Background: Adequate sleep is crucial for children's health, especially for children with ADHD and concurrent sleep problems. There is a need for more studies focusing on sleep problems in children with ADHD as these problems may exacerbate ADHD symptoms and vice versa, impacting negatively on everyday life. The aim of this study was to investigate the differences in health-related factors between children with ADHD without clinically relevant sleep problems and those with clinically relevant sleep problems after a sleep intervention.

Methods: This cross-sectional study involved 83 children diagnosed with ADHD and sleep problems, 46 boys and 37 girls; aged 6-14 years, divided into two groups after a sleep intervention according to the parent-reported Children's Sleep Habits Questionnaire (CSHQ) and a cut-off for clinically relevant sleep problems. Data from a 16-week follow-up of the sleep intervention were analysed in terms of the following health-related measures: The Insomnia Severity Index (ISI), The short form of State-Trait Anxiety Inventory (Short-STAI), The Child Outcome Rating Scale (CORS), The EQ-5D-Y-3L (child-reported), and The Swanson, Nolan, and Pelham Rating Scale (SNAP-IV) (parent-reported). The Mann-Whitney u-test, Independent samples t-test, and Chi-square/Fisher's exact test were used for the analysis.

Results: Forty-two of the 83 children (50.6%) were grouped as having clinically relevant sleep problems and 41 (49.4%) as being without the same. The results indicated that the group without clinically relevant sleep problems reported less insomnia (ISI, total score p = 0.011), less tension in the anxiety scale (Short-STAI, tense p = 0.047), and their parents reported less ADHD symptoms (SNAP-IV, total score for attention deficit, p < 0.001). No group differences were observed for life functioning (CORS) or health-related quality of life (EQ-5D-Y-3 L).

Conclusions: This study showed that children with ADHD without parent-reported clinically relevant sleep problems had fewer health-related issues after a sleep intervention, including self-reported insomnia, tension, and parent-reported ADHD symptoms, compared to children with clinically relevant sleep problems. Longitudinal studies are necessary to fully comprehend the long-term impact of sleep problems and various health-related factors in this cohort. © 2025. The Author(s).

Aim: The role of infant nutrition in rapid weight gain (RWG) is not well understood. This study investigated associations between milk cereal drinks, early RWG, and later body mass index (BMI) and waist-to-height ratio (WHtR). Methods: In total, 1333 children, from three communities in Western Sweden constituted the combined IDEFICS–I. Family cohort. Data were obtained retrospectively from the National Medical Birth Register, child health centres and school health services. Anthropometric data and parental reported food habits were collected in the 2007–2008 IDEFICS baseline survey. Follow-up data for 656 children were collected in the 2013–2014 I. Family survey. Linear and logistic regressions were used. Results: At baseline, 820 (62%) of the 658 boys and 675 girls, median age 6.0 years, interquartile range 4.0–7.5 years, consumed milk cereal drinks and 229 (18%) had early RWG. Milk cereal drinks were associated with early RWG without effects on later BMI or WHtR status 6 years later. Early RWG was predictive of higher anthropometric measures later in childhood, particularly abdominal adiposity. Conclusion: Despite early-life correlations between RWG and milk cereal drinks, this study could not demonstrate a long-term detrimental association between milk cereal drinks and BMI or WHtR. Acta Paediatrica© 2024 The Author(s). Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

Background: Approximately 7.6% of children are diagnosed with attention deficit/hyperactivity disorder (ADHD), and sleep impairments affect 25–85%. There is a noticeable lack of research on girls and sex differences. The aim of this study was to examine sex differences in children with uncomplicated ADHD and sleep problems. Methods: Cross-sectional baseline data were retrieved from a randomized controlled trial with weighted blankets (55 boys and 41 girls, 6–14 years) on a cohort recently diagnosed with uncomplicated ADHD and sleep problems. Differences between boys and girls in ADHD symptoms, objectively and subjectively measured sleep, anxiety, and functioning were examined via parent- or self-reported validated instruments. Results: Girls reported significantly lower (worse) satisfaction with well-being, life overall, and school, but not for family. Parents reported more sleep anxiety and night-time wakings among boys, but no sex differences in other measures and also not in self-reported measures or objective sleep measures. Children who reported worry, sadness, or unhappiness had more sleep problems. Conclusions: Boys with ADHD and sleep problems may need support with sleep-related anxiety and night-time wakings, while girls may require support with overall functioning. Additionally, children who express feelings of worry, sadness, or unhappiness alongside their ADHD symptoms should have attention given to their sleep. © 2024 by the authors. Licensee MDPI, Basel, Switzerland.

Purpose: Early rapid weight gain (RWG) is associated with overweight and abdominal adiposity in children, and these factors are in turn related to adverse health consequences later in life. Early nutrition has been identified as an important risk factor. In Sweden, milk cereal drink (MCD) is recommended to be introduced at 6 months and continued during introduction of complementary foods, often longer. The aim of this study was to investigate if MCD consumption was associated with RWG in infancy and elevated waist-to-height ratio (WHtR) later in childhood. 

Methods: This study is based on longitudinal data in the Swedish cohort of the IDEFICS study between birth and 15 years. Early growth data from archival health records and information from parents regarding MCD consumption, maternal BMI and family income was available for 1391 children. After excluding 58 children born prematurely, n=1333. RWG was defined as a change > 0.67 in weight standard deviation scores between 6–12 months. Follow-up data regarding waist circumference and height were available in around half of the children who were re-examined at ages 7–15 years. Logistic and linear regressions were used to study associations between MCD and early RWG and subsequent predictive value of RWG on WHtR later in childhood. 

Results/findings: MCD was consumed by 61% of the children and 59% of them consumed it for more than three months. RWG, which was observed in 17% of the children between 6–12 months was associated with MCD consumption ever/never (OR: 1.52 95% CI: 1.19–2.07 p: <0.01), when corrected for maternal BMI, birth weight, sex and household income. When investigating WHtR in the 626 children at follow-up, RWG between 6–12 months was associated with WHtR (3.98, 1.15–13.83 and p<0.05) when corrected for birth weight, sex, maternal BMI, age at follow-up, parental education and breastfeeding. In the full model considering the total observation time the MCD effect was not independent of RWG. 

Conclusions: Our results indicate that early RWG is associated with higher WHtR later in childhood. Our results also raise the possibility that MCD consumption may be involved in later development of centralized adiposity.

Purpose: Early rapid weight gain (RWG) is associated with overweight and abdominal adiposity in children, and these factors are in turn related to adverse health consequences later in life. Early nutrition has been identified as an important risk factor. In Sweden, milk cereal drink (MCD) is recommended to be introduced at 6 months and continued during introduction of complementary foods, often longer. The aim of this study was to investigate if MCD consumption was associated with RWG in infancy and elevated waist-to-height ratio (WHtR) later in childhood.

Methods: This study is based on longitudinal data in the Swedish cohort of the IDEFICS study between birth and 15 years. Early growth data from archival health records and information from parents regarding MCD consumption, maternal BMI and family income was available for 1391 children. After excluding 58 children born prematurely, n=1333. RWG was defined as a change > 0.67 in weight standard deviation scores between 6–12 months. Follow-up data regarding waist circumference and height were available in around half of the children who were re-examined at ages 7–15 years. Logistic and linear regressions were used to study associations between MCD and early RWG and subsequent predictive value of RWG on WHtR later in childhood.

Results/findings: MCD was consumed by 61% of the children and 59% of them consumed it for more than three months. RWG, which was observed in 17% of the children between 6–12 months was associated with MCD consumption ever/never (OR: 1.52 95% CI: 1.19–2.07 p: <0.01), when corrected for maternal BMI, birth weight, sex and household income. When investigating WHtR in the 626 children at follow-up, RWG between 6–12 months was associated with WHtR (3.98, 1.15–13.83 and p<0.05) when corrected for birth weight, sex, maternal BMI, age at follow-up, parental education and breastfeeding. In the full model considering the total observation time the MCD effect was not independent of RWG.

Conclusions: Our results indicate that early RWG is associated with higher WHtR later in childhood. Our results also raise the possibility that MCD consumption may be involved in later development of centralized adiposity.

Background/Objectives: Obesity-related adverse health consequences are closely associated with abdominal obesity. Risk factors for overweight and obesity have been studied but there is a lack of information regarding risk factors for abdominal obesity, especially in the preschool population. The aim of the present study was to examine early life risk factors for an increased waist-to-height ratio (WHtR) in children at five years of age and, in addition, to investigate if these risk factors also were associated with overweight or obesity. 

Subjects/Methods: The study population comprised 1,540 children from a population-based longitudinal birth cohort study that included 2,666 Swedish children. The children were included if they had complete growth data for the analyses used in this study. Children were classified as having WHtR standard deviation scores (SDS) ≥ 1 or < 1 at five years of age, according to Swedish reference values, and as having body mass index standard deviation scores (BMI_SDS) for overweight/obesity, or normal weight/underweight according to the International Obesity Task Force criteria. Associations between child-related, socioeconomic status-related, parental health-related and nutrition- and feeding practice-related factors during the first two years and a WHtR_SDS ≥ 1 or a BMI_SDS for overweight/obesity at five years were investigated with logistic regression analyses. 

Results: At five years of age, 15% of the children had WHtR_SDS ≥ 1 and 11% had overweight or obesity. In multivariable analyses, rapid weight gain (RWG) during 0-6 months (OR: 1.90, 95% CI: 1.23–2.95, p=0.004), maternal pre-pregnancy BMI (1.06, 1.01–1.11, p=0.019) and paternal BMI (1.11, 1.01–1.21, p=0.028) were associated with WHtR_SDS ≥ 1. RWG during 0-6 months (2.53, 1.53–4.20, p<0.001), 6-12 months (2.82, 1.37–5.79, p=0.005), and maternal pre-pregnancy BMI (1.11, 1.06–1.17, p<0.001) were associated with overweight or obesity.

Conclusions: Early risk factors, including rapid weight gain, are associated with increased WHtRSDS and overweight or obesity at 5 years of age. Preventive interventions should target early RWG and parental overweight and obesity. 

Background: Rapid weight gain (RWG) during infancy increases the risk of excess weight later in life. Nutrition- and feeding practices associated with RWG need to be further examined. The present study aimed to examine nutrition- and feeding practice-related risk factors for RWG during the first year of life.

Methods: A population-based longitudinal birth cohort study of 1780 infants, classified as having RWG or non-RWG during 0–3-4, 0–6 and 6–12 months. RWG was defined as a change > 0.67 in weight standard deviation scores. Associations between nutrition- and feeding practice-related factors and RWG were examined with logistic regression models.

Results: Of the participating infants, 47% had RWG during 0–3-4 months, 46% during 0–6 months and 8% during 6–12 months. In the fully adjusted models, bottle-feeding at birth and at 3–4 months and nighttime meals containing formula milk were positively associated with RWG during 0–3-4 months (p < 0.05 for all). Breastfeeding at 3–4 months and nighttime meals containing breast milk were negatively associated with RWG during this period

(p < 0.001). Bottle-feeding at birth, 3–4 and 6 months and nighttime meals containing formula milk at 3–4 months were positively associated with RWG during 0–6 months (p < 0.01 for all). Breastfeeding at 3–4 and 6 months was negatively associated with RWG (p < 0.01). During 6–12 months, only bottle-feeding at 3–4 months was positively associated with RWG (p < 0.05).

Conclusions: RWG was more common during the first 6 months of life and bottle-feeding and formula milk given at night were risk factors for RWG during this period. © 2020, The Author(s).

Background:  Abdominal adiposity is an important risk factor in the metabolic syndrome. Since BMI does not reveal fat distribution, waist-to-height ratio (WHtR) has been suggested as a better measure of abdominal adiposity in children, but only a few studies cover the preschool population. The aim of the present study was to examine BMI and WHtR growth patterns and their association regarding their ability to identify children with an elevated WHtR at 5 years of age.

Methods: A population-based longitudinal birth cohort study of 1540 children, followed from 0 to 5 years with nine measurement points. The children were classified as having WHtR standard deviation scores (WHtRSDS) <1 or ≥1 at 5 years. Student’s t-tests and Chi-squared tests were used in the analyses.

Results: Association between BMISDS and WHtRSDS at 5 years showed that 55% of children with WHtRSDS ≥1 at 5 years had normal BMISDS (p < 0.001). Children with WHtRSDS ≥1 at 5 years had from an early age significantly higher mean BMISDS and WHtRSDS than children with values <1.

Conclusions: BMI classification misses every second child with WHtRSDS ≥1 at 5 years, suggesting that WHtR adds value in identifying children with abdominal adiposity who may need further investigation regarding cardiometabolic risk factors.

© 2018, International Pediatric Research Foundation, Inc.

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

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