael Salter, Shannon Weir, Laura N. Anderson, Cornelia M. Borkhoff, Charles Keown-Stoneman, Christine Kowal, Dalah Mason, Murtala Abdurrahman, Kelly Anderson, Gordon Arbess, Jillian Baker, Tony Barozzino, Sylvie Bergeron, Dimple Bhagat, Gary Bloch, Joey Bonifacio, Ashna Bowry, Caroline Calpin, Sohail Cheema, Elaine Cheng, Brian Chisamore, Evelyn Constantin, Karoon Danayan, Paul Das, Anh Do, Kathleen Doukas, Anne Egger, Allison Farber, Amy Freedman, Sloane Freeman, Sharon Gazeley, Dan Ha, Laura Hanson, Leah Harrington, Sheila Jacobson, Lukasz Jagiello, Gwen Jansz, Paul Kadar, Florence Kim, Holly Knowles, Bruce Kwok, Sheila Lakhoo, Fok-Han Leung, Alan Li, Patricia Li, Jessica Malach, Roy Male, Vashti Mascoll, Aleks Meret, Rosemary Moodie, Maya Nader, Katherine Nash, Sharon Naymark, James Owen, Kifi Pena, Navindra Persaud, Andrew Pinto, Michelle Porepa, Vikky Qi, Nasreen Ramji, Danyaal Raza, Alana Rosenthal, Katherine Rouleau, Caroline Ruderman, Janet Saunderson, Vanna Schiralli, Michael Sgro, Hafiz Shuja, Susan Shepherd, Barbara Smiltnieks, Cinntha Srikanthan, Carolyn Taylor, Stephen Treherne, Fatima Uddin, Meta van den Heuvel, Joanne Vaughan, Thea Weisdorf, Sheila Wijayasinghe, Peter Wong, John Yaremko, Ethel Ying, Elizabeth Young, Michael Zajdman, Farnaz Bazeghi, Vincent Bouchard, Marivic Bustos, Charmaine Camacho, Dharma Dalwadi, Tarandeep Malhi, Sharon Thadani, Laurie Thompson, Mary Aglipay, Imaan Bayoumi, Sarah Carsley, Katherine Cost, Karen Eny, Theresa Kim, Laura Kinlin, Jessica Omand, Shelley Vanderhout, Leigh Vanderloo, Bryan Boodhoo, Olivia Chan, David W.H. Dai, Judith Hall, Karen Pope, Rita Kandel, Michelle Rodrigues, Hilde Vandenberghe, Gita Wahi, Vinusha Gunaseelan, and Denis Leuc

Subjects
Pediatrics, RJ1-570
Abstract

Objectives This study aimed to evaluate the association between maternal ethnicity and iron deficiency (ID) in early childhood, and to evaluate whether infant feeding practices linked to ID differ between maternal ethnic groups.Methods This was a cross-sectional study of healthy children 1–3 years of age. Adjusted multivariable logistic regression analyses were used to evaluate the association between maternal ethnicity and ID (serum ferritin 2 cups; meat consumption).Results Of 1851 children included, 12.2% had ID. Compared with the European referent group, we found higher odds of ID among children of South Asian and West Asian/North African maternal ethnicities, and lower odds of ID among children of East Asian maternal ethnicity. Statistically significant covariates associated with higher odds of ID included longer breastfeeding duration and daily cow’s milk intake >2 cups. Current infant formula use was associated with lower odds of ID. Children of South Asian maternal ethnicity had higher odds of bottle use beyond 15 months of age and lower odds of meat consumption.Conclusions We found increased odds of ID among children of South Asian and West Asian/Northern African maternal ethnicities. We found a higher odds of feeding practices linked to ID in children of South Asian maternal ethnicity, but not in children of West Asian/North African maternal ethnicity. Culturally tailored approaches to providing guidance to parents on healthy infant feeding practices may be important to prevent ID in early childhood.Trial registration number NCT01869530.

Published
2020
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3. Timing of Introduction to Solid Food, Growth, and Nutrition Risk in Later Childhood

Author

Eddy Lau, Vashti Mascoll, Dalah Mason, Elaine Cheng, Anne Egger, Danyaal Raza, Evelyn Constantin, Mary Beth Derocher, Michael Salter, Elizabeth H. Young, Paul Das, Dharma Dalwadi, Charlie Guiang, Jillian M. Baker, Ronald D. Cohn, Kathleen Doukas, Patricia C. Parkin, Tony Barozzino, Gordon Arbess, Jessica Malach, Tarandeep Malhi, Karen M. Eny, Michelle Rodrigues, Tara Kiran, Karen Pope, Fok-Han Leung, Noor Ramji, Ashna Bowry, Elise Mok, Brian Chisamore, Shelley M Vanderhout, Kelly E. Anderson, Sarah Carsley, M Peer, Kevin E. Thorpe, Vikky Qi, Sohail Cheema, Laurie Thompson, Roy Male, Rosemary G Moodie, Hafiz Shuja, Sheila Lakhoo, Ethel Ying, Sheila Jacobson, Laura N. Anderson, Sharon Thadani, Susan Shepherd, Caroline Calpin, Christine Kowal, Murtala Abdurrahman, Gerald Lebovic, Maya Nader, Douglas M Campbell, Charles D G Keown-Stoneman, Andrew Pinto, Holly Knowles, Shannon Weir, Marivic Bustos, Hilde Vandenberghe, Joanne Vaughan, Sylvie Bergeron, James Owen, Sheila Wijayasinghe, Alan Li, Paul Kadar, Leigh M. Vanderloo, Carolyn Taylor, Patricia Li, Meta van den Heuvel, Charmaine Camacho, Peter Szatmari, Alana Rosenthal, Jonathon L Maguire, Navindra Persaud, Suzanne Turner, Allison Farber, Caroline Ruderman, Katherine Rouleau, Fatima Uddin, Dan Ha, Laura Hanson, Florence Kim, Julia Thompson, David Dai, Andreas Laupacis, Dimple Bhagat, Christine Koroshegyi, Michelle Porepa, Imaan Bayoumi, Michael Zajdman, Peter Jüni, Gary Bloch, Rita Kandel, Curtis J. D'Hollander, John Yaremko, Joey Bonifacio, Catherine S Birken, Michael Sgro, Gwen Jansz, Anh Do, Bruce Kwok, Kifi Pena, Lukasz Jagiello, Barbara Smiltnieks, Christopher Allen, Nasreen Ramji, Curtis Handford, Deborah L O'Connor, Peter D Wong, Stephen Treherne, Jessica A Omand, Cornelia M. Borkhoff, Margarita Lam-Antoniades, Amy Freedman, Marty Perlmutar, Leah Harrington, Laura Kinlin, Judith Hall, Katherine Tombeau Cost, Mary Aglipay, Cinntha Srikanthan, Sharon Gazeley, Aleks Meret, Theresa H. M. Kim, Karoon Danayan, Bryan Boodhoo, Sloane Freeman, Thea Weisdorf, Katherine Nash, Farnaz Bazeghi, Sharon Naymark, Denis Leduc, Vincent Bouchard, Vanna Schiralli, Olivia Chan, and Janet Saunderson

Subjects
Male, Pediatric Obesity, Standard score, Overweight, Sampling Studies, Odds, Body Mass Index, Cohort Studies, Child Development, Medicine, Humans, Longitudinal Studies, Child, business.industry, Age Factors, Infant, Feeding Behavior, medicine.disease, Obesity, Body Height, Nutrition risk, Solid food, Child, Preschool, Pediatrics, Perinatology and Child Health, Female, Infant Food, medicine.symptom, business, Edible Grain, Body mass index, Demography, Cohort study
Abstract

Objective To evaluate the relationship between the timing of infant cereal introduction between 4 and 6 months of age and growth and dietary intake in later childhood. Study design A longitudinal cohort study was conducted among healthy children 0-10 years of age participating in The Applied Research Group for Kids cohort study between June 2008 and August 2019 in Toronto, Canada. Results Of 8943 children included, the mean (SD) age of infant cereal introduction was 5.7 (2.1) months. In the primary analysis, children who were introduced to infant cereal at 4 vs 6 months had 0.17 greater body mass index z score (95% CI 0.06-0.28; P = .002) and greater odds of obesity (OR 1.82; 95% CI 1.18-2.80; P = .006) at 10 years of age. In the secondary analysis, children who were introduced to infant cereal at 4 vs 6 months had 0.09 greater height-for-age z score (95% CI 0.04-0.15; P = .002) at 1 year of age, an association that was not observed at 5 or 10 years of age. Children who were introduced to infant cereal at 4 vs 6 months had greater nutrition risk which was primarily determined by a less-favorable eating behavior score at 18 months to 5 years of age (0.18 units higher; 95% CI 0.07-0.29; P = .001). Conclusions Introduction of infant cereal at 4 vs 6 months was associated with greater body mass index z score, greater odds of obesity, similar height-for-age z score, and less favorable eating behavior. These findings support recommendations for introducing solid food around 6 months of age.

Published
2021

4. Temperament Is Associated With Outdoor Free Play in Young Children: A TARGet Kids! Study

Author

Julia R. Sharp, Jonathon L. Maguire, Sarah Carsley, Kawsari Abdullah, Yang Chen, Eliana M. Perrin, Patricia C. Parkin, Catherine S. Birken, Eddy Lau, Andreas Laupacis, Michael Salter, Peter Szatmari, Shannon Weir, Mary Aglipay, Yamna Ali, Laura N. Anderson, Imaan Bayoumi, Cornelia M. Borkhoff, Shiyi Chen, David W.H. Dai, Denise Darmawikarta, Cindy-Lee Dennis, Karen Eny, Stephanie Erdle, Kayla Furlong, Kanthi Kavikondala, Christine Koroshegyi, Christine Kowal, Grace Jieun Lee, Dalah Mason, Jessica Omand, Navindra Persaud, Lesley Plumptre, Meta van den Heuvel, Shelley Vanderhout, Peter Wong, Weeda Zabih, Murtala Abdurrahman, Barbara Anderson, Kelly Anderson, Gordon Arbess, Jillian Baker, Tony Barozzino, Sylvie Bergeron, Dimple Bhagat, Nicholas Blanchette, Gary Bloch, Joey Bonifacio, Ashna Bowry, Anne Brown, Jennifer Bugera, Caroline Calpin, Douglas Campbell, Sohail Cheema, Elaine Cheng, Brian Chisamore, Evelyn Constantin, Erin Culbert, Karoon Danayan, Paul Das, Mary Beth Derocher, Anh Do, Michael Dorey, Kathleen Doukas, Anne Egger, Allison Farber, Amy Freedman, Sloane Freeman, Keewai Fung, Sharon Gazeley, Donna Goldenberg, Charlie Guiang, Dan Ha, Shuja Hafiz, Curtis Handford, Laura Hanson, Leah Harrington, Hailey Hatch, Teresa Hughes, Sheila Jacobson, Lukasz Jagiello, Gwen Jansz, Paul Kadar, Tara Kiran, Lauren Kitney, Holly Knowles, Bruce Kwok, Sheila Lakhoo, Margarita Lam-Antoniades, Fok-Han Leung, Alan Li, Patricia Li, Jennifer Loo, Joanne Louis, Sarah Mahmoud, Roy Male, Vashti Mascoll, Rosemary Moodie, Julia Morinis, Maya Nader, Sharon Naymark, Patricia Neelands, James Owen, Jane Parry, Michael Peer, Kifi Pena, Marty Perlmutar, Andrew Pinto, Tracy Pitt, Michelle Porepa, Vikky Qi, Nasreen Ramji, Noor Ramji, Jesleen Rana, Alana Rosenthal, Katherine Rouleau, Janet Saunderson, Rahul Saxena, Vanna Schiralli, Michael Sgro, Susan Shepherd, Barbara Smiltnieks, Cinntha Srikanthan, Carolyn Taylor, Suzanne Turner, Fatima Uddin, Joanne Vaughan, Thea Weisdorf, Sheila Wijayasinghe, Anne Wormsbecker, Ethel Ying, Elizabeth Young, Michael Zajdman, Marivic Bustos, Charmaine Camacho, Dharma Dalwadi, Thivia Jegathesan, Tarandeep Malhi, Sharon Thadani, Julia Thompson, Laurie Thompson, Christopher Allen, Bryan Boodhoo, Judith Hall, Peter Juni, Gerald Lebovic, Karen Pope, Jodi Shim, Kevin Thorpe, and Azar Azad

Subjects
Male, Surgency, media_common.quotation_subject, Psychological intervention, Negative affectivity, Developmental psychology, 03 medical and health sciences, Sex Factors, 0302 clinical medicine, Risk Factors, 030225 pediatrics, medicine, Humans, Obesity, 030212 general & internal medicine, Temperament, Association (psychology), Exercise, media_common, Extraversion and introversion, Confounding, Infant, medicine.disease, Play and Playthings, Child, Preschool, Multivariate Analysis, Pediatrics, Perinatology and Child Health, Linear Models, Female, Sedentary Behavior, Psychology, Clinical psychology
Abstract

Objective Outdoor free play is important for preschoolers' physical activity, health, and development. Certain temperamental characteristics are associated with obesity, nutrition, and sedentary behaviors in preschoolers, but the relationship between temperament and outdoor play has not been examined. This study examined whether there is an association between temperament and outdoor play in young children. Methods Healthy children aged 1 to 5 years recruited to The Applied Research Group for Kids (TARGet Kids!), a community-based primary care research network, from July 2008 to September 2013 were included. Parent-reported child temperament was assessed using the Childhood Behavior Questionnaire. Outdoor free play and other potential confounding variables were assessed through validated questionnaires. Multivariable linear regression was used to determine the association between temperament and outdoor play, adjusted for potential confounders. Results There were 3393 children with data on outdoor play. The association between negative affectivity and outdoor play was moderated by sex; in boys, for every 1-point increase in negative affectivity score, mean outdoor play decreased by 4.7 minutes per day. There was no significant association in girls. Surgency was associated with outdoor play; for every 1-point increase in surgency/extraversion, outdoor play increased by 4.6 minutes per day. Conclusions Young children's temperamental characteristics were associated with their participation in outdoor free play. Consideration of temperament could enhance interventions and strategies to increase outdoor play in young children. Longitudinal studies are needed to elucidate the relationship between children's early temperament and physical activity.

Published
2018

5. A Positive Association Between Dietary Intake of Higher Cow's Milk-Fat Percentage and Non-High-Density Lipoprotein Cholesterol in Young Children

Author

Vincent C.H. Wong, Jonathon L. Maguire, Jessica A. Omand, David W.H. Dai, Gerald Lebovic, Patricia C. Parkin, Deborah L. O'Connor, Catherine S. Birken, Ronald Cohn, Eddy Lau, Andreas Laupacis, Michael Salter, Peter Szatmari, Shannon Weir, Laura N. Anderson, Cornelia M. Borkhoff, Charles Keown-Stoneman, Christine Kowal, Dalah Mason, Murtala Abdurrahman, Kelly Anderson, Gordon Arbess, Jillian Baker, Tony Barozzino, Sylvie Bergeron, Dimple Bhagat, Gary Bloch, Joey Bonifacio, Ashna Bowry, Caroline Calpin, Douglas Campbell, Sohail Cheema, Elaine Cheng, Brian Chisamore, Evelyn Constantin, Karoon Danayan, Paul Das, Mary Beth Derocher, Anh Do, Kathleen Doukas, Anne Egger, Allison Farber, Amy Freedman, Sloane Freeman, Sharon Gazeley, Charlie Guiang, Dan Ha, Curtis Handford, Laura Hanson, Leah Harrington, Sheila Jacobson, Lukasz Jagiello, Gwen Jansz, Paul Kadar, Florence Kim, Tara Kiran, Holly Knowles, Bruce Kwok, Sheila Lakhoo, Margarita Lam-Antoniades, Denis Leduc, Fok-Han Leung, Alan Li, Patricia Li, Jessica Malach, Roy Male, Vashti Mascoll, Aleks Meret, Elise Mok, Rosemary Moodie, Maya Nader, Katherine Nash, Sharon Naymark, James Owen, Michael Peer, Kifi Pena, Marty Perlmutar, Navindra Persaud, Andrew Pinto, Michelle Porepa, Vikky Qi, Nasreen Ramji, Noor Ramji, Danyaal Raza, Alana Rosenthal, Katherine Rouleau, Caroline Ruderman, Janet Saunderson, Vanna Schiralli, Michael Sgro, Hafiz Shuja, Susan Shepherd, Barbara Smiltnieks, Cinntha Srikanthan, Carolyn Taylor, Stephen Treherne, Suzanne Turner, Fatima Uddin, Meta van den Heuvel, Joanne Vaughan, Thea Weisdorf, Sheila Wijayasinghe, Peter Wong, John Yaremko, Ethel Ying, Elizabeth Young, Michael Zajdman, Farnaz Bazeghi, Vincent Bouchard, Marivic Bustos, Charmaine Camacho, Dharma Dalwadi, Christine Koroshegyi, Tarandeep Malhi, Sharon Thadani, Julia Thompson, Laurie Thompson, Mary Aglipay, Imaan Bayoumi, Sarah Carsley, Katherine Cost, Karen Eny, Theresa Kim, Laura Kinlin, Jessica Omand, Shelley Vanderhout, Leigh Vanderloo, Christopher Allen, Bryan Boodhoo, Olivia Chan, Judith Hall, Peter Juni, Karen Pope, Kevin Thorpe, Rita Kandel, Michelle Rodrigues, and Hilde Vandenberghe

Subjects
Male, Longitudinal study, Canada, Lipoproteins, Breastfeeding, Physiology, Standard score, Cardiovascular System, Body Mass Index, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Risk Factors, 030225 pediatrics, Medicine, Animals, Humans, 030212 general & internal medicine, Longitudinal Studies, Child, Generalized estimating equation, 2. Zero hunger, Primary Health Care, Cholesterol, business.industry, Data Collection, food and beverages, Dietary Fats, 3. Good health, Breast Feeding, Milk, Treatment Outcome, chemistry, Cardiovascular Diseases, Child, Preschool, Pediatrics, Perinatology and Child Health, lipids (amino acids, peptides, and proteins), Cattle, Female, business, Body mass index, Breast feeding, Lipoprotein
Abstract

To determine the association between cow's milk-fat and non-high-density lipoprotein (non-HDL) cholesterol, a marker of cardiovascular disease (CVD) risk in young children, and whether this association is mediated by the typical volume of cow's milk consumed.A longitudinal study in 2- to 8-year-old children (n = 2890) was conducted through The Applied Research Group for Kids (TARGet Kids!), a practice-based research network in Toronto, Canada. Generalized estimating equations were used to examine the relationship between parent-reported cow's milk-fat percentage intake and serum non-HDL cholesterol concentrations as well as having high non-HDL cholesterol (≥3.75 mmol/L [145 mg/dL]), adjusting for covariates including age, sex, body mass index z score, breastfeeding duration, mother's ethnicity, and parental history of CVD. Bootstrap resampling (10 000 repetitions) was used to assess whether typical volume consumed mediated the association between cow's milk-fat percentage and non-HDL cholesterol.In total, 156 (5.4%) had high non-HDL cholesterol. Each percent increase in cow's milk-fat was associated with a 0.035 mmol/L (1.35 mg/dL) (P .001) and 0.024 mmol/L (0.92 mg/dL) (P = .01) increase in non-HDL cholesterol, unadjusted and adjusted for covariates respectively. Cow's milk-fat percentage was not associated with greater odds of having high non-HDL cholesterol. Volume of cow's milk partially mediated the association between cow's milk-fat percentage and non-HDL cholesterol, accounting for 28% of the relationship (P .001).Consumption of higher-fat cow's milk was associated with a small increase in non-HDL cholesterol but not greater odds of having high non-HDL cholesterol. Further research is needed to assess this relationship with other CVD risk factors in young children.ClinicalTrials.gov: NCT01869530.

Published
2018

6. Higher Body Mass Index Is Associated with Iron Deficiency in Children 1 to 3 Years of Age

Author

Patricia Li, Dalah Mason, Amy Freedman, Marty Perlmutar, Leah Harrington, John Yaremko, Suzanne Turner, Ellen Culbert, Hailey Hatch, Sheila Jacobson, Jessica Malach, Michael Peer, Carolyn Taylor, Susan Shepherd, Roy Male, Barbara Smiltnieks, Colin Macarthur, Hafiz Shuja, Jane Parry, Fatima Uddin, James Owen, Laura Hanson, Thea Weisdorf, Murtala Abdurrahman, Marivic Bustos, Noor Ramji, Teresa Hughes, Mona Jasuja, Aleks Meret, Sloane Freeman, Joanne Louis, Kelly E. Anderson, Anne Wormsbecker, Rosemary G Moodie, Douglas M Campbell, Karoon Danayan, Charmaine Camacho, Ethel Ying, Gwen Jansz, Cornelia M. Borkhoff, Mary Beth Derocher, Elizabeth H. Young, Laura N. Anderson, Katherine Rouleau, Tara Kiran, Caroline Calpin, Nicholas Blanchette, Jennifer Loo, Andrew Pinto, Kifi Pena, Lukasz Jagiello, Elise Mok, Joanne Vaughan, Anne Egger, Gary Bloch, Stephen Treherne, Meta van den Heuvel, Sheila Wijayasinghe, Julia Morinis, Dharma Dalwadi, Dan Ha, Alana Rosenthal, Holly Knowles, Jillian M. Baker, Alan Li, Michael Sgro, Anh Do, Janet Saunderson, Evelyn Constantin, Michelle Porepa, Cinntha Srikanthan, Rahul Saxena, Ashna Bowry, Elaine Cheng, Paul Das, David Dai, Sarah Carsley, Fok-Han Leung, Imaan Bayoumi, Gordon Arbess, Nasreen Ramji, Vashti Mascoll, Anne M. Brown, Vikky Qi, Laurie Thompson, Michael Zajdman, Sheila Lakhoo, Jonathon L Maguire, Maya Nader, Jennifer Bugera, Sharon Gazeley, Sharon Thadani, Christine Koroshegyi, Allison Farber, Sarah Mahmoud, Paul Kadar, Julia Thompson, Danyaal Raza, Margarita Lam-Antoniades, Christine Kowal, Tony Barozzino, Joey Bonifacio, Denis Leduc, Peter D Wong, Vincent Bouchard, Vanna Schiralli, Barbara J. Anderson, Jesleen Rana, Katherine Nash, Farnaz Bazeghi, Curtis Handford, Sharon Naymark, Charlie Guiang, Patricia C. Parkin, Kathleen Doukas, Sohail Cheema, Tarandeep Malhi, Charles Keown-Stoneman, Michael Dorey, Emma E. Sypes, Brian Chisamore, Mary Aglipay, Sylvie Bergeron, Dimple Bhagat, Catherine S Birken, Bruce Kwok, Navindra Persaud, and Eddy Lau

Subjects
Male, Canada, medicine.medical_specialty, National Health and Nutrition Examination Survey, Iron, Systemic inflammation, Risk Assessment, Gastroenterology, Body Mass Index, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, 030225 pediatrics, Internal medicine, Humans, Medicine, 030212 general & internal medicine, Risk factor, Serum ferritin, Retrospective Studies, Bmi z score, Inflammation, 2. Zero hunger, Anemia, Iron-Deficiency, biology, business.industry, Incidence, C-reactive protein, Age Factors, Infant, Iron deficiency, medicine.disease, 3. Good health, C-Reactive Protein, Cross-Sectional Studies, Child, Preschool, Ferritins, Pediatrics, Perinatology and Child Health, Disease Progression, biology.protein, Female, medicine.symptom, business, Body mass index, Biomarkers, Follow-Up Studies
Abstract

To examine the association between body mass index (BMI) and iron deficiency in early childhood, while considering the influence of low-grade systemic inflammation.Healthy children ages 1-3 years were included in a cross-sectional analysis. Age- and sex-standardized World Health Organization BMI z score (zBMI) was calculated using height/length and weight measurements; iron status was assessed by serum ferritin; inflammation was assessed by C-reactive protein (CRP). Children with CRP ≥10 mg/L were excluded because this may indicate acute systemic inflammation. Adjusted multivariable regression analyses were used to investigate the association between zBMI and both serum ferritin (µg/L), and iron deficiency (serum ferritin12 µg/L). We performed prespecified subgroup analyses according to CRP level (normal [≤1.0 mg/L] and low-grade inflammation [1.0 mg/L to10.0 mg/L]).Of 1607 children included, 20% were categorized as with zBMI1, 13% had iron deficiency, and 18% had low-grade inflammation. Higher zBMI was associated with lower serum ferritin (-1.51 µg/L, 95% CI -2.23, -0.76, P .0001) and increased odds of iron deficiency (OR 1.28, 95% CI 1.10, 1.50, P = .002). Though there was no interaction between zBMI and CRP for the adjusted linear regression model (P = .79) or logistic regression model (P = .43), children with low-grade inflammation had a higher serum ferritin (P .0001).Higher zBMI is associated with increased risk for iron deficiency in children between 1 and 3 years, and should be considered as a risk factor in targeted screening. Further research is needed to better understand the relationship between serum ferritin and CRP for children in all weight categories.ClinicalTrials.gov: NCT01869530.

Published
2019

7. The Association of Breastfeeding Duration and Early Childhood Cardiometabolic Risk

Author

Peter D. Wong, Laura N. Anderson, David D.W. Dai, Patricia C. Parkin, Jonathan L. Maguire, Catherine S. Birken, Eddy Lau, Andreas Laupacis, Michael Salter, Peter Szatmari, Shannon Weir, Charmaine Camacho, Arthana Chandraraj, Dharma Dalwadi, Ayesha Islam, Thivia Jegathesan, Tarandeep Malhi, Megan Smith, Laurie Thompson, Christopher Allen, Bryan Boodhoo, Judith Hall, Peter Juni, Gerald Lebovic, Karen Pope, Jodi Shim, Kevin Thorpe, Azar Azad, Kawsari Abdullah, Yamna Ali, Imaan Bayoumi, Cornelia M. Borkhoff, Sarah Carsley, Shiyi Chen, Yang Chen, Denise Darmawikarta, Cindy-Lee Dennis, Karen Eny, Stephanie Erdle, Kayla Furlong, Kanthi Kavikondala, Christine Koroshegyi, Christine Kowal, Grace Jieun Lee, Dalah Mason, Jessica Omand, Navindra Persaud, Lesley Plumptre, Meta van den Heuvel, Shelley Vanderhout, Weeda Zabih, Murtala Abdurrahman, Barbara Anderson, Kelly Anderson, Gordon Arbess, Jillian Baker, Tony Barozzino, Sylvie Bergeron, Dimple Bhagat, Nicholas Blanchette, Gary Bloch, Joey Bonifacio, Ashna Bowry, Anne Brown, Jennifer Bugera, Douglas Campbell, Sohail Cheema, Elaine Cheng, Brian Chisamore, Ellen Culbert, Karoon Danayan, Paul Das, Mary Beth Derocher, Anh Do, Michael Dorey, Kathleen Doukas, Anne Egger, Allison Farber, Amy Freedman, Sloane Freeman, Keewai Fung, Sharon Gazeley, Charlie Guiang, Dan Ha, Curtis Handford, Laura Hanson, Hailey Hatch, Teresa Hughes, Sheila Jacobson, Lukasz Jagiello, Gwen Jansz, Paul Kadar, Tara Kiran, Lauren Kitney, Holly Knowles, Bruce Kwok, Sheila Lakhoo, Margarita Lam-Antoniades, Fok-Han Leung, Alan Li, Jennifer Loo, Joanne Louis, Sarah Mahmoud, Roy Male, Vashti Mascoll, Rosemary Moodie, Julia Morinis, Maya Nader, Sharon Naymark, Patricia Neelands, James Owen, Jane Parry, Michael Peer, Kifi Pena, Marty Perlmutar, Andrew Pinto, Tracy Pitt, Michelle Porepa, Vikky Qi, Nasreen Ramji, Noor Ramji, Jesleen Rana, Alana Rosenthal, Katherine Rouleau, Janet Saunderson, Rahul Saxena, Vanna Schiralli, Michael Sgro, Hafiz Shuja, Susan Shepherd, Barbara Smiltnieks, Cinntha Srikanthan, Carolyn Taylor, Suzanne Turner, Fatima Uddin, Joanne Vaughan, Thea Weisdorf, Sheila Wijayasinghe, Anne Wormsbecker, Ethel Ying, Elizabeth Young, Michael Zajdman, and Ian Zenlea

Subjects
Male, Pediatrics, medicine.medical_specialty, Time Factors, Waist, Heart disease, Cross-sectional study, Breastfeeding, 030209 endocrinology & metabolism, Standard score, 03 medical and health sciences, 0302 clinical medicine, Metabolic Diseases, Risk Factors, 030225 pediatrics, Humans, Medicine, Early childhood, Child, business.industry, Age Factors, Infant, Newborn, Infant, Protective Factors, medicine.disease, Breast Feeding, Cross-Sectional Studies, Blood pressure, Cardiovascular Diseases, Child, Preschool, Pediatrics, Perinatology and Child Health, Linear Models, Female, business, Breast feeding
Abstract

Objective To evaluate the association between breastfeeding duration and early childhood cardiometabolic risk. Study design A cross-sectional study of 1539 healthy children, 3-6 years of age, recruited through The Applied Research Group for Kids! practice-based research network between October 2009 and August 2015. Adjusted multivariable linear regression was used to examine the association between breastfeeding duration and cardiometabolic risk z score and individual cardiometabolic risk factors of waist circumference, systolic blood pressure, glucose, high-density lipoprotein cholesterol, and triglycerides. Results The mean breastfeeding duration was 12.5 months (SD = 8.4). Breastfeeding duration was associated with lower cardiometabolic risk z score (beta = −0.03; 95% CI −0.05, −0.01). In analysis of cardiometabolic risk factors, each additional 3 months of breastfeeding was associated with a 0.13 cm (95% CI −0.20, −0.05) lower waist circumference and 0.16 mm Hg (95% CI −0.30, −0.02) lower systolic blood pressure. Compared with children who breastfed for 6-12 months, those who breastfed for 12-24 months had a lower systolic blood pressure of 1.07 mm Hg (95% CI −2.04, −0.10). There was no association between breastfeeding duration and cardiometabolic risk for those who breastfed beyond 24 months. Conclusions Breastfeeding duration is associated with lower cardiometabolic risk, although the magnitude of association is small. Causation cannot be inferred. Breastfeeding beyond 24 months may not have an added benefit for cardiometabolic health.

Published
2018

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