Celine Murrin

Body mass index and height over three generations: evidence from the Lifeways cross-generational cohort study

BackgroundObesity and its measure of body mass index are strongly determined by parental body size. Debate continues as to whether both parents contribute equally to offspring body mass which is key to understanding the aetiology of the disease. The aim of this study was to use cohort data from three generations of one family to examine the relative maternal and paternal associations with offspring body mass index and how these associations compare with family height to demonstrate evidence of genetic or environmental cross-generational transmission.Methods669 of 1082 families were followed up in 2007/8 as part of the Lifeways study, a prospective observational cross-generation linkage cohort. Height and weight were measured in 529 Irish children aged 5 to 7 years and were self-reported by parents and grandparents. All adults provided information on self-rated health, education status, and indicators of income, diet and physical activity. Associations between the weight, height, and body mass index of family members were examined with mixed models and heritability estimates computed using linear regression analysis.ResultsSelf-rated health was associated with lower BMI for all family members, as was age for children. When these effects were accounted for evidence of familial associations of BMI from one generation to the next was more apparent in the maternal line. Heritability estimates were higher (h2 = 0.40) for mother-offspring pairs compared to father-offspring pairs (h2 = 0.22). In the previous generation, estimates were higher between mothers-parents (h2 = 0.54-0.60) but not between fathers-parents (h2 = -0.04-0.17). Correlations between mother and offspring across two generations remained significant when modelled with fixed variables of socioeconomic status, health, and lifestyle. A similar analysis of height showed strong familial associations from maternal and paternal lines across each generation.ConclusionsThis is the first family cohort study to report an enduring association between mother and offspring BMI over three generations. The evidence of BMI transmission over three generations through the maternal line in an observational study corroborates the findings of animal studies. A more detailed analysis of geno and phenotypic data over three generations is warranted to understand the nature of this maternal-offspring relationship.

Maternal macronutrient intake during pregnancy and 5 years postpartum and associations with child weight status aged five.

BACKGROUND/OBJECTIVES:Animal models have demonstrated that maternal overnutrition during pregnancy influences offspring adiposity. Few human studies of normal pregnancy have replicated these findings. We examined the association between child body mass index at age 5 years and maternal nutrient intake during pregnancy and 5 years postpartum.SUBJECTS/METHODS:Five-year-old children (n=585) and their mothers were recruited during pregnancy from two maternity hospitals in Ireland. Data are from the Lifeways Cross-Generation Cohort study with detailed dietary information obtained during pregnancy and postpartum using a food frequency questionnaire. Nutrient intake was adjusted for energy intake (EI) and expressed in quartiles. Heights and weights were measured when the children were aged 5 years. We performed multivariate logistic regression analyses to examine the independent associations of macronutrients (protein, fat and carbohydrate) and their components (saturated fatty acid (SFA)/monounsaturated fatty acid/polyunsaturated fatty acid and sugar/starch) with child overweight/obesity. Associations were examined for nutrient intake during pregnancy (T1), at 5 years postpartum (T2) and the change in nutrient intake between T1 and T2.RESULTS:Total mean (s.d.) EI was significantly higher during pregnancy (2548±1239 kcal) than 5 years postpartum (2084±718 kcal). Increased odds of overweight/obesity were found in mothers with higher intakes of sugar at T1 (Q4 odds ratio (OR): 4.57, 95% confidence interval (CI): 1.01–20.69) and high intakes of SFA at T2 (Q4 OR: 3.35, 95% CI: 0.97–11.57). Mothers with persistently high intakes of SFA and those who reduce their sugar intake between T1 and T2 were more likely to have overweight/obese children.CONCLUSION:Maternal prenatal sugar and pre/postnatal SFA was associated with offspring adiposity.

Familial intergenerational and maternal aggregation patterns in nutrient intakes in the Lifeways Cross-Generation Cohort Study.

OBJECTIVE The current study prospectively examines the intra-uterine hypothesis by comparing maternal, paternal and grandparental lineage influences on children’s diet and also maternal–child aggregation patterns during pregnancy and early childhood. DESIGN Prenatal dietary information was available for expectant mothers, fathers and up to four grandparents through a detailed validated semi-quantitative FFQ. At 6-year follow-up, when children averaged 5 years of age, dietary information was re-collected for mothers and a subset of maternal grandmothers using the same FFQ. Child’s FFQ version was used for children. Anthropometric and sociodemographic variables were also collected. SETTINGS Three-generation familial cohort representative of the contemporary Irish national population. SUBJECTS Children aged 5 years (n 567) and their parents and grandparents. RESULTS Associations for energy, macronutrient and fibre intakes were compared using Pearson’s correlations, intra-class correlations (ICC) and linear regression models, adjusted for energy and potential confounders. Significant, moderatestrength positive correlations were observed for nutrient intakes in children’s nuclear families (ICC (range)50?22–0?28). The father–child associations (r (range)5 0?13–0?20) were weaker than the mother–child associations (r (range)50?14–0?33). In general, associations were stronger for maternal postnatal intake–child intake than for maternal prenatal intake–child intake, except for percentage of energy from fat (adjusted b50?16, 95% CI 0?05, 0?26; P50?004), which was stronger for maternal prenatal intake, specifically in non-breast-fed children (adjusted b50?28, 95% CI 0?12, 0?44; P50?001). Among all grandparents, correlations were significant only for maternal grandmother–mother pairs (r (range)50?10–0?36). Significant positive ICC were observed for nutrient intakes of maternal grandmother–mother–child triads (ICC (range)50?12–0?27), not found in paternal lines. CONCLUSIONS These findings suggest that maternal-environment programming influences dietary intake.

Determinants of partial or no primary immunisations

Objective To determine if different factors affect children having full, partial or no primary immunisations. Methods This was a crossgenerational cohort study with linkage to primary care and hospital records conducted in urban and rural settings in Ireland, recruiting in 2001–2003 with 5-year follow-up. A total of 749 children with immunisation information took part. Results The uptake of reported primary immunisations was 92.8% full, 4.9% partial and 2.3% no primary immunisations. Adjusted relative risk ratios for children receiving no primary immunisations were significant for: having a mother who had ever visited an alternative practitioner 3.69 (1.05 to 12.9), a mother with means tested full general medical services eligibility 8.11 (1.58 to 41.65), a mother who scored <50 for the World Health Organization Quality of Life (WHO-QOL) scale psychological domain 8.82 (1.79 to 43.6) or living in the west of Ireland (rural) 3.64 (1.0 to 13.2). Being born prematurely was associated with partial primary immunisation, adjusted OR 4.63 (1.24 to 17.3). Conclusions Knowledge of these differences will help target campaigns to increase full uptake of primary immunisations.

Longitudinal follow-up of the relationship between dietary intake and growth and development in the Lifeways cross-generation cohort study 2001-2013.

In this paper we will review evidence on the early life and familial influences on childhood growth and development, with particular reference to the Lifeways cross-generation cohort study in the Republic of Ireland. The Lifeways cross-generation cohort study was established in 2001-2013 through two maternity hospitals in the Republic of Ireland and was one of many new cohort studies established worldwide in the millennium period. Mothers were recruited at first booking visit, completing a self-administered questionnaire, which included a 147 item semi-quantitative FFQ. Longitudinal follow-up is ongoing in 2013, with linkage data to hospital and general practice records and examination of children when aged 5 and 9 years. The study is one of very few containing data on grandparents of both lineages with at least one grandparent recruited at baseline. There have been consistent associations between parental and grandparental health status characteristics and childrens outcomes, including infant birth-weight, BMI when child was aged 5 years and childhood wheeze or asthma when child was aged 3 and aged 5 years. In conclusion, empirical evidence to date shows consistent familial and cross-generational patterns, particularly in the maternal line.

Consumer views on “healthier” processed meat

Purpose – The purpose of this paper is to investigate consumer attitudes towards and interest in enriching processed meat with healthy ingredients (“functional processed meat”). Design/methodology/approach – Seven focus groups across age and gender were conducted. Discussions were analysed using an inductive thematic approach. Findings – Strategies that participants felt as important for improving the healthiness of processed meat mainly included the use of better quality meat and less salt, fat, preservatives and other additives. “Functional processed meat” was a new concept for participants. Four themes were constructed to reflect participants’ attitudes towards functional processed meat: opposing views on processed meat as a carrier of healthy ingredients; belief in the health benefits of functional processed meat; perceived value of functional processed meat for different consumer groups; and trust and perceived risk surrounding the functional food concept. A large proportion of the participants were ...

Body mass index is associated with the maternal lines but height is heritable across family lines in the Lifeways Cross-Generation Cohort Study.

Objectives Overweight and obesity is a problem in children in particular and determining pathways of transmission is important in prevention. We aimed to examine associations for body mass index (BMI) across three generations of the same families. Participants Members of 556 families in the Lifeways Cross-Generation Cohort Study 2001–2014. Setting Community-based study with linkage to health records in the Republic of Ireland. Methods Employing a novel mixed-method approach which adjusts for age and familial group, BMI correlations were estimated at three ages of the index child, that is, at birth and at ages 5 and 9. Height was also examined for comparative purposes. Results Correlation of offsprings BMI with that of the mother increased with age (correlation coefficient 0.15 increasing to 0.28, p value <0.001 in all cases) while no consistent pattern was seen with offspring and fathers. There was an association also with each parent and their own mother. Offsprings BMI was correlated to a lesser extent with that of the maternal grandmother while for girls only there was an association with that of the paternal grandmother at ages 0 and 5 (correlation coefficients 0.25, 0.28, p values 0.02, 0.01, respectively). In contrast, height of the child was strongly associated with those of all family members at age 5, but at birth and at age 9 only there was an association with those of the parents and the paternal grandfather. Correlation of offsprings height with those of the mother and father increased with age. Conclusions The results suggest that BMI is predominantly associated with the maternal line, possibly either with intrauterine development, or inherited through the X chromosome, or both, while height is a more complex trait with genetic influences of the parents and that of the paternal grandfather predominating.

Socio-demographic and health-related predictors of uptake of first MMR immunisation in the Lifeways Cohort Study

The aim of this study was to investigate the uptake of the first dose of measles, mumps and rubella (MMR) vaccine and factors associated with not receiving this vaccine. A cross-generation cohort study was conducted with prospective linkage to primary care and hospital health records in urban and rural settings in Ireland 2001-2004. Seven hundred and forty-nine singleton children were included, with an MMR uptake of 88.7% by the age of 5 years. These data confirm prospectively for the first time that in addition to factors associated with disadvantage, other health practices and beliefs, particularly mothers complementary and alternative medicine use, are associated with decreased MMR uptake (adjusted OR 2.65 (1.76-3.98)). This information suggests that parental attitudes and beliefs regarding vaccines must be considered when developing programmes to improve immunisation uptake.

Consumer preferences towards healthier reformulation of a range of processed meat products: A qualitative exploratory study

In response to increasing public health concerns about processed meat consumption, many innovations in meat technology focus on health-oriented product reformulations. Processed meat is not a homogeneous food category. The purpose of this paper is to explore consumer perception of the “healthier” reformulation of different processed meat products using two approaches: salt and fat reduction; and enrichment with healthy ingredients.,Seven focus group interviews were carried out with 40 Irish regular meat consumers (30 female, ten male) who were solely or jointly responsible for food shopping. Two rounds of card sorting procedures were employed to reveal perceptions on reformulation of 20 different processed meat products. Thematic analysis was used for analysing transcripts.,Health and flavour concerns and product popularity were the main factors influencing participants’ perceptions. Some participants were unsure or had misconceptions about the healthiness of certain meat products. Participants suggested reducing salt and fat content in processed meat products they perceived as the least healthy ones (theme 1) and improving the healthiness of products which were favoured by children (theme 2) and those meat products which people consumed regularly as a source of protein (theme 3). Participants were not in favour of any reformulation of speciality-type products (theme 4).,Consumer insights identified in this study can inform future approaches to making processed meats healthier.

Inventory of surveillance systems assessing dietary, physical activity and sedentary behaviours in Europe: a DEDIPAC study.

Background There is a need for harmonized public health surveillance systems to monitor regional variations and temporal trends of health behaviours and health outcomes and to align policies, action plans and recommendations in terms of healthy diet and physical (in)activity within Europe. We provide an inventory of currently existing surveillance systems assessing diet, physical activity, and sedentary behaviours in Europe as a tool to assist in the identification of gaps and needs and to contribute to the roadmap for an integrated pan-European surveillance system. Methods An inventory questionnaire was completed by representatives of eleven European countries. Eligible surveillance systems were required to meet specific inclusion criteria. First, pre-screening of available surveillance systems in each country was conducted. Second, an in-depth appraisal of the retained surveillance systems complying with the pre-defined requirements was performed. Results Fifty surveillance systems met the inclusion criteria: six multinational European surveys and forty-four national surveys. Dietary intake and physical activity are the domains predominantly assessed and adults are the most frequently studied age group. Conclusions Many on-going activities were identified at the national level focussing on adults, but fewer surveillance systems involving vulnerable groups such as infants and pre-school children. Assessment of sedentary and dietary behaviours should be more frequently considered. There is a need for harmonization of surveillance methodologies, indicators and target populations for between-country and over time comparisons. This inventory will serve to feed future discussions within the DEDIPAC-JPI major framework on how to optimize design and identify priorities within surveillance.