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Putting a SPRING in the step of mums-to-be

Making sure that mums-to-be are in the best possible health is key to ensuring their baby gets the best possible start in life. But what sorts of things can help them achieve that? In this episode of the Child of our Time Podcast, Professor Hazel Inskip from the MRC Lifecourse Epidemiology Unit at the University of Southampton, talks about an ongoing trial making use of healthy conversations and Vitamin D supplements to try to improve the diet of just pregnant women.

Photo credit: Pregnant, Frank de Kleine

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Better start for children

Giving children the best possible start in life is the topic of a keynote talk today by our editor Yvonne Kelly.

Yvonne will be presenting a range of new evidence from the ESRC International Centre for Lifecourse Studies  to politicians, business leaders, and other professionals and key decision makers at an event discussing how Gothenburg can be made an equal and socially sustainable city.

Yvonne will talk about the factors which are most closely linked with a child’s health and well-being and present findings on children’s verbal skills, behaviour, bedtimes, reading and obesity. She will make the case that signs of social inequalities are evident early in a child’s life and that it is important to intervene early to tackle those inequalities.

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Sugar-coating the childhood obesity problem

Child obesity figures appear to be on the rise again, causing much concern after earlier signs they had levelled off.  The proportion of  10- and 11-year-olds who were obese in 2015-16 was 19.8 percent, up 0.7 percent on the year before. There was a rise of 0.2 percent among four- and five-year-olds. The announcement comes as researchers at the ESRC International Centre for Lifecourse Studies at UCL have been looking in detail at how and when children become overweight. The team has also been asking whether children who are overweight are more likely to go on to smoke and drink alcohol and if their mental health suffers as they become adolescents. Yvonne Kelly explains the research findings, and considers their implications for the Government’s recent strategy for tackling the childhood obesity epidemic.

The Government’s much-awaited and much-debated childhood obesity strategy was published in August. In the end, it was less comprehensive than had been anticipated, less draconian too. It focuses on two things – reducing sugar consumption and increasing physical activity. But will it be effective in reversing this worrying obesity trend among our children?

It’s fair to say we don’t fully understand what things influence whether, when and why a child might become overweight. Research to date has shown three distinct weight pathways for children: a healthy BMI throughout childhood; becoming overweight during childhood and being overweight/obese throughout childhood.

Previous research has also shown that the child’s mother’s weight, smoking in pregnancy, mental health and other social and economic factors have some link to childhood obesity. But the evidence is far from complete and, where a child’s own mental health is concerned, it’s not at all clear which way the association works.

To try to get a clearer picture of all these things, our research looked at the BMI paths of the participants in the Millennium Cohort Study, which has tracked the lives of nearly 20,000 children born between 2000-2002. We used data collected at birth, 9 months, age 3, 5, 7 and 11.

Once we had established who was on which BMI path, we were able to look at what factors were at play in their lives and to see whether a tendency to overweight and obesity was an indication that a child would go on to face mental health difficulties in early adolescence or start smoking and drinking.

Four pathways to obesity

The BMI data for the 17,000 children we were able to look at for our study showed four distinct groups of children. More than 80 per cent of them stayed on an average non-overweight path throughout their childhood – we call it the ‘stable’ path. There was a small group (0.6 percent) of children who were obese at age 3 but were then in the stable group by age 7. We call them the the ‘decreasing’ group. There was a ‘moderate increasing group’ (13.1 percent) where children were not overweight at age 3 but whose BMIs increased throughout childhood into the overweight (but not obese) range. Finally we had a ‘high increasing’ group of children (2.5 percent) who were obese at age 3 and whose BMIs continued to increase.

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Girls were 30 percent more likely to be in the ‘moderate increasing’ group than boys and were half as likely to be on the ‘decreasing’ path. Indian, Pakistani and Black African children were up to two times more likely to be on the ‘moderate increasing’ path whilst Pakistani, Black Caribbean and Black African children were up to three times more likely to belong to the ‘high increasing’ group.

The wealthiest children were least likely to be in the ‘moderate increasing’ BMI group and children of mums who smoked during pregnancy were up to two times as likely to belong to increasing BMI groups. Children with overweight mums were most likely to be on the moderate and high increasing paths.

Children on the moderate and high increasing paths were less likely to have regular family routines – they were more likely to skip breakfast or have non-regular bedtime schedules. Interestingly, however, no strong links emerged with some of the things more readily linked with childhood obesity such as sugary drinks and snacks, watching TV and lack of physical activity such as sports, the main focus of the newly published childhood obesity strategy.

Overweight factors

So it seems quite a large range of factors influence the likelihood of a child becoming overweight or obese over the first decade of their life. On top of this, being overweight or obese would also seem to point to a less happy and fulfilling early adolescence and a tendency to explore risky behaviours like smoking and drinking.

Although our research did not show a clear link with sugary drinks and snacks, there are nevertheless some compelling arguments for reducing the sugar intake of our children. These are not only related to problems of obesity, but to wider issues including the major issue of tooth decay and associated emergency hospital admissions. There is also increasing evidence of the ‘addictive’ nature of sugar with research suggesting that it stimulates a sort of ‘reward path’ in certain centres of the brain meaning that the more we have the more we want. It has been shown that people who reduce their sugar intake tend to crave it less.

Where sugar taxes have been introduced in other countries (Mexico, France, Denmark, South Africa amongst others), the intervention has been shown to help reduce the consumption of sugary drinks. As yet, there is no evidence that it helps reduce BMI and tackle obesity, but it’s argued it will take time for us to see an effect on whole populations.

Disadvantaged families

It is hard to predict how much impact the voluntary rather than mandatory reduction in sugar content of drinks and snacks agreed in the strategy will have. As for the sugar tax that will be introduced in two years’ time, there remain concerns that disadvantaged families more likely to purchase and consume sugary goods than their better off counterparts will be hardest hit. Policy makers will need to think hard about how any negative consequences of this might be counteracted.

Our research shows clearly that when it comes to the likelihood of a child becoming overweight or obese in the first decade of their life, there are many more influences than just sugar. Those influences are at play in families even before our children are born.

Helping pregnant women to stop smoking and maintain a healthy weight, making sure all young children have healthy eating and sleeping routines would seem to be key, together with targeted support for the ethnic and social groups identified as being most at risk.

Further information and resources

BMI development and early adolescent psychosocial well-being: UK Millennium Cohort Study is research by Yvonne Kelly, Praveetha Patalay, Scott Montgomery, and Amanda Sacker. The work, published in Pediatrics, is funded by the Economic and Social Research Council.

Media coverage

Photo credit: Kim Stromstad

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BMI development and early adolescent psychosocial well-being

Research looking at how and when children become overweight is helping to shed new light on ongoing efforts by the Government and others to tackle the childhood obesity epidemic.

A team of researchers at the ESRC International Centre for Lifecourse Studies at UCL has also been asking whether children who are overweight are more likely to go on to smoke and drink alcohol and if their mental health suffers as they become adolescents.

The research, published in Pediatrics, shows clearly that when it comes to the likelihood of a child becoming overweight or obese in the first decade of their life, there are many more influences than just sugar (a main plank in the Government’s Childhood Obesity Strategy).

The research also shows that  influences are at play in families even before children are born and indicates that helping pregnant women to stop smoking and maintain a healthy weight, making sure all young children have healthy eating and sleeping routines may be key, together with targeted support for ethnic and social groups identified as being most at risk.

Lead researcher, Yvonne Kelly presented the findings at the Society for Longitudinal and Life Course Studies 2016 conference in Bamberg.

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Never too early, never too late

n2en2l_620x877The research team at the ESRC International Centre for Lifecourse Studies at UCL has produced a plain English booklet summarising some of its recent research and what can be learned from it in respect of living as long and as healthy and happy a life as possible.

Never too early, never too late shares a number of important research findings from research making use of longitudinal surveys such as the British Birth Cohort Studies and the UK Household Longitudinal Study.

 

The free booklet explains why it’s so important to take a life course approach  to research and the benefits off looking at how our social and material circumstances and our biology intertwine to impact on our health and happiness over time.

Issues covered include mental health, obesity, stress and its links to chronic illnesses such as cancer and heart and lung disease,  cancer, diabetes and dementia.

Further information

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Early puberty: a question of background?

New research examining the connections between early puberty in girls and their socioeconomic and ethnic backgrounds is being presented to an international audience of researchers in Germany today.

Early puberty in 11-year-old girls: Millennium Cohort Study findings is work led by Child of our Time editor Yvonne Kelly using information on 5,839 girls from the Millennium Cohort Study.

The findings, presented at the Society for Longitudinal and Life Course Studies 2016 conference in Bamberg indicate clearly that socioeconomic and ethnic disparities are apparent in the UK and are important for all those interested in the short and long term implications for early puberty on women’s health and well being.

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Girls growing up – questions of early puberty

The early onset of puberty in girls has been linked with better bone health in older women, but it is also associated with a host of negative outcomes including teenage pregnancy and serious ill health in mid-life. With girls over the last few decades starting their periods earlier and earlier, this is a real cause for concern. A better understanding is needed of who is affected and how if this trend is to be reversed and the long-term health of girls and women is to be secured. Researchers at the ESRC International Centre for Lifecourse Studies at UCL have investigated whether a girl’s socioeconomic background or ethnicity are associated with early puberty and have looked in detail at more commonly supposed links with weight and stress. Yvonne Kelly explains more.

Sexual activity whilst still young, teenage pregnancy, mental health problems, heart disease and breast cancer later in life are just some of the things linked to early puberty in girls. Over the last few decades, girls have started their periods much earlier with the average age falling from puberty has age falling to 12.9 years in 2015.

This research is the first to look over time at whether and how a girl’s social and economic circumstances and her ethnicity might be linked to the early onset of puberty. We suspected that any link that did emerge would, most likely, be explained away by other factors such as being overweight or suffering from stress.

Using information on 5,839 girls from the Millennium Cohort Study, which has been tracking the lives of nearly 20,000 children born at or around the start of the century, it was possible to know, at age 11 whether they had started their period or not.

Details of their birth weight, ethnicity, family income when they were aged 5 and height and weight when they were 7 were also available. This rich information gathered across 11 years of the girls’ lives really enabled us to put together a detailed picture over time of how these factors come together to influence the early onset of puberty.

The girls’ mothers completed questionnaires any social or emotional problems their daughter might be facing, and their own mental health.

Puberty facts and figures

Nearly one in ten of the girls, a total of 550, had started their period at age 11, with girls from the poorest families twice as likely as their most well-off peers to have done so (14.1 per cent v 6.8 per cent). Those from the second poorest group were also nearly twice as likely to have started their period.

Indian, Bangladeshi and Black African girls were most likely to have started their period at age 11, with Indian girls three and a half times more likely than their White counterparts to have done so.

Other factors

On average, girls who were heavier at age 7 and suffered stress in early childhood were more likely to have begun menstruating. Those who had started their periods early also tended to have mothers with higher stress levels, were from single parent families, and tended to have had some social and emotional difficulties themselves.

However, even when we took all these things into account, girls from the poorest and second poorest groups were still one and a half times more likely to have started their periods early.

As far as ethnicity was concerned, income, excess body weight and stress accounted for part or all of the differences in most cases. Interestingly, though with most Indian girls coming from more advantaged backgrounds than their White peers, the likelihood of them having started their period was not explained after we took all the above factors into account.

Lived experiences

Our findings highlight the different lived experiences of ethnic minority groups in the UK: for example Indians are relatively advantaged whereas Pakistanis tend to be materially disadvantaged, Bangladeshis and Black Africans are materially and psychosocially disadvantaged and have a tendency to be overweight compared with the majority ethnic group. They also demonstrate the complex and potentially opposing factors at play for the onset of puberty.

All that considered, we can say with considerable confidence that socioeconomic and ethnic disparities are indeed apparent in the UK. Given the short and long term implications for early puberty on women’s health and well being, improving our understanding of these underlying processes could help identify opportunities for interventions with benefits right across the lifecourse, not just for the girls in our study, but for future generations.

It was also encouraging to note that in the decade or so covered by the data we used, there appears to have been no further decline in the average age that girls begin puberty.

Early puberty in 11-year-old girls: Millennium Cohort Study findings is research by Yvonne Kelly, Afshin Zilanawala, Amanda Sacker, Robert Hiatt andRussell Viner and is published in Archives of Disease in Childhood.

Photo credit: Afla

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Young drinkers: using evidence to prevent alcohol abuse

Research by Child of our Time Editor Yvonne Kelly on 11 year-old drinking has caught the eye of Mentor, a charity working to build resilience among young people to prevent alcohol and drug misuse. The charity’s CEO, Michael O’Toole is now looking to collaborate with Yvonne in future research that will take a look a first look at data from the Millennium Cohort Study in the Autumn. In this episode of the Child of our Time podcast, Michael explains what Mentor is doing, why research based evidence is so important to the charity and how he hopes it will help prevent alcohol abuse among young children in the future.

Photo credit: Joseph Choi

 

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Alcohol – who is drinking or drunk age 11?

Child of our Time editor, Professor Yvonne Kelly was among a group of experts looking at drinking behaviour across the life course this week. She presented her recent thought-provoking work on 11 year-olds and drinking at a seminar for policy makers and third sector workers on alcohol and health,  organised by the ESRC International Centre for Lifecourse Studies at UCL.

The talk shared findings from her research on 11 year-olds in the Millennium Cohort Study who had ever drunk alcohol or been drunk. It also explored links with a range of family and social factors including other risky behaviours such as smoking and truancy.

Listen to her talk and see her slides.

Drunkenness and heavy drinking among 11 year olds – Findings from the UK Millennium Cohort Study is research by Yvonne Kelly, Annie Britton, Noriko Cable, Amanda Sacker and Richard G. Watt

What influences 11-year-olds to drink? Findings from the Millennium Cohort Study is research by Yvonne Kelly, Alice Goisis, Amanda Sacker, Noriko Cable, Richard G Watt and Annie Britton and is published in BMC Public Health.

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Mixed race kids: happier than we might think!

It’s been said and shown over the last few decades that mixed race and mixed ethnicity children tend not to do as well socially and emotionally as their non mixed peers. But new research casts a rather different light on the matter, showing that children both in the UK and US who are from mixed backgrounds are actually doing rather better.  James Nazroo from the University of Manchester has been looking at the issue with colleagues at the ESRC International Centre for Lifecourse Studies, UCL and discusses his surprising findings in our latest podcast episode.

Socioemotional wellbeing among mixed race/ethnicity children in the UK and US: Patterns and underlying mechanisms is due to be published in the Journal of Health and Social Behaviour. It is part of a wider programme of ESRC funded research led by Child of Our Time editor, Yvonne Kelly at ICLS.

Photo credit: Philippe Put

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