MCH Alert


Maternal and Child Health Library

This and past issues of the MCH Alert are available at http://www.mchlibrary.info/alert/archives.html


January 8, 2010

1. Report Provides National- and State-Level Data on Multiple Aspects of Children's Health and Well-being
2. Study Assesses Association Between Lactation Duration and Incidence of the Metabolic Syndrome in Women
3. Article Addresses Overweight and Obesity Prevalence Among Children from 2003 to 2007
4. Analysis Examines Associations of Television Content Type and Obesity in Children

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1. REPORT PROVIDES NATIONAL- AND STATE-LEVEL DATA ON MULTIPLE ASPECTS OF CHILDREN'S HEALTH AND WELL-BEING

The Health and Well-Being of Children: A Portrait of States and the Nation 2007 presents indicators of the health and well-being of children as well as the factors in the family environment and aspects of the neighborhood that may support or undermine children's and families' health. The report, published by the Health Resources and Services Administration's Maternal and Child Health Bureau, is based on data from the 2007 National Survey of Children's Health. National-level indicators present basic information on children's health status and risk and protective factors and show the subpopulations at particular risk in each area. Key indicators for each of the 50 states and the District of Columbia -- including indicators related to the child's health, health care, and activities; the child's family; and the child's and family's neighborhood -- are presented in comparison with national statistics. Because some of the survey questions were revised to improve the quality of the data obtained and may have influenced parents' responses, the authors note where current (2007) findings cannot be compared with those reported in 2003. The report is available at http://mchb.hrsa.gov/nsch07/index.html. Print copies are also available from the HRSA Information Center's Web site at http://ask.hrsa.gov, or by phone at (888) ASK-HRSA or (703) 442-9051.

Readers: More information about the survey and its findings and other resources are available from the Data Resource Center on Child and Adolescent Health's Web site at http://www.childhealthdata.org. The public use data set is also available from the National Center for Health Statistics' Web site at http://www.cdc.gov/nchs/nhcs.htm

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2. STUDY ASSESSES ASSOCIATION BETWEEN LACTATION DURATION AND INCIDENCE OF THE METABOLIC SYNDROME IN WOMEN

"Longer duration of lactation was associated with lower incidence of the metabolic syndrome years after delivery and post-weaning among women with non-GDM [gestational diabetes mellitus] as well as GDM pregnancies. Lifestyle behaviors did not explain these associations," state the authors of an article published in Diabetes (online ahead of print) on December 3, 2009. Lactation has been shown to have favorable effects on cardiometabolic risk factors in women with and without a history of GDM, a strong predictor of type 2 diabetes and the metabolic syndrome (MetS) following pregnancy. Yet, few studies have investigated whether lactation's favorable effects on cardiometabolic risk factors persist post-weaning to protect women against future disease. Specifically, studies have not examined lactation and incidence of the MetS or variation in disease risk by GDM status. The article presents findings from a study to prospectively examine whether increasing duration of lactation was associated with lower incidence of the MetS among women of childbearing age.

Data for the study were drawn from the CARDIA Study, a multi-center, longitudinal, population-based, observational study designed to describe the development of risk factors for coronary heart disease in black adults and white adults recruited from four geographic areas in the United States: Birmingham, Alabama; Chicago, Illinois; Minneapolis, Minnesota; and Oakland, California. In 1985-1986, baseline data were collected for 2,787 women ages 18-30. MetS components were measured at examinations in years 0, 7, 10, 15, and 20. Data from women who were free of the MetS and nulliparous at baseline and subsequently delivered at least one singleton, live birth during the 20-year period (N=704) were used to examine the association of lactation duration and incidence of the MetS. The analyses examined incidence rates for GDM and non-GDM pregnancies, controlling for preconception risk factor levels, sociodemographics, and follow-up behavioral attributes.

The authors found that
"Our data provide strong evidence that lactation may have lasting favorable effects on metabolic risk profiles among women with a history of GDM who are most susceptible to developing metabolic diseases, as well as women without GDM," conclude the authors. They suggest that "further investigation is needed to elucidate the mechanisms through which lactation may influence women’s cardiometabolic risk profiles, and whether lifestyle modifications, including lactation duration, may affect development of coronary heart disease and type 2 diabetes, particularly, among high-risk groups such as women with a history of GDM."

Gunderson EP, Jacobs DR, Chiang V, et al. 2009. Duration of lactation and incidence of the metabolic syndrome in women of reproductive age according to gestational diabetes mellitus status: A 20-year prospective study in CARDIA -- the Coronary Artery Risk Development in Young Adults Study. Diabetes [published online ahead of print on December 3, 2009]. Abstract available at http://diabetes.diabetesjournals.org/content/early/2009/11/12/db09-1197.abstract

Readers: More information is available from the following MCH Library resources:

- Preconception and Pregnancy: Knowledge Path at
http://mchlibrary.info/KnowledgePaths/kp_pregnancy.html

- Breastfeeding: Resource Brief at
http://mchlibrary.info/guides/breastfeeding.html

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3. ARTICLE ADDRESSES OVERWEIGHT AND OBESITY PREVALENCE AMONG CHILDREN FROM 2003 TO 2007

"Monitoring disparities in U.S. childhood obesity across a broader set of social groups is vital in tracking progress toward achieving the Healthy People 2010 objectives of reducing and ultimately eliminating health inequalities and in assessing the effectiveness of specific social and public policy interventions in reducing childhood obesity," write the authors of an article published in the January 2010 issue of Annals of Epidemiology. Childhood obesity in the United States has seen a three-fold increase during the past three decades, and racial/ethnic and socioeconomic disparities in U.S. childhood obesity are well documented. However, the extent to which social disparities in obesity and overweight have changed over time is less well examined. The purpose of the study described in this article was (1) to provide the latest estimates of and changes in obesity and overweight prevalence among children ages 10-17 from detailed racial/ethnic and socioeconomic groups using two large, nationally representative samples of U.S. children in 2003 and 2007 and (2) to examine temporal changes in social gradients in childhood obesity and overweight before and after adjusting for behavioral and neighborhood characteristics.

Data for the study came from the 2003 and 2007 National Survey of Children's Health, telephone surveys conducted to provide national and state-specific prevalence estimates for a variety of children's health and well-being indicators. The analysis used parent-reported children's height and weight data to compute overweight and obesity (body mass index greater than or equal to the 85th and 95th percentiles, respectively) differentials for 46,707 children in 2003 and 44,101 children in 2007. Covariates included age, gender, race and ethnicity, household composition, metropolitan and non-metropolitan residence, geographic region, household poverty status, parental education, household employment, perceived neighborhood safety, the amount of television viewing, recreational computer use, and physical activity. An index of disparity was used to summarize disparities across social groups.

The authors found that
The authors conclude that "the recent trends presented in this paper underlie the significance of increased monitoring of social-group disparities and of an urgent need for effective social and public health policies to tackle the problem of increasing prevalence and rising social inequalities in childhood obesity."

Singh GK, Siahpush M, Kogan MD. 2010. Rising social inequalities in US childhood obesity, 2003-2007. Annals of Epidemiology 20(1):40-52. Abstract available at http://www.annalsofepidemiology.org/article/S1047-2797%2809%2900324-X/abstract

Readers: More information is available from the following MCH Library resource:

- Overweight and Obesity in Children and Adolescents: Knowledge Path at
http://mchlibrary.info/KnowledgePaths/kp_overweight.html

- Racial and Ethnic Disparities in Health: Knowledge Path at
http://mchlibrary.info/KnowledgePaths/kp_race.html

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4. ANALYSIS EXAMINES ASSOCIATIONS OF TELEVISION CONTENT TYPE AND OBESITY IN CHILDREN

"In our analysis, only viewing of commercial content -- programs in which children are exposed to in-program advertisements -- was associated with obesity," state the authors of an article published in the American Journal of Public Health (ahead of print) on December 17, 2009. Television viewing has been shown to be associated with obesity in many, but not all, studies. A review of the literature identified no scholarly articles analyzing the associations of different types of television content with obesity status in children. This article presents an analysis of nationally representative longitudinal data on the effects of different kinds of television content on body mass index (BMI).

Data for the study were drawn from the Panel Survey of Income Dynamics, a longitudinal study that began in 1968 with 48,000 families. In 1997 the study added a questionnaire to collect detailed demographic data, a psychological and behavioral assessment of parents and children, and time-use diary data. In 2002 respondents to the first questionnaire were followed up with a second, similar instrument. The analysis sample included 2,037 children for whom BMI was assessed (the outcome measure), time use diaries were completed, and data for covariates were available. The sample was split into two age groups: birth to age 7 and ages 7 and older. The 1997 and 2002 values for hours of television viewing per day and average number of minutes per day spent in either moderate or vigorous physical activity were captured through the time-use diaries. Television viewing categories were consolidated into two categories: commercial viewing (consisting of children's broadcast entertainment and general-audience broadcast entertainment) and noncommercial viewing (consisting of broadcast educational television, video educational television, and video entertainment television). The analyses assessed differences in the effects of different television content types on obesity and whether the effect of television content types was independent of the effects of exercise, controlling for other child and family attributes that may affect both television viewing and health behaviors associated with obesity, including child's gender, age, race and ethnicity, and average duration of sleep and mother's BMI (self-reported in 1999) and education. To test whether the television-obesity relationship was mediated by eating in front of the television, the analyses also included a variable for 2002 indicating how often the child was permitted to eat in front of the television.

The authors found that
"Television viewing may be a sedentary activity, but it is not for that reason that it is associated with obesity in children," state the authors. They conclude, "the relationship between television viewing and obesity among children is limited to commercial television viewing."

Zimmerman FJ, Bell JF. 2010. Associations of television content type and obesity in children. American Journal of Public Health [published online ahead of print on December 17, 2009]. Abstract available at http://ajph.aphapublications.org/cgi/content/abstract/AJPH.2008.155119v1

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MCH Alert © 1998-2010 by National Center for Education in Maternal and Child Health and Georgetown University. MCH Alert is produced by Maternal and Child Health Library at the National Center for Education in Maternal and Child Health under its cooperative agreement (U02MC00001) with the Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services. The Maternal and Child Health Bureau reserves a royalty-free, nonexclusive, and irrevocable right to use the work for federal purposes and to authorize others to use the work for federal purposes.
 
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