Azab Sandi M, Naqvi Saba, Rafiq Talha, Beyene Joseph, Deng Wei, Lamri Amel, Morrison Katherine M, Teo Koon, Santorelli Gillian, Wright John, Williams Natalie C, de Souza Russell J, Wahi Gita, Anand Sonia S
Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Department of Pharmacognosy, Alexandria University, Alexandria, Egypt.
JAMA Netw Open. 2025 Apr 1;8(4):e254439. doi: 10.1001/jamanetworkopen.2025.4439.
Measures of childhood adiposity merit investigation, particularly in individuals of South Asian descent.
To investigate prenatal and childhood factors associated with the trajectory of adiposity in South Asian children, and the cumulative contribution of modifiable factors, such as diet and physical activity, on this trajectory.
DESIGN, SETTING, AND PARTICIPANTS: This cohort study was a prospective analysis of the South Asian Birth Cohort (START; 2011-2015) for discovery; and the Family Atherosclerosis Monitoring In Early Life (FAMILY; 2002-2009) in Ontario, Canada, and the Born in Bradford (BiB; 2008-2009) cohort in Bradford, UK, for validation. Mother-child pairs included 903 South Asian individuals (START), 675 White European individuals (FAMILY), and 1593 individuals (BiB), of which 52% were South Asian. Analysis was conducted from March 2020 to September 2024.
Maternal, infancy, and early childhood exposures.
Adiposity, assessed by the sum of subscapular and triceps skinfold thicknesses (SSF) from birth to 3 years, aggregated to a single measure as total area under the growth curve (AUC for SSF); multivariable linear regression models to identify determinants of AUC for SSF; and a cumulative score to assess joint contribution of modifiable risk factors to AUC for SSF.
START included 903 children (456 female [50.5%]; mean [SD] maternal age, 30.2 [4.0] years; maternal mean [SD] prepregnancy body mass index [BMI], 23.8 [4.50]). Maternal sum of skinfold thicknesses (β = 0.80 [95% CI, 0.30-1.30] per 10 mm), gestational weight gain (β = 0.38 [95% CI, 0.02-0.74] per 5 kg), a health-conscious diet score (β = -0.68 [95% CI, -1.26 to -0.10] per 1 SD), and infant breastfeeding for the first year (β = -1.68 [95% CI, -2.94 to -0.42), as well as physical activity (β = -0.33 [95% CI, -0.57 to -0.09] per 30-min/d) and screen time (β = 0.49 [95% CI, 0.18-0.81] per 30-min/d) were each independently associated with AUC for SSF. These 6 early-life modifiable factors combined into a single score had a direct, graded association between number of factors and AUC for SSF (P for trend < .001). In the validation cohorts, maternal BMI, breastfeeding, and child physical activity were replicated and showed a similar graded association with AUC for SSF (P for trend < .001) when combined.
In this cohort study of South Asian children, 6 modifiable factors were associated with lower adiposity and combined into a single score. This score may be useful in clinical and public health settings to help mitigate childhood obesity in South Asian individuals and beyond.
儿童肥胖的测量值得研究，尤其是在南亚裔个体中。
研究与南亚儿童肥胖轨迹相关的产前和儿童期因素，以及饮食和身体活动等可改变因素对该轨迹的累积影响。
设计、背景和参与者：这项队列研究对南亚出生队列（START；2011 - 2015年）进行前瞻性分析以进行发现；并对加拿大安大略省的早期生命家庭动脉粥样硬化监测（FAMILY；2002 - 2009年）以及英国布拉德福德的布拉德福德出生队列（BiB；2008 - 2009年）进行验证。母婴对包括903名南亚个体（START）、675名欧洲白人个体（FAMILY）和1593名个体（BiB），其中52%为南亚裔。分析于2020年3月至2024年9月进行。
母亲、婴儿期和幼儿期的暴露因素。
肥胖程度，通过从出生到3岁的肩胛下和三头肌皮褶厚度（SSF）之和进行评估，并汇总为生长曲线下总面积的单一测量指标（SSF的AUC）；多变量线性回归模型用于确定SSF的AUC的决定因素；以及一个累积评分，用于评估可改变风险因素对SSF的AUC的联合贡献。
START队列包括903名儿童（456名女性[50.5%]；母亲平均年龄[标准差]为30.2[4.0]岁；母亲孕前体重指数[BMI]平均[标准差]为23.8[4.50]）。母亲皮褶厚度之和（每增加10毫米，β = 0.80[95%置信区间，0.30 - 1.30]）、孕期体重增加（每增加5千克，β = 0.38[95%置信区间，0.02 - 0.74]）、健康意识饮食评分（每增加1个标准差，β = -0.68[95%置信区间，-1.26至 -0.10]）、婴儿第一年母乳喂养（β = -1.68[95%置信区间，-2.94至 -0.42]），以及身体活动（每天每增加30分钟，β = -0.33[95%置信区间，-0.57至 -0.09]）和屏幕时间（每天每增加30分钟，β = 0.49[95%置信区间，0.18 - 0.81]）均分别与SSF的AUC独立相关。这6个早期可改变因素合并为一个单一评分后，因素数量与SSF的AUC之间存在直接的分级关联（趋势P <.001）。在验证队列中，母亲BMI、母乳喂养和儿童身体活动得到了重复验证，并在合并时显示出与SSF的AUC类似的分级关联（趋势P <.001）。
在这项针对南亚儿童的队列研究中，6个可改变因素与较低的肥胖程度相关，并合并为一个单一评分。该评分可能在临床和公共卫生环境中有助于减轻南亚及其他地区个体的儿童肥胖。
