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Association of parental body mass index before pregnancy on infant growth and body composition: Evidence from a pregnancy cohort study in Malaysia

Zalbahar N, Jan Mohamed HJ, Loy SL, Najman J, McIntyre HD, Mamun A

Obes Res Clin Pract, 2016 09;10 Suppl 1:S35-S47.
PMID: 26321098 DOI: 10.1016/j.orcp.2015.08.002

BACKGROUND AND OBJECTIVES: Parental body mass index (BMI) is strongly linked with the development of offspring overweight and obesity. However, there are a limited number of studies focusing on the association of parental body mass index before pregnancy on offspring growth and body composition in early life, particularly in developing countries.
METHODS: Data from the University Sains Malaysia (USM) Pregnancy Cohort which consists of 153 mother-offspring pairs were used. Data were collected using interview-administered questionnaires and anthropometric measurements were also obtained. Multiple linear regression and generalised equation estimation (GEE) were used to examine the direction and impact of the association between parental BMI and child growth and body composition (weight for age, height for age, body mass index for age, weight for height and fat mass at age 2m, 6m, and 12m). Potential confounders, including validated measures of maternal diets and physical activity during pregnancy, were considered.
RESULTS: Of 153 parents, one-quarter of the mothers and 42.2% of the fathers, respectively, were overweight or obese before pregnancy. A significant association was found between maternal BMI and child's weight for height z-score (WHZ) and body mass index for age z-score (BAZ).
CONCLUSIONS: Having high pre-pregnancy BMI may increase BMI and WAZ of offspring in early life. Findings from this study emphasise the importance of monitoring maternal weight status, particularly before and during pregnancy and early life of offspring among Malaysians.

Matched MeSH terms: Pediatric Obesity/etiology*
Fulltext Association between the school environment and children's body mass index in Terengganu: A cross sectional study

Wafa SW, Ghazalli R

PLoS One, 2020;15(4):e0232000.
PMID: 32330177 DOI: 10.1371/journal.pone.0232000

With the on-going interest in implementing school policies to address the problem of childhood obesity in Malaysia, there is urgent need for information about the association between school environment and children's weight status. This study aims to investigate the association between school environmental factors (physical, economic, political and sociocultural) with BMI of school children in Terengganu. The school environment factors were assessed using a set of validated whole-school environmental mapping questionnaires, consisting of 76 criteria with four domains; physical environment (41 criteria), economic environment (nine criteria), political environment (nine criteria) and sociocultural environment (17 criteria). This involved face-to-face interview sessions with 32 teachers from 16 schools (eight rural and eight urban). In addition, 400 school children aged between 9 and 11 years of the selected schools were assessed for BMI (WHO 2007 reference chart), dietary intake (food frequency questionnaire (FFQ)) and physical activity level (physical activity questionnaire for children (PAQ-C)). Multiple regression was used to examine the association between school environment factors and BMI of the school children. Seven school environment criteria were found to be associated with BMI of school children when it was adjusted for calorie intake and physical activity level. About 33.4% of the variation in BMI of school children was explained by health professional involvement, simple exercise before class, encouragement to walk/ride bicycle to/from school, no high-calorie food sold, healthy options of foods and drinks at tuck shop, availability of policy on physical activity and training teacher as a role model. Policy makers should make urgent actions to address the obesogenic features of school environments. It should strive towards setting up healthy school environment and improving school curricula to promote healthy behaviours among the school children.

Matched MeSH terms: Pediatric Obesity/etiology*
The Family Diet Study: a cross-sectional study into the associations between diet, food habits and body weight status in Malay families

Yang WY, Burrows T, MacDonald-Wicks L, Williams LT, Collins CE, Chee WS

J Hum Nutr Diet, 2016 08;29(4):441-8.
PMID: 26879748 DOI: 10.1111/jhn.12356

BACKGROUND: Childhood obesity is becoming more common as Malaysia experiences rapid nutrition transition. Current evidence related to parental influences on child dietary intake and body weight status is limited. The present study aimed to report, among Malay families, the prevalence of energy mis-reporting and dietary relationships within family dyads.
METHODS: The cross-sectional Family Diet Study (n = 236) was conducted at five primary schools in central of Peninsular Malaysia. Each family consisted of a Malay child, aged 8-12 years, and their main caregiver(s). Information on socio-demographics, dietary intake and anthropometry were collected. Correlations and regression analyses were used to assess dietary relationships within family dyads.
RESULTS: Approximately 29.6% of the children and 75.0% parents were categorised as being overweight or obese. Intakes of nutrients and food groups were below the national recommended targets for majority of children and adults. A large proportion of energy intake mis-reporters were identified: mothers (55.5%), fathers (40.2%) and children (40.2%). Children's body mass index (BMI) was positively associated with parental BMI (fathers, r = 0.37; mothers, r = 0.34; P < 0.01). For dietary intakes, moderate-to-strong (0.35-0.72) and weak-to-moderate (0.16-0.35) correlations were found between mother-father and child-parent dyads, respectively. Multiple regression revealed that maternal percentage energy from fat (β = 0.09, P < 0.01) explained 81% of the variation in children's fat intake.
CONCLUSIONS: Clear parental dietary relationships, especially child-mother dyads, were found. Despite a significant proportion of families with members who were overweight or obese, the majority reported dietary intakes below recommended levels, distorted by energy mis-reporting. The findings of the present study can inform interventions targeting parent-child relationships to improve family dietary patterns in Malaysia.

Matched MeSH terms: Pediatric Obesity/etiology*
Dietary patterns and cognitive ability among 12- to 13 year-old adolescents in Selangor, Malaysia

Nurliyana AR, Mohd Nasir MT, Zalilah MS, Rohani A

Public Health Nutr, 2015 Feb;18(2):303-12.
PMID: 24507623 DOI: 10.1017/S1368980014000068

OBJECTIVE: The present study aimed to identify dietary patterns and determine the relationship between dietary patterns and cognitive ability among 12- to 13 year-old Malay adolescents in the urban areas of Gombak district in Selangor, Malaysia.
DESIGN: Data on sociodemographic background were obtained from parents. Height and weight were measured and BMI-for-age was determined. Adolescents were interviewed on their habitual dietary intakes using a semi-quantitative FFQ. Cognitive ability was assessed using the Wechsler Nonverbal Scale of Ability in a one-to-one manner. Dietary patterns were constructed using principal component analysis based on thirty-eight food groups of the semi-quantitative FFQ.
SETTING: Urban secondary public schools in the district of Gombak in Selangor, Malaysia.
SUBJECTS: Malay adolescents aged 12 to 13 years (n 416).
RESULTS: The mean general cognitive ability score was 101·8 (sd 12·4). Four major dietary patterns were identified and labelled as 'refined-grain pattern', 'snack-food pattern', 'plant-based food pattern' and 'high-energy food pattern'. These dietary patterns explained 39·1 % of the variance in the habitual dietary intakes of the adolescents. The refined-grain pattern was negatively associated with processing speed, which is a construct of general cognitive ability. The high-energy food pattern was negatively associated with general cognitive ability, perceptual reasoning and processing speed. Monthly household income and parents' educational attainment were positively associated with all of the cognitive measures. In multivariate analysis, only the high-energy food pattern was found to contribute significantly towards general cognitive ability after controlling for socio-economic status.
CONCLUSIONS: Consumption of foods in the high-energy food pattern contributed towards general cognitive ability after controlling for socio-economic status. However, the contribution was small.

Matched MeSH terms: Pediatric Obesity/etiology
Fulltext Maternal Serum and Breast Milk Adiponectin: The Association with Infant Adiposity Development

Mohamad M, Loy SL, Lim PY, Wang Y, Soo KL, Mohamed HJJ

Int J Environ Res Public Health, 2018 Jun 12;15(6).
PMID: 29895806 DOI: 10.3390/ijerph15061250

The prevalence of childhood obesity is increasing at an alarming rate in Malaysia. Metabolic changes during pregnancy are critical to the development of infant adiposity, due to imbalanced adipokines production. Hence, we aimed to investigate the association of maternal serum and breast milk adipokines with infant adiposity development. The study was conducted from April 2010 until December 2012. A total of 155 healthy pregnant mothers aged 19 to 40 years were recruited during the first and second trimester in Kelantan, Malaysia. Data consisted of maternal sociodemographic details, anthropometry and clinical biochemistry analysis; and the infant’s anthropometry and feeding patterns. Maternal fasting serum and breast milk samples were analysed for adiponectin and leptin levels. Data collection was performed in the second and third trimester of pregnancy, and continued with follow-up visits at birth, two, six, and 12 months postpartum. Multiple linear regression (MLR) analyses were performed to examine the associations between maternal serum and breast milk adiponectin and leptin and infant adiposity development. MLR models showed that, in the first year, as maternal serum and breast milk adiponectin increased, infant weight, BMI-for-age Z scores and abdominal circumference significantly decreased (p < 0.05). Maternal serum and/or breast milk adiponectin was associated with first-year infant adiposity development.

Matched MeSH terms: Pediatric Obesity/etiology*