BACKGROUND:Evidence suggests that pre-conceptional paternal factors, including BMI and diet, may influence offspring development. OBJECTIVES:We examined the associations between paternal BMI, dietary protein intake, glycemic index (GI), smoking and alcohol consumption and offspring development during the first 5 years of life. METHODS:This secondary analysis of an RCT included 162 father-child pairs from pregnancies among women with pre-pregnancy overweight or obesity. Paternal characteristics were reported at gestational week 15, reflecting the preceding 3 months. Offspring anthropometry was measured at birth, 6 and 18 months, 3 and 5 years. Associations were examined using linear mixed models and linear regression models. RESULTS:No consistent associations were found between paternal characteristics and offspring outcomes from birth to 3 years. At age 5, higher paternal BMI was associated with higher offspring BMI z-score (β = 0.07 (CI: 0.03; 0.10)), fat mass index (β = 0.07 kg/m2 (CI: 0.02; 0.12)) and fat-free mass index (β = 0.05 kg/m2 (CI: 0.01; 0.08)). Lower paternal protein intake was associated with higher offspring BMI z-score (β = 0.54 (CI: 0.07; 1.01)) and fat-free mass index (β = 0.60 kg/m2 (CI: 0.13; 1.07)), while moderately higher protein intake was associated with higher waist-to-height ratio (β = 0.03 (CI: 3.00 × 10-3; 0.05)). Higher paternal GI was associated with lower offspring BMI z-score (β = -0.04 (CI: -0.08; -2.14-10-3)) at age 5. Smoking and alcohol were not associated with offspring outcomes. CONCLUSION:Paternal BMI was associated with offspring outcomes at age 5 years, while findings for paternal dietary factors were less consistent.
BACKGROUND:The early vascular impact of metabolic dysfunction-associated steatotic liver disease (MASLD) remains unclear. This study examined associations of steatosis in childhood and young adulthood with cardiovascular risk in adulthood. METHODS:Children with severe obesity were investigated for MASLD and cardiovascular risk, with 10-year follow-up. Hepatic steatosis was measured using proton magnetic resonance spectroscopy and cardiovascular risk by ultrasound carotid intima-media thickness (cIMT). Participants were categorised into four trajectory groups based on presence of steatosis in childhood and/or adulthood: 'absent', 'diminishing', 'adult-onset' and 'persistent'. Associations between steatosis (presence and change over time) and cIMT, and between childhood metabolic factors and cIMT progression, were evaluated. RESULTS:Of 52 participants, 46% had steatosis in childhood ('diminishing' or 'persistent'), and 46% in adulthood ('adult-onset' or 'persistent'). Childhood steatosis was not associated with cIMT in adulthood, whereas adulthood steatosis was independently associated with increased cIMT (mean difference 0.035 mm, 95% CI: 0.010-0.060 mm; p-adjusted = 0.008). Mean cIMT at follow-up increased progressively across steatosis trajectory groups; (adjusted p-for-trend = 0.003). Childhood steatosis was the only metabolic factor associated with cIMT progression (β = 0.006, p = 0.030). CONCLUSIONS:Hepatic steatosis in young adulthood is independently associated with increased cardiovascular risk, and childhood steatosis relates to cIMT progression, supporting early MASLD detection and prevention.
Large variability exists in outcome following Family-based treatment (FBT) for severe obesity in youth. In the present study, we aimed to expand our understanding of how mental health impacts FBT outcomes. In total, 90 participants (58.9% girls) 5.9-18.6 years (mean ± SD: 13.2 ± 3.1) were enrolled in a 17-session FBT-programme. Baseline mean percentage above the IOTF threshold for overweight (%IOTF25) was 146 ± 13, and Body Mass Index standard deviation score (BMIz) was 3.02 ± 0.52. Mental health predictors were assessed using the Self-Perception Profile for Children and the Child Behaviour Checklist. A multivariate multilevel Bayesian linear mixed-effects model with repeated measures was utilized to estimate the effects of mental health predictors on BMI outcomes. Average change in BMI during FBT was -3.80 (%IOTF25) and -0.08 (BMIz) units. Higher scores of Attention Deficit/Hyperactivity (ADH) Problems were associated with a smaller reduction in BMI (0.31 units for %IOTF25 (p = 0.02), 0.01 units for BMIz (p = 0.03) for each one-unit T-score increase on the ADH problem scale). Self-Worth, Emotional Dysregulation, Internalizing- and Externalizing problems were not associated with differences in BMI outcomes. Identifying children with higher ADH problems and incorporating additional family support strategies within FBT should be a focus for further treatment development.
BACKGROUND:Ultra-processed foods (UPFs) are linked to obesity and cognitive decline, but evidence on their association with executive function (EF) in children is limited. OBJECTIVE:To evaluate the UPFs-EF relationship in parent-child dyads with obesity seeking treatment. METHODS:Secondary analysis of the FRESH trial (NCT01197443) conducted at the University of California, San Diego. A total of 141 Parent-child dyads; parent age = 43 years (6.6), BMI = 32 (6.4); child age = 9.9 years (1.3), BMIz = 2.0 (0.3); 31% Hispanic, 44% White, 25% other completed anthropometric, digit span backward (DSB), stop signal task (SST) and Wisconsin Card Sorting Test (WCST), and dietary assessments. Linear regression models evaluated UPFs-EF associations, controlling for covariates. RESULTS:Parent-child associations were observed for energy β = 0.15, p = 0.024; total UPFs β = 0.20, p = 0.018; savoury snacks β = 0.28, p = 0.018; ultra-processed (UP) meat, β = 0.60, p < 0.001; and sweetened beverages β = 0.24, p = 0.023. Most UPFs-EF associations were null. In children, UP meat predicted lower DSB scores (β = -0.104, 95% CI [-0.197, -0.013], p = 0.013), and in parents, sweetened beverages predicted failed SST (β = 0.606, 95% CI [0.018, 1.210], p = 0.044). CONCLUSIONS:There were a few associations between UPFs intake and EF; however, most were nonsignificant. Future research should involve community samples and children across the weight spectrum.
BACKGROUND:Whether breastfeeding intensity, the relative amount of breastfeeding versus formula across the first year, relates to growth trajectories among infants exposed to gestational diabetes (GDM) in utero is unknown. OBJECTIVE:To identify growth trajectory patterns and associations with breastfeeding intensity among infants exposed to GDM. METHODS:SWIFT Offspring cohort (2009-2011) singleton, GDM-exposed infants (n = 435) born at a Kaiser Permanente Northern California hospital. Monthly summed lactation intensity ratio (sumLIR, proportion of breastfeeding versus overall feeds over 7 days). Latent class mixed models for weight-for-age (WAZ), length-for-age (LAZ), and weight-for-length (WLZ) z-scores, and skinfold thicknesses (triceps, subscapular, and sum of skinfolds). Multinomial logistic regression related sumLIR to growth trajectories. RESULTS:A higher sumLIR throughout the first year was associated with lower odds of class membership in trajectories with accelerated growth patterns for WLZ from early infancy (1-mo OR: 0.11, 95% CI 0.02, 0.54) to 1 year (12-mo OR: 0.84, 95% CI 0.75, 0.95), as well as a lower likelihood of having accelerated WAZ growth after 6-months (12-mo OR: 0.91, 95% CI 0.84, 0.98), but not skinfold trajectory classes. CONCLUSIONS:Higher sumLIR was associated with more favourable growth trajectories, suggesting that continued breastfeeding, even when combined with infant formula, may benefit growth among GDM-exposed infants.
