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Before-school and after-school childcare and children's risk of obesity.

ABSTRACT: In the USA, half of children are regularly cared for before or after school by someone other than a parent.Describe the relationship between childcare arrangements and obesity among school-aged children.Data are from the fifth-grade wave of the Early Childhood Longitudinal Study - Kindergarten Cohort 1998-1999, a nationally representative study of US children who were in kindergarten in 1998-1999 or first grade in 1999, collected in spring 2004 (analytic sample?=?9617). We estimated survey-adjusted logistic regression models to examine the association between childcare arrangements before and after school and obesity.The prevalence of obesity was highest among fifth graders who received care from multiple sources and lowest among children who received care from adults not related to them in either the child's or the caregiver's home [29.9%, 95% confidence interval {CI}: 18.7%, 44.3%; and 17.3%, 95% CI: 12.1%, 24.0%]. Childcare arrangement was not an independent risk factor for obesity for most children. However, Hispanic children who were cared for by a person who was not a relative had significantly higher odds of obesity compared with non-Hispanics in similar care arrangements (odds ratio: 5.11, 95% CI: 2.00, 13.06).Type of childcare before or after school was not an independent risk factor for obesity in most fifth graders, but implications of childcare for Hispanic children should be explored further.

SUBMITTER: Shah PM

PROVIDER: S-EPMC4980278 | biostudies-literature | 2017 Feb

REPOSITORIES: biostudies-literature

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Before-school and after-school childcare and children's risk of obesity.

Shah P M PM Sudharsanan N N Cunningham S A SA

Pediatric obesity 20160209 1

<h4>Background</h4>In the USA, half of children are regularly cared for before or after school by someone other than a parent.<h4>Objective</h4>Describe the relationship between childcare arrangements and obesity among school-aged children.<h4>Methods</h4>Data are from the fifth-grade wave of the Early Childhood Longitudinal Study - Kindergarten Cohort 1998-1999, a nationally representative study of US children who were in kindergarten in 1998-1999 or first grade in 1999, collected in spring 200 ...[more]

PMID: 26860620

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Project description:INTRODUCTION:The effects of Build Our Kids Success-a 12-week, 1-hour before-school physical activity program-on BMI and social-emotional wellness among kindergarten to eighth grade students was examined. STUDY DESIGN:This was a nonrandomized trial. SETTING/PARTICIPANTS:Participants were from 24 schools in Massachusetts; there were 707 children from kindergarten to eighth grade. INTERVENTION:Children registered for Build Our Kids Success in 2015-2016 participated in a 2 days/week or 3 days/week program. Nonparticipating children served as controls. MAIN OUTCOME MEASURES:At baseline and 12 weeks, study staff measured children's heights/weights; children aged ≥8 years completed surveys. Main outcomes were 12-week change in BMI z-score, odds of a lower BMI category at follow-up, and child report of social-emotional wellness. Analyses were completed in March-June 2017. RESULTS:Follow-up BMI was obtained from 67% of children and self-reported surveys from 72% of age-eligible children. Children in the 3 days/week group had improvements in BMI z-score (-0.22, 95% CI= -0.31, -0.14) and this mean change was significantly different than the comparison group (-0.17 difference, 95% CI= -0.27, -0.07). Children in the 3 days/week group also had higher odds of being in a lower BMI category at follow-up (OR=1.35, 95% CI=1.12, 1.62); significantly different than the comparison group (p<0.01). Children in the 2 days/week program had no significant changes in BMI outcomes. Children in the 3 days/week group demonstrated improvement in their student engagement scores (0.79 units, p=0.05) and had nonsignificant improvements in reported peer relationships, affect, and life satisfaction versus comparison. The 2 days/week group had significant improvements in positive affect and vitality/energy versus comparison. CONCLUSIONS:A 3 days/week before-school physical activity program resulted in improved BMI and prevented increases in child obesity. Both Build Our Kids Success groups had improved social-emotional wellness versus controls. TRIAL REGISTRATION:This study is registered at www.clinicaltrials.gov NCT03190135.

Project description:PAPER 1:"Identification of novel subgroups of high-risk pediatric precursor B acute lymphoblastic leukemia (B-ALL) by unsupervised microarray analysis: clinical correlates and therapeutic implications. A Children's Oncology Group (COG) study." ABSTRACT We examined gene expression profiles of pre-treatment specimens from 207 patients from the COG P9906 study to identify signatures of children with high risk B-precursor acute lymphoblastic leukemia (ALL) and to determine whether the resulting clusters are associated with either specific clinical features or treatment response characteristics. Four unsupervised clustering methods were utilized to classify patients into similar groups. The different clustering algorithms showed significant overlap in cluster membership. Two clusters contained all cases with either t(1;19)(q23;p13) translocations or MLL rearrangements. The other six clusters were novel and had no recurring chromosomal abnormalities or distinctive clinical features. Members of two of these novel clusters had significant survival differences when compared to the overall 4-year relapse-free survival (RFS) of 61%. These included clusters of patients with either significantly better (94.7%) or worse (21.0%) RFS at 4 years. Children of Hispanic/Latino ethnicity were disproportionately present in the poor outcome cluster. The poor outcome cluster represents a novel biologically distinctive subset of B-precursor ALL that may occur at least as frequently as BCR/ABL. Further molecular characterization of this cluster may lead to the discovery of genomic abnormalities that can be targeted to improve the currently dismal outcome for children with this gene signature. The Sample data have also been used in another study: PAPER 2: "Gene expression classifiers for minimal residual disease and relapse free survival improve outcome prediction and risk classification in children with high risk acute lymphoblastic leukemia. A Children's Oncology Group study". ABSTRACT Background. Nearly 25% of children with B-precursor ALL present with "high-risk" disease (HR-ALL) that is resistant to current therapies. Gene expression profiling may yield molecular classifiers for outcome prediction that can be used to improve risk classification and therapeutic targeting. Methods. Expression profiles were obtained in pre-treatment leukemic samples from 207 uniformly treated children with HR-ALL. Relapse free survival (RFS) was 61% at 4 years and flow cytometric measures of minimal residual disease (MRD) at the end of induction (day 29) were predictive of outcome (P<0.001). Molecular classifiers predictive of RFS and MRD were developed using extensive cross-validation procedures. Results. A 38 gene molecular risk classifier predictive of RFS (MRC-RFS) distinguished two groups in HR-ALL with different relapse risks: low (4 yr RFS: 81%, n=109) vs. high (4 yr RFS: 50%, n=98) (P<0.0001). In multivariate analysis, the best predictor combined MRC-RFS and day 29 flow MRD data, classifying children into low (87% RFS), intermediate (62% RFS), or high risk (29% RFS) groups (P<0.0001). A 21 gene molecular classifier predictive of MRD could effectively substitute for day 29 flow MRD, yielding a combined classifier that similarly distinguished three risk groups at pre-treatment (low: 82% RFS; intermediate: 63% RFS; and high risk: 45% RFS) (P<0.0001). This combined molecular classifier was further validated on an independent cohort of 84 children with HR-ALL (P = 0.006). Conclusions. Molecular classifiers predictive of RFS and MRD can be used to distinguish distinct prognostic groups within HR-ALL, significantly improving risk classification schemes and the ability to prospectively identify children at diagnosis who will respond to or fail current treatment regimens. NOTE: Due to Children's Oncology Group (COG) restrictions, outcome and MRD data cannot be provided as part of the covariate data for this dataset at the present time. If you would like to arrange individual access to this data, please contact COG or the PI of this study, Dr. Cheryl Willman, at the University of New Mexico Cancer Center (cwillman@unm.edu) to arrange a collaboration.

Dataset Information

Before-school and after-school childcare and children's risk of obesity.

Publications

Before-school and after-school childcare and children's risk of obesity.

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