Is obesity associated with a decline in intelligence quotient during the first half of the life course? What are the causal effects of breastfeeding on IQ, obesity and blood pressure? Evidence from comparing high-income with middle-income cohorts Risk Factors for Decline in IQ in Youth With Type 1 Diabetes Over the 12 Years From Diagnosis/Illness Onset Lifetime exposure to environmental lead and children's intelligence at 11-13 years: the Port Pirie cohort study The association of physical activity and physical fitness with pre-adolescent obesity: an observational study in Metromanila, Philippines. Compliance with the Australian national physical activity guidelines for children: relationship to overweight status. The Infant Feeding Activity and Nutrition Trial (INFANT) an early intervention to prevent childhood obesity: Cluster-randomised controlled trial Effectiveness of parent‐centred interventions for the prevention and treatment of childhood overweight and obesity in community settings: a systematic review Behavioural effects of a community-oriented setting-based intervention for prevention of childhood obesity in eight European countries. Main results from the IDEFICS study. The effect of vitamin-mineral supplementation on the intelligence of American schoolchildren: a randomized, double-blind placebo-controlled trial. Gut Microbiota in the First 2 Years of Life and the Association with Body Mass Index at Age 12 in a Norwegian Birth Cohort Energy balance-related behaviours associated with overweight and obesity in preschool children: a systematic review of prospective studies. Randomised controlled trial of primary school based intervention to reduce risk factors for obesity Socio-economic, behavioural and environmental factors predicted body weights and household food insecurity scores in the Early Childhood Longitudinal Study-Kindergarten. Preventing obesity in infants: the Growing healthy feasibility trial protocol Obesity and Type 2 Diabetes Risk in Midadult Life: The Role of Childhood Adversity Effects of A School-Based Intervention on BMI and Motor Abilities in Childhood. Association between Physical Activity in Obese Pregnant Women and Pregnancy Outcomes: The UPBEAT Pilot Study Pilot of “Families for Health”: community-based family intervention for obesity Effectiveness of a school-based program focusing on diet and health habits taught through physical exercise. Long term outcome of prophylaxis for febrile convulsions. Do Dietary Trajectories between Infancy and Toddlerhood Influence IQ in Childhood and Adolescence? Results from a Prospective Birth Cohort Study Physical activity and body mass index of school children and adolescents in Abeokuta, Southwest Nigeria
Cross-sectional studies have found that obesity is associated with low intellectual ability and neuroimaging abnormalities in adolescence and adulthood . Some have interpreted these associations to suggest that obesity causes intellectual decline in the first half of the life course . We analyzed data from a prospect i ve longitudinal study to test whether becoming obese was associated with intellectual decline from childhood to midlife . We used data from the ongoing Dunedin Multidisciplinary Health and Development Study , a population -representative birth cohort study of 1,037 children in New Zeal and who were followed prospect ively from birth ( 1972 - 1973 ) through their fourth decade of life with a 95 % retention rate .  Intelligence quotient ( IQ ) was measured in childhood and adulthood . Anthropometric measurements  were taken at birth and at 12 subsequent in-person assessment s. As expected , cohort members who became obese had lower adulthood IQ scores . However , obese cohort members exhibited no excess decline in IQ . Instead , these cohort members had lower IQ scores since childhood . This pattern remained consistent when we accounted for children 's birth weights and growth during the first years of life , as well as for childhood-onset obesity . Lower IQ scores among children who later developed obesity were present as early as 3 years of age . We observed no evidence that obesity contributed to a decline in IQ , even among obese individuals who displayed evidence of the metabolic syndrome and /or elevated systemic inflammation Background A novel approach is explored for improving causal inference in observational studies by comparing cohorts from high-income with low- or middle-income countries ( LMIC ) , where confounding structures differ . This is applied to assessing causal effects of  breastfeeding  on child blood pressure ( BP ) , body mass index ( BMI ) and intelligence quotient ( IQ ) . Methods St and ardized approaches for assessing the confounding structure of breastfeeding by socio-economic position were applied to the British Avon Longitudinal Study of Parents and Children ( ALSPAC ) ( N ≃ 5000 ) and Brazilian Pelotas 1993 cohorts ( N ≃ 1000 ) . This was used to improve causal inference regarding associations of breastfeeding with child BP , BMI and IQ . Analyses were extended to include results from a meta- analysis of five LMICs ( N ≃ 10 000 ) and compared with a r and omized trial of breastfeeding promotion . Findings Although higher socio-economic position was strongly associated with breastfeeding in ALSPAC , there was little such patterning in Pelotas . In ALSPAC , breastfeeding was associated with lower BP , lower BMI and higher IQ , adjusted for confounders , but in the directions expected if due to socioeconomic patterning . In contrast , in Pelotas , breastfeeding was not strongly associated with BP or BMI but was associated with higher IQ . Differences in associations observed between ALSPAC and the LMIC meta- analysis were in line with those observed between ALSPAC and Pelotas , but with robust evidence of heterogeneity detected between ALSPAC and the LMIC meta- analysis associations . Trial data supported the conclusions inferred by the cross-cohort comparisons , which provided evidence for causal effects on IQ but not for BP or BMI . Conclusion While reported associations of breastfeeding with child BP and BMI are likely to reflect residual confounding , breastfeeding may have causal effects on IQ . Comparing associations between population s with differing confounding structures can be used to improve causal inference in observational studies OBJECTIVE This study examined illness-related change in intelligence quotient ( IQ ) in a cohort of youth with type 1 diabetes studied prospect ively from disease onset in childhood to follow-up 12 years later in late adolescence/early adulthood . RESEARCH DESIGN AND METHODS Participants included type 1 diabetes patients ( n = 95 ; mean age at follow-up 21.3 years ) and healthy control participants ( HCs ; n = 67 ; mean age at follow-up 21.0 years ) from a cohort followed prospect ively . Measures included Wechsler Preschool and Primary Scale of Intelligence-Revised , Wechsler Intelligence Scale for Children-Revised , and Wechsler Abbreviated Scale of Intelligence and prospect i ve collection of data on metabolic control history . RESULTS Young people with type 1 diabetes showed greater decline in verbal IQ ( VIQ ) and full-scale IQ ( FSIQ ) , but not performance IQ ( PIQ ) , than HCs . Within the diabetes group , a younger age at diabetes onset was associated with a decline in PIQ and FSIQ ( P ≤ 0.001 ) . A history of hypoglycemic seizures was associated with a decline in VIQ ( P = 0.002 ) . Long-term metabolic control was not associated with changes in IQ . Interaction terms were not significant , suggesting no moderating effect of one diabetes-related variable over another . CONCLUSIONS The presence of diabetes may negatively influence some aspects of IQ over time . Specific illness risk factors , such as an earlier age of disease onset and a history of hypoglycemic seizures , appear to put the young person at greater risk . Academic progress of children identified as at risk should be monitored and educational supports provided if necessary Abstract Objective : To examine the association between environmental exposure to lead and children 's intelligence at age 11 - 13 years , and to assess the implication s of exposure in the first seven years of life for later childhood development . Design : Prospect i ve cohort study . Subjects : 375 children born in or around the lead smelting town of Port Pirie , Australia , between 1979 and 1982 . Main outcome measure : Children 's intelligence quotient ( IQ ) measured at 11 - 13 years of age . Results : IQ was inversely associated with both antenatal and postnatal blood lead concentrations . Verbal , performance , and full scale IQ were inversely related to blood lead concentration with no apparent threshold . Multivariate analyses indicated that after adjustment for a wide range of confounders , the postnatal blood lead concentrations ( particularly within the age range 15 months to 7 years ) exhibited inverse associations with IQ . Strong associations with IQ were observed for lifetime average blood lead concentrations at various ages . The expected mean full scale IQ declined by 3.0 points ( 95 % confidence interval 0.07 to 5.93 ) for an increase in lifetime average blood lead concentration from 0.48 to 0.96 µmol/l ( 10 to 20 µg/dl ) . Conclusions : Exposure to environmental lead during the first seven years of life is associated with cognitive deficits that seem to persist into later childhood . Key messages Few longitudinal data have yet been reported on the time course of the effects of exposure to environmental lead Exposure to environmental lead early in life is associated with cognitive deficits that persist into middle childhood The duration , intensity , and timing of exposure to lead , as well as other social and familial factors , may influence the nature and degree of reversibility The formulation of a public health policy for preventing any possible effects of lead exposure should be based on a composite consideration of the child 's health and the best use of existing re BACKGROUND Childhood obesity has been inconsistently associated with decreased levels of physical activity and fitness . Moreover , little is known about this relationship among Filipino preteens . METHODS This cross sectional study reports the association between childhood obesity , measures of physical activity , and fitness .  Children aged 11 to 12 from r and omly selected schools from San Juan , Metromanila were included . Outcome measures were body mass index , Filipino modified Physical Activity Question naire for Older children ( F_PAQ-C ) ,  st and ing broad jump , 50 m sprint  and  20 m multistage shuttle run .  RESULTS 380 children participated in the study . Obese children had significantly lower median scores in the F_PAQ-C compared with overweight children . Overweight children had lower scores in the st and ing broad jump , 50 m sprints and predicted VO2max as compared with children with normal BMI . There were modest associations between the 50 m sprint , predicted VO2max , and F_PAQ-C. CONCLUSION Our study has showed that physical activity and fitness scores were strongly correlated with childhood obesity . If childhood physical fitness is a predictor of physical fitness in adulthood which is a risk factor in cardiovascular diseases , there is a strong possibility that the prevalence of cardiovascular disease in the Philippines will increase dramatically in the future Childhood obesity incidence has increased substantially and it has been argued that decreasing physical activity levels , coinciding with an increase in sedentary behaviours , are responsible . Australian guidelines were published in 2004 , recommending that children participate in a minimum of 60 min of physical activity daily and spend no more than 2h a day using electronic media for entertainment . We aim ed to compare compliance with these guidelines amongst children of differing weight status . The Childhood Injury Prevention Study ( CHIPS ) collected data from a r and omly selected sample of Brisbane primary and preschool children aged 5 - 12 years . The following data were available for 518 participants : age , gender , measured height and weight and estimated time per week from a parent-completed 7 days diary in physical activity out of school and sedentary leisure activities including television viewing and computer use . Using age st and ardised body mass index estimates , approximately 20 % of the cohort were overweight . Non-compliance with guidelines was 14.7 % for out of school physical activity participation , and 30.9 % for excess electronic media entertainment use . There was a 63 % increase in the odds of overweight status amongst children who were non-compliant with the electronic entertainment recommendations than those who were compliant ( adjusted odds ratio=1.63 ; 95 % CI=1.05 - 2.54 ) . Female gender and school level socioeconomic category were also independently associated with overweight status . Non-compliance with the minimal physical activity guideline increased the odds of being overweight by 28 % , however this difference was not statistically significant . One in seven children from the Greater Brisbane area are at risk for being insufficiently active whilst a third overuse electronic media . Given that overuse of electronic entertainment was positively associated with childhood obesity , these children should be the target of public health campaigns to promote alternative leisure time activities Background Multiple factors combine to support a compelling case for interventions that target the development of obesity-promoting behaviours ( poor diet , low physical activity and high sedentary behaviour ) from their inception . These factors include the rapidly increasing prevalence of fatness throughout childhood , the instigation of obesity-promoting behaviours in infancy , and the tracking of these behaviours from childhood through to adolescence and adulthood . The Infant Feeding Activity and Nutrition Trial ( INFANT ) aims to determine the effectiveness of an early childhood obesity prevention intervention delivered to first-time parents . The intervention , conducted with parents over the infant 's first 18 months of life , will use existing social networks ( first-time parent 's groups ) and an anticipatory guidance framework focusing on parenting skills which support the development of positive diet and physical activity behaviours , and reduced sedentary behaviours in infancy . Methods / Design This cluster-r and omised controlled trial , with first-time parent groups as the unit of r and omisation , will be conducted with a sample of 600 first-time parents and their newborn children who attend the first-time parents ' group at Maternal and Child Health Centres . Using a two-stage sampling process , local government areas in Victoria , Australia will be r and omly selected at the first stage . At the second stage , a proportional sample of first-time parent groups within selected local government areas will be r and omly selected and invited to participate . Informed consent will be obtained and groups will then be r and omly allocated to the intervention or control group . Discussion The early years hold promise as a time in which obesity prevention may be most effective . To our knowledge this will be the first r and omised trial internationally to demonstrate whether an early health promotion program delivered to first-time parents in their existing social groups promotes healthy eating , physical activity and reduced sedentary behaviours . If proven to be effective , INFANT may protect children from the development of obesity and its associated social and economic costs . Trial registration Current Controlled Trials IS RCT Background Worldwide in 2000 , 10 % of children aged five to 17 years were reported as being overweight with an additional 2‐3 % being obese . Overweight and obesity in childhood can adversely impact on both physical and psychological health . The rise in the prevalence of childhood obesity is a complex issue but widely recognised contributors include increased energy intake , decreased levels of physical activity and greater time spent in sedentary pursuits . A large number of environmental and cultural factors have also been identified as contributing to the problem . Evidence to support an optimal approach to treating childhood obesity is limited with many studies showing only modest results at best in the long‐term . However , the importance of family‐based treatment that combines diet , physical activity and behavioral components has been acknowledged in a recent Cochrane Systematic Review . It has also been suggested that interventions offered in the community setting may help overcome barriers to participation , by making programs more accessible and allowing the targeting of specific sub‐groups of the population . Objectives The objective of this review was to identify the effectiveness of parent‐centred interventions implemented in the community setting in modifying eating and physical activity behaviors or weight‐related outcomes of children . Inclusion criteria Types of participants This review considered studies that included free‐living children of pre‐school , primary and secondary school age and /or their parents/guardians aged > 18 years . Types of intervention(s)/phenomena of interest Intervention programs were required to have a parental component , to target eating and /or exercise behaviors for the prevention or treatment of obesity , and child weight status reported . Types of studies All intervention studies were included in the review including : r and omized controlled trials ( RCTs ) ; non‐r and omized controlled trials , longitudinal studies , cohort ( both retrospective and prospect i ve ) , case control and time series studies which had been conducted in a community setting . Types of outcomes This review considered studies that included overweight/obesity related outcomes , eating behavior outcomes , physical activity behaviour outcomes , and sedentary behavior outcomes and constructs . Search strategy A literature search of community‐based parent‐centred intervention studies to promote nutrition and physical activity for the prevention and treatment and of childhood overweight and obesity was performed in eight electronic data bases dating from 1975 to April 2009 . Method ological quality Studies were critically appraised for method ological quality using st and ardized tools . Data collection Data was extracted by one review er using a st and ardized data extraction form developed by the research ers and checked for accuracy and consistency by a second review er . Data synthesis Data in relation to setting , methodology , intervention components and effect on weight , dietary intake and physical activity was extracted , and described in a narrative synthesis . Where possible a meta‐ analysis was undertaken . Results Of the home‐based interventions , five of nine studies reported statistically significant changes in anthropometric outcomes post intervention . Of the 10 studies in the before and after school care setting , seven reported a significant decrease in a weight‐related outcome post intervention , with only one reporting an increase . Conclusions Results from the review support the after‐school setting as the most promising for community intervention setting for targeting parents as agents of change within child obesity prevention and treatment programs . Implication s for practice At this stage , interventions to support parents should target the after‐school environment as opposed to being conducted in the home , summer camps , leisure centers or churches . Targeting a decrease in energy intake and sweetened beverages in parallel with increasing number of daily steps and decreasing screen time use . Implication s for research Future studies of high quality are needed across the full range of community setting s. Given that currently most of the higher quality RCTs and the studies showing positive impacts of weight change are in the after‐school setting , further studies in this area using similar method ologies to those already published will facilitate future meta‐analyses in this area OBJECTIVE The objective of this paper is to evaluate the behavioural effects , as reported by the parents of the participating boys and girls , of the IDEFICS ( Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS ) intervention . METHODS The effectiveness of the IDEFICS intervention was evaluated through a cluster-controlled trial in eight European countries ( control and intervention communities in each country ) including more than 16,000 children . The 2- to 9.9-year-old children in the intervention group were exposed to a culturally adapted intervention that aim ed to prevent childhood obesity through the community , schools/kindergartens and family . Parents completed question naires to measure  water , soft drink and fruit juice intake ; fruit and vegetable intake ; daily TV viewing and other sedentary behaviours ; daily physical activity levels and strengthening of the parent-child relationships at baseline and follow-up ( 2 years later ) . Mixed models with an additional r and om effect for country were used to account for the clustered study design , and results were stratified by sex . RESULTS The pan-European analysis revealed no significant time by condition interaction effects , neither for boys nor girls , i.e. the analysis revealed no intervention effects on the behaviours of the IDEFICS children as reported by their parents ( F = 0.0 to 3.3 , all p > 0.05 ) . Also very few significance s were found in the country-specific analyses . Positive intervention effects were only found for sport club participation in Swedish boys , for screen time in weekends for Spanish boys and for TV viewing in Belgian girls . CONCLUSION Although no expected intervention effects as reported by the parents on diet , physical activity and sedentary behaviours could be shown for the overall IDEFICS cohort , a few favourable intervention effects were found on specific behaviours in some individual countries . More in-depth analyses of the process evaluation data are needed to obtain more insight into the relationship between the level of exposure to the intervention and its effect CONTEXT Many medical , nutrition , and education professionals have long suspected that poor diet impairs the academic performance of Western schoolchildren ; academic performance often improves after improved diet . However , others have suggested that such academic gains may be due to psychologic effects rather than nutrition . To resolve this issue , two independent research teams conducted r and omized trials in which children were given placebos or low-dose vitamin-mineral tablets design ed to raise nutrient intake to the equivalent of a well-balanced diet . Both teams reported significantly greater gains in nonverbal intelligence among the supplemented groups . The findings were important because of the apparent inadequacy of diet they revealed and the magnitude of the potential for increased intelligence . However , none of the ten subsequent replications , or the two original trials , were without limitations leaving this issue in controversy . OBJECTIVES To determine if schoolchildren who consume low-dose vitamin-mineral tablets will have a significantly larger increase in nonverbal intelligence than children who consume placebos in a study that overcomes the primary criticisms directed at the previous 12 controlled trials . DESIGN A double-blind , placebo-controlled trial using stratified r and omization within each teacher 's class based on preintervention nonverbal intelligence . SETTING S AND SUBJECTS Two " working class , " primarily Hispanic , elementary schools in Phoenix , Arizona , participated in the study . Slightly more than half the teachers in each school distributed the tablets daily to 245 schoolchildren aged 6 to 12 years . INTERVENTION Daily vitamin-mineral supplementation at 50 % of the U.S. daily recommended allowance ( RDA ) for 3 months versus placebo . OUTCOME MEASURES Post-test nonverbal IQ , as measured by the Wechsler Intelligence Scale for Children-Revised ( WISC-R ) , while controlling for pretest nonverbal IQ as a covariate . FOUR MAIN RESULTS : First , a significant difference of 2.5 IQ points ( 95 % CI : 1.85 - 3.15 ) was found between 125 children given active tablets and 120 children given placebo tablets ( p = 0.038 ) . Second , this finding is consistent with the mean 3.2 IQ point net gain found in the 12 similar but less rigorous studies . Third , a significantly higher proportion of children in the active group gained 15 or more IQ points when compared to the placebo group ( p < 0.01 ) . Fourth , although 81 matched pairs produced no difference at all in nonverbal IQ gain , the modest 2.5 IQ point net gain for the entire sample can be explained by the remaining 24 children who took active tablets , and had a 16 point higher net gain in IQ than the remaining 19 placebo controls . CONCLUSIONS This study confirms that vitamin-mineral supplementation modestly raised the nonverbal intelligence of some groups of Western schoolchildren by 2 to 3 points but not that of most Western schoolchildren , presumably because the majority were already adequately nourished . This study also confirms that vitamin-mineral supplementation markedly raises the non-verbal intelligence of a minority of Western schoolchildren , presumably because they were too poorly nourished before supplementation for optimal brain function . Because nonverbal intelligence is closely associated with academic performance , it follows that schools with children who consume subst and ard diets should find it difficult to produce academic performance equal to those schools with children who consume diets that come closer to providing the nutrients suggested in the U.S. RDA . The parents of schoolchildren whose academic performance is subst and ard would be well advised to seek a nutritionally oriented physician for assessment of their children 's nutritional status as a possible etiology Underst and ing the role of the early-life gut microbiota in obesity is important because there may be opportunities for preventive strategies . We examined the relationships between  infant gut microbiota at six times during the first two years of life and BMI at age 12 in a birth cohort of 165 children and their mothers . We found that the gut microbiota from early life to two years shows an increasingly strong association with childhood BMI . This study provides preliminary evidence that the gut microbiome at 2 years of age may offer useful information to help to identify youth who are at risk for obesity , which could facilitate more-targeted early prevention efforts . ABSTRACT Childhood obesity is a growing problem worldwide . Recent research suggests that the gut microbiota may play an important and potentially causal role in the development of obesity and may be one mechanism that explains the transgenerational transmission of obesity risk . Here we examine the early-life gut microbiota at days 4 , 10 , 30 , 120 , 365 , and 730 and the association with body mass index ( BMI ) z-scores at age 12 in a Norwegian prospect i ve cohort ( n = 165 ) , and evaluate how these BMI -associated taxa relate to maternal overweight/obesity ( Ow/Ob ) and excessive gestational weight gain ( GWG ) . We performed 16S rRNA gene sequencing on the gut microbiota sample s. Taxonomic phylogeny at days 10 and 730 was significantly associated with childhood BMI , and the gut microbiota taxa at two years of age explained over 50 % of the variation in childhood BMI in this cohort . The subset of the early-life taxa within the gut microbiota that best predicted later childhood BMI showed substantial overlap with the maternal taxa most strongly associated with maternal Ow/Ob and excessive GWG . Our results show an association between the infant gut microbiota and later BMI , and they offer preliminary evidence that the infant gut microbiota , particularly at 2 years of age , may have potential to help identify children at risk for obesity . IMPORTANCE Underst and ing the role of the early-life gut microbiota in obesity is important because there may be opportunities for preventive strategies . We examined the relationships between  infant gut microbiota at six times during the first two years of life and BMI at age 12 in a birth cohort of 165 children and their mothers . We found that the gut microbiota from early life to two years shows an increasingly strong association with childhood BMI . This study provides preliminary evidence that the gut microbiome at 2 years of age may offer useful information to help to identify youth who are at risk for obesity , which could facilitate more-targeted early prevention efforts The current review aim ed to systematic ally identify dietary , physical activity and sedentary behaviours in preschool children ( 4 - 6 years of age ) that are prospect ively related to overweight or obesity later in childhood . Prospect i ve studies published between January 1990 and June 2010 were selected from search es in PubMed , EMBASE , PsycINFO , CINAHL and Cochrane Library . Studies examining the prospect i ve association between at least one relevant behaviour measured during preschool period ( children aged 4 - 6 years at baseline ) in relation to at least one anthropometric measurement at follow-up ( age < 18 years ) were included . Harvest plots were used to summarize the results and draw conclusions from the evidence . Of the 8,718 retrieved papers , 23 papers reporting on 15 different study sample s were included in this review . Strong evidence was found for an inverse association between total physical activity and overweight . Moderate evidence was observed for a positive association between television viewing and overweight . Because of the heterogeneity in the assessed dietary behaviours , insufficient evidence was found for an association between  dietary intake or specific dietary behaviours and overweight . These results suggest that interventions aim ing to prevent overweight among preschool children should focus on promotion of total physical activity and limitation of screen time and that further research is needed to establish whether and which dietary behaviours are important for obesity prevention in this age group . However , despite the lack of evidence for dietary behaviours from the present review , future interventions may already target specific dietary behaviours that are highly prevalent and for which there a clear rationale as well as preliminary evidence that these behaviours are associated with overweight Abstract Objective : To assess if a school based intervention was effective in reducing risk factors for obesity . Design : Group r and omised controlled trial . Setting : 10 primary schools in Leeds . Participants : 634 children aged 7 - 11 years . Intervention : Teacher training , modification of school meals , and the development of school action plans targeting the curriculum , physical education , tuck shops , and playground activities . Main outcome measures : Body mass index , diet , physical activity , and psychological state . Results : Vegetable consumption by 24 hour recall was higher in children in the intervention group than the control group ( weighted mean difference 0.3 portions/day , 95 % confidence interval 0.2 to 0.4 ) , representing a difference equivalent to 50 % of baseline consumption . Fruit consumption was lower in obese children in the intervention group ( −1.0 , −1.8 to −0.2 ) than those in the control group . The three day diary showed higher consumption of high sugar foods ( 0.8 , 0.1 to 1.6 ) ) among overweight children in the intervention group than the control group . Sedentary behaviour was higher in overweight children in the intervention group ( 0.3 , 0.0 to 0.7 ) . Global self worth was higher in obese children in the intervention group ( 0.3 , 0.3 to 0.6 ) . There was no difference in body mass index , other psychological measures , or dieting behaviour between the groups . Focus groups indicated higher levels of self reported behaviour change , underst and ing , and knowledge among children who had received the intervention . Conclusion : Although it was successful in producing changes at school level , the programme had little effect on children 's behaviour other than a modest increase in consumption of vegetables . What is already known on this topic Obesity is increasing among school children and dem and s preventive strategies R and omised controlled trials of school based primary prevention programmes have all used a prescriptive approach What this study adds Behavioural changes were disappointing with this programme based on the health promoting schools philosophy , despite changes at school level The only positive outcome was a modest increase in vegetable consumption The discrepancy between changes achieved at the individual and school level raises issues regarding the problems inherent in such Recent increases in obesity prevalence among children in developed countries are of policy concern . While significant positive associations between households ' food insecurity status and body weights have been reported for adults , it is known from the energy physiology literature that energy requirements depend on BMR , anthropometric measures and physical activity . It is therefore important to model the bi-directional relationships between body weights and households ' food insecurity scores especially for children that have evolving nutrient and energy requirements . The present paper estimated dynamic r and om effects models for children 's body weights and BMI , and households ' food insecurity scores using longitudinal data on 7635 children in the USA enrolled in 1st , 3rd and 5th grade s ( 1999 - 2003 ) of the Early Childhood Longitudinal Study -Kindergarten . The main findings were , first , physical exercise and numbers of siblings were significantly ( P < 0.05 ) negatively associated with body weights , while households ' food insecurity score was not a significant predictor . Moreover , children 's body weights were significantly lower in households with higher parental education and incomes ; time spent watching television and in non-parental care were positively associated with weights . Second , models for households ' food insecurity scores showed that poverty and respondents ' poor emotional and physical health significantly increased food insecurity . Moreover , households with children who were taller and heavier for their ages faced significantly higher food insecurity levels . Overall , the results showed that household food insecurity was unlikely to exacerbate child obesity in the USA and it is important that children receive balanced school meals and perform higher physical activity Introduction Early childhood is an important period for establishing behaviours that will affect weight gain and health across the life course . Early feeding choices , including breast and /or formula , timing of introduction of solids , physical activity and electronic media use among infants and young children are considered likely determinants of childhood obesity . Parents play a primary role in shaping these behaviours through parental modelling , feeding styles , and the food and physical activity environments provided . Children from low socio-economic background s have higher rates of obesity , making early intervention particularly important . However , such families are often more difficult to reach and may be less likely to participate in traditional programs that support healthy behaviours . Parents across all socio-demographic groups frequently access primary health care ( PHC ) services , including nurses in community health services and general medical practice s , providing unparalleled opportunity for engagement to influence family behaviours . One emerging and promising area that might maximise engagement at a low cost is the provision of support for  healthy parenting  through electronic media such as the Internet or smart phones . The Growing healthy study explores the feasibility of delivering such support via primary health care services . Methods This paper describes the Growing healthy study , a non-r and omised quasi experimental study examining the feasibility of an intervention delivered via a smartphone app ( or website ) for parents living in socioeconomically disadvantaged areas , for promoting infant feeding and parenting behaviours that promote healthy rather than excessive weight gain .  Participants will be recruited via their primary health care practitioner and followed until their infant is 9 months old . Data will be collected via web-based question naires and the data collected inherently by the app itself . Ethics and dissemination This study received approval from the University of Technology Sydney Ethics committee and will be disseminated via peer- review ed publications and conference presentations OBJECTIVE . Child abuse has been associated with poorer physical health in adulthood , but less is known about childhood adversity more broadly , including neglect and family problems , or the pathways from adversity to adult disease . We have examined how different stressful emotional or neglectful childhood adversities are related to adiposity and glucose control in midadulthood , taking into account childhood factors , and whether the relationships are mediated by adult health behaviors and socioeconomic position . METHODS . This was a prospect i ve longitudinal study of 9310 members of the 1958 British birth cohort who participated in a biomedical interview at 45 years of age . Primary outcomes consisted of continuous measures of BMI , waist circumference , and glycosylated hemoglobin at 45 years and categorical indicators : total obesity ( BMI ≥ 30 ) , central obesity ( waist circumference : ≥102 cm for men and ≥88 cm for women ) , and glycosylated hemoglobin level of ≥6 . RESULTS . The risk of obesity increased by 20 % to 50 % for several adversities ( physical abuse , verbal abuse , witnessed abuse , humiliation , neglect , strict upbringing , physical punishment , conflict or tension , low parental aspirations or interest in education , hardly takes outings with parents , and father hardly reads to child ) . Adversities with the strongest associations with adiposity ( eg , physical abuse ) tended to be associated with glycosylated hemoglobin levels of ≥6 , but in most cases associations were explained by adjustment for adulthood mediators such as adiposity . Effects of other adversities reflecting less severe emotional neglect and family environment were largely explained by childhood socioeconomic factors . CONCLUSIONS . Some childhood adversities increase the risk of obesity in adulthood and thereby increase the risk for type 2 diabetes  . Research is needed to underst and the interrelatedness of adversities , the social context of their occurrence , and trajectories from adversity to adult disease Obesity in childhood is increasing worldwide . To combat overweight and obesity in childhood , the school-based Children 's Health InterventionaL Trial ( CHILT ) project combines health education and physical activity . This paper examines the effect of intervention on the body mass index ( BMI ) and motor abilities after 20.8 ± 1.0 months in 12 r and omly selected primary schools compared with 5 r and omly selected control schools .  The anthropometric data were assessed , BMI was calculated . Coordination was determined by lateral jumping and endurance performance by a 6-minute run . No difference in the prevalence of overweight and obesity was found between the intervention ( IS ) and control schools ( CS ) either at baseline or following intervention ( each p > 0.05 ) . The increase in the number of lateral jumps was significantly higher in the IS than in the CS ( p < 0.001 ) . For the 6-minute run the increase in distance run was significantly improved in IS ( p = 0.020 ) . All variables were controlled for gender and age . Overweight and obese children in both IS and CS produced significantly lower scores in coordination and endurance tasks than normal and underweight children during both examinations ( each p ≤ 0.001 ) , adjusted for gender and age . Preventive intervention in primary schools offers an effective means to improve motor skills in childhood and to break through the vicious circle of physical inactivity - motor deficits - frustration - increasing inactivity possibly combined with an excess energy intake and weight gain . To prevent overweight and obesity these measures have to be intensified . Key PointsSchool-based prevention improves motor abilities in primary school children . The incidence of obesity is not influenced by school-based intervention . To prevent obesity in early childhood the measures have to be intensified and parents should be included Background : Obesity in pregnancy is associated with fetal macrosomia , a raised neonatal fat mass and an increased risk of obesity and poor metabolic health in childhood which persists into adulthood . The offspring of obese women are more likely to be obese than the offspring of lean women when they become pregnant themselves , perpetuating a cycle of obesity and its associated negative metabolic consequences . Increasing physical activity during pregnancy could improve insulin sensitivity and reduce the risk of maternal and offspring adverse outcomes . The UK Pregnancy Better Eating and Activity Trial ( UPBEAT ) is a trial of a complex intervention design ed to improve pregnancy outcomes through dietary changes and physical activity .  Data from the pilot trial of 183 women were available for analysis . The relationship between the time spent at different physical activity levels and maternal and infant pregnancy outcomes was examined . Key Messages : Strong evidence exists that physical activity improves insulin sensitivity in non-pregnant population s , and lifestyle interventions of proven effectiveness in non-pregnant population s have been developed . Women who are active in pregnancy demonstrate better glucose control and favourable pregnancy outcomes . There is a lack of effective interventions to support obese pregnant women to be physically active . Conclusions : No difference was detected in objective ly measured physical activity between women r and omised to the intervention and control arms of the UPBEAT pilot trial . Light-intensity physical activity was lower in early pregnancy in women who delivered macrosomic infants . Maternal sedentary time at 35 - 36 weeks ' gestation was positively associated and moderate-intensity physical activity was inversely associated with neonatal abdominal circumference . Maternal physical activity is associated with infant birth weight and abdominal circumference and is an appropriate target for intervention to improve infant outcomes . The challenge remains to develop an effective intervention to support obese pregnant women to be physically active Objective : To develop and evaluate “ Families for Health ” , a new community based family intervention for childhood obesity . Design : Programme development , pilot study and evaluation using intention-to-treat analysis . Setting : Coventry , Engl and . Participants : 27 overweight or obese children aged 7–13 years ( 18 girls , 9 boys ) and their parents , from 21 families . Intervention : Families for Health is a 12-week programme with parallel groups for parents and children , addressing parenting , lifestyle change and social and emotional development . Main outcome measures : Change in baseline BMI z score at the end of the programme ( 3 months ) and 9-month follow-up . Attendance , drop-out , parents ’ perception of the programme , child ’s quality of life and self-esteem , parental mental health , parent – child relationships and lifestyle changes were also measured . Results : Attendance rate was 62 % , with 18 of the 27 ( 67 % ) children completing the programme . For the 22 children with follow-up data ( including four who dropped out ) , BMI z score was reduced by −0.18 ( 95 % CI −0.30 to −0.05 ) at 3 months and −0.21 ( −0.35 to −0.07 ) at 9 months . Statistically significant improvements were observed in children ’s quality of life and lifestyle ( reduced sedentary behaviour , increased steps and reduced exposure to unhealthy foods ) , child – parent relationships and parents ’ mental health . Fruit and vegetable consumption , participation in moderate/vigorous exercise and children ’s self-esteem did not change significantly . Topics on parenting skills , activity and food were rated as helpful and used with confidence by most parents . Conclusions : Families for Health is a promising new childhood obesity intervention . Definitive evaluation of its clinical effectiveness by r and omised controlled trial is now required The global rate of obesity in childhood is becoming an epidemic and many authors have established a significant association between childhood obesity and overweight in adulthood . It is therefore necessary to seek effective strategies to reduce these levels of obesity . The aim of this study was to evaluate the impact of the Healthy Habits Program ( HHP ) . The participants comprised 158 children from the fifth and sixth grade s ( intervention group , n = 82 ; control group , n = 76 ) . The HHP is a school-based physical activity program focusing on promoting a healthy lifestyle . It lasted for 8 months , and measurements were taken at the beginning and end of the program . Physiological variables ( total cholesterol , triglycerides , blood glucose , blood pressure , and maximal oxygen consumption ) , anthropometric variables ( body mass index ( BMI ) ) and behavioral variables ( breakfast , quality of diet , meal frequency , physical activity , sedentary behavior , sleep , and perceived health ) were evaluated . Repeated- measures ANOVA showed significant improvements ( p < 0.05 ) after the intervention for the intervention group in triglycerides , blood glucose and maximal oxygen consumption . Significant improvements were also observed in breakfast habits and quality of diet . Finally , a significant improvement in prevalence of normal levels was observed for total cholesterol , blood pressure , and BMI . It can therefore be stated that the HHP is an innovative and useful school-based program that can help to improve diet and health in childhood A cohort of 289 children with febrile convulsions who had been r and omised in early childhood to either intermittent prophylaxis ( diazepam at fever ) or no prophylaxis ( diazepam at seizures )  was followed up 12 years later . The study focused on the occurrence of epilepsy and on neurological , motor , intellectual , cognitive , and scholastic achievements in the cohort . At follow up the two groups were of almost identical age ( 14.0 v 14.1 years ) , body weight ( 58.2 v 57.2 kg ) , height ( 168.2 v 167.7 cm ) , and head circumference ( 55.9 v 56.2 cm ) . The occurrence of epilepsy ( 0.7 % v 0.8 % ) , neurological examination , fine and gross motor development on the Stott motor test , intellectual performance on the Wechsler intelligence scale for children verbal IQ ( 105 v 105 ) , performance IQ ( 114 v 111 ) , and full scale IQ ( 110 v 108 ) , cognitive abilities on a neuropsychological test battery , including short and long term , auditory and visual memory , visuomotor tempo , computer reaction time , reading test , and scholastic achievement were also very similar . Children with simple and complex febrile convulsions had the same benign outcome . The long term prognosis in terms of subsequent epilepsy , neurological , motor , intellectual , cognitive , and scholastic ability was not influenced by the type of treatment applied in early childhood . Preventing new febrile convulsions appears no better in the long run than abbreviating them Objective We examined whether trajectories of dietary patterns from 6 to 24 months of age are associated with  intelligence quotient ( IQ ) in childhood and adolescence . Methods Participants were children enrolled in a prospect i ve UK birth cohort ( n = 7652 ) who had IQ measured at age 8 and /or 15 years .  Dietary patterns were previously extracted from question naires when children were aged 6 , 15 and 24 months using principal component analysis . Dietary trajectories were generated by combining scores on similar dietary patterns across each age , using multilevel mixed models . Associations between dietary trajectories and IQ were examined in generalized linear models with adjustment for potential confounders . Results Four dietary pattern trajectories were constructed from 6 to 24 months of age and were named according to foods that made the strongest contribution to trajectory scores ; Healthy ( characterised by breastfeeding at 6 months , raw fruit and vegetables , cheese and herbs at 15 and 24 months ) ; Discretionary ( biscuits , chocolate , crisps at all ages ) , Traditional ( meat , cooked vegetables and puddings at all ages ) and , Ready-to-eat ( use of ready-prepared baby foods at 6 and 15 months , biscuits , bread and breakfast cereals at 24 months ) . In fully-adjusted models , a 1 SD change in the Healthy trajectory was weakly associated with higher IQ at age 8 ( 1.07 ( 95%CI 0.17 , 1.97 ) ) but not 15 years ( 0.49 ( −0.28 , 1.26 ) ) . Associations between the Discretionary and Traditional trajectories with IQ at 8 and 15 years were as follows ; Discretionary ; 8 years −0.35(−1.03 , 0.33 ) , 15 years −0.73(−1.33 , −0.14 ) Traditional ; 8 years −0.19(−0.71 , 0.33)15 years −0.41(−0.77 , −0.04 ) ) . The Ready-to-eat trajectory had no association with IQ at either age ( 8 years 0.32(−4.31 , 4.95 ) , 15 years 1.11(−3.10 , 5.33 ) . Conclusions The Discretionary and Traditional dietary pattern trajectories from 6 to 24 months of age , over the period when food patterns begin to emerge , are weakly associated with IQ  in adolescence Background Physical inactivity and sedentary lifestyles are known to predispose to overweight and obesity . These lifestyles are also known to track from childhood into adulthood with consequent cardiovascular and metabolic problems . This study aim ed to describe the frequency of physical activity  and the relationship between physical activity and body mass index of urban Nigerian school children and adolescents . Methods Children from seven schools in Abeokuta , southwest Nigeria were selected using a multi-staged r and om sampling technique . Results Of 570 children , 411 ( 72.1 % ) were involved in moderate to vigorous physical activities . Involvement in physical activity was higher in older children ( P<0.001 ) , males ( P<0.001 ) , and children of mothers with a higher educational level ( P=0.03 ) . Eleven ( 1.9 % ) children were overweight or obese whereas 163 ( 28.6 % ) were underweight . There were more children with underweight than overweight among the subject population with a high level of physical activity ( 35.6 % vs. 4.4 % , P=0.499 ) . Conclusions A large proportion of the children in urban Nigeria participate in physical activity . The prevalence of overweight and obesity is low but undernutrition is a major nutritional problem among these children
The authors even suggested in this case increasing educational levels as a means of reducing obesity .
Indeed , we have recently reported results from two experimental studies showing that mental work up-regulates appetite-stimulating hormones and promotes overconsumption of food ( 3,4 ) .
Furthermore , a careful examination of our data revealed that when the subjects were categorized on the basis of the mental workload intensity , those for whom the intensity of the mental effort was greater significantly increased their spontaneous food intake as compared with those characterized by a less strenuous cognitive effort .
In other words , the harder we think the more we eat .
This hyperphagic effect of intense thinking was also accompanied by more plasma glucose instabilities ( 5 ) .
The fluctuations in plasma glucose levels that were observed are in agreement with the literature showing that a period of intense cognitive processing leads to a measurable decrease in levels of blood glucose ( 6 ) , a fall that has also been associated with feeling less energetic ( 7 ) .
Accordingly , food intake might be perceived as a strategy for allowing the individual to recover optimal body functioning .
These observations are also relevant for students having hard times to learn at school and for whom study ing is arduous and mentally challenging .
On the basis of our observations , we find it realistic to postulate that those susceptible to commit more cognitive effort to take in charge st and ard mental tasks are more likely to over-eat and gain weight compared with those for whom the accomplishment of mental tasks at the same level of performance is elementary or more natural .
Along the same lines , it would not be surprising to find a higher dropout rate for those ‘ mentally stressed ’ students .
In a system where academic performance continues to rank as high priority in public schools , it seems obvious that some students are genetically more gifted and likely to perform at a higher level ( 8) .
As previously shown , better cognitive abilities are predictive of more important life achievements such as earning a doctorate , securing a patent , or publishing a novel or major literary work ( 9 ) .
It may be somewhat paradoxical that the amount of knowledge-based work is more important in the higher socioeconomic groups whereas population data show a higher prevalence of obesity for the socioeconomically disadvantaged .
Thus , individuals highly involved in mental work are not all likely to over-eat and other healthy behaviours such as regular physical activity may counterbalance the net impact on energy balance .
As mentioned in the paper by Yu and co-workers ( 1 ) , educational attainment seems to be an important mediator of this relationship .
In an early view issue of this journal , Yu and co-workers ( 1 ) published a systematic review and meta- analysis about the mutual relationship between obesity and intelligence quotient ( IQ ) .
The authors observed that a lower IQ score in childhood was associated with obesity in later adulthood .
Although it is not possible to definitively rule out reverse causation in the IQ – obesity relationship , two main mechanisms have been put forward by the authors that could explain why a low IQ has been found to be a predictor of obesity .
First , higher intelligence may reduce the risk of obesity by promoting more healthful behaviours .
For example , data from a cohort study showed that children with higher mental ability scores reported significantly more frequent consumption of fruit and vegetables and more high-intensity physical activity participation in adulthood ( 2 ) .
Second , higher childhood IQ may predict favourable socioeconomic positions later in life .
With the advent of computers and new technologies , the pendulum has swung far in the direction of excessive mental activities , as opposed to excessive physical activities .
A careful examination of computer-related activities reveals that they represent a particular type of sedentary activities ; they are stressful and biologically dem and ing for the body and deserve to be counterbalanced by an adequate physical activity regimen ( 10 ) .