Exposures across childhood and their relationship with weight and metabolic status
Walls, Courtney Elizabeth
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Pediatric obesity has reached epidemic proportions. Reducing obesity among children is expected to lower their likelihood of being obese as adults and, therefore, lower their cardiovascular and metabolic risk profile in adulthood including hypertension, dyslipidemia, type II diabetes, heart disease, and stroke. Pediatric obesity among ages 2–19 is defined as a body mass index (BMI) greater than or equal to the 95th percentile for age and gender as defined according to the CDC BMI-for-age growth charts. Risk factors for obesity are present as early as birth, suggesting exposures at different stages of the life cycle are important to study. The primary objective of this thesis was to evaluate exposures throughout childhood and evaluate their association with both weight and metabolic status. Study 1 examined the relationship between physical activity and metabolic syndrome in overweight and obese youth ages 12–19. We found that even modest amounts of moderate to vigorous physical activity were associated with a reduction in risk of metabolic syndrome, with time spent in vigorous physical activity driving the association. Study 2 explored the relationship between environmental tobacco smoke (ETS) exposure and childhood overweight and obesity in 3–6 year old children. We observed that ETS has a positive association with risk of overweight/obesity, with a dose-response effect observed. Study 3 examined the relationship between maternal antibiotic use during pregnancy and infant birthweight. We did not observe any association between maternal antibiotic use and birthweight or BW/GA-z (birthweight adjusted for gestational age z-score), but we did observe a reduction in risk of SGA (small for gestational age) for infants exposed to antibiotics during gestation. This association was most evident among third trimester users.