| 1. |
- Butler, Eadaoin M., et al.
(författare)
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A prediction model for childhood obesity in New Zealand
- 2021
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Ingår i: Scientific Reports. - : Springer Nature. - 2045-2322. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Several early childhood obesity prediction models have been developed, but none for New Zealand's diverse population. We aimed to develop and validate a model for predicting obesity in 4-5-year-old New Zealand children, using parental and infant data from the Growing Up in New Zealand (GUiNZ) cohort. Obesity was defined as body mass index (BMI) for age and sex >= 95th percentile. Data on GUiNZ children were used for derivation (n=1731) and internal validation (n=713). External validation was performed using data from the Prevention of Overweight in Infancy Study (POI, n=383) and Pacific Islands Families Study (PIF, n=135) cohorts. The final model included: birth weight, maternal smoking during pregnancy, maternal pre-pregnancy BMI, paternal BMI, and infant weight gain. Discrimination accuracy was adequate [AUROC=0.74 (0.71-0.77)], remained so when validated internally [AUROC=0.73 (0.68-0.78)] and externally on PIF [AUROC=0.74 [0.66-0.82)] and POI [AUROC=0.80 (0.71-0.90)]. Positive predictive values were variable but low across the risk threshold range (GUiNZ derivation 19-54%; GUiNZ validation 19-48%; and POI 8-24%), although more consistent in the PIF cohort (52-61%), all indicating high rates of false positives. Although this early childhood obesity prediction model could inform early obesity prevention, high rates of false positives might create unwarranted anxiety for families.
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| 2. |
- Butler, Eadaoin M., et al.
(författare)
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Acceptability of early childhood obesity prediction models to New Zealand families
- 2019
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Ingår i: PLOS ONE. - : PUBLIC LIBRARY SCIENCE. - 1932-6203. ; 14:12
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Tidskriftsartikel (refereegranskat)abstract
- Objective: While prediction models can estimate an infant's risk of developing obesity at a later point in early childhood, caregiver receptiveness to such information is largely unknown. We aimed to assess the acceptability of these models to New Zealand caregivers.Methods: An anonymous questionnaire was distributed online. The questionnaire consisted of multiple choice and Likert scale questions. Respondents were parents, caregivers, and grandparents of children aged.5 years.Results: 1,934 questionnaires were analysed. Responses were received from caregivers of various ethnicities and levels of education. Nearly two-thirds (62.1%) of respondents would "definitely" or "probably" want to hear if their infant was at risk of early childhood obesity, although "worried" (77.0%) and "upset" (53.0%) were the most frequently anticipated responses to such information. With lower mean scores reflecting higher levels of acceptance, grandparents (mean score = 1.67) were more receptive than parents (2.10; p = 0.0002) and other caregivers (2.13; p = 0.021); males (1.83) were more receptive than females (2.11; p = 0.005); and Asian respondents (1.68) were more receptive than those of European (2.05; p = 0.003), Maori (2.11; p = 0.002), or Pacific (2.03; p = 0.042) ethnicities. There were no differences in acceptance according to socioeconomic status, levels of education, or other ethnicities.Conclusions: Almost two-thirds of respondents were receptive to communication regarding their infant's risk of childhood obesity. While our results must be interpreted with some caution due to their hypothetical nature, findings suggest that if delivered in a sensitive manner to minimise caregiver distress, early childhood obesity risk prediction could be a useful tool to inform interventions to reduce childhood obesity in New Zealand.
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| 3. |
- Glover, Marewa, et al.
(författare)
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Ranked Importance of Childhood Obesity Determinants : Parents' Views across Ethnicities in New Zealand
- 2019
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Ingår i: Nutrients. - : MDPI. - 2072-6643. ; 11:9
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Tidskriftsartikel (refereegranskat)abstract
- Maori, Pacific, Indian, and New Zealand European pre-school children's caregivers' views on determinants of childhood obesity are needed to inform strategies that will reduce disparities in prevalence. Nineteen focus groups were conducted to explore the relative influence of factors contributing to body weight in children. Predetermined and participant-suggested factors were ranked. Discussion data were inductively analysed. The cost of healthy foods was the highest ranked factor across all groups. Ranked similarly were ease of access to takeaways and lack of time for food preparation. Cultural factors followed by screen time induced sedentariness in children and lack of time to ensure children exercised was next. Participant-raised factors included lack of familial, social, and health promotion support, and others' behaviour and attitudes negatively impacting what children ate. All groups rejected stereotyping that blamed culture for higher obesity rates. Compared to the Maori and NZ European groups, the Pacific Island and Indian participants spoke of losing culture, missing extended family support, and not having access to culturally appropriate nutrition education or social support and services. Public health policies need to mitigate the negative effects of economic deprivation on food insecurity. Complementary interventions that increase access to healthier meal choices more often are needed.
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| 4. |
- Glover, Marewa, et al.
(författare)
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The Complexity of Food Provisioning Decisions by Mori Caregivers to Ensure the Happiness and Health of Their Children
- 2019
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Ingår i: Nutrients. - : MDPI. - 2072-6643. ; 11:5
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Tidskriftsartikel (refereegranskat)abstract
- Obesity in children is a global health concern. In New Zealand, one in three school entrant children are overweight or obese. Mori, the indigenous people, are disproportionately represented among the lowest economic group and have a disproportionately high incidence of obesity. This study explored Mori parents' and caregivers' views of the relative importance of weight to health, and the facilitators and barriers to a healthy weight in children aged 6 months to 5 years. Using a grounded qualitative method, in-depth information was collected in focus groups with mostly urban parents and other caregivers. A general inductive thematic analysis (content driven) was used. Insufficient money was an overriding food provisioning factor, but cost interacted with the lack of time, the number of people to feed, their appetites, and allergies. Other factors included ideologies about healthy food, cultural values relating to food selection, serving, and eating, nutrition literacy, availability of food, cooking skills, and lack of help. Childhood obesity was not a priority concern for participants, though they supported interventions providing education on how to grow vegetables, how to plan and cook cheaper meals. Holistic interventions to reduce the negative effects of the economic and social determinants on child health more broadly were recommended.
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| 5. |
- Leong, Karen S. W., et al.
(författare)
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Associations of Prenatal and Childhood Antibiotic Exposure With Obesity at Age 4 Years
- 2020
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Ingår i: JAMA Network Open. - : AMER MEDICAL ASSOC. - 2574-3805. ; 3:1
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Tidskriftsartikel (refereegranskat)abstract
- Importance Although antibiotics are associated with obesity in animal models, the evidence in humans is conflicting. Objective To assess whether antibiotic exposure during pregnancy and/or early childhood is associated with the development of childhood obesity, focusing particularly on siblings and twins. Design, Setting, and Participants This cross-sectional national study included 284 & x202f;211 participants (132 & x202f;852 mothers and 151 & x202f;359 children) in New Zealand. Data analyses were performed for 150 & x202f;699 children for whom data were available, 30 & x202f;696 siblings, and 4188 twins using covariate-adjusted analyses, and for 6249 siblings and 522 twins with discordant outcomes using fixed-effects analyses. Data analysis was performed November 2017 to March 2019. Exposure Exposure to antibiotics during pregnancy and/or early childhood. Main Outcomes and Measures The main outcome is odds of obesity at age 4 years. Anthropometric data from children born between July 2008 and June 2011 were obtained from the B4 School Check, a national health screening program that records the height and weight of 4-year-old children in New Zealand. These data were linked to antibiotics (pharmaceutical records) dispensed to women before conception and during all 3 trimesters of pregnancy and to their children from birth until age 2 years. Results The overall study population consisted of 132 & x202f;852 mothers and 151 & x202f;359 children (77 & x202f;610 [51.3%] boys) who were aged 4 to 5 years when their anthropometrical measurements were assessed. Antibiotic exposure was common, with at least 1 course dispensed to 35.7% of mothers during pregnancy and 82.3% of children during the first 2 years of life. Results from covariate-adjusted analyses showed that both prenatal and early childhood exposures to antibiotics were independently associated with obesity at age 4 years, in a dose-dependent manner. Every additional course of antibiotics dispensed to the mothers yielded an adjusted odds ratio (aOR) of obesity in their children (siblings) of 1.02 (95% CI, 0.99-1.06), which was similar to the odds across pregnancy for the whole population (aOR, 1.06; 95% CI, 1.04-1.07). For the child's exposure, the aOR for the association between antibiotic exposure and obesity was 1.04 (95% CI, 1.03-1.05) among siblings and 1.05 (95% CI, 1.02-1.09) among twins. However, fixed-effects analyses of siblings and twins showed no associations between antibiotic exposure and obesity, with aORs of 0.95 (95% CI, 0.90-1.00) for maternal exposure, 1.02 (95% CI, 0.99-1.04) for child's exposure, and 0.91 (95% CI, 0.81-1.02) for twins' exposure. Conclusions and Relevance Although covariate-adjusted analyses demonstrated an association between antibiotic exposure and odds of obesity, further analyses of siblings and twins with discordant outcomes showed no associations. Thus, these discordant results likely reflect unmeasured confounding factors. Question Is antibiotic exposure during pregnancy and/or during early childhood associated with the development of childhood obesity? Findings This cross-sectional national study of 284 & x202f;211 participants (132 & x202f;852 mothers and 151 & x202f;359 children) in New Zealand found that both prenatal and early childhood exposures to antibiotics were independently associated with obesity at age 4 years in a dose-dependent manner. However, fixed-effects analyses of siblings and twins with discordant outcomes showed no associations between antibiotic exposure and obesity. Meaning Although judicious use of antibiotics is necessary, antibiotics are unlikely to be a major contributor to childhood obesity. This cross-sectional study of mothers and their children in New Zealand assesses whether exposure to antibiotics during pregnancy and/or early childhood is associated with the development of childhood obesity.
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| 6. |
- Shackleton, Nichola, et al.
(författare)
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Decomposing ethnic differences in body mass index and obesity rates among New Zealand pre-schoolers
- 2019
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Ingår i: International Journal of Obesity. - : NATURE PUBLISHING GROUP. - 0307-0565 .- 1476-5497. ; 43:10, s. 1951-1960
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Tidskriftsartikel (refereegranskat)abstract
- Objective To determine the extent to which ethnic differences in BMI Z-scores and obesity rates could be explained by the differential distribution of demographic (e.g. age), familial (e.g. family income), area (e.g. area deprivation), parental (e.g. immigration status), and birth (e.g. gestational age) characteristics across ethnic groups. Methods We used data on 4-year-old children born in New Zealand who attended the B4 School Check between the fiscal years of 2010/2011 to 2015/2016, who were resident in the country when the 2013 census was completed (n = 253,260). We implemented an Oaxaca-Blinder decomposition to explain differences in BMI Z-score and obesity between Maori (n = 63,061) and European (n = 139,546) children, and Pacific (n = 21,527) and European children. Results Overall, 15.2% of the children were obese and mean BMI Z-score was 0.66 (SD = 1.04). The Oaxaca-Blinder decomposition demonstrated that the difference in obesity rates between Maori and European children would halve if Maori children experienced the same familial and area level conditions as Europeans. If Pacific children had the same characteristics as European children, differences in obesity rates would reduce by approximately one third, but differences in mean BMI Z-scores would only reduce by 16.1%. Conclusion The differential distribution of familial, parental, area, and birth characteristics across ethnic groups explain a substantial percentage of the ethnic differences in obesity, especially for Maori compared to European children. However, marked disparities remain.
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