Adolescence/Teens11

Concussion treatment: Adolescent athletes 'prescribed' aerobic exercise recovered faster

Study is the first randomized clinical trial on treatment of acute concussion

Science Daily/February 4, 2019

University at Buffalo

Adolescent athletes who sustained concussions while playing a sport recovered more quickly when they underwent a supervised, aerobic exercise regimen.

 

The study, by University at Buffalo researchers and colleagues, is the first randomized clinical trial of a treatment in the acute phase after a sport-related concussion. The goal was to evaluate prescribed, progressive sub-symptom threshold exercise as a treatment within the first week of a concussion in adolescents after a few days of rest. Sub-symptom threshold exercise is physical activity that doesn't exacerbate symptoms.

 

The researchers followed 103 participants ages 13-18, with nearly the same number of males and females. All were seen within 10 days after sustaining a sport-related concussion at one of the UBMD Orthopaedics and Sports Medicine clinics in Western New York or at the Pan Am Clinic in Winnipeg.

 

Patients who followed the aerobic exercise program took on average 13 days to recover while those in the control group, who performed stretching exercises, took 17 days. In addition, fewer patients in the exercise program took longer than four weeks to recover than did patients in the control group.

 

"This research provides the strongest evidence yet that a prescribed, individualized aerobic exercise program that keeps the heart rate below the point where symptoms worsen is the best way to treat concussion in adolescents," said John J. Leddy, MD, first author, clinical professor of orthopaedics in the Jacobs School of Medicine and Biomedical Sciences at UB, and director of the UB Concussion Management Clinic at UBMD Orthopaedics and Sports Medicine.

 

The researchers plan to investigate if the treatment is also effective in adults with concussion.

 

No proven treatment

 

The researchers noted that there is no proven treatment for concussion, especially among adolescents, who typically take the longest to recover.

 

"Until now, nothing else has been proven in any way effective for treating concussion," said Barry S. Willer, PhD, senior author, director of research in the UB Concussion Management Clinic and professor of psychiatry in the Jacobs School. "This is the best evidence so far for a treatment that works."

 

The findings directly contradict the conventional approach to concussion, which often consists of nearly total rest, eliminating most physical and mental activities, including schoolwork.

 

"Telling a teenager to go home and basically do nothing is depressing," said Willer. "It can actually increase their physical and psychological symptoms, and we see that particularly among girls. But with our approach, you're saying, sure, you can return to school and you should start doing these exercises. Their chins are up, Mom and Dad are happy and so is the student."

 

The fact that all states have now passed laws requiring schools to make accommodations for students who have sustained concussions is also helpful, said Willer, so that the student can opt out of some activities during the school day, if necessary.

 

The proper 'dose' of exercise

 

To determine how much exercise each patient could sustain without exacerbating symptoms, the researchers had each one undergo the Buffalo Concussion Treadmill Test, developed by Leddy and Willer, to determine at what level their symptoms worsen. As the patient walks on a treadmill, the incline is gradually increased and the heart rate is recorded at the point where concussion symptoms intensify.

 

"We prescribed exercise at 80 percent of that threshold," Leddy explained, "so each patient's exercise 'dose' was individually tailored."

 

Patients were randomly assigned to the aerobic exercise group (52) or to a stretching group (51). Patients in both groups were sent home with a heart rate monitor so they could make sure they stayed below the threshold while exercising.

 

Both groups performed their assigned exercise for about 20 minutes each day and were required to report compliance and daily symptoms online. Those in the aerobic group either walked on a treadmill, rode a stationary bike, or walked either inside or out. Aside from the prescribed exercise, patients were advised to refrain from contact sports, gym class or team practice. They were given advice about getting schoolwork done and told to avoid excessive use of electronic devices, since that can also aggravate symptoms.

 

Each patient's condition was re-evaluated weekly and as symptoms improved, the "dose" of exercise or stretching was increased, according to the weekly treadmill test results.

 

Recovery was rigorously defined, requiring agreement among three independent criteria: the patient's reporting a normal (minimal) level of symptoms, a normal physical examination by a medical doctor, and the return of normal exercise tolerance on the Buffalo Concussion Treadmill Test. The physicians were blinded as to the group assignment of each participant.

 

One surprising finding was that only two participants out of 52 (4 percent) in the aerobic exercise group took longer than four weeks to recover compared to seven out of 51 (14 percent) in the stretching group. This did not reach statistical significance, but the scientific literature suggests, by contrast, that between 15 and 25 percent of adolescents who do not receive any treatment will be symptomatic past four weeks.

 

"Reducing the number of concussed adolescents who have delayed recovery has major implications," Willer said, noting that delayed recovery creates more difficulty with schoolwork, can lead to depression and puts additional demands on the health care system and its costs.

 

Expanding capacity for medically supervised exercise treatment

 

Michael J. Ellis, MD, co-author and medical director of the Pan Am Concussion Program in the Department of Surgery and Pediatrics at the University of Manitoba, said that for years, his clinic has been successfully using the Buffalo Concussion Treadmill Test and a medically supervised sub-symptom-threshold aerobic exercise program to treat professional, collegiate and elite adolescent athletes.

 

Expanding access to this treatment is now critical, he said.

 

"The results of this study suggest that we must build greater capacity within our health care systems to allow patients access to multidisciplinary concussion programs and clinics that have the medical expertise to carry out early targeted rehabilitation of acute concussion," he said.

 

Leddy and Willer are internationally known for their research into the best ways to diagnose and treat concussion, especially among adolescents, who are the most vulnerable age group for concussions and take the longest time to recover. They have led the emerging body of research findings that show that a patient's degree of exercise intolerance in the first week after injury, i.e., the lower the threshold of activity at which symptoms increase, is a key clinical indicator of how severe the concussion may be.

https://www.sciencedaily.com/releases/2019/02/190204114615.htm

Despite common obesity gene variants obese children lose weight after lifestyle changes

November 28, 2018

Science Daily/University of Copenhagen The Faculty of Health and Medical Sciences

Children who are genetically predisposed to overweight, due to common gene variants, can still lose weight by changing their diet and exercise habits, according to a new study.

 

Overweight and obesity constitute an increasing global problem that may lead to serious sequelae such as heart attacks, diabetes and cancer. In 2016, 124 million children and adolescents worldwide suffered from obesity. Now researchers from the University of Copenhagen and the Children's Obesity Clinic, the Department of Paediatrics at Holbæk Hospital have examined how genetics affect children and young people's ability to lose excess weight.

 

'We are trying to understand the genetic driving force behind overweight and whether this force also makes it impossible for some to lose weight. We show that a high genetic predisposition to overweight during childhood in fact had no influence on whether the children reacted to lifestyle intervention compared to children with low genetic predisposition to overweight. The 15 genetic variants we have studied are common in the population and are the ones that in general increase a child's risk of becoming overweight,' says Postdoc at the Novo Nordisk Foundation Center for Basic Metabolic Research at UCPH Theresia Maria Schnurr, who is one of the authors of the study.

 

The new research results have just been published in the scientific journal Obesity. The researchers' aim was to determine the influence of specific gene variants on children and adolescents' ability to lose weight. Therefore, they studied the 15 specific gene variants implicated in childhood obesity and which are common in the population. In the study, the researchers demonstrate that these genetic variants did not predict whether children and adolescents' were able to lose weight when they changed their lifestyle. So far only children with a rare genetic mutation in the MC4R gene do not seem to lose weight when undergoing lifestyle intervention.

 

Lifestyle Intervention Led to Weight Loss

 

The researchers examined 754 children and adolescents with overweight and obesity. The median age was 11.6 years. The genetic profile of all participants was mapped, and the researchers then calculated a genetic risk score for childhood overweight for each participant based on the 15 genetic variants. They all carried one or more of the 15 genetic variants associated with increased risk for obesity and overweight during childhood. To determine whether a genetic predisposition for overweight affected the children and adolescents' ability to lose weight the children had to implement a series of lifestyle changes.

 

They followed a treatment protocol developed at Holbæk Hospital. The protocol centres around the family with behavioural lifestyle changes. For example, the children and adolescents had to change their diet, means of transportation, physical activity, sedentary activity, amount of sleep, consumption of snacks and sweet things and social activities. The intervention lasted six to 24 months. Subsequently, the researchers followed up on the treatment and found that the lifestyle changes had affected the weight of the participants, despite their genetic disposition for overweight and obesity.

 

'Large parts of the population believes that when you have problematic genes it is game over. That is why it is very important we send a clear message that even though you have a genetic sensitivity this treatment can help people. We have discovered that it does not matter whether the children and adolescents have an increased genetic risk score or not. They can respond to treatment just as well. This means our treatment is efficient despite carrying common obesity risk genes. It gives hope to people with obesity and obesity related complications such as high blood pressure, cholesterol and fatty liver that we can in fact help them,' says one of the study's authors Jens-Christian Holm, doctor and head of the Children's Obesity Clinic, Holbæk Hospital.

 

Genetic Markers

 

The genetic variants the researchers have examined are common in the population and turned out not to have an effect on the ability to lose weight during the intervention. So far, the researchers did not find any biological markers for a poor response on lifestyle intervention except for the rare gene MC4R associated with poor response in terms of weight loss following a lifestyle intervention.

 

'MC4R is a rare genetic mutation and thus the question remains why around 75 percent of children in a group of children receiving the exact same treatment react more positively to the treatment compared to the remaining 25 percent of children not responding to lifestyle treatment. Identifying additional common genetic markers would help us understand the biological pathways that affect obesity and a person's reaction to lifestyle changes -- and thus in the long term help us provide even better treatments,' says Professor at the Novo Nordisk Foundation Center for Basic Metabolic Research Torben Hansen, last author of the study.

https://www.sciencedaily.com/releases/2018/11/181128115006.htm

Does a woman's weight gain during pregnancy affect children's bone health?

November 7, 2018

Science Daily/Wiley

A new study has examined whether managing weight during pregnancy might affect children's bone mass. In under/normal weight mothers, weight gain during pregnancy was associated with slightly increased bone mass at seven years of age in children, while in overweight/obese mothers, no beneficial effect of weight gain on bone mass was observed.

 

In the Journal of Bone and Mineral Research study, investigators analyzed prospective data from 2,167 mother-child pairs from Portugal. In under/normal weight mothers, weight gain during pregnancy was associated with slightly increased bone mass at 7 years of age in children, while in overweight/obese mothers, no beneficial effect of weight gain on bone mass was observed.

 

Given the well-known adverse implications of excessive weight gain during pregnancy for both the mother and child on various aspects of health, following the current recommendations on pregnancy weight gain should not have consequences on children's skeletal health.

 

"Until recently, it was a widely held scientific belief that any weight gain from the mother during pregnancy would have a beneficial effect on children's bone mass. Our study results corroborate that there is no benefit in gaining weight above the US Institute of

 

Medicine recommendations for pregnancy weight gain for children's bone mass, in both normal and overweight women prior to pregnancy," said lead author Dr. Teresa Monjardino, of the Universidade do Porto, in Portugal.

https://www.sciencedaily.com/releases/2018/11/181107082520.htm

Childhood obesity linked to poor school performance and coping skills

November 2, 2018

Science Daily/American Academy of Pediatrics

Study suggests that childhood obesity, now at epidemic levels in the United States, may affect school performance and coping skills for challenging situations.

 

Researchers analyzed responses from 22,914 parents and caregivers of children aged 10-17 years who participated in the 2016 National Survey of Children's Health. The goal was to determine the independent association between body mass index (BMI) and five markers of "flourishing," or overall well-being as it relates to the development of positive psychosocial and coping skills.

 

"Childhood obesity is one of the biggest public health challenges we face today," said Natasha Gill, MD, FAAP, a Pediatric Emergency Medicine Fellow at the Alpert Medical School of Brown University and Hasbro Children's Hospital. "We know that children with obesity are at a greater risk for long-term health conditions that can last into adulthood, and we wanted to see whether obesity affects a child's immediate well-being as it relates to development of psychosocial skills and other signs of flourishing."

 

Adjusting for several confounding variables, including gender, child depression status, average sleep hours per night, average digital media exposure per day, highest parental education level, and household poverty status, Dr. Gill and her colleagues analyzed parents' responses to questions about whether their child:

 

·     "Shows interest and curiosity in learning new things"

·     "Works to finish tasks he or she starts"

·     "Stays calm and in control when faced with a challenge"

·     "Cares about doing well in school"

·     "Does all required homework"

 

Researchers found that only 27.5 percent of children with obesity, defined as a BMI at or above the 95th percentile for children and teens of the same age and sex, were reported to have all five flourishing markers. This compares with 36.5 percent of those in the overweight range, with BMI at or above the 85th percentile, and 39 percent of children with normal BMI.

 

"The negative relationship between obesity and flourishing markers suggests that when compared to children with a normal BMI, obese youth may be less likely to develop healthy relationships, positive attitudes, a sense of purpose and responsibility, and interest in learning," Dr. Gill said. "Individual markers of flourishing have been shown to stay the same over time like a person's personality," she said, "so it may be important to monitor these markers in childhood to ensure optimal development into adulthood."

 

"We want all children to reach their maximum potential," she said. "If we can intervene early enough, we can promote positive physical, mental, and social development for these at-risk children and help them become responsible, hard-working members of society." She said her study's findings support the need for focused and coordinated efforts and resources from schools and health care providers that target obesity to improve overall well-being.

https://www.sciencedaily.com/releases/2018/11/181102083441.htm

Childhood antibiotics and antacids may be linked to heightened obesity risk

These drugs may alter gut microbes associated with weight gain, say researchers

October 30, 2018

Science Daily/BMJ

Young children prescribed antibiotics and, to a lesser extent, drugs to curb excess stomach acid, may be at heightened risk of obesity, new research suggests.

 

These drugs, particularly if taken for lengthy periods, may alter gut microbes that have been associated with weight gain, explain the researchers.

 

The composition of gut bacteria (the microbiome) has been linked to various aspects of human health, including obesity. And certain drugs, such as antibiotics and acid suppressants-histamine 2 receptor antagonists (H2RA) and proton pump inhibitors (PPIs)-can alter the type and volume of bacteria in the gut.

 

To try and find out if exposure to these drugs in early childhood might increase the risk of obesity, the researchers looked at the medicines prescribed to 333,353 infants, whose medical records had been input into the US Military Health System database between 2006 and 2013, in the first two years of their lives.

 

In all, 241, 502 (72.5%) had been prescribed an antibiotic; 39,488 (just under 12%) an H2RA; and 11,089 (just over 3%) a PPI during this period. Some 5868 children were prescribed all three types of drug.

 

Some 46,993 (just over 14%) children became obese, of whom 9628 (11%) had not been prescribed any antibiotics or acid suppressants.

 

Boys, those born after a caesarean section, and those whose parents were below officer rank were more likely to become obese.

 

But after taking account of potentially influential factors, a prescription for antibiotics or acid suppressants was associated with a heightened risk of obesity by the age of 3 -- the average age at which obesity was first identified in these children.

 

A prescription for antibiotics was associated with a 26 per cent heightened risk of obesity. This association persisted, irrespective of antibiotic type, and strengthened with each additional class of antibiotic prescribed.

 

Acid suppressants were also associated with a heightened obesity risk, although to a lesser extent, and this association strengthened for each 30-day supply prescribed.

 

Although the largest study of its kind, it is nevertheless observational, and as such, can't establish cause. And potentially influential information on how much the children's mothers weighed, and whether they smoked or had other underlying conditions wasn't available.

 

And the researchers emphasise that the links between the individual, the environment, and obesity are complex, highlighting the "current difficulty of drawing clear conclusions about the interplay between exposure history, gut microbiota and propensity to develop obesity."

 

They add: "There is an important therapeutic role for microbiota-altering medications. The long term risks to health must be weighed against the short-term benefits."

 

But they also point out that over prescription of both antibiotics and acid suppressants, including in young children, is "a significant problem."

https://www.sciencedaily.com/releases/2018/10/181030184507.htm

Gut microbiota of infants predicts obesity in children

October 23, 2018

Science Daily/American Society for Microbiology

Evaluating the gut microbiota of infants may help identify children who are at risk for becoming overweight or obese. The research revealed that gut microbiota composition at two years of life is associated with body mass index (BMI) at age 12. In addition, the BMI at age two was not significantly higher in children who later became overweight/obese, indicating that gut microbiota composition may be the earliest warning sign for detecting obesity.

 

"Our study provides more evidence that the gut microbiota might be playing a role in later obesity," said lead author Maggie Stanislawski, PhD, who is a research associate at the LEAD Center, University of Colorado Anschutz Medical Campus, Colorado School of Public Health, Aurora, Colorado. "If our findings can be confirmed by other studies, the gut microbiota might play an important part of the obesity prediction algorithm, to identify at-risk kids early in life, before they start to gain any excess weight that might put them at risk for later obesity."

 

Prior to this study, a growing body of evidence has demonstrated that the gut microbiota plays a role in obesity, and there is some evidence that the role might be causal. To shed more light on the issue, the University of Colorado researchers collaborated with Merete Eggesbø, MD, PhD, who leads the NoMIC study at the Norwegian Institute of Public Health in Oslo, and analyzed data from 165 infants who had BMI measured at 12 years.

 

The NoMIC study began in 2002 as one of the earliest birth cohorts in the world to investigate the early life gut microbiome and includes roughly 550 kids who are now teenagers. The study recruited moms and infants in the hospital at the time of delivery. At 12 years of age, 20% of the 165 children in the study cohort were overweight or obese.

 

The researchers compared the BMI at age 12 with gut microbiota samples from six time points throughout their childhood, at day 4, day 10, one month, four months, one year, and two years. They performed 16s rRNA gene sequencing on the gut microbiota samples. "We looked at whether there were specific taxa that were predictive of later BMI at each time point," said Dr. Stanislawski.

 

The researchers found qualitative differences in the composition of children's gut microbiota at day ten and at two years that were associated with BMI z-scores at age 12. BMI z-scores are measures of relative weight adjusted for child age and sex. They also examined how much of the variation in childhood BMI z-scores was explained by the early gut microbiota taxa.

 

"At the early time points, there was somewhat of a relationship between the gut microbiota taxa and later BMI, but the relationship was much stronger as the kids got older," said Dr. Stanislawski. "At one year, it was stronger than the earlier time points. At two years, it was the strongest. We found this very interesting because, at two years, there wasn't any obvious phenotype in terms of whether or not the kids were going to become obese. Kids who became obese later in life didn't have high BMI z-scores at age 2. The findings suggest that the gut microbiota phenotype was present before any overt sign of overweight or obesity. Since the gut microbiota is influenced by diet, this association could also reflect dietary choices that are precursors to obesity."

 

Dr. Stanislawski said the study was limited in that the entire cohort was of Norwegian descent. This research, she said, needs to be repeated in other cohorts, but if replicated, it may lead to a new tool to identify kids at risk for developing obesity. "It is better to identify at-risk kids early. It is easier to prevent obesity than to reverse it," said Dr. Stanislawski. "It's possible that if we follow up some of these findings in the lab, it will reveal more about the pathophysiology of obesity as well."

 

The study also exposed a potential health caution. The researchers found that some gut microbes that are generally thought to be healthy in both children and adults were associated with higher childhood BMI. This highlights that we do not fully understand the dynamics of the gut colonization process.

 

"When I was pregnant, my doctor suggested giving the baby probiotics every day, and I think a lot of people are giving their infants probiotics," said Dr. Stanislawski. "However, it might not be the best idea to give babies the same types of bacteria every day, particularly in very early life when overloading the gut with one or two strains may prevent colonization with other types of important bacteria." She pointed out that one way to improve the gut microbiota in kids and adults is to eat a well-balanced diet with lots of different types of vegetables and fiber, so there are lots of things feeding the gut microbiota.

 

Future research will focus on further examining the colonization process in relation to other markers of metabolic health in children. "We will focus on the temporal dynamics of first two years," said Dr. Stanislawski.

https://www.sciencedaily.com/releases/2018/10/181023085640.htm

Effects of a high-fat diet may be passed on for three generations

October 12, 2018

Science Daily/BioMed Central

A high-fat diet in female mice affects their offspring's obesity, insulin resistance and addictive-like behaviors for three generations, according to a new study.

 

Researchers at ETH Zurich, Switzerland showed that second generation offspring -- grandchildren of mice that had consumed a high-fat diet before, during and after pregnancy showed addictive-like behaviors such as increased sensitivity and preference for drugs, as well as characteristics of obesity, including changes in their metabolism. In third generation offspring (the great grandchildren), the authors observed differences between males and females, with only females showing addictive-like behaviors and only males showing obesity characteristics.

 

This was the case although the original female mice themselves never became obese and although none of the following generations consumed a high-fat diet.

 

Dr Daria Peleg-Raibstein, the corresponding author said: "Most studies so far have only looked at the second generation or followed the long-term effects of obesity and diabetes on the immediate offspring. This study is the first to look at the effects of maternal overeating up until the third generation in the context of addiction as well as obesity."

 

The authors investigated these effects specifically for transmission via male offspring up until, and including, the third generation. To do so, they fed female mice either high-fat diet or a standard laboratory diet for nine weeks -- pre-mating, during pregnancy and during lactation. Their male offspring were then mated with females that had been fed a standard laboratory diet to generate the second-generation offspring. The male offspring of these mice was again mated with females that had been fed a standard laboratory diet to generate the third-generation offspring.

 

The authors measured body weight, insulin sensitivity, metabolic rates, and blood plasma parameters such as insulin and cholesterol in second and third-generation offspring. In behavioral experiments they investigated if the mice chose a high-fat over a standard laboratory diet or an alcohol solution over water, as well as their activity levels after exposure to amphetamines. They did this to better understand if a maternal high-fat diet had an effect on obesity, overeating and drug sensitivity in subsequent generations.

 

Dr Peleg-Raibstein said: "To combat the current obesity epidemic, it is important to identify the underlying mechanisms and to find ways for early prevention. The research could help improve health advice and education for pregnant and breastfeeding couples and give their children, grandchildren and great-grandchildren a better chance of a healthy lifestyle. It may also provide a way of identifying risk factors for how people develop obesity and addiction and suggest early interventions for at-risk groups."

 

Dr Peleg-Raibstein added: "It is quite a leap to apply conclusions from mouse studies to humans, but studying effects of maternal over-eating is almost impossible to do in people because there are so many confounding factors, such as socio-economic background, the parents' food preferences or their existing health conditions. The mouse model allowed us to study the effects of a high-fat diet on subsequent generations without these factors."

 

Further studies are needed to determine the molecular mechanism by which the effects of a female high-fat diet may be passed on to following generations.

https://www.sciencedaily.com/releases/2018/10/181012082710.htm

Vitamin D supplements may promote weight loss in obese children

September 27, 2018

Science Daily/European Society for Paediatric Endocrinology

Vitamin D supplements may promote weight loss and reduce risk factors for future heart and metabolic disease in overweight and obese children, according to new research. These findings indicate that simple vitamin D supplementation may be part of an effective strategy to tackle childhood obesity and reduce the risk of serious health problems, such as heart disease, in adulthood.

 

Obesity in childhood and adolescence represents a major health problem worldwide, which leads to the development of expensive, serious and debilitating complications, including heart disease and diabetes, in later life. Although vitamin D deficiency is typically associated with impaired bone health, in recent years it has been increasingly linked with increased body fat accumulation and obesity, with the precise nature of this relationship currently under intense investigation by researchers. However, the effect of vitamin D supplementation on the weight and health of obese children and adolescents had not yet been investigated.

 

In this study, Dr. Christos Giannios, Professor Evangelia Charmandari and colleagues at the University of Athens Medical School and the 'Aghia Sophia' Children's Hospital in Athens, assessed 232 obese children and adolescents over 12 months, with 117 randomly assigned to receive vitamin D supplementation, in accordance with the Endocrine Society's guidelines on treatment and prevention of deficiency. Levels of vitamin D, body fat, and blood markers of liver function and heart health were assessed at the start of the study and 12 months later. The study reported that children given vitamin D supplements had significantly lower body mass index, body fat and improved cholesterol levels after 12 months of supplementation.

 

"These findings suggest that simple vitamin D supplementation may reduce the risk of overweight and obese children developing serious heart and metabolic complications in later life," says lead researcher Prof Charmandari.

 

The team now plan to investigate the effects of vitamin D supplementation on the health of obese children and adolescents that already have unhealthy conditions, such as high blood pressure, high blood glucose and high cholesterol, all of which increase the risk of heart disease, stroke and diabetes.

 

Prof Charmandari cautions, "Although these initial findings indicate that vitamin D could be used in the treatment of obesity, there remains a lack of evidence on the safety and long-term effects of supplementation, particularly if there is no vitamin D deficiency. However, if your child is overweight or obese I recommend that you consult your primary care physician for advice, and consider having their vitamin D levels tested."

https://www.sciencedaily.com/releases/2018/09/180927215656.htm

Overweight pregnant women can safely cut calories, restrict weight gain

Healthier for mom and baby to control mom's weight gain during pregnancy

September 24, 2018

Science Daily/Northwestern University

With proper nutrition guidance, it is safe and feasible to restrict weight gain in obese and overweight pregnant women, a new study shows.

 

Being obese or overweight during pregnancy can result in serious health problems for the mother and child. Obstetricians are often reluctant to recommend restricted weight gain for pregnant women due to safety concerns for the baby and lack of time and tools to safely guide women in their weight control efforts.

 

A new Northwestern Medicine study shows with proper nutrition guidance it is safe and feasible to restrict weight gain in obese and overweight pregnant women. The obese and overweight women in the study gained five pounds less during their pregnancy than those in the control group. Their babies were born in the normal weight range.

 

The approach included nutritional counseling on a healthy diet and lifestyle as supported by a commercially available smartphone diet app, with ongoing coaching via the phone and online.

 

"We need to help these women, who make up the majority of pregnancies in the U.S, leverage this unique opportunity during their pregnancy to adopt a healthier diet and lifestyle plan that they can follow throughout pregnancy and, hopefully, post-partum," said lead study author Linda Van Horn, professor of preventive medicine at Northwestern University Feinberg School of Medicine. "These results show promise in harnessing modern technology to help a mom achieve those goals."

 

The majority of U.S. women of reproductive age are overweight or obese, and the risk of excess gestational weight gain is higher for them than women of healthy weight. Among the risks for women and their babies: diabetes, preeclampsia, hypertension and birth defects.

 

Van Horn, along with obstetrician colleague Dr. Alan Peaceman, developed and led the study, called MOMFIT (Maternal Offspring Metabolics: Family Intervention Trial). It was part of the Lifestyle Interventions for Expectant Moms (LIFE-Moms) Consortium, a National Institutes of Health (NIH)-supported research project, with each study implementing separate interventions.

 

The Northwestern study was novel because it concentrated on improving diet quality and healthy lifestyle in the moms using modern tools and focused on potential maternal fetal nutrition advantages that could have lifelong benefits, Van Horn said.

 

The study will be published Sept. 24 in the American Journal of Preventive Medicine.

 

This is believed to be the first study of obese and overweight pregnant women using a technologically advanced, commercially available weight-loss smartphone app to test the effects of a specially tailored diet combined with modest physical activity.

 

Existing commercial weight control technologies target non-pregnant women and don't address prenatal energy and nutrient needs, the authors said. Most commercial apps are designed to support weight loss. During pregnancy, weight gain is anticipated and appropriate, but it should be curtailed in overweight and obese women.

 

"MOMFIT demonstrates the feasibility of counseling pregnant women in healthy diet and lifestyle behaviors through nutrition coaching using modern technology," Van Horn said. "Applying this approach in a clinical setting could help women achieve recommended weight-gain goals during pregnancy and improve postpartum lifestyle behaviors for the whole family."

 

One unusual outcome of the trial was a higher rate of cesarean sections for the women in the intervention group. Researchers are investigating possible contributors to this finding.

 

Will MOMFIT kids have less risk of developing obesity?

 

"The next big question is whether the children born to moms who restricted their weight gain will have a reduced risk of becoming obese themselves compared to children whose moms were in the control group," Van Horn said.

 

Children born to overweight and obese moms have more than a 50 percent chance of becoming overweight themselves. If both parents are overweight or obese, this risk can increase to more than 70 percent, according to epidemiological data.

 

The difference in the children's obesity risk won't be evident until they are three, four and five years old, which is when weight trajectories start to separate. Van Horn and colleagues have recently launched a new study -- KIDFIT -- to monitor the children of the women in her MOMFIT study and determine whether prenatal and/or postpartum diet and lifestyle counseling can help these children lower their risk of obesity.

 

Rebooting the whole family's diet

 

The study's goal was not weight loss. "Weight loss during pregnancy is not encouraged. Rather, we aimed for controlled weight gain by developing healthy diet habits and increasing physical activity that could be sustained long term.

 

"The overarching goal of MOMFIT was to help the mom make these changes while she was still pregnant, a time when many women are more motivated to do what is right for their babies, and then maintain these new behaviors and become a role model for the family and better informed about how to feed them," Van Horn said.

 

"The perpetuation of obesity is a never-ending cycle. We're attempting to interrupt that cycle and successfully influence the risk for developing pediatric obesity starting in utero and -- with additional follow up -- protect that child from adopting that parental heritage in the family home."

 

Fewer participants in the intervention group, 68.6 percent versus 85 percent, exceeded the National Academy of Medicine recommendations for pregnancy weight gain for obese and overweight women, which is limited to 11 to 25 pounds compared to 25 to 35 pounds for women of healthy weight. This is important evidence demonstrating the challenges of encouraging pregnant women to adhere to recommended diet and activity levels at a time when emotional-eating and reluctance to exercise tend to increase.

 

How the study worked

 

MOMFIT studied 281 ethnically diverse overweight or obese women ages 18 to 45, who were divided into the intervention or control group. Women in the intervention group met with a nutritionist who calculated the appropriate amount of calories for each participant and counseled her on a DASH-type diet -- higher in fruits, vegetables, whole grains, nuts, fish and lean protein. It was modified to the restricted weight gain recommendations for each participant.

 

The DASH (Diet Approach to Stopping Hypertension) eating pattern is ideally suited to pregnancy, providing a pregnant woman with the calcium, potassium and protein she needs without the salt, sugar and saturated fat that she does not need, Van Horn said.

 

The women were also encouraged to walk at least 30 minutes or take 10,000 steps per day. The nutrition coach tracked each woman's weight gain, food intake and exercise. Telephone, text message prompts and e-mail reminders encouraged women to adhere to the program.

 

"It was technologically convenient yet strategic and nutritionally individualized," Van Horn said. "MOMFIT took a precision medicine approach to healthy eating utilizing a commercially available product."

 

Women tracked their food intake with the Lose It! app. Participants were also encouraged to sleep seven to nine hours daily, because sleep deprivation hampers metabolism and contributes to weight gain.

https://www.sciencedaily.com/releases/2018/09/180924084332.htm

Young children's oral bacteria may predict obesity

September 19, 2018

Science Daily/Penn State

Weight gain during early childhood is related to the composition of oral bacteria of two-year-old children, suggesting this understudied aspect of a children's collection of microorganisms could serve as an early indicator for childhood obesity.

 

Weight gain trajectories in early childhood are related to the composition of oral bacteria of two-year-old children, suggesting that this understudied aspect of a child's microbiota -- the collection of microorganisms, including beneficial bacteria, residing in the mouth -- could serve as an early indicator for childhood obesity. A study describing the results appears September 19 in the journal Scientific Reports.

 

"One in three children in the United States is overweight or obese," said Kateryna Makova, Pentz Professor of Biology and senior author of the paper. "If we can find early indicators of obesity in young children, we can help parents and physicians take preventive measures."

 

The study is part of a larger project with researchers and clinicians at the Penn State Milton S. Hershey Medical Center called INSIGHT, led by Ian Paul, professor of pediatrics at the Medical Center, and Leann Birch, professor of foods and nutrition at the University of Georgia. The INSIGHT trial includes nearly 300 children and tests whether a responsive parenting intervention during a child's early life can prevent the development of obesity. It is also designed to identify biological and social risk factors for obesity.

 

"In this study, we show that a child's oral microbiota at two years of age is related to their weight gain over their first two years after birth," said Makova.

 

The human digestive tract is filled with a diverse array of microorganisms, including beneficial bacteria, that help ensure proper digestion and support the immune system. This "microbiota" shifts as a person's diet changes and can vary greatly among individuals. Variation in gut microbiota has been linked to obesity in some adults and adolescents, but the potential relationship between oral microbiota and weight gain in children had not been explored prior to this study.

 

"The oral microbiota is usually studied in relation to periodontal disease, and periodontal disease has in some cases been linked to obesity," said Sarah Craig, a postdoctoral scholar in biology at Penn State and first author of the paper. "Here, we explored any potential direct associations between the oral microbiota and child weight gain. Rather than simply noting whether a child was overweight at the age of two, we used growth curves from their first two years after birth, which provides a more complete picture of how the child is growing. This approach is highly innovative for a study of this kind, and gives greater statistical power to detect relationships."

 

Among 226 children from central Pennsylvania, the oral microbiota of those with rapid infant weight gain -- a strong risk factor for childhood obesity -- was less diverse, meaning it contained fewer groups of bacteria. These children also had a higher ratio of Firmicutes to Bacteroidetes, two of the most common bacteria groups found in the human microbiota.

 

"A healthy person usually has a lot of different bacteria within their gut microbiota," said Craig. "This high diversity helps protect against inflammation or harmful bacteria and is important for the stability of digestion in the face of changes to diet or environment. There's also a certain balance of these two common bacteria groups, Firmicutes and Bacteroidetes, that tends to work best under normal healthy conditions, and disruptions to that balance could lead to dysregulation in digestion."

 

Lower diversity and higher Firmicutes to Bacteroidetes (F:B) ratio in gut microbiota are sometimes observed as a characteristic of adults and adolescents with obesity. However, the researchers did not see a relationship of weight gain with either of these measures in gut microbiota of two-year-olds, suggesting that the gut microbiota may not be completely established at two years of age and may still be undergoing many changes.

 

"There are usually dramatic changes to an individual's microbiota as they develop during early childhood," said Makova. "Our results suggest that signatures of obesity may be established earlier in oral microbiota than in gut microbiota. If we can confirm this in other groups of children outside of Pennsylvania, we may be able to develop a test of oral microbiota that could be used in clinical care to identify children who are at risk for developing obesity. This is particularly exciting because oral samples are easier to obtain than those from the gut, which require fecal samples."

 

Interestingly, weight gain in children was also related to diversity of their mother's oral microbiota. This could reflect a genetic predisposition of the mother and child to having a similar microbiota, or the mother and child having a similar diet and environment.

 

"It could be a simple explanation like a shared diet or genetics, but it might also be related to obesity," said Makova. "We don't know for sure yet, but if there is an oral microbiome signature linked to the dynamics of weight gain in early childhood, there is a particular urgency to understand it. Now we are using additional techniques to look at specific species of bacteria -- rather than larger taxonomic groups of bacteria -- in both the mothers and children to see whether specific bacteria species influence weight gain and the risk of obesity."

https://www.sciencedaily.com/releases/2018/09/180919083508.htm

Strength-based exercises could help child obesity fight

September 19, 2018

Science Daily/University of Edinburgh

Encouraging young people to do strength-based exercises -- such as squats, push ups and lunges -- could play a key role in tackling child obesity, research suggests.

 

Taking part in exercises that cause muscles to contract, and strengthen muscles and bones, was found to reduce children's body fat percentage.

 

The findings also suggests an increase in muscle mass -- gained from strength-based exercises -- could help boost children's metabolism and energy levels.

 

The effects were small but meaningful, prompting calls for further research to investigate how resistance training could treat and prevent the growing issue of child obesity.

 

Researchers at the Universities of Edinburgh and Dundee examined the findings from a number of studies that explored effects of resistance training on body weight for children aged nine to 18 years.

 

They found that resistance training decreased body fat, but had no overall effect on other measures, including lean muscle mass, body mass index and waist circumference.

 

This is the most extensive review so far of resistance training's impact on young people.

 

Research from 18 studies across eight countries was examined, including the US, Australia, and Japan.

 

Helen Collins, a PhD student at the University of Edinburgh and Sport and Exercise Scientist at the University of Dundee, said the results show the positive effect resistance training can have on maintaining a healthy weight and reducing body fat for young people.

 

"Treatment, and more importantly, prevention, of child obesity is a growing concern. Our findings highlight the need for more robust research into the role strength-based exercises can play in helping everyone make healthy life choices and be more physically active."

https://www.sciencedaily.com/releases/2018/09/180919083145.htm

Either too much or too little weight gain during pregnancy is associated with adverse outcomes in children aged 7 years

September 17, 2018

Science Daily/Diabetologia

New research shows that if a woman gains either too much or too little weight during pregnancy, there are adverse effects in children at 7 years of age.

 

There have been various studies on the effects of weight gain during pregnancy (gestational weight gain or GWG), however data on the metabolic effects in the children subsequently born have not been comprehensively studied. This study aims to evaluate the relationship between GWG and cardiometabolic risk in offspring aged 7 years.

 

The study included a total of 905 mother-child pairs who were enrolled in the follow-up visit of the multicentre Hyperglycemia and Adverse Pregnancy Outcome study, at the study centre in Hong Kong. Women were classified as having gained weight below, within or exceeding the 2009 Institute of Medicine (IOM) guidelines. Also factored in the study were standardised GWG values based on pre-pregnancy body-mass index (BMI).

 

Among the 905 women, the mean pre-pregnancy BMI was 21 kg/m2, the total prevalence of overweight and/or obese participants was 8.3%. The weight change from pre-pregnancy to delivery was 15kg on average, with 17% having gained weight below, 42% having gained weight within and 41% having gained weight exceeding the IOM recommendation.

 

Independent of pre-pregnancy BMI, gestational hyperglycaemia and other confounders, women who gained more weight than the IOM recommendation had offspring with larger body size at age 7 years, and increased odds of higher body fat, high blood pressure and poor blood sugar control, while women who gained less than the recommendation had offspring with increased risks of high blood pressure and poor blood sugar control at 7 years of age, compared with those who gained weight within the recommended range.

 

The authors say: "We found evidence of linkage between GWG and several cardiometabolic risk factors in the offspring aged 7 years, independently of maternal BMI prior to pregnancy and glucose level during pregnancy. These findings have important implications for both prevention and treatment. There is a need for greater awareness and monitoring of weight gain during pregnancy. Pregnancy might be a potential window of opportunity for intervention through modifiable behaviours, including maternal nutrition and physical activity."

 

However, they add: "Although limiting excessive GWG may help minimise the intergenerational cycle of obesity, the benefits of lower weight gain must be balanced against other cardiometabolic risks -- such as high blood pressure and poorer blood sugar control -- and risk of stunted growth in the offspring if GWG is inadequate."

 

They conclude: "Long-term follow-up of these children is necessary to evaluate the effect of maternal GWG on cardiometabolic risk in adolescence and adulthood."

https://www.sciencedaily.com/releases/2018/09/180917191907.htm

Fish oil supplement in pregnancy is linked to increase in lean and bone mass by age 6 years

September 4, 2018

Science Daily/BMJ

Taking fish oil supplements in the later stages of pregnancy is associated with a higher weight (BMI) in children in the first six years of life, but not an increased risk of overweight or obesity by age 6, a new study suggests.

 

Fish oil supplement in the later stages of pregnancy is associated with a higher body mass index (BMI) in children in the first six years of life, which is explained by an increase in total lean and bone mass at 6 years of age, but with no increase in fat mass, suggest the findings of a large randomised controlled trial published by The BMJ today.

 

Studies in animals have shown that supplementing the diet with fish oil during pregnancy affects adipogenesis (the development of fat cells). However, while trials in humans have shown that pregnant women with a higher intake of fish oil give birth to higher birth weight infants, the impact on children later in life has been unclear.

 

So a team of researchers based in Denmark and the UK set out to examine the effect of taking fish oil supplements during pregnancy on the growth and body composition of children later in life.

 

The trial involved 736 pregnant women from the Copenhagen Prospective Studies on Asthma in Childhood study who were randomised to receive n-3 long-chain polyunsaturated fatty acids (LCPUFAs) (fish oil) or olive oil (control) daily from week 24 of pregnancy week until one week after birth.

 

Height, weight, head and waist measurements were assessed 11 times from birth to age 6 years and adjusted for age and sex. These revealed a sustained higher BMI from 1 year to 6 years of age.

 

Body composition was assessed using dual-energy X-ray absorptiometry (DXA) scans at 3.5 and 6 years of age and demonstrated that the higher BMI was not the result of a higher fat percentage, but reflected a proportional increase in lean mass, bone mass, and fat mass, suggesting that the fish oil supplementation had a general growth stimulating effect.

 

At age 6, DXA scans showed children whose mothers had taken fish oil supplements while pregnant had a 395g higher total mass, 280.7g higher lean mass, 10.3g higher bone mineral content and 116.3g higher fat mass compared with children of mothers who took the control oil.

 

The researchers conclude: "The body composition at age 6 years in children given fish oil supplementation was characterised by a proportional increase in lean, bone, and fat mass suggesting a general growth stimulating effect."

https://www.sciencedaily.com/releases/2018/09/180904190616.htm

Switching to hunter-gatherer lifestyle may increase diversity in children's gut microbes

August 29, 2018

Science Daily/American Society for Microbiology

Immersing city dwellers in the traditional lifestyle and diet of a rainforest village for two weeks increases the diversity of the visiting children's -- but not the adults' -- gut microbiota. In a small pilot study, researchers show that the immersion visit did little to shift the adults' skin, oral, nasal and fecal microbiota.

 

An international team of researchers has shown that immersing city dwellers in the traditional lifestyle and diet of a rainforest village for two weeks increases the diversity of the visiting children's -- but not the adults' -- gut microbiota. In a small pilot study published this week in mSphere®, an open-access journal of the American Society for Microbiology, the team shows that the immersion visit did little to shift the adults' skin, oral, nasal and fecal microbiota.

 

"We wanted to look at the question of whether microbiota change during a drastic, radical change of diet and lifestyle," says Maria Gloria Dominguez-Bello, a microbial ecologist at Rutgers University in New Brunswick, New Jersey who led the study with microbiologist Monica Contreras from the Venezuelan Institute of Scientific Research. "In this village, there was no market economy, no bodega, no Coca-Cola -- so this represented a radical shift in diet from a high percentage of processed foods in urban places to zero processed foods and an all-natural diet."

 

Dominguez-Bello, along with researchers from New York University and two Venezuelan institutes, took advantage of a visit planned by five, city-dwelling adult visitors -- and two of their children -- to live among an indigenous Yekwana village in the Bolivar State of Venezuela for 16 days. The village has a hunter-gatherer-gardener lifestyle and diet.

 

Typical fare includes cassava (a starchy, high-fiber tuber), corn, various wild fruits, including plantains, pineapples, and berries, fish, and small amounts of game meat and eggs gathered from wild birds. Visitors had two meals a day that consisted of soup with a bit of fish or meat. The rest of their diet consisted of "all-day snacking on cassava with fruit" says Dominguez-Bello. The visitors also bathed in the river without soap and followed the natural circadian rhythms of their hosts.

 

"The diet contains very little animal protein and it's very, very high in fiber and very low in fat," compared to Western diets, says Dominguez-Bello.

 

While it is known that people with traditional diets have higher gut microbiota diversity compared to those with urban diets, it was unknown if urban dwellers could shift the diversity of their microbiota higher simply by following a traditional lifestyle and diet. In the gut, a high diversity of microbes is considered a sign of good health.

 

Traditional people eat diets rich in unprocessed plant material, which are much more chemically complex compared to processed foods. The smorgasbord of chemicals acts as fuel for a higher variety of microbes. Traditional people use less antimicrobial medicines and compounds in daily life, which might also contribute to their increased gut microbe diversity.

 

During the 16-day visit, the researchers collected samples from the visitors' skin, mouth, nose, and from a fecal swab. Age-matched samples were also collected from villagers. The samples were sequenced and compared.

 

Surprisingly, none of the adult visitors' microbiota shifted significantly during the visit, while the two children's gut microbiota trended toward a higher number of total microbial species present. Although these results were not statistically significant and in just two subjects, the researchers saw this as interesting nonetheless, given the children's ages of 4 and 7.

 

Up to now, it was thought that children's gut microbiota become stable and more 'adult-like' by the time they reach 3 years of age. "This indicates that the window for maturing your microbiome may not be 3 years of age, but longer," says Dominguez-Bello. Her team plans to do a larger study with 12 children participating in an "immersion summer camp" to a traditional village.

 

Because the children's gut microbiota exhibited more plasticity, these results raise an interesting possibility that urban children who eat a more traditional, high-fiber, low-fat and low-processed diet early in life might cultivate a more diverse set of gut microbes. Conversely, adults may have a limited response due to their low microbiome plasticity.

 

Dominguez-Bello was not terribly surprised that the adults' gut and other microbiota changed so little: "If you take traditional people and bring them to New York, give them antibiotics and McDonald's to eat everyday, it's not surprising that they lose diversity," she says. "But if, as an urban dweller, you've already lost that gut microbe diversity and you move to a high-diversity diet, maybe you cannot 'bloom' diversity because you simply don't have those microbes present anymore."

https://www.sciencedaily.com/releases/2018/08/180829133429.htm

Father's diet could affect the long-term health of his offspring

August 29, 2018

Science Daily/University of Nottingham

New research has shown that a lack of protein in a father's diet affects sperm quality which can have a direct impact on the long-term health of their offspring.

 

The study -- 'Paternal diet programs offspring health through sperm- and seminal plasma-specific pathways in mice' -- carried out at the University of Nottingham fed male mice a poor quality diet which resulted in their offspring becoming over weight, with symptoms of type 2 diabetes and reduced expression of genes which regulate the metabolism of fat.

 

Researchers from the University of Nottingham's Schools of Medicine and Biosciences have published a report in PNAS showing that both sperm and the fluid they are carried in (seminal plasma) from male mice fed a low protein diet could affect the long-term metabolic health of their offspring.

 

There has been much research showing that sperm from men who are overweight, smoke, drink excessively or who have type 2 diabetes are often of poorer quality than sperm from healthy, fertile men. However, little is known about the impact of such lifestyle factors on the long-term health of a father's offspring. This new study bridges this gap in our understanding by using a mouse model to explore the long-term growth and metabolic health of offspring from males fed a poor quality diet.

 

Improving dietary advice given to prospective fathers

 

Dr Adam Watkins, Assistant Professor in Reproductive Biology at the University of Nottingham led the study. He said: "It is well understood that what a mother eats during pregnancy can affect the development and health of her child. As such, there is a lot of information available to women who want to become pregnant about the importance of a healthy lifestyle and good dietary choices both for their own health and that of their child. Interestingly, little, if any, advice is available for the father. Our research using mice shows that at the time of conception, the diet and well-being of the father influences the long-term growth and metabolic health of his offspring. Our study not only identifies what impact a poor paternal diet has on the health of his offspring but also starts to uncover how these effects are established''.

 

The study, carried out on mice, found that males fed a low-protein diet produced sperm with fewer chemical tags on their DNA that regulate gene expression than mice fed a normal diet. Researchers also observed that the seminal plasma suppressed maternal uterine inflammatory and immunological responses, essential for a healthy pregnancy. The researchers believe that the health of a father's offspring is affected both by the quality of a father's genetic information passed on within the sperm at conception, and by the seminal plasma-primed maternal uterine environment in which the embryo will develop.

 

Kevin Sinclair, Professor of Developmental Biology in the School of Biosciences, who collaborated on this study said: "It is important to recognise that sperm contribute more than just half of the genes that make up a child. During natural conception sperm deposited in the female reproductive tract are bathed in seminal plasma which can in itself influence pregnancy outcomes. Our study shows that the composition of seminal plasma can be altered by father's diet, and that this can also influence offspring wellbeing."

https://www.sciencedaily.com/releases/2018/08/180829115539.htm

When fathers exercise, children are healthier, even as adults

October 22, 2018

Science Daily/Ohio State University Wexner Medical Center

Most parents know that the diet and exercise habits of a pregnant woman impacts the health of her baby, but little is known about how a father's health choices are passed to his children. A new study finds that lifestyle practices of fathers prior to conception may have a major impact on the lifelong health of their children.

 

In a new study led by Kristin Stanford, a physiology and cell biology researcher with The Ohio State University College of Medicine at the Wexner Medical Center, paternal exercise had a significant impact on the metabolic health of offspring well into their adulthood.

 

Laurie Goodyear of the Joslin Diabetes Center and Harvard Medical School co-led the study, published today in the journal Diabetes.

 

"This work is an important step in learning about metabolic disease and prevention at the cellular level," said Dr. K. Craig Kent, dean of the Ohio State College of Medicine.

 

Recent studies have linked development of type 2 diabetes and impaired metabolic health to the parents' poor diet, and there is increasing evidence that fathers play an important role in obesity and metabolic programming of their offspring.

 

Stanford is a member of Ohio State's Diabetes and Metabolism Research Center. Her team investigated how a father's exercise regimen would affect his offspring's metabolic health. Using a mouse model, they fed male mice either a normal diet or a high-fat diet for three weeks. Some mice from each diet group were sedentary and some exercised freely. After three weeks, the mice bred and their offspring ate a normal diet under sedentary conditions for a year.

 

The researchers report that adult offspring from sires who exercised had improved glucose metabolism, decreased body weight and a decreased fat mass.

 

"Here's what's really interesting; offspring from the dads fed a high-fat diet fared worse, so they were more glucose intolerant. But exercise negated that effect," Stanford said. "When the dad exercised, even on a high-fat diet, we saw improved metabolic health in their adult offspring."

 

Stanford's team also found that exercise caused changes in the genetic expression of the father's sperm that suppress poor dietary effects and transfer to the offspring.

 

"We saw a strong change in their small-RNA profile. Now we want to see exactly which small-RNAs are responsible for these metabolic improvements, where it's happening in the offspring and why," Stanford said.

 

Previous studies from this group have shown that when mouse mothers exercise, their offspring also have beneficial effects of metabolism.

 

"Based on both studies, we're now determining if both parents exercising has even greater effects to improve metabolism and overall health of offspring. If translated to humans, this would be hugely important for the health of the next generation," Goodyear said.

 

The researchers believe the results support the hypothesis that small RNAs could help transmit parental environmental information to the next generation.

 

"There's potential for this to translate to humans. We know that in adult men obesity impairs testosterone levels, sperm number and motility, and it decreases the number of live births," Stanford said. "If we ask someone who's getting ready to have a child to exercise moderately, even for a month before conception, that could have a strong effect on the health of their sperm and the long-term metabolic health of their children."

 

Other Ohio State researchers involved in the study were Lisa Baer, Adam Lehnig and Joseph White.

 

Funding from the National Institutes of Health supported this research.

https://www.sciencedaily.com/releases/2018/10/181022085844.htm

Increasing vigorous exercise decreases risk of type two diabetes, cardiovascular disease in childhood

October 15, 2018

Science Daily/University of Eastern Finland

Physical exercise can reduce the risk factors of type two diabetes and cardiovascular disease even in children, a new study shows. In a two-year follow-up of primary school children, sedentary behavior increased the accumulation of risk factors, whereas increasing the amount of vigorous exercise reduced it. This is one of the first follow-up studies to reliably demonstrate these associations in children.

 

The results are based on follow-up data from the Physical Activity and Nutrition in Children (PANIC) Study, ongoing at the University of Eastern Finland. Conducted in collaboration with scientists from the University of Cambridge, the Norwegian School of Sport Sciences and the University of Copenhagen, the findings of the study were published in the Scandinavian Journal of Medicine & Science in Sports.

 

The two-year follow-up study analysed associations of changes in the amount of vigorous, moderate and light exercise, as well as sedentary behaviour, with risk factors of type 2 diabetes and cardiovascular disease, such as body fat content, waist circumference, blood insulin and glucose levels, blood lipids and blood pressure. The amounts of vigorous, moderate and light exercise, as well as sedentary behaviour, were objectively measured using the Actiheart® device, which records heart rate and body movement. Children wore the Actiheart® device continuously for a minimum of four days, and the measurement period included weekdays and days of the weekend.

 

During the two-year follow-up, the overall risk and individual risk factors of type 2 diabetes and cardiovascular reduced in children who increased their amount of vigorous exercise. In children whose sedentary behaviour increased, the risk increased as well. These changes were independent of gender, biological maturity and lean body mass, as well as of the levels of risk factors and physical activity measured at the beginning of the study. The study is highly significant, as it is one of the first follow-up studies in the world to reliably show that increasing the amount of vigorous exercise is independently associated with a reduced risk of type 2 diabetes and cardiovascular disease in ordinary primary school children.

 

"A physically passive lifestyle is gradually becoming alarmingly widespread among children and young people almost all over the world. Our findings provide support for the role of physical activity in preventing common chronic diseases already in childhood," says Researcher Juuso Väistö, the first author of the article, from the University of Eastern Finland.

 

He points out that children and young people should engage in more physical exercise than what it takes to go about their daily activities.

 

"Our findings show that increasing the amount of vigorous exercise and reducing sedentary behaviour are equally important in preventing type 2 diabetes and cardiovascular disease. According to latest recommendations, children need diverse physical activity every day, and at least 60 minutes should be vigorous exercise. In practice, vigorous exercise refers to exercise or games that cause shortness of breath and perspiration."

 

Prevention of type 2 diabetes and cardiovascular disease are best begun already in childhood

 

The PANIC Study has earlier shown that the accumulation of risk factors of type 2 diabetes and cardiovascular disease, which typically exists in people who are overweight, often begins already in childhood. This is a cause for concern, as the accumulation of risk factors in childhood significantly increases the risk of these diseases in adulthood. According to this newly published study, regular exercise and avoiding a physically passive lifestyle constitute efficient means of mitigating the risk factors type 2 diabetes and cardiovascular disease.

 

PANIC Study -- a source of scientifically valuable data on children's health

 

The Physical Activity and Nutrition in Children (PANIC) Study is an on-going lifestyle intervention study. A total of 512 children aged 6 to 8 years participated in the onset measurements in 2007-2009. The study applies scientifically sound methods to extensively study the lifestyles, health and well-being of children. The study provides novel information on children's physical activity, sedentary behaviour, nutrition, physical fitness, body composition, metabolism, cardiovascular system function, brain function, oral health, life quality, effects of exercise and nutrition on children's health and well-being, and on the effects of these factors on health care costs.

https://www.sciencedaily.com/releases/2018/10/181015100459.htm

For preterm infants, skin-to-skin contact affects hormone levels -- and may promote parental engagement

October 19, 2018

Science Daily/Wolters Kluwer Health

For premature infants in the neonatal intensive care unit (NICU), skin-to-skin contact with parents influences levels of hormones related to mother-infant attachment (oxytocin) and stress (cortisol) -- and may increase parents' level of engagement with their infants.

 

Promoting early contact and parental engagement might help to lessen the risk of neurodevelopmental delay associated with preterm birth and NICU care, according to the exploratory study by Dorothy J. Vittner, PhD, RN, CHPE, of University of Connecticut School of Nursing and colleagues. They write, "Parental touch, especially during skin-to-skin contact (SSC) has potential to reduce adverse consequences."

 

Study Attempts to Measure Benefits of Skin-to-Skin Contact for Preterm Infants

 

The pilot study included 28 preterm infants, average gestational age 33 weeks. All infants were in stable condition while receiving NICU care. Infants underwent periods of SSC on two consecutive days: once with the mother and once with the father. Saliva samples were collected from infants and parents to measure levels of oxytocin, a hormone that has been linked to maternal-infant attachment; and the stress-related hormone cortisol.

 

"Oxytocin facilitates social sensitivity and attunement necessary for developing relationships and nurturance for emotional and physical health," the researchers write. Cortisol plays an important role in the "fight or flight" reaction to fear or stress.

 

Levels of both hormones changed in response to SSC. "Oxytocin significantly increased and cortisol levels decreased for mothers, fathers, and infants during SSC as compared to baseline," Dr. Vittner and coauthors write. The changes indicate the "calming and beneficial impact of SSC for both parents and infants."

 

Parents also completed a questionnaire called the "PREEMI" (Parent Risk Evaluation and Engagement Model and Instrument) scale, designed to measure attachment between parents and their preterm infants. Overall PREEMI scores indicated a "moderate to high" level of parental engagement for all participants.

 

Increased oxytocin and decreased cortisol levels during SSC were associated with higher PREEMI scores by the time the infant was discharged from the hospital. "We believe these findings suggest that parents with a lower salivary cortisol as seen with SSC (decreased stress) may facilitate increased parental engagement," Dr. Vittner and colleagues write.

 

Mothers and fathers had similar increases in oxytocin during SSC. In mothers, the rise in oxytocin was related to increased parental engagement. Unexpectedly, however, increased oxytocin during SSC in fathers was negatively related to parental engagement. Dr. Vittner and colleagues note that for many fathers, the study SSC intervention was the first time they had held their infants.

 

The study provides new evidence of how SSC might work to promote attachment between parents and premature infants. "The changes in oxytocin and cortisol levels provide robust support to advocate for increased SSC during infancy, especially for the vulnerable infant in the NICU," the researchers write. They note that further studies will be needed to understand these relationships, and how they affect parent-infant relationships -- especially in overcoming the obstacles posed by having a premature infant who need NICU care.

 

The results also suggest that the PREEMI questionnaire can provide a "window into parent engagement," potentially useful in identifying parents who may need interventions to increase engagement with their premature infant. Dr. Vittner and coauthors conclude: "Uncovering the bio-behavioral basis of early parent-infant interactions is an important step in developing therapeutic modalities to improve infant health outcomes."

https://www.sciencedaily.com/releases/2018/10/181019100711.htm

Babies of overweight mothers may risk developing self-regulation problems

October 10, 2018

Science Daily/Springer

A mother's weight during early pregnancy may affect how well her baby is able to self-regulate during its first months and years of life. This is according to a study of more than 3100 Finnish women.

 

Previous research has found that one in every five infants struggles to self-regulate in the first year of life. This means that these babies may cry excessively, have problems feeding or difficulties falling asleep unless soothed by a caregiver. As they grow older, such children often show behavioural and neurodevelopmental problems such as hyperactivity or difficulties concentrating, as well as having poorer muscle function. Some have lower IQs or are placed on the autism spectrum.

 

The aim of this study was to find out whether a mother's weight during early pregnancy influences her child's neurodevelopment. Girchenko and her colleagues drew on data from 3117 women from different Finnish towns who had given birth between 2006 and 2010. All participants were part of the Prediction and Prevention of Pre-eclampsia and Intrauterine Growth Restriction (PREDO) study.

 

Medical data was gathered about the mothers' weight during the first few months of their pregnancies, and whether they suffered from high blood pressure or gestational diabetes during this period. Up to three months after delivery, the women then answered questions about their babies' ability to regulate and calm themselves. Follow-up assessments of the children's developmental milestones were conducted between 2011 and 2012.

 

In general, the participants who were overweight or obese tended to be older mothers and to deliver their babies through a caesarean section. They were also less likely to have a tertiary education and quite often decided to stop smoking when they first heard that they were pregnant.

 

By the age of 17 days, infants of mothers who were overweight were already found to struggle more often with regulatory behaviour problems. In fact, there was a 22 per cent higher chance that overweight or obese mothers would have children with multiple self-regulatory problems. The research team confirmed that weight was the significant factor, and not whether a mother suffered from high blood pressure or gestational diabetes.

 

"Our findings show that regulatory behavior problems in infancy have prenatal origins that can be attributed at least partially to mothers being overweight or obesity," explains Girchenko. "We suggest that the prevention of weight problems in women of childbearing age may benefit their later offspring and could reduce the burden of regulatory problems in infancy and prevent their long-term neurodevelopmental consequences."

https://www.sciencedaily.com/releases/2018/10/181010105634.htm

Insufficient sleep associated with risky behavior in teens

Mental health issues, substance abuse, accidents more likely for high school students sleeping less than six hours per night

October 1, 2018

Science Daily/Brigham and Women's Hospital

Researchers examined a national data sample of risk-taking behaviors and sleep duration self-reported by high school students over eight years and found an association between sleep duration and personal safety risk-taking actions.

 

Adolescents require 8-10 hours of sleep at night for optimal health, according to sleep experts, yet more than 70 percent of high school students get less than that. Previous studies have demonstrated that insufficient slsleep eep in youth can result in learning difficulties, impaired judgement, and risk of adverse health behaviors. In a new study, researchers at Brigham and Women's Hospital examined a national data sample of risk-taking behaviors and sleep duration self-reported by high school students over eight years and found an association between sleep duration and personal safety risk-taking actions. Results are published in a JAMA Pediatrics research letter on October 1.

 

"We found the odds of unsafe behavior by high school students increased significantly with fewer hours of sleep," said lead author Mathew Weaver, PhD, research fellow, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital. "Personal risk-taking behaviors are common precursors to accidents and suicides, which are the leading causes of death among teens and have important implications for the health and safety of high school students nationally."

 

Compared to students who reported sleeping eight hours at night, high school students who slept less than six hours were twice as likely to self-report using alcohol, tobacco, marijuana or other drugs, and driving after drinking alcohol. They were also nearly twice as likely to report carrying a weapon or being in a fight. Researchers found the strongest associations were related to mood and self- harm. Those who slept less than six hours were more than three times as likely to consider or attempt suicide, and four times as likely to attempt suicide, resulting in treatment. Only 30 percent of the students in the study reported averaging more than eight hours of sleep on school nights.

 

The Youth Risk Behavior Surveys are administered biannually by the U.S. Centers for Disease Control and Prevention (CDC) at public and private schools across the country. Researchers used data from 67,615 high school students collected between 2007 and 2015. Personal safety risk-taking behaviors were examined individually and as composite categories. All analyses were weighted to account for the complex survey design and controlled for age, sex, race, and year of survey in mathematical models to test the association between sleep duration and each outcome of interest.

 

"Insufficient sleep in youth raises multiple public health concerns, including mental health, substance abuse, and motor vehicle crashes," said senior author Elizabeth Klerman, MD, PhD, director of the Analytic Modeling Unit, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital. "More research is needed to determine the specific relationships between sleep and personal safety risk-taking behaviors. We should support efforts to promote healthy sleep habits and decrease barriers to sufficient sleep in this vulnerable population."

https://www.sciencedaily.com/releases/2018/10/181001114300.htm

 

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