J.W.R. Twisk

Tracking of childhood overweight into adulthood: a systematic review of the literature.

Overweight and obesity in youth are important public health concerns and are of particular interest because of possible long‐term associations with adult weight status and morbidity. The aim of this study was to systematically review the literature and update evidence concerning persistence of childhood overweight. A computerized bibliographical search – restricted to studies with a prospective or retrospective longitudinal design – was conducted. Two authors independently extracted data and assessed the methodological quality of the included studies in four dimensions (i) study population and participation rate; (ii) study attrition; (iii) data collection and (iv) data analysis. Conclusions were based on a rating system of three levels of evidence. A total of 25 publications were selected for inclusion in this review. According to a methodological quality assessment, 13 studies were considered to be of high quality. The majority of these high‐quality studies were published after 2001, indicating that recently published data, in particular, provide us with reliable information. All included studies consistently report an increased risk of overweight and obese youth becoming overweight adults, suggesting that the likelihood of persistence of overweight into adulthood is moderate for overweight and obese youth. However, predictive values varied considerably. Limiting aspects with respect to generalizability and methodological issues are discussed.

Adolescent motor skill and performance: Is physical activity in adolescence related to adult physical fitness?

In the Amsterdam Growth and Health Longitudinal Study (AGAHLS), a cohort of about 400 boys and girls (mean age 13 years) were followed over a period of 20 years. Over that period repeated measurements were done of body dimensions (height, weight, skinfolds), physical fitness (eight motor performance field tests: plate tapping, bent arm hang, 10 × 5 m sprint, arm pull, sit and reach, standing high jump, 10 leg lifts, 12‐min endurance run, and one laboratory test to measure maximal aerobic power), and physical activity (by a cross‐check interview). Three research questions were studied: (1) Is there a positive relationship between adolescent fitness (age 13–17 years) and adult physical activity (age 33 years)? (2) Do physical fitness and physical activity track from adolescence into adulthood? (3) What is the longitudinal relationship between physical fitness and physical activity? Multiple linear regression analysis showed that of the 9 physical fitness tests, only the 12‐min endurance run and the maximal aerobic power during adolescence are significant (P < 0.05) predictors of adult physical activity. The effects are not influenced by biological age but by sex: only in females are the predictions significant (P < 0.05) Tracking over the period of 20 years estimated from stability coefficients showed values for physical fitness varying between 0.83 (plate tapping) to 0.38 (standing high jump and maximal aerobic power). Physical activity shows lower stability coefficients (0.35–0.29). A longitudinal linear regression technique was used to analyse the relationship between physical activity and physical fitness over the 20‐year period; in this analysis corrections were made for both time‐dependent (time, biological age, and cardiovascular factors) and time‐independent variables (sex). All physical fitness tests show positive and significant (P < 0.05) standardized regression coefficients with physical activity, but the explained variance is less than 1%. Only maximal aerobic power has a higher explained variance of 1.8%. It can be concluded that: (1) Physical fitness in adolescence is only weakly related to adult physical activity; (2) between age 13 and 33 years, physical activity has low stability and physical fitness was higher stability; and (3) the longitudinal relationships between physical fitness and physical activity are only meaningful with maximal aerobic power. Am. J. Hum. Biol. 13:180–189, 2001.

Physical fitness, body fatness and physical activity: the Amsterdam Growth and Health Study.

The purpose of this study was to examine sex‐specific longitudinal relationships between physical fitness (cardiopulmonary and neuromotor fitness) and body fatness (sum of skinfolds) and to examine the influence of physical activity (weighted activity score) on these relationships. The data were obtained from the Amsterdam Growth and Health Study (AGHS), an observational longitudinal study of 98 females and 83 males, with six repeated measurements over a period from 13 to 27 years of age. The longitudinal relationship between body fatness and physical fitness was analyzed using generalized estimating equations (GEE). For each of the eight fitness items used as outcome variables, standardized regression coefficients were calculated for the relationships with body fatness and for the relationships with physical activity with and without correcting for height and weight. In all analyses, body fatness was inversely related to running speed, standing high jump, leg lift speed, and maximal oxygen uptake. Physical activity was positively related to leg lift speed and maximal oxygen uptake, and only in females to the standing high jump. Thus, body fatness is inversely related to most fitness items, while physical activity is positively related to only several fitness items. Further, body fatness and physical activity are independently related to physical fitness. Am. J. Hum. Biol. 12:593–599, 2000.

Dairy intake from adolescence into adulthood is not associated with being overweight and metabolic syndrome in adulthood: the Amsterdam Growth and Health Longitudinal Study.

BACKGROUNDnDairy intake may have beneficial effects with respect to becoming overweight, insulin resistance and metabolic syndrome (MS), although most of the available studies are cross-sectional and conducted among adults. The present study aimed to investigate whether dairy intake during adolescence and young adulthood protects against becoming overweight and (components of) MS at age 36 years.nnnMETHODSnDairy intake was repeatedly measured between the ages of 13 and 36 years among participants (n=374) of a Dutch prospective longitudinal cohort study. Being overweight and components of MS were examined at age 36 years. A statistical method for longitudinal data, generalised estimating equations, was used to assess whether the time course of total dairy intake, high-fat and low-fat dairy was associated with being overweight and with (components of) MS.nnnRESULTSnThe time course from age 13-36 years for total dairy intake did not differ between overweight and non-overweight participants, nor for participants with and without MS at age 36 years. Significant differences between groups were only observed at certain time points, mainly around the age of 21 and 27 years. High-fat dairy intake during adolescence tended to be higher in subjects with lower weight, a lower body fat percentage, lower waist circumference and lower triglyceride concentrations at age 36 years. In those having at least two risk factors for MS and high glycosylated haemoglobin, differences in dairy intake were in the opposite direction.nnnCONCLUSIONSnThese results do not support the hypothesis that dairy consumption protects against potentially becoming overweight and metabolic disturbances.

The relationship between BMI and dietary intake of primary school children from a rural area of South Africa: The Ellisras longitudinal study

To investigate the relationship between dietary intake and BMI of primary school children from a rural area of South Africa cross‐sectionally. Both under and over nutrition remain major health problems in South Africa. In rural areas, where especially undernutrition leads to child morbidity and mortality, determinants should be detected.

Smoking behaviour and biological maturation in males and females: a 20-year longitudinal study. Analysis of data from the Amsterdam Growth and Health Longitudinal Study.

Primary objective : (1) Describe the longitudinal smoking behaviour of boys and girls during adolescence in relation to calendar age, skeletal age, years from peak height velocity (PHV) and years from menarche (in girls). (2) and (3) Investigate the timing of biological maturation (early or late maturation) in relation to smoking behaviour in adolescence and in adulthood (i.e. calendar age 32/33). Hypothesis : We hypothesized skeletal age, years from PHV and years from menarche to be better predictors of smoking than calendar age. Research design : This study is part of the Amsterdam Growth and Health Longitudinal Study (AGAHLS) that was started in 1977 with 619 pupils from two secondary schools (mean age 13.0 SD 0.6). Methods and procedures : Smoking behaviour was assessed four times between 1977 and 1980 and once in 1996/1997. Calendar age and skeletal age were measured annually whereas height and menarche were measured every 4 months. Maturation rate (skeletal age minus calendar age), age at PHV and age at menarche were used to estimate timing of biological maturation. Generalized Estimating Equation (GEE) analysis was used to study maturation rate in relation to smoking during adolescence, whereas logistic regression analyses were used to study mean maturation rate, years from PHV and years from menarche in relation to smoking in adulthood. Outcomes and results : Skeletal age, years from PHV and years from menarche are no better predictors of smoking during adolescence than calendar age. The prevalence of smoking rises gradually with the increase in all four estimates of biological maturation. Timing of biological maturation was positively related to smoking but only at calendar age 13 (OR 3.34, CI 1.58, 7.07). None of the three measures to estimate timing of biological maturation was significantly related to smoking status in adulthood.

The incidence and predictors of depressive and anxiety symptoms in older adults with vision impairment: a longitudinal prospective cohort study

Depression and anxiety are highly prevalent in older adults with vision impairment. Because symptoms of depression and anxiety appear to fluctuate, it is important to identify patients who are at risk of developing these symptoms for early diagnosis and treatment. Therefore, the aim of this study was to determine the incidence of subthreshold depression and anxiety, and to investigate predictors of developing symptoms of depression and anxiety in older adults with vision impairment who had no subthreshold depression or anxiety at baseline.

Daytime births are associated with better perinatal outcomes in secondary and tertiary hospitals.

Commentary on: de GraafJPRavelliACVisserGH. Increased adverse perinatal outcome of hospital delivery at night. BJOG 2010;117:1098–107.

Quality of life and patient satisfaction after one-stage implant-based breast reconstruction with an acellular dermal matrix versus two-stage breast reconstruction (BRIOS): primary outcome of a randomised, controlled trial

BACKGROUNDnThere is increasing interest in the use of acellular dermal matrices (ADMs) in implant-based breast reconstruction (IBBR). Suggested advantages are that ADMs facilitate one-stage IBBR and improve aesthetic outcomes. We compared immediate one-stage ADM-assisted IBBR with two-stage IBBR (current standard of care). Our previously reported secondary endpoint showed that one-stage ADM-assisted IBBR was associated with significantly more adverse outcomes. Here, we present the primary endpoint results aiming to assess whether one-stage IBBR with ADM provides higher patient-reported quality of life (QOL) compared with two-stage IBBR.nnnMETHODSnThis multicentre, open-label, randomised controlled trial (BRIOS study) was done in eight hospitals in the Netherlands. We recruited women aged older than 18 years with breast carcinoma or a genetic predisposition who intended to undergo skin-sparing mastectomy and immediate IBBR. Participants were randomly assigned to undergo one-stage IBBR with ADM (Strattice, LifeCell, Branchburg, NJ, USA) or two-stage IBBR. Randomisation was stratified by centre and indication for surgery (oncological or prophylactic) in blocks of ten participants. The primary endpoint was patient-reported QOL, as measured with the BREAST-Q (ie, health-related QOL scales and satisfaction scales), in the modified intention-to-treat population. The study follow-up is complete. This study is registered with the Netherlands Trial Register, number NTR5446.nnnFINDINGSnBetween April 14, 2013, and May 29, 2015, we enrolled 142 women, of whom 69 were randomly assigned to receive one-stage ADM-assisted IBBR and 73 to receive two-stage IBBR. After exclusions, the modified intention-to-treat population comprised 60 patients in the one-stage group and 61 patients in the two-stage group. Of these, 48 women (mean follow-up 17·0 months [SD 7·8]) in the one-stage group and 44 women (17·2 months [SD 6·7]) in the two-stage group completed the BREAST-Q at least 1 year after implant placement. We found no significant differences in postoperative patient-reported QOL domains, including physical wellbeing (one-stage mean 78·0 [SD 14·1] vs two-stage 79·3 [12·2], p=0·60), psychosocial wellbeing (72·6 [17·3] vs 72·8 [19·6], p=0·95), and sexual wellbeing (58·0 [17·0] vs 57·1 [19·5], p=0·82), or in the patient-reported satisfaction domains: satisfaction with breasts (63·4 [15·8] vs 60·3 [15·4], p=0·35) and satisfaction with outcome (72·8 [19·1] vs 67·8 [16·3], p=0·19).nnnINTERPRETATIONnTaken together with our previously published findings, one-stage IBBR with ADM does not yield superior results in terms of patient-reported QOL compared with two-stage IBBR. Risks for adverse outcomes were significantly higher in the one-stage ADM group. Use of ADM for one-stage IBBM should be considered on a case-by-case basis.nnnFUNDINGnPink Ribbon, Nuts-Ohra, and LifeCell.

Predicting the course of persistent physical symptoms: Development and internal validation of prediction models for symptom severity and functional status during 2 years of follow-up

OBJECTIVEnIncreased knowledge about predictors of the course of persistent physical symptoms (PPS) is needed to identify patients at risk for long-term PPS in clinical settings. Therefore, we developed prediction models for the course of PPS in terms of symptom-severity and related functional status during a 2-year follow-up period.nnnMETHODSnWe used data of the PROSPECTS cohort study, consisting of 325 PPS patients from several health care settings. Symptom severity (PHQ-15), physical functioning (RAND 36 PCS) and mental functioning (RAND 36 MCS) were assessed at baseline and 6, 12 and 24u202fmonths afterwards. We applied mixed model analyses to develop prediction models for all outcomes, using all follow-up measurements. Potential predictors were based on empirical and theoretical literature and measured at baseline.nnnRESULTSnFor symptom severity, physical functioning and mental functioning we identified predictors for the adverse course of PPS included physical comorbidity, higher severity and longer duration of PPS at baseline, anxiety, catastrophizing cognitions, embarrassment and fear avoidance cognitions, avoidance or resting behaviour and neuroticism. Predictors of a favourable course included limited alcohol use, higher education, higher levels of physical and mental functioning at baseline, symptom focusing, damage cognitions and extraversion. Explained interpersonal variance for all three models varied between 70.5 and 76.0%. Performance of the models was comparable in primary and secondary/tertiary care.nnnCONCLUSIONnThe presented prediction models identified several relevant demographic, medical, psychological and behavioural predictors for adverse and favourable courses of PPS. External validation of the presented models is needed prior to clinical implementation.