1.
Almquist-Tangen, Gerd, et al.
(author)
Consuming milk cereal drinks at one year of age was associated with a twofold risk of being overweight at the age of five
2019
In: Acta Paediatrica. - Chichester : Wiley-Blackwell Publishing Inc.. - 0803-5253 .- 1651-2227. ; 108:6, s. 1115-1121
Journal article (peer-reviewed) abstract
Aim: We previously reported that consuming milk cereal drinks at six months of age was associated with a high body mass index (BMI) at 12 and 18 months. This study examined the association between daily consumption at 12 months of age and BMI at the age of five.Methods: We followed up 1870/2666 (70%) children recruited at birth in 2007–2008 for the Swedish longitudinal population‐based Halland Health and Growth Study a mean of 5.09 ± 0.28 years. Feeding practices were obtained from parental questionnaires, and anthropometric data were collected by child health nurses.Results: At five years, 11.6% were overweight and 2.3% were obese. Milk cereal drinks were consumed by about 85% and 10% at one and five years of age, respectively. Consumption at 12 months was associated with almost double the risk of being overweight at five years of age (adjusted odds ratio 1.94, 95% confidence interval 1.08–3.50). Other risk factors were a family history of obesity, low paternal educational level and paternal smoking.Conclusion: Consuming milk cereal drinks daily at 12 months was associated with a twofold risk of being overweight at five years. These findings may affect the counselling guidelines used at child healthcare centres. Copyright © 2019 John Wiley & Sons, Inc. All rights reserved
2.
Lindholm, Annelie, 1975-, et al.
(author)
Nutrition- and feeding practice-related risk factors for rapid weight gain during the first year of life: a population-based birth cohort study
2020
In: BMC Pediatrics. - London : Springer Science and Business Media LLC. - 1471-2431. ; 20:1
Journal article (peer-reviewed) abstract
Background Rapid weight gain (RWG) during infancy increases the risk of excess weight later in life. Nutrition- and feeding practices associated with RWG need to be further examined. The present study aimed to examine nutrition- and feeding practice-related risk factors for RWG during the first year of life. Methods A population-based longitudinal birth cohort study of 1780 infants, classified as having RWG or non-RWG during 0-3-4, 0-6 and 6-12 months. RWG was defined as a change > 0.67 in weight standard deviation scores. Associations between nutrition- and feeding practice-related factors and RWG were examined with logistic regression models. Results Of the participating infants, 47% had RWG during 0-3-4 months, 46% during 0-6 months and 8% during 6-12 months. In the fully adjusted models, bottle-feeding at birth and at 3-4 months and nighttime meals containing formula milk were positively associated with RWG during 0-3-4 months (p < 0.05 for all). Breastfeeding at 3-4 months and nighttime meals containing breast milk were negatively associated with RWG during this period (p < 0.001). Bottle-feeding at birth, 3-4 and 6 months and nighttime meals containing formula milk at 3-4 months were positively associated with RWG during 0-6 months (p < 0.01 for all). Breastfeeding at 3-4 and 6 months was negatively associated with RWG (p < 0.01). During 6-12 months, only bottle-feeding at 3-4 months was positively associated with RWG (p < 0.05). Conclusions RWG was more common during the first 6 months of life and bottle-feeding and formula milk given at night were risk factors for RWG during this period.
3.
Almquist-Tangen, Gerd, et al.
(author)
Influence of neighbourhood purchasing power on breastfeeding at four months of age : a Swedish population-based cohort study
2013
In: BMC Public Health. - London : BioMed Central. - 1471-2458. ; 13:1
Journal article (peer-reviewed) abstract
BACKGROUND: Parental socioeconomic status (SES) is an important determinant in child health, influencing beneficial factors such as breastfeeding. A better understanding of the influence of neighbourhood-level SES measures, relating to spatial determinants, might lead to targeted actions to promote breastfeeding during infancy.METHODS: A cross-sectional study analysis the association between breastfeeding at four months of age and neighbourhood purchasing power, taking account of individual-level variables including maternal age, smoking and parental level of education. Data were obtained from a prospective population- based cohort study recruited from birth in 2007-2008 in the Halland region, southwestern Sweden. Questionnaire data on the individual-level variables and the outcome variable of breastfeeding at four months (yes/no) were used (n=2,407). Each mother was geo-coded with respect to her residential parish (there are 61 parishes in the region) and then stratified by parish-level household purchasing power. It emerged that four neighbourhood characteristics were reasonable to use, viz. <10%, 10-19%, 20-29% and ≥ 30% of the resident families with low purchasing power.RESULTS: The proportion of mothers not breastfeeding at four months of age showed a highly significant trend across the neighbourhood strata (p=0.00004): from 16.3% (< 10% with low purchasing power) to 29.4% (≥ 30% with low purchasing power), yielding an OR of 2.24 (95% confidence interval: 1.45-3.16). After adjusting for the individual-level variables, the corresponding OR=1.63 (1.07-2.56) was significant and the trend across the strata was still evident (p=0.05). A multi-level analysis estimated that, in the neighbourhoods with ≥ 30% of the families with low purchasing power, 20% more mothers than expected, taking account of the individual-level factors, reported no breastfeeding at four months of age (≥ 95% posterior probability of an elevated observed-to-expected ratio).CONCLUSION: The neighbourhood purchasing power provided a spatial determinant of low numbers of mothers breastfeeding at four months of age, which could be relevant to consider for targeted actions. The elevated observed-to-expected ratio in the neighbourhoods with the lowest purchasing power points toward a possible contextual influence. © 2013 Almquist-Tangen et al.; licensee BioMed Central Ltd.
4.
Almquist-Tangen, Gerd, et al.
(author)
What makes parents act and react? Parental views and considerations relating to "child health' during infancy
2017
In: Journal of Child Health Care. - London : SAGE Publications. - 1367-4935 .- 1741-2889. ; 21:4, s. 415-423
Journal article (peer-reviewed) abstract
Lifestyle factors and behaviours are adopted very early in life and tend to persist throughout life. Considering that the parents are the primary gatekeepers for their child's health, there is a need to gain more knowledge and deeper understanding about what causes parents to act and react in order for early preventive efforts to have any effect. The aim was to explore the parental views and considerations concerning child health' among parents with infants 8-10 months old. The sample was strategic and 16 parents (aged 23-41) were recruited from three child health centres in Sweden. Open-ended interviews were conducted and a qualitative, manifest content analysis approach was utilized. The parents described the subject child health' as a large, multifaceted concept. Three categories emerged during data analysis: developing a sixth sense, being affected by perceptions and believing health and ill health as a continuum. The parents perceived food and feeding issues as one of the most worrying aspects and a significant indicator of child health'. In order to meet the parents on their turf, the healthy health message' conveyed needs to take the parental perspective into consideration rather than attempting to educate the parents from predetermined assumption, belief and values.
5.
Skantze, Caroline, Doktorand, 1967-, et al.
(author)
School nurses' experience of communicating growth data and weight development to parents of children 8 and 10 years of age
2023
In: BMC Public Health. - London : Springer Science and Business Media LLC. - 1471-2458. ; 23:1
Journal article (peer-reviewed) abstract
Introduction The prevalence of overweight and obesity among children has risen sharply during recent decades. School nurses are key health professionals in interventions targeting the early onset of overweight and obesity during childhood. Understanding how school nurses experience communication with parents concerning their child & PRIME;s growth and weight development are essential. The aim of the study is to describe school nurses' experience of communicating growth data and weight development to parents of school children ages 8 and 10 years.Method The design of the study is a descriptive, qualitative design with purposive and snowball sampling. Sixteen interviews with school nurses were conducted and analysed with qualitative content analysis.ResultThe analysis resulted in three main categories including subcategories. In Challenges in the professional role, the school nurses expressed a lack of knowledge, skills and tools in communication, described a perception of parental responsibility and stated using several different approaches in communicating growth data and weight development to parents. In Sustainable communication with parents, the school nurses described the value of creating a dialogue, a supportive approach to the parents, and the building of a relation between them and the parents as essential. In Barriers in communicating the child & PRIME;s weight, the school nurses described the experience of stigma concerning the subject of overweight and obesity, increased concern when they detected underweight as well as an ambivalence towards measuring weight.Conclusion The study highlights an educational challenge concerning the need for training, skills, and strategies for communication with parents. A variety of ways in school nurses' communication with parents were identified in the present study and this shows an inconsistency in how School health services was offered and a need for the development of evidence-based procedures for communicating growth data and weight development to parents.
6.
Malmborg, Julia, PhD, 1988-, et al.
(author)
Associations between pain, health, and lifestyle factors in 10-year-old boys and girls from a Swedish birth cohort
2023
In: BMC Pediatrics. - London : BioMed Central (BMC). - 1471-2431. ; 23:1
Journal article (peer-reviewed) abstract
BackgroundPain is common in children and its associations with various biopsychosocial factors is complex. Comprehensive pain assessments could contribute to a better understanding of pediatric pain, but these assessments are scarce in literature. The aim of this study was to examine differences in pain prevalence and pain patterns in 10-year-old boys and girls from a Swedish birth cohort and to study associations between pain, health-related quality of life and various lifestyle factors stratified by sex.Methods866 children (426 boys and 440 girls) and their parents from the "Halland Health and Growth Study" participated in this cross-sectional study. Children were categorized into two pain groups, "infrequent pain" (never-monthly pain) or "frequent pain" (weekly-almost daily pain), based on a pain mannequin. Univariate logistic regression analyses, stratified by sex, were performed to study associations between frequent pain and children's self-reports of disease and disability and health-related quality of life (Kidscreen-27, five domains), and parents' reports of their child's sleep (quality and duration), physical activity time, sedentary time, and participation in organized physical activities.ResultsThe prevalence of frequent pain was 36.5% with no difference between boys and girls (p = 0.442). Boys with a longstanding disease or disability had higher odds of being in the frequent pain group (OR 2.167, 95% CI 1.168-4.020). Higher scores on health-related quality of life in all five domains for girls, and in two domains for boys, was associated with lower odds of being categorized into the frequent pain group. Frequent pain was associated with poor sleep quality (boys OR 2.533, 95% CI 1.243-5.162; girls OR 2.803, 95% CI 1.276-6.158) and more sedentary time (boys weekends OR 1.131, 95% CI 1.022-1.253; girls weekdays OR 1.137, 95% CI 1.032-1.253), but not with physical activity.ConclusionsThe high prevalence of frequent pain needs to be acknowledged and treated by school health-care services and the healthcare sector in order to prevent pain from influencing health and lifestyle factors negatively in children.
7.
Lindholm, Annelie, 1975-
(author)
Overweight and Obesity in Preschool Children : Early Risk Factors and Early Identification
2019
Doctoral thesis (other academic/artistic) abstract
BACKGROUND: Overweight and obesity in children has reached epidemic proportions in recent decades, and even the youngest age groups are affected. Excess weight during childhood often follows the child into adulthood and is associated with diseases such as cardiovascular diseases and type 2 diabetes mellitus. In addition, excess weight often leads to health problems already during childhood. Childhood obesity is therefore one of the greatest public health challenges of the 21st century.AIM: The overall aim was to study growth patterns and early risk factors for overweight, obesity and an elevated waist-to-height ratio (WHtR) in preschool children. The specific aims were to: examine early body mass index (BMI) and WHtR growth patterns and their ability to predict overweight or obesity in children at 5 years of age (Paper I); examine if BMI and WHtR growth patterns from an early age could identify children with an elevated WHtR at 5 years of age by using standard deviation score(s) (SDS) in children classified according to WHtRSDS at 5 years of age. Another aim was to study the association between BMISDS and WHtRSDS at 5 years of age (Paper II); examine nutrition- and feeding practice-related risk factors for rapid weight gain during the first 0–6 months and the following 6–12 months (Paper III); examine the association between potential early risk factors and an elevated WHtR, defined as WHtRSDS ≥ 1 at 5 years of age, and examine whether similar associations also were found for overweight or obesity at the same age (Paper IV).METHODS: This project was part of the population-based birth cohort study the Halland Health and Growth Study, including 2,666 children born in the county of Halland in the southwestern part of Sweden between October 2007 and December 2008. Weight, height and waist circumference were measured at nine time points starting at birth. At every measurement point the parents filled in questionnaires regarding their child’s nutrition, health and lifestyle and also background information about the family.RESULTS: We found that children with overweight or obesity at 5 years of age could be identified already from an early age by significantly higher mean BMISDS and WHtRSDS than corresponding values in children with normal weight or underweight. BMI was sufficient for predicting overweight or obesity at 5 years of age and WHtR did not add any further information in this prediction.Children with a WHtRSDS ≥ 1 at 5 years of age could be identified already from an early age by significantly higher mean BMISDS and WHtRSDS than corresponding values in children with a WHtRSDS < 1. When comparing WHtRSDS and BMISDS at 5 years of age, 55% of the children with an elevated WHtRSDS had normal BMISDS.Rapid weight gain was more common during the first 6 months of the first year than during the next 6 months. Bottle-feeding and nighttime meals containing formula milk were associated with rapid weight gain between 0 and 6 months. Breastfeeding was negatively associated with rapid weight gain during the same period.Rapid weight gain during 0–6 months and also maternal pre-pregnancy BMI and paternal BMI were associated with a WHtRSDS ≥ 1 at 5 years of age. Rapid weight gain during both 0–6 and 6–12 months and also maternal pre-pregnancy BMI, were associated with overweight or obesity at 5 years of age.CONCLUSION: This thesis showed that BMI was sufficient for predicting overweight or obesity at 5 years of age, and WHtR did not add any further information to this prediction. For identification of children with an elevated WHtR, BMI classification missed every second child, indicating that WHtR adds value in children who may need further investigation regarding cardiometabolic risk factors. Risk factors operating before pregnancy and early in life increase the risk of early rapid weight gain, an elevated WHtR and overweight or obesity at 5 years of age and bottle feeding, nighttime meals, early rapid weight gain as well as parental overweight are potential modifiable risk factors in this development.
8.
Lindholm, Annelie, 1975-, et al.
(author)
Early life risk factors for an elevated waist-to-height ratio at 5 years of age
Other publication (other academic/artistic) abstract
Objective: To examine early life risk factors for an elevated waist-to-height ratio (WHtR) at 5 years of age. A second aim was to examine if the same risk factors also were associated with overweight or obesity at the same age.Methods: A population-based longitudinal birth cohort study of 1,540 children, from the southwestern part of Sweden, born between October 2007 and December 2008. The children were classified as having ≥ 1 or < 1 in WHtR standard deviation scores (SDS) at five years of age, according to Swedish reference values and as having overweight/obesity or normal weight/underweight according to the IOTF. Results: At five years of age, 15% of the children had WHtRSDS ³ 1 and 11% had overweight or obesity. In multivariable analyses, RWG during 0-6 months (OR: 1.90, 95% CI: 1.23, 2.95), maternal pre- pregnancy BMI (1.06, 1.01,1.11) and paternal BMI (1.11, 1.01-1.21) were associated with a WHtRSDS ³ 1 at five years. RWG during 0-6 months (2.53, 1.53, 4,20), during 6-12 months (2.82, 1.37, 5.79) and maternal pre-pregnancy BMI (1.12, 1.06,1.17) was associated with overweight or obesity at 5 years of age.Conclusions: Risk factors operating early in life are associated with an elevated WHtR and overweight or obesity at 5 years of age. Preventive interventions should especially address early RWG and parental overweight.
9.
Malmborg, Julia, PhD, 1988-, et al.
(author)
Pain and its association with health-related quality of life, sleep, physical activity, and sedentary behavior in 10-year-old children from a Swedish birth cohort
2022
In: Annals of the Rheumatic Diseases. - London : BMJ Publishing Group Ltd. - 0003-4967 .- 1468-2060. ; 81:Suppl. 1, s. 988-988
Journal article (peer-reviewed) abstract
Pain in children may be underreported and undertreated today, but due to methodological variations, pain prevalence is difficult to determine. Moreover, it is unclear to what extent pediatric pain is associated with health-related quality of life (HRQoL) and other lifestyle habits. There is a need for an increased understanding of pain in children.ObjectivesTo study pain prevalence and cross-sectional associations between pain, HRQoL, sleep, physical activity, and sedentary behavior in 10-year-old children from a Swedish birth cohort.MethodsThe Swedish birth cohort the “Halland Health and Growth Study” (H2GS) recruited 2860 children at birth (2007–2009). At 10 years of age the children answered questionnaires regarding pain (mannequin with 20 regions, frequency never–daily for each region) and HRQoL (Kidscreen-27, 27 questions, 5 domains scored worst–best). Parents estimated their child’s sleep (6–8, 9, or 10–12 hours/night), physical activity time, and sedentary time (hours/weekdays and hours/weekends respectively). Children were categorized into the groups of “infrequent pain” (never–monthly pain) or “frequent pain” (weekly–almost daily pain) from the highest reported pain frequency from at least one body region. Differences in pain prevalence between boys and girls were analyzed with chi2-test. Logistic regression analyses were performed to study associations between frequent pain (dependent variable) and HRQoL, sleep, physical activity, and sedentary behavior (independent variables). Each variable was adjusted for sex.Results733 children (351 boys and 382 girls) answered pain and HRQoL questions at 10 years of age. Frequent pain was reported by 37% (boys 35% vs. girls 39%, p=0.267). The number of frequent pain regions ranged from 1–13 in boys and 1–20 in girls. Higher HRQoL in the domains physical wellbeing (OR 0.965; 95%CI 0.948–0.983; p<0.001), psychological wellbeing (OR 0.971; 95%CI 0.955–0.987; p<0.001), autonomy and parents (OR 0.971; 95%CI 0.954–0.988; p=0.001), peers and social support (OR 0.977; 95%CI 0.961–0.994; p=0.007), and school environment (OR 0.972; 95%CI 0.956–0.989; p=0.002) was associated with less risk of belonging to the frequent pain group. More sedentary time in weekdays (OR 1.107; 95%CI 1.028–1.192; p=0.007) and weekends (OR 1.122; 95%CI 1.037–1.215; p=0.004) was associated with having frequent pain, but no associations were found between frequent pain and the amount of physical activity or sleep.ConclusionThe high prevalence of frequent pain in 10-year-old children must receive attention by the school and health-care services. The association between frequent pain and low HRQoL is troublesome. Improving HRQoL and reducing sedentary time is beneficial for children’s health, but further studies are needed to follow associations over time.Disclosure of InterestsNone declared
10.
