Dataset Information

Differences in respiratory consultations in primary care between underweight, normal-weight, and overweight children.

ABSTRACT: This prospective cohort study investigates whether the suggested association between weight status and respiratory complaints in open populations is also reflected in the frequency of consultations for respiratory complaints at the general practice. Children aged 2-18 years presenting at one of the participating general practices in the Netherlands could be included. Electronic medical files were used to extract data on consultations. Logistic regression analyses and negative binomial regression analyses were used to assess the associations between weight status and the presence, and frequency of respiratory consultations, respectively, during 2-year follow-up. Subgroup analyses were performed in children aged 2-6, 6-12, and 12-18 years old. Of the 617 children, 115 (18.6%) were underweight, 391 (63.4%) were normal-weight, and 111 (18%) were overweight. Respiratory consultations were not more prevalent in underweight children compared to normal-weight children (odds ratio (OR) 0.87, 95% confidence inteval (CI) 0.64-1.10), and in overweight children compared to normal-weight children (OR 1.33, 95% CI 0.99-1.77). Overweight children aged 12-18 years had more respiratory consultations (OR 2.14, 95% CI 1.14-4.01), more asthma-like consultations (OR 3.94, 95%CI 1.20-12.88), and more respiratory allergy-related consultations (OR 3.14, 95% CI 1.25-7.86) than normal-weight children. General practitioners should pay attention to weight loss as part of the treatment of respiratory complaints in overweight and obese children.

SUBMITTER: van Leeuwen J

PROVIDER: S-EPMC6499776 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Differences in respiratory consultations in primary care between underweight, normal-weight, and overweight children.

van Leeuwen Janneke J El Jaouhari Zoubeir Z Paulis Winifred D WD Bindels Patrick J E PJE Koes Bart W BW van Middelkoop Marienke M

NPJ primary care respiratory medicine 20190503 1

This prospective cohort study investigates whether the suggested association between weight status and respiratory complaints in open populations is also reflected in the frequency of consultations for respiratory complaints at the general practice. Children aged 2-18 years presenting at one of the participating general practices in the Netherlands could be included. Electronic medical files were used to extract data on consultations. Logistic regression analyses and negative binomial regression ...[more]

PMID: 31053706

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Project description:Research shows that obesity prevention has to start early. Targeting interventions towards subgroups of individuals who are predisposed, but yet normal weight, may prove more effective in preventing overweight than interventions towards unselected normal weight subsets. Finally, interventions focused on other factors than diet and activity are lacking. The objectives were to perform a randomized, controlled intervention aiming at preventing overweight in children aged 2-6 years, who are yet normal weight, but have high predisposition for future overweight, and to intervene not only by improving diet and physical activity, but also reduce stress and improve sleep quality and quantity.Based on information from the Danish National Birth Registry and administrative birth forms, children were selected based on having either a high birth weight, a mother who was overweight prior to pregnancy, or a familial low socioeconomic status. Selected children (n = 5,902) were randomized into three groups; an intervention group, a shadow control group followed in registers exclusively, and a control group examined at the beginning and at the end of the intervention. Approximately 21% agreed to participate. Children who presented as overweight prior to the intervention were excluded from this study (n = 92). In the intervention group, 271 children were included, and in the control group 272 were included. Information obtained from the shadow control group is on-going, but it is estimated that 394 children will be included. The intervention took place over on average 1½ year between 2009 and 2011, and consisted of optional individual guidance in optimizing diet and physical activity habits, reducing chronic stress and stressful events and improving sleep quality and quantity. The intervention also included participation in cooking classes and play arrangements. Information on dietary intake, meal habits, physical activity, sleep habits, and overall stress level was obtained by 4-7 day questionnaire diaries and objective measurements.If the Healthy Start project is effective in preventing excessive weight gain, it will provide valuable information on new determinants of obesity which should be considered in future interventions, and on new strategies to prevent development of overweight and obesity at an early age.

Project description:Excessive gestational weight gain (GWG) is associated with postpartum weight retention (PPWR) and abdominal adiposity, but long-term effects are understudied in low-income and minority populations at high risk of obesity and associated sequelae.We examined associations between GWG and long-term PPWR and adiposity in a prospective cohort of African American and Dominican mothers in the Bronx and Northern Manhattan.Women (n = 302) were enrolled during pregnancy and were followed for 7 y postpartum. Linear regression was used to relate excessive GWG [greater than 2009 Institute of Medicine (IOM) guidelines] to outcomes [percentage body fat and long-term PPWR (change in weight from prepregnancy to 7 y postpartum)], adjusting for covariates and included an interaction term between prepregnancy body mass index (BMI; in kg/m(2)) and GWG.Mean ± SD prepregnancy BMI and total GWG were 25.6 ± 5.8 (42% of women had BMI ?25) and 16.6 ± 7.8 kg (64% of women had total GWG greater than IOM guidelines), respectively. Associations between GWG and long-term PPWR and the percentage body fat varied by prepregnancy BMI (P-interaction ? 0.06); excessive GWG was associated with a higher percentage body fat and greater long-term PPWR in mothers with lower prepregnancy BMI. To illustrate the interaction, a predicted covariate-adjusted model, which was used to derive estimates for the percentage body fat and PPWR associated with excessive GWG, was estimated for 2 prepregnancy BMI examples. For a woman with prepregnancy BMI of 22, excessive GWG was associated with 3.0% higher body fat (P < 0.001) and a 5.6-kg higher PPWR (P < 0.001); however, for a woman with a prepregnancy BMI of 30, excessive GWG was associated with 0.58% higher body fat (P = 0.55) and 2.06 kg PPWR (P = 0.24).Long-term adiposity and PPWR in low-income African American and Dominican mothers were predicted by interacting effects of prepregnancy BMI and excessive GWG. The provision of support for mothers to begin pregnancy at a healthy weight and to gain weight appropriately during pregnancy may have important lasting implications for weight-related health in this population. This study was registered at clinicaltrials.gov as NCT00043498.

Dataset Information

Differences in respiratory consultations in primary care between underweight, normal-weight, and overweight children.

Publications

Differences in respiratory consultations in primary care between underweight, normal-weight, and overweight children.

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