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  • 1.
    Almquist-Tangen, Gerd
    et al.
    Child Health Care Unit, Halmstad, Sweden & Department of Paediatrics, Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Bergman, Stefan
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Dahlgren, Jovanna
    Department of Paediatrics, Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Lindholm, Annelie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Roswall, Josefine
    Department of Paediatrics, Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Alm, Bernt
    Department of Paediatrics, Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Consuming milk cereal drinks at one year of age was associated with a twofold risk of being overweight at the age of five2019In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, no 6, p. 1115-1121Article in journal (Refereed)
    Abstract [en]

    Aim: We previously reported that consuming milk cereal drinks at six months of age was associated with a high body mass index (BMI) at 12 and 18 months. This study examined the association between daily consumption at 12 months of age and BMI at the age of five.

    Methods: We followed up 1870/2666 (70%) children recruited at birth in 2007–2008 for the Swedish longitudinal population‐based Halland Health and Growth Study a mean of 5.09 ± 0.28 years. Feeding practices were obtained from parental questionnaires, and anthropometric data were collected by child health nurses.

    Results: At five years, 11.6% were overweight and 2.3% were obese. Milk cereal drinks were consumed by about 85% and 10% at one and five years of age, respectively. Consumption at 12 months was associated with almost double the risk of being overweight at five years of age (adjusted odds ratio 1.94, 95% confidence interval 1.08–3.50). Other risk factors were a family history of obesity, low paternal educational level and paternal smoking.

    Conclusion: Consuming milk cereal drinks daily at 12 months was associated with a twofold risk of being overweight at five years. These findings may affect the counselling guidelines used at child healthcare centres. Copyright © 2019 John Wiley & Sons, Inc. All rights reserved

  • 2.
    Almquist-Tangen, Gerd
    et al.
    Child Health Care Unit, Region Halland, Halmstad, Sweden & Department of Paediatrics, Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Dahlgren, Jovanna
    Department of Paediatrics, Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Roswall, Josefine
    Department of Paediatrics, Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden & Department of Paediatrics, Halland Hospital, Halmstad, Sweden.
    Bergman, Stefan
    Research and Development Centre, Spenshult Hospital, Oskarström, Sweden.
    Alm, Bernt
    Child Health Care Unit, Region Halland, Halmstad, Sweden & Department of Paediatrics, Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Milk cereal drink increases BMI risk at 12 and 18 months, but formula does not2013In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 102, no 12, p. 1174-1179Article in journal (Refereed)
    Abstract [en]

    AIM: Infant feeding affects growth, obesity and life-long health. This study examined the impact of dietary patterns on body mass index (BMI) at 12 and 18 months.

    METHODS: We followed a cohort of 2,666 children recruited in 2007-2008. Feeding practices were obtained from parental questionnaires and anthropometric data collected by child health nurses.

    RESULTS: At six months, 58.3% of the infant were breastfed, but only 1.6% exclusively. Many had begun eating solids (91.8%), porridge (87.7%) or milk cereal drink (46.6%). Bottle-feeding at four months was not a risk factor for a high BMI (>1 SD) at 12 or 18 months. Milk cereal drink at six months increased the risk of a high BMI at 12 and 18 months respectively (OR 1.58, 95% CI 1.12-2.22, and 1.52, 1.07-2.17). Milk cereal drink use was increased by low parental education and maternal obesity and reduced by troubled sleep and parental group participation.

    CONCLUSION: Formula at four months did not predict a high BMI at 12 or 18 months. Milk cereal drink use at six months was a risk factor for a high BMI at 12 and 18 months. The choice of milk cereal drink was influenced by parental factors, especially educational levels. ©2013 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd.

  • 3.
    Almqvist-Tangen, Gerd
    et al.
    Child Health Care Team, County Council Halland, Sweden & Department of Paediatrics, University of Gothenburg, Gothenburg, Sweden.
    Bergman, Stefan
    Research and Development Centre, Spenshult Hospital, Oskarström, Sweden.
    Dahlgren, Jovanna
    Department of Paediatrics, University of Gothenburg, Gothenburg, Sweden.
    Roswall, Josefine
    Department of Paediatrics, County Hospital, Halmstad, Sweden & Department of Paediatrics, University of Gothenburg, Gothenburg, Sweden.
    Alm, Bernt
    Child Health Care Team, County Council Halland, Sweden & Department of Paediatrics, University of Gothenburg, Gothenburg, Sweden.
    Factors associated with discontinuation of breastfeeding before 1 month of age2012In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 101, no 1, p. 55-60Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Breastfeeding is associated with many benefits for both mother and child. Initiation rates are high in Sweden. Recently a slight decline is seen.

    AIM: The aim of this study was to assess factors associated with discontinuation of breastfeeding during the first 4 weeks.

    METHOD: A population-based longitudinal birth cohort study recruiting from 2007 to 2008 in south-western Sweden. At the first visit to the child health centre, parents were asked to complete a questionnaire. Also, the infants' height, weight, head and waist circumference were collected. Response rate was 69.2%.

    RESULTS: Twenty-seven per cent of mothers had breastfeeding problems. In a multivariate analysis, there was a negative correlation between breastfeeding and use of pacifier (OR 3.72; CI 2.09-6.63), maternal smoking (OR 2.09; CI 1.08-4.05) and breastfeeding problems (OR 2.54; CI 1.73-3.71). Breastfeeding problems were correlated with poor sucking technique (OR 2.96; CI 2.14-4.07), support from maternity ward (OR 2.56; CI 2.05-3.19) and perceived poor weight gain (OR 1.37; CI 1.00-1.86).

    CONCLUSION: Many mothers reported breastfeeding problems that are associated with an early cessation. This is preventable with support, but the timing is crucial. To promote breastfeeding, the support from the child health centres must be tailored with the maternal perspective in mind.

    © 2011 Foundation Acta Pædiatrica

  • 4.
    Bramsved, Rebecka
    et al.
    The Queen Silvia Children’s Hospital, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Regber, Susann
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Novak, Daniel
    The Queen Silvia Children’s Hospital, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Mehlig, Kirsten
    Institute of Medicine, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Lissner, Lauren
    Institute of Medicine, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Mårild, Staffan
    The Queen Silvia Children’s Hospital, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Parental education and family income affect birthweight, early longitudinal growth and body mass index development differently2018In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 107, no 11, p. 1946-1952Article in journal (Refereed)
    Abstract [en]

    AIM: This study investigated the effects of two parental socio-economic characteristics, education and income, on growth and risk of obesity in children from birth to 8 years of age.

    METHODS: Longitudinal growth data and national register-based information on socio-economic characteristics were available for 3,030 Swedish children. The development of body mass index (BMI) and height was compared in groups dichotomised by parental education and income.

    RESULTS: Low parental education was associated with a higher BMI from 4 years of age, independent of income, immigrant background, maternal BMI and smoking during pregnancy. Low family income was associated with a lower birthweight, but did not independently predict BMI development. At 8 years of age, children from less educated families had a three times higher risk of obesity, independent of parental income. Children whose parents had fewer years of education but high income had significantly higher height than all other children.

    CONCLUSION: Parental education protected against childhood obesity, even after adjusting for income and other important parental characteristics. Income-related differences in height, despite similar BMIs, raise questions about body composition and metabolic risk profiles. The dominant role of education underscores the value of health literacy initiatives for the parents of young children. ©2018 Foundation Acta Pædiatrica.

  • 5.
    Lindholm, Annelie
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Research and Development Center Spenshult, Halmstad, Sweden.
    Bergman, Stefan
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Research and Development Center Spenshult, Halmstad, Sweden & Department of Public Health and Community Medicine, The Primary Health Care Unit at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Alm, Bernt
    Department of Pediatrics, The Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Almquist-Tangen, Gerd
    Department of Pediatrics, The Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden & Child Health Care Unit, Region Halland, Kungsbacka, Sweden.
    Dahlgren, Jovanna
    Department of Pediatrics, The Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Roswall, Josefine
    Department of Pediatrics, The Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden & Department of Pediatrics, County Hospital, Halmstad, Sweden.
    Infant body mass index growth patterns predicted overweight at five years, waist-to-height ratio did not add to this predictivity2019In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, no 5, p. 945-953Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of the present study was to examine body mass index (BMI) and waist‐to‐height ratio (WHtR) growth patterns from birth until five years regarding their ability to predict overweight or obesity in children at five years of age.

    Methods: Population‐based longitudinal birth cohort study of 1540 children from the south‐west region of Sweden, recruited at the first visit to the child health care centres in 2007–2008. The children were followed for five years and classified into two weight groups according to the 2012 International Obesity Task Force criteria. BMI and WHtR standard deviation scores (SDS) were analysed with Student's t‐tests and multiple logistic regression models. ©2018 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd

    Results: BMI‐SDS and WHtR‐SDS growth patterns were from an early age different in children with overweight or obesity, compared to in children with normal weight or underweight. Overweight or obesity was significantly predicted by BMI‐SDS at 0–1 month (p < 0.001), ΔBMI‐SDS between 0–1 and 12 months (p < 0.001) and between 18 and 48 months (p < 0.001), but not by WHtR‐SDS, except for a negative association between 18 and 48 months in the boys (p = 0.040).

    Conclusion: Overweight or obesity at five years could be predicted by early BMI‐SDS growth patterns, and WHtR‐SDS did not add to the predictivity with regard to BMI‐SDS. ©2018 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd

  • 6.
    Regber, Susann
    et al.
    Department of Pediatrics, Institute for the Health of Women and Children, Göteborg University, The Queen Silvia Children’s Hospital, Göteborg, Sweden.
    Berg Kelly, Kristina
    Department of Pediatrics, Institute for the Health of Women and Children, Göteborg University, The Queen Silvia Children’s Hospital, Göteborg, Sweden.
    Missed opportunities–adolescents with a chronic condition (insulin-dependent diabetes mellitus) describe their cigarette-smoking trajectories and consider health risks2007In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 96, no 12, p. 1770-1776Article in journal (Refereed)
    Abstract [en]

    AIM: To enhance our knowledge on why adolescents with a chronic condition (insulin-dependent diabetes mellitus, IDDM) choose to smoke despite possible awareness of health risks.

    METHODS: Twelve patients aged 15-20 with IDDM who smoked cigarettes volunteered to participate in qualitative interviews. The results were analyzed with content analysis according to Miles and Huberman 1994.

    RESULTS: One set confirmed what is earlier known on cigarette smoking among adolescents, such as plain exploring, needs to conform with group norms, identity needs and denial of risks. Other themes gave new insights. One was the emotional attitudes-or lack of emotions-expressed by important others, which exerted strong influences on the smoking trajectories. These emotions affected both initiation and motivation for quitting cigarette smoking and seemed crucial as means of meaningful communications concerning smoking. One theme was a flow path of cigarette smoking, which demonstrated opportunities for secondary prevention. Finally, developmental reasons for smoking and motivation for quitting could be described.

    CONCLUSIONS: There are several windows of opportunities to lower the risk of adolescents with IDDM and other chronic conditions from becoming and remaining smokers, as reported by young people themselves. © 2007 The Author(s).

  • 7.
    Regber, Susann
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Jormfeldt, Henrika
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Foster homes for neglected children with severe obesity— Debated but rarely studied2019In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, no 11, p. 1955-1964Article in journal (Refereed)
    Abstract [en]

    Aim: To explore current research and theoretical articles on foster home placement of children with severe obesity.

    Methods: An integrative literature review. Literature searches in six electronic databases included theoretical, quantitative and qualitative articles and case reports published in English (2008‐2018) on the topic of severe childhood obesity and foster home placement.

    Results: Seventeen selected papers included six theoretical articles, nine quantitative studies, one qualitative study and one case report. Eight of the nine quantitative studies did not specify the grading of obesity in children in foster care. The case report and the qualitative study showed distinct and sustainable body mass index (BMI) reductions after a child had been placed in foster care. Five theoretical articles justified foster care placement when chronic parental neglect led to severe obesity in the child, while one article emphasised the opposite.

    Conclusion: Parental and societal neglect of children with severe obesity placed in a foster home is rarely studied or the exclusive aim of research. The views of the chil‐dren themselves are lacking in research articles, as well as the child’s right to health obligations concerning children with severe obesity. © 2019 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd.

  • 8.
    Roswall, J.
    et al.
    Department of Paediatrics, County Hospital Halmstad, Halmstad, Sweden & Department of Paediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Karlsson, A.-K.
    Department of Paediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Allvin, K.
    Department of Paediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Tangen, G. A.
    Department of Paediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Bergman, Stefan
    Research and Development Centre, Spenshult Hospital, Oskarström, Sweden.
    Niklasson, A.
    Department of Paediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Alm, B.
    Department of Paediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden & Child Health Care Unit, County of Halland, Halland, Sweden.
    Dahlgren, J.
    Department of Paediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Preschool children born moderately preterm have increased waist circumference at two years of age despite low body mass index2012In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 101, no 11, p. 1175-1181Article in journal (Refereed)
    Abstract [en]

    AIM: To investigate the development of waist circumference (WC) in preschool children born preterm compared with a population-based reference.

    BACKGROUND: Children born preterm are reported to be insulin resistant, despite being lean during early childhood. We hypothesize that the mechanism is through increased visceral adiposity.

    METHODS: Data from 4446 preschool children (2169 girls/2277 boys) born in 2001-2006 from a population-based study were compared with longitudinal measurements of body mass index (BMI) and WC from a cohort of 152 children (64 girls/88 boys) born moderately preterm in 2002-2004 (gestational age, 32-37 weeks).

    RESULTS: In the preterm children, the mean WC was 2.8 cm larger compared with the reference group (p < 0.001) at 2 years of age but not at 5 years of age. There was no significant difference in the mean BMI at 2 years of age. The preterm group was significantly leaner at 5 years of age, with a mean BMI of 15.13 compared with 15.98 in the reference group (p < 0.001).

    CONCLUSION: Children born moderately preterm present as lean during early childhood but have an increased waist circumference in infancy, pointing towards a change in fat distribution with more abdominal fat. This may have implications for their metabolic status.

  • 9.
    Roswall, Josefine
    et al.
    Department of Paediatrics, University of Gothenburg, Sahlgrenska Academy, Sweden.
    Bergman, Stefan
    Research and Development Centre, Spenshult Hospital, Oskarström, Sweden.
    Almqvist-Tangen, Gerd
    Department of Paediatrics, University of Gothenburg, Sahlgrenska Academy, Sweden & Child Healthcare Team, County of Halland, Sweden.
    Alm, Bernt
    Department of Paediatrics, University of Gothenburg, Sahlgrenska Academy, Sweden.
    Niklasson, Aimon
    Department of Paediatrics, University of Gothenburg, Sahlgrenska Academy, Sweden.
    Nierop, Andreas F. M.
    MUVARA, Leiderdorp, Netherlands.
    Dahlgren, Jovanna
    Department of Paediatrics, University of Gothenburg, Sahlgrenska Academy, Sweden.
    Population-based waist circumference and waist-to-height ratio reference values in preschool children2009In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 98, no 10, p. 1632-1636Article in journal (Refereed)
    Abstract [en]

    AIM: To establish new reference values for measurements of waist circumference and waist-to-height ratio in preschool children.

    METHODS: A population-based, cross-sectional study of 4502 children aged 0-5 years derived from child health care in a Swedish county. Measurements of weight, height and waist circumference were recorded using a standardized procedure.

    RESULTS: New reference values for waist circumference and waist-to-height ratio for preschool children are presented. Reference charts were constructed and are presented. Waist circumference increased with age (r = 0.80, p < 0.001). After adjustment to the individual height, expressed as waist-to-height ratio, there was an inverse correlation to age during the first 5 years of age (r = -0.87, p < 0.001).

    CONCLUSION: The new reference values for waist circumference and waist-to-height ratio for Swedish preschool children enable future identification of new risk populations for childhood obesity. For clinicians, new reference charts for these two variables are provided for practical use.

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