27 July 2018 In General Health

OBJECTIVE: To examine the association between an overall maternal healthy lifestyle (characterized by a healthy body mass index, high quality diet, regular exercise, no smoking, and light to moderate alcohol intake) and the risk of developing obesity in offspring.

DESIGN: Prospective cohort studies of mother-child pairs.

SETTING: Nurses' Health Study II (NHSII) and Growing Up Today Study (GUTS) in the United States.

PARTICIPANTS: 24 289 GUTS participants aged 9-14 years at baseline who were free of obesity and born to 16 945 NHSII women.

MAIN OUTCOME MEASURE: Obesity in childhood and adolescence, defined by age and sex specific cutoff points from the International Obesity Task Force. Risk of offspring obesity was evaluated by multivariable log-binomial regression models with generalized estimating equations and an exchangeable correlation structure.

RESULTS: 1282 (5.3%) offspring became obese during a median of five years of follow-up. Risk of incident obesity was lower among offspring whose mothers maintained a healthy body mass index of 18.5-24.9 (relative risk 0.44, 95% confidence interval 0.39 to 0.50), engaged in at least 150 min/week of moderate/vigorous physical activities (0.79, 0.69 to 0.91), did not smoke (0.69, 0.56 to 0.86), and consumed alcohol in moderation (1.0-14.9 g/day; 0.88, 0.79 to 0.99), compared with the rest. Maternal high quality diet (top 40% of the Alternate Healthy Eating Index 2010 diet score) was not significantly associated with the risk of obesity in offspring (0.97, 0.83 to 1.12). When all healthy lifestyle factors were considered simultaneously, offspring of women who adhered to all five low risk lifestyle factors had a 75% lower risk of obesity than offspring of mothers who did not adhere to any low risk factor (0.25, 0.14 to 0.47). This association was similar across sex and age groups and persisted in subgroups of children with various risk profiles defined by factors such as pregnancy complications, birth weight, gestational age, and gestational weight gain. Children's lifestyle did not significantly account for the association between maternal lifestyle and offspring obesity risk, but when both mothers and offspring adhered to a healthy lifestyle, the risk of developing obesity fell further (0.18, 0.09 to 0.37).

CONCLUSION: Our study indicates that adherence to a healthy lifestyle in mothers during their offspring's childhood and adolescence is associated with a substantially reduced risk of obesity in the children. These findings highlight the potential benefits of implementing family or parental based multifactorial interventions to curb the risk of childhood obesity.

BACKGROUND: Heavy episodic drinking (HED) or consuming 4+/5+ drinks in 1 occasion for women/men is linked consistently with alcohol-related harms. Recent research suggests that many individuals drink at levels more than twice this cutoff (8+/10+ drinks), commonly referred to as "high-intensity drinking." Prevalence rates of high-intensity drinking and its dynamic association with alcohol use disorder (AUD) across all ages, however, remain unknown. The current study used data from a nationally representative sample to document age-varying prevalence rates of HED-only drinking and high-intensity drinking, prevalence rates of AUD for HED-only drinkers and high-intensity drinkers, and relative odds of experiencing an AUD for high-intensity drinkers as compared to HED-only drinkers. METHODS: Data were from the National Epidemiologic Survey on Alcohol and Related Conditions-III. The final analytic sample consisted of past-year drinkers aged 18 to 64 years (n = 22,776). RESULTS: Time-varying effect modeling revealed that high-intensity drinking and HED-only drinking were equally prevalent during young adulthood and prevalence rates of both types of drinking generally became less common with increasing age. At all ages, high-intensity drinkers were at 3 or more times greater odds of meeting criteria for an AUD than HED-only drinkers. The association between high-intensity relative to HED-only drinking was strongest earlier in adulthood with approximately 83% of 18-year-old high-intensity drinkers having AUD relative to 42% of HED-only drinkers. CONCLUSIONS: Future research aiming to identify drinkers most at risk of harms and in need of treatment may benefit from assessing the extent to which an individual exceeds the 8+/10+ threshold of drinking
22 June 2017 In Drinking & Eating Patterns

OBJECTIVE: Using a national sample of young adults, this study identified latent classes of alcohol use including high-intensity drinking (10+ drinks) from ages 18 to 25/26, and explored associations between time-invariant covariates measured at age 18 and class membership.

METHOD: Longitudinal data from the national Monitoring the Future study were available for 1078 individuals (51% female) first surveyed as 12th grade students in 2005-2008, and followed through modal age 25/26. Repeated measures latent class analysis was used to identify latent classes based on self-reported alcohol use: no past 30-day drinking, 1-9 drinks per occasion in the past 2weeks, and 10+ drinks per occasion.

RESULTS: Four latent classes of alcohol use from ages 18 to 25/26 were identified: (1) Non-Drinkers (21%); (2) Legal Non-High-Intensity Drinkers (23%); (3) Persistent Non-High-Intensity Drinkers (40%); and (4) High-Intensity Drinkers (16%). Membership in the High-Intensity Drinkers class was characterized by higher than average probabilities of high-intensity drinking at all ages, with the probability of high-intensity drinking increasing between ages 18 and 21/22. Both gender and race/ethnicity significantly differentiated class membership, whereas neither parental education (a proxy for socioeconomic status) nor college plans at 12th grade showed significant associations.

CONCLUSIONS: More than one in seven individuals who were seniors in high school experienced a long-term pattern of high-intensity drinking lasting into middle young adulthood. Young adult high-intensity drinking is often preceded by high-intensity drinking in high school, suggesting the importance of screening and prevention for high-intensity drinking during adolescence.

23 July 2015 In Drinking & Eating Patterns

PURPOSE: To estimate the prevalence of alcohol use at the age of 10-11 years and document variation by early sociodemographic and concurrent alcohol-specific risk factors.

METHODS: The Millennium Cohort Study is a prospective, nationally representative study of live births in the United Kingdom across 12 months. A random sample of electoral wards was stratified to adequately represent U.K. countries, economically deprived areas, and areas with high concentrations of Asian and Black British families. A total of 12,305 child-mother pairs provided self-report data at 9 months (mother's marital status, age, education, occupational level; child gender, ethnicity, country) and age 10-11 years (adolescent alcohol use and attitudes).

RESULTS: After adjusting for attrition and sampling design, 13.4% of 10- to 11-year-olds had had an alcoholic drink (more than few sips), 1.2% had felt drunk, and .6% had five or more drinks at a time. Odds of ever drinking were higher among boys (1.47, 95% confidence interval, 1.29-1.68) and lower among early adolescents who were Asian British (vs. white; .09, .05-.17) or Black British (.42, .29-.62). Beyond sociodemographic differences, more positive attitudes about alcohol were associated with greater odds of drinking (1.70, 1.51-1.91), feeling drunk (2.96, 2.07-4.24), and having five or more drinks (4.20, 2.66-6.61).

CONCLUSIONS: Alcohol use in the last year of primary school was identified but not common. Its use varied by sociodemographic groups; early adolescents with more positive alcohol attitudes had especially high risks of early alcohol initiation. Results support calls for increased surveillance and screening for very early drinking.

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