Conference Theme: Maternal and Child Health: the Foundation of Population HealthAbstractpostprin

Schooling, CM

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Title Modifiable determinants of child health: what have we learntfrom Hong Kong's Children of 1997 birth cohort?Author(s) Schooling, CMCitation The 2012 Maternal and Child Health Conference, Hong Kong,China, 7-8 September 2012, p. 40-41Issued Date 2012URL http://hdl.handle.net/10722/165148Rights Creative Commons: Attribution 3.0 Hong Kong License Modifiable determinants of child health: What have we learnt from Hong Kong's children of 1997 birth cohort? cohort  Dr CM Schooling School of Public Health, The University of Hong Kong Childhood BMI in Hong Kong over 50 years 10 15 20 250.00.10.20.30.4GIRLS10 15 20 250.00.10.20.30.4BOYSBMI (kg/m2) 1963 1993 2005/6 BMI (kg/m2) 1963 1993 2005/6 Distribution of 7-year-olds BMI in Hong Kong Other potential determinants of early obesity/ higher BMI (beyond diet and physical activity)  • Maternal age • Birth order • Gestational age • Maternal BMI    • Fetal and infant growth • Cesarean birth • Introduction of solid food • Secondhand smoking • Child care • Dairy products   Hong Kong’s “Children of 1997” (as on TVB)  1. First Chinese “First world”  generation  • growing up in a resource rich Chinese environment  2. Only large active Chinese birth cohort, with many differences from more commonly studied western populations • Diet and lifestyle • Child care, child rearing • Less socio-economic patterning of BMI  3. Provides local evidence  Contrasts with the West may be helpful for understanding East and West  Hong Kong’s “Children of 1997” Birth Cohort 2010 2 3 4 5 6 7 8 9 10 11 12 13 14 0 1 1997 2000 Age(yrs) Year 3m 9m 18m Infant health and lifestyle survey                                            Survey I,  Survey II, Survey III 8,327 infants born in Hong Kong in April and May 1997 Body Mass Index   BMI=weight/height2 (kg/m2 ) Weight and height: record linkage with Maternal and Child Health Centres, Student Health Service  1. Sex and age specific BMI z-score relative to WHO growth standard 2. Overweight/obesity: international obesity task force (IOTF)  Active follow-up  Passive follow-up  Public hospital use  Physical and psychological assessments from the Student Health Service  Deaths from the Department of Health Children of 1997 BMI growth trajectories Fetal and infant  growth and overweight/obesity Caveats • Do not know if these associations will continue to the completion of growth • Associations may be different for other measures of obesity • Have not considered body composition Cesarean birth and overweight/obesity Vaginal birth               Cesarean birth  Risk of overweight/obesity by type of birth throughout childhood Introduction of solid food and BMI z-score Age of solid food introduction Secondhand smoking and BMI Differences in BMI z-scores at 7 and 11 years by  sources of SHS exposure (compared with non SHS-exposed) Informal child care and BMI z-score at 11 years Adjusted mean difference 6 months Dairy products and BMI Summary 1. Childhood BMI has changed dramatically in the last 50 years in Hong Kong 2. Modifiable factors driving early BMI, such as informal childcare or paternal smoking may contribute 3. Social changes such as smaller families (lower birth order) may also play a role  Discussion  Strengths • Large sample • Detailed information on growth and BMI • Unique setting, enables us to test empirically derived hypotheses from the west • Provides useful etiological information  Limitations  • Exposures not always well defined • Associations may be different at the completion of growth • Cannot identify body composition from BMI   Next Steps • Explanatory framework for population health that unites the social and the biological Conclusions  • Hard to find individual exposures which explain BMI  • May indicate the need for environmental interventions  Acknowledgement  • The Department of Health • Prof. GM Leung • Prof. TH Lam • Cindy Lin, Dr Maggie Kwok, Dr Connie Hui • The “Children of 1997” birth cohort research team • Funding sources: – Hong Kong Health Care and Promotion Fund                   [HCPF Grant # 216106] – Hong Kong Health and Health Services Research Fund      [HHSRF Grant # 03040771 #07080751 #08090761] – Research Fund for the Control of Infectious Diseases                        [RFCID Grant # 04050172] – University Research Committee SRT of Public Health Granted Research  

Modifiable determinants of child health: what have we learnt from Hong Kong's Children of 1997 birth cohort?

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Modifiable determinants of child health: what have we learnt from Hong Kong's Children of 1997 birth cohort?

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