Andraea Van Hulst

Cohort Profile: The Quebec Adipose and Lifestyle Investigation in Youth Cohort

Departement de pediatrie, Universite de Montreal, Montreal, Quebec, Canada, Centre de recherche du Centre Hospitalier Universitaire (CHU) Sainte-Justine, Montreal, Quebec, Canada, Departement de medecine sociale et preventive, Universite de Montreal, Montreal, Quebec, Canada, Centre de Recherche du Centre Hospitalier de l’Universite de Montreal, Montreal, Quebec, Canada, Division of Kinesiology, Faculty of Medicine, Universite Laval, Quebec, Canada, Departement d’education physique, Universite Laval, Quebec, Canada, Departement de radiologie, CHU Sainte-Justine, Montreal, Quebec, Canada, School of Dietetics and Human Nutrition, McGill University, Montreal, Quebec, Canada, Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada, Department of Psychiatry, McGill University, Montreal, Quebec, Canada, Office of Senior Medical Advisor, First Nations Inuit Health Branch, Health Canada, Vancouver, British-Columbia, Canada, Departement de kinesiologie, Universite de Montreal, Montreal, Quebec, Canada, School of Public Health, University of Alberta, Edmonton, Alberta, Canada, Department of Psychology, Concordia University, Montreal, Quebec, Canada, Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Laval, Quebec, Canada, Institut universitaire de cardiologie et de pneumologie de Quebec, Faculte de pharmacie, Universite Laval, Quebec, Canada, Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada, McGill University Health Center Research Institute, Montreal, Quebec, Canada and Institut national de sante publique du Quebec, Montreal, Quebec, Canada

The influence of poverty and social support on the perceived health of children born to minority migrant mothers.

Objective. Poverty and low social support are common among minority migrant families. Little is known about their impact on the health of children of minority migrants to Canada. This study examined the associations between maternal perception of childs health and migration status, and examined the specific role of poverty and low social support in these associations. Design. Data from the first two rounds of the Quebec Longitudinal Study of Child Development (QLSCD) were analysed. The sample included 1990 children at 17 months of age, classified according to their mothers migration status: children of minority migrant mothers (n=165) and Canadian-born mothers (n=1825). Maternal perception of childs health status and social support were measured at 17 months, household income was measured at 5 and 17 months. Multivariable logistic regressions were performed; interactions of migration status with poverty and social support were tested. Results. Poverty and low social support were more common among minority migrant mothers than among Canadian-born mothers. Children of minority migrant mothers who were ‘never poor’ and reported high levels of social support were perceived in better health (OR 0.42; 95% confidence interval (CI): 0.19–0.91) than children of Canadian-born mothers (reference group). In contrast, children of minority migrant mothers who were ‘always poor’ and reported low social support were perceived in worse health (OR 6.32; 95% CI: 1.69–23.71) compared to the reference group. Conclusion. In Quebec, economic hardship and lack of social support are common realities among minority migrants with young children. Combined exposure to poverty and low social support is most detrimental to the perceived health of children of minority migrants.

Road, rail, and air transportation noise in residential and workplace neighborhoods and blood pressure (RECORD Study)

Associations between road traffic noise and hypertension have been repeatedly documented, whereas associations with rail or total road, rail, and air (RRA) traffic noise have rarely been investigated. Moreover, most studies of noise in the environment have only taken into account the residential neighborhood. Finally, few studies have taken into account individual/neighborhood confounders in the relationship between noise and hypertension. We performed adjusted multilevel regression analyses using data from the 7,290 participants of the RECORD Study to investigate the associations of outdoor road, rail, air, and RRA traffic noise estimated at the place of residence, at the workplace, and in the neighborhoods around the residence and workplace with systolic blood pressure (SBP), diastolic blood pressure (DBP), and hypertension. Associations were documented between higher outdoor RRA and road traffic noise estimated at the workplace and a higher SBP [+1.36 mm of mercury, 95% confidence interval (CI): +0.12, +2.60 for 65-80 dB(A) vs 30-45 dB(A)] and DBP [+1.07 (95% CI: +0.28, +1.86)], after adjustment for individual/neighborhood confounders. These associations remained after adjustment for risk factors of hypertension. Associations were documented neither with rail traffic noise nor for hypertension. Associations between transportation noise at the workplace and blood pressure (BP) may be attributable to the higher levels of road traffic noise at the workplace than at the residence. To better understand why only noise estimated at the workplace was associated with BP, our future work will combine Global Positioning System (GPS) tracking, assessment of noise levels with sensors, and ambulatory monitoring of BP.

Identifying risk profiles for childhood obesity using recursive partitioning based on individual, familial, and neighborhood environment factors

BackgroundFew studies consider how risk factors within multiple levels of influence operate synergistically to determine childhood obesity. We used recursive partitioning analysis to identify unique combinations of individual, familial, and neighborhood factors that best predict obesity in children, and tested whether these predict 2-year changes in body mass index (BMI).MethodsData were collected in 2005–2008 and in 2008–2011 for 512 Quebec youth (8–10 years at baseline) with a history of parental obesity (QUALITY study). CDC age- and sex-specific BMI percentiles were computed and children were considered obese if their BMI was ≥95th percentile. Individual (physical activity and sugar-sweetened beverage intake), familial (household socioeconomic status and measures of parental obesity including both BMI and waist circumference), and neighborhood (disadvantage, prestige, and presence of parks, convenience stores, and fast food restaurants) factors were examined. Recursive partitioning, a method that generates a classification tree predicting obesity based on combined exposure to a series of variables, was used. Associations between resulting varying risk group membership and BMI percentile at baseline and 2-year follow up were examined using linear regression.ResultsRecursive partitioning yielded 7 subgroups with a prevalence of obesity equal to 8%, 11%, 26%, 28%, 41%, 60%, and 63%, respectively. The 2 highest risk subgroups comprised i) children not meeting physical activity guidelines, with at least one BMI-defined obese parent and 2 abdominally obese parents, living in disadvantaged neighborhoods without parks and, ii) children with these characteristics, except with access to ≥1 park and with access to ≥1 convenience store. Group membership was strongly associated with BMI at baseline, but did not systematically predict change in BMI.ConclusionFindings support the notion that obesity is predicted by multiple factors in different settings and provide some indications of potentially obesogenic environments. Alternate group definitions as well as longer duration of follow up should be investigated to predict change in obesity.

Physical activity growth curves relate to adiposity in adolescents.

PURPOSE Findings from prospective studies on associations between physical activity and adiposity among youth are inconsistent. Our aim was to describe physical activity trajectories during secondary school and examine the association with change in adiposity in youth. METHODS Physical activity was measured in 20 survey cycles from 1999 to 2005; anthropometrics were measured in survey cycles 1, 12, and 19. Individual growth curves modeling moderate-to-vigorous physical activity (MVPA) and vigorous physical activity (VPA) were estimated. Estimates of initial level and rate of decline in MVPA and VPA bouts per week were included as potential predictors of body fat% and body mass index using age- and sex-specific linear regression. RESULTS Complete data were available for 840 and 760 adolescents aged 12-13 years at baseline, followed from survey cycles 1-12 and 12-19, respectively. Among girls, yearly declines of one MVPA and one VPA bout per week during earlier adolescence were associated with increases of 0.19 (95% confidence interval [CI], 0.02-0.36) and 0.47 (95% CI, 0.015-0.92) units of body fat%, respectively. In boys, a yearly decline of one MVPA bout per week was associated with an increase of 0.38 (95% CI, 0.05-0.70) units of body fat% during later adolescence. CONCLUSIONS Obesity prevention programs should include strategies to prevent declines in physical activity.

Lifestyle Habits, Dietary Factors, and the Metabolically Unhealthy Obese Phenotype in Youth

Objective To determine whether lifestyle habits and dietary factors at age 8‐10 years predict the development of metabolically unhealthy obesity 2 years later among children who were previously metabolically healthy obese. Study design The QUebec Adipose and Lifestyle InvesTigation in Youth cohort comprises 630 youth with a parental history of obesity. Metabolically healthy obesity and metabolically unhealthy obesity were defined using cut‐offs for the components of pediatric metabolic syndrome. Dietary factors, physical activity, fitness, sedentary behavior, screen time, and sleep duration were measured. Multivariable logistic regressions were used to examine associations. Results At baseline, 48 participants with metabolically healthy obesity were identified; 2 years later, 19 became metabolically unhealthy obese and 29 remained metabolically healthy obese. Every additional daily portion of fruits and vegetables decreased the risk of converting to metabolically unhealthy obesity by 39% (OR 0.61, 95% CI 0.40‐0.94). Cumulating more hours of screen time and diets high in saturated fat and sugar‐sweetened beverages and low in protein were associated with a tendency to develop metabolically unhealthy obesity. Conclusions Fruit and vegetable intake and possibly screen time, saturated fat, sugar‐sweetened beverages, and protein intake may be important targets for the prevention of cardiometabolic complications in obese children. Trial registration ClinicalTrials.gov: NCT03356262.

Normal weight metabolically unhealthy phenotype in youth: do definitions matter?

Normal weight metabolically unhealthy (NWMU) adults are at increased risk of cardiometabolic disease, however, little is known regarding NWMU children.