Clustering and correlates of multiple health behaviours in 9-10 year old children.

BACKGROUND: Sleep, physical activity, screen time and dietary behaviours influence health during childhood, but few studies have looked at all of these behaviours simultaneously and previous research has relied predominantly on self- or proxy-reports of physical activity and food frequency questionnaires for the assessment of diet. PURPOSE: To assess the prevalence and clustering of health behaviours and examine the socio-demographic characteristics of children that fail to meet multiple health behaviour guidelines. METHODS: Data are from the Sport, Physical activity and Eating behaviour: Environmental Determinants in Young people (SPEEDY) study. Participants (n = 1472, 42.9% male) were dichotomized based on whether or not they met public health guidelines for accelerometer-assessed physical activity, diet-diary assessed fruit/vegetable intake and fat/non-milk extrinsic sugar (NMES) intake, and self-reported screen time and sleep duration. Behavioural clustering was assessed using an observed over expected ratio (O/E). Socio-demographic characteristics of participants that failed to meet multiple health behaviour guidelines were examined using ordinal logistic regression. Data were analysed in 2013. RESULTS: 83.3% of children failed to meet guidelines for two or more health behaviours. The O/E ratio for two behavioural combinations significantly exceeded 1, both of which featured high screen time, insufficient fruit/vegetable consumption and excessive fat/NMES intake. Children who were older (Proportional odds ratio (95% confidence interval): 1.69 (1.21,2.37)) and those that attended a school with a physical activity or diet-related policy (1.28 (1.01,1.62)) were more likely to have a poor health behaviour profile. Girls (0.80 (0.64,0.99)), participants with siblings (0.76 (0.61,0.94)) and those with more highly educated parents (0.73 (0.56,0.94)) were less likely to have a poor health behaviour profile. CONCLUSIONS: A substantial proportion of children failed to meet guidelines for multiple health behaviours and there was evidence of clustering of screen viewing and unhealthy dietary behaviours. Sub-groups at greatest risk may be targeted for intervention.This is the final published version, which can also be found online at: http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0099498#ac

The Longitudinal Relation Between Accumulation of Adverse Life Events and Body Mass Index From Early Adolescence to Young Adulthood

Objective: Stressors, such as adverse life events, can cause weight changes through behavioral and biological mechanisms. Whether the accumulation of adverse life events is related to body mass index (BMI) across multiple time points from early adolescence to young adulthood has not been investigated to date. Methods: Data are from 2188 children participating at T1 (10-12 years), T3 (14-18 years), and/or T5 (21-23 years) of the prospective Tracking Adolescents' Individual Lives Survey cohort study. Adverse events before T1 and between T1, T3, and T5 were measured with a parent interview at T1 and a semistructured interview (Event History Calendar) with the adolescent at T3 and T5. An adverse events score was calculated per wave. Body mass index z-scores were determined from objectively measured height and weight using the LMS (skewness, median, and coefficient of variation) reference curves of the International Obesity Task Force for children 18 years or younger. Data were analyzed using a modified bivariate autoregressive cross-lagged structural equation model. Results: Adverse events before T1 and between T3 and T5 were related to BMI at T5 (beta = 0.06, p =.001 and beta = -0.04, p =.04, respectively). Specifically, health events before T1 were associated with a higher BMI at T5, and events related to relationships and victimhood events between T3 and T5 were associated with a lower BMI at T5. Conclusions: Adverse relationship and victimhood events in their recent past were related to a lower BMI in young adults, whereas adverse health events during childhood were related to a higher BMI in young adults. No relationships were found between adverse life events with BMI in children and adolescents

Accumulation of adverse childhood events and overweight in children:A systematic review and meta-analysis

ObjectiveThis study systematically summarizes the evidence of all observational studies investigating the relation between accumulation of adverse life events and measures of overweight in children MethodsMEDLINE, Embase, PsycINFO, and CINAHL were systematically searched (last search date 18 February 2015). The Newcastle-Ottawa Scale was used for methodological quality assessment. Study estimates were pooled using a random-effects model, and sources of heterogeneity were explored (PROSPERO registration number CRD42014014927). ResultsEighteen articles were included, containing five longitudinal (n=6,361) and fourteen cross-sectional and case-control study results (n=52,318). The pooled estimate of the longitudinal studies showed that accumulation of adverse life events is positively related to childhood overweight measures (OR [95% CI]=1.12 [1.01-1.25]). Cross-sectional and case-control study results were heterogeneous. Subgroup analyses showed that cross-sectional and case-control studies using a continuous adverse events measure, studies using a continuous overweight measure, and studies in children >6-12 years also generated positive pooled estimates, while the pooled estimate of studies assessing recent adverse events (past 2 years) was indicative of no relation with overweight. ConclusionsAccumulation of adverse life events and childhood overweight measures are positively associated. However, increases in overweight measures in response to adverse childhood events do not seem to occur instantaneously

Hospitalisation patterns among children exposed to childhood adversity: a population-based cohort study of half a million children.

BackgroundChildren who are exposed to adversities might be more susceptible to disease development during childhood and in later life due to impaired physiological and mental development. To explore this hypothesis, we assessed hospitalisation patterns through childhood and into adult life among those exposed to different trajectories of adversities during childhood.MethodsFor this population-based cohort study, we used annually updated data from Danish nationwide registers covering more than half a million children (aged 0-15 years) born between 1994 and 2001. Children who were alive and resident in Denmark on their 16th birthday were included in the analysis. Cluster analysis was used to divide children into five distinct trajectories according to their experience of childhood adversities, including poverty and material deprivation, loss or threat of loss within the family, and aspects of family dynamics. To describe comprehensively the disease patterns experienced by these groups of children, we assessed the associations of each adversity trajectory with hospital admission patterns according to the entire spectrum of disease diagnoses in the International Classification of Diseases 10th edition, from birth to 24 years of age, using survival models.Findings508 168 children born between Jan 1, 1994, and Dec 31, 2001, were followed up until Dec 31, 2018, capturing more than 3·8 million hospital admissions from birth to early adulthood. Hospitalisation rates were consistently higher in all four adversity groups compared with the low adversity group. The high adversity group (14 577 children, 3%), who were exposed to adversities of deprivation, family loss, and negative family dynamics, had a markedly higher rate of hospitalisations across all ages. For example, we observed 243 additional hospital admissions per 1000 person-years (95% CI 238-248) in the high versus low adversity group for those aged 16-24 years. These associations were particularly strong for diagnoses related to injuries, unspecified symptoms, and factors influencing health service contacts (eg, health screening and observation). They also covered a considerable burden of respiratory and infectious diseases, congenital malformations, diseases of the nervous system (especially in early life), mental and behavioural diagnoses, and diagnoses related to pregnancy and childbirth in early adult life.InterpretationThe close linkage between childhood adversities and poor lifelong health outcomes highlights a need for public health and policy attention on improving the socioeconomic circumstances children are born into to prevent the early emergence of health inequalities.FundingNone

Health behaviour risk score (No. of unmet guidelines) by socio-demographic and anthropometric characteristics (n (%) unless stated otherwise).

<p>GCSE: General Certificate of Secondary Education; A level: General Certificate of Education Advanced level.</p

Relationship Between Childhood Abuse and Body Mass Index in Young Adulthood: Mediated by Depression and Anxiety?

We examined whether childhood abuse is related to body mass index (BMI) in young adults and whether this relationship is mediated by depression and anxiety. Data are from the Dutch longitudinal cohort study TRAILS (nfemales = 836, nmales = 719). At wave 4, childhood sexual, physical and verbal abuse, and lifetime major depressive disorder (MDD) and generalized anxiety disorder (GAD) were assessed. BMI was measured at wave 4 and 5 (mean age = 19.2/22.4 years). Sex-stratified structural equation models were estimated. Females who had experienced sexual abuse had a higher BMI at wave 4 (B = 0.97, 95%CI = [−0.01,1.96]) and a higher increase in BMI between wave 4 and 5 (B = 0.52, 95%CI = [0.04,1.01]) than females who had not experienced sexual abuse. Additionally, MDD and BMI at wave 4 were related in females (B = 1.35, 95%CI = [0.52,2.18]). MDD mediated the relationship between sexual abuse and BMI at wave 4 in females. In addition, sexual abuse moderated the relationship between MDD and BMI at wave 4. The relationship was stronger among females who had experienced sexual abuse than among females who had not. Prevention of BMI changes among females who experienced sexual abuse may thus be warranted, particularly when they developed MDD. MDD treatment, such as abuse-focused psychotherapy, may aid this prevention