Development of Socioeconomic Inequalities in Obesity Among Dutch Pre-School and School-Aged Children

ObjectiveTo investigate the emergence of the inverse socioeconomic gradient in body mass index (BMI) in the first 6 years of life. Furthermore, associations of socioeconomic position (SEP) with BMI and total fat mass (%) were assessed at age 6, and potential mediating factors in the pathway between SEP and children's body composition were investigated. MethodsNearly 3,656 Dutch children participating in a prospective cohort study in Rotterdam, the Netherlands, were included from 2002 to 2006. Maternal educational level and net household income were used as indicators of SEP. BMI and fat mass were both outcome measures. Associations and mediation analyses were investigated using linear mixed models and linear regression analyses. ResultsThe lowest SEP groups showed a larger increase in BMI over time as compared to the highest SEP groups (P<0.001), which resulted in the emergence of the inverse SEP gradient around 3-4.5 years of age. In 6-year-old children, both BMI and total fat mass were significantly higher for children of low educated mothers (difference in BMI SDS: 0.24; 95% CI 0.15, 0.33; and in total fat mass (%): 2.68; 95% CI 2.19, 3.17), which was also shown for children with a low household income. This was mainly explained by parental BMI and prenatal smoking. ConclusionsThe inverse socioeconomic gradient in obesity emerges during the preschool period, and widens with increasing age. A public health strategy aimed at tackling the development of inequalities in obesity in early childhood needs to start before birth and should include the prevention of prenatal smoking and obesity of parents

Ethnic Differences in Blood Pressure and Hypertensive Complications During Pregnancy The Generation R Study

The aim was to investigate ethnic differences in blood pressure levels in each trimester of pregnancy and the risk of gestational hypertensive disorders and the degree to which such differences can be explained by education and lifestyle-related factors. The study included 6215 women participating in a population-based prospective cohort study from early pregnancy onward in Rotterdam. Ethnicity was assessed at enrollment. Blood pressure was measured in each trimester. Information about gestational hypertensive disorders was available from medical charts. Lifestyle factors included smoking, alcohol, caffeine intake, folic acid supplementation, sodium and energy intake, body mass index, and maternal stress. Associations and explanatory pathways were investigated using linear and logistic regression analysis. Dutch pregnant women had higher systolic blood pressure levels as compared with women in other ethnic groups in each trimester of pregnancy. Compared with Dutch women, Turkish and Moroccan women had lower diastolic blood pressure levels in each trimester. These differences remained after adjusting for education and lifestyle factors. Turkish and Moroccan women had a lower risk of gestational hypertension as compared with Dutch women (odds ratio, 0.32 [95% CI, 0.18-0.58] and odds ratio, 0.28 [95% CI, 0.14-0.58]), and Cape Verdean women had an elevated risk of preeclampsia (odds ratio, 2.22 [95% CI, 1.22-4.07]). Differences could not be explained by education or lifestyle. Substantial ethnic differences were observed in blood pressure levels and risk of gestational hypertensive disorders in each trimester of pregnancy, and a wide range of variables could not explain these differences. (Hypertension. 2012; 60:198-205.) circle Online Data Supplemen

Sedentary behaviors, physical activity behaviors, and body fat in 6-year-old children: the Generation R Study

Background: Childhood overweight and obesity is a major public health concern. Knowledge on modifiable risk factors is needed to design effective intervention programs. This study aimed to assess associations of children's sedentary behaviors (television viewing and computer game use) and physical activity behaviors (sports participation, outdoor play, and active transport to/from school) with three indicators of body fat, i.e., percent fat mass, body mass index (BMI) standard deviation scores, and weight status (normal weight, overweight). Methods: Cross-sectional data from 5913 6-year-old ethnically diverse children were analyzed. Children's weight and height were objectively measured and converted to BMI. Weight status was defined according to age-and sex-specific cut-off points of the International Obesity Task Force. BMI standard deviation scores were created, based on Dutch reference growth curves. Fat mass was measured my dual-energy X-ray absorptiometry (DXA). Sedentary and physical activity behaviors were assessed by parent-reported questionnaires. Series of logistic and linear regression analyses were performed, controlling for confounders (i.e., socio-demographic factors, family lifestyle factors, and other sedentary behaviors and physical activity behaviors). Results: Sports participation was inversely associated with fat mass (p < 0.001), even after adjustment for socio-demographic factors, family lifestyle factors, and other sedentary behaviors and physical activity behaviors. No other independent associations were observed. Conclusions: The results of this study indicate that sports participation is inversely associated with percent body fat among ethnically diverse 6-year-old children. More research in varied populations including objective measurements and longitudinal designs are needed to confirm these current results