Browsing by Subject "WEIGHT-GAIN"

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  • Kaukonen, Riikka; Lehto, Elviira; Ray, Carola; Vepsäläinen, Henna; Nissinen, Kaija; Korkalo, Liisa; Koivusilta, Leena; Sajaniemi, Nina; Erkkola, Maijaliisa; Roos, Eva (2019)
    Although evidence exists of the association between children's temperament and weight, only few studies have examined how temperament is associated with actual food consumption among preschoolers. We examined concurrent associations between children's temperament and the consumption of different foods, and investigated whether the association between children's temperament and vegetable consumption is mediated by vegetable-related parenting practices. We utilized the data from the cross-sectional DAGIS study of 864 preschool children aged between three to six and their families, conducted between 2015 and 2016 in Finland. The parents reported their children's temperament, food consumption, and their vegetable-related parenting practices. Adjusted logistic regression analyses found positive associations between surgency and vegetable consumption as well as between effortful control and vegetable consumption. Both associations were mediated by one examined vegetable-related parenting practice: enhanced availability and autonomy support. No associations were found between children's negative affectivity and food consumption or vegetable-related parenting practices. In conclusion, children's temperament may be an important factor behind food-related parenting practices and children's diet. However, further longitudinal research and research covering different food-related parenting practices and home environment factors is necessary to better understand the complex associations between temperament and food consumption among young children.
  • Koivuaho, E.; Laru, J.; Ojaniemi, M.; Puukka, K.; Kettunen, J.; Tapanainen, J. S.; Franks, S.; Järvelin, M. -R.; Morin-Papunen, L.; Sebert, S.; Piltonen, T. T. (2019)
    Background: Adiposity rebound (AR), the second BMI rise in childhood at around the age of 6 years, is associated with obesity and metabolic alteration in later life. Given that polycystic ovary syndrome (PCOS) has a strong metabolic component, early life growth patterns could reveal a risk of PCOS. Thus, we aimed to investigate the associations between age at AR and PCOS diagnosis and BMI later in life. Materials and methods: This study is part of a prospective, population-based longitudinal study, where women with PCOS diagnosis by age 46 (n = 280) were compared with asymptomatic women (CTRLs, n = 1573). Weight and height data from birth to age 13 years, at age at menarche, and at ages 31 and 46 years were analyzed Results: Women with PCOS had lower birth weight (3357 +/- 477 vs. 3 445 +/- 505 g, p <0.001), earlier age at AR (5.2 +/- 1.0 vs. 5.6 +/- 0.90 years, p <0.001) and higher BMI from AR onwards compared with controls. Early timing of AR was associated with PCOS diagnosis independently of BMI (OR 1.62, 95% CI 1.37-1.92). Women with PCOS and early AR had higher BMI at 31 and 46 years when compared to controls with early AR. The age at AR did not associate with T levels at ages 31 or 46 years. Conclusions: Early AR was associated with PCOS diagnosis and high BMI in adulthood. Adolescent girls with early AR and persisting obesity should be screened for PCOS symptoms, such as persistent irregular cycles and hirsutism.
  • Derrien, Muriel; Belzer, Clara; de Vos, Willem M. (2017)
    Akkermansia muciniphila is an intestinal bacterium that was isolated a decade ago from a human fecal sample. Its specialization in mucin degradation makes it a key organism at the mucosal interface between the lumen and host cells. Although it was isolated quite recently, it has rapidly raised significant interest as A. muciniphila is the only cultivated intestinal representative of the Verrucomicrobia, one of the few phyla in the human gut that can be easily detected in phylogenetic and metagenome analyses. There has also been a growing interest in A. muciniphila, due to its association with health in animals and humans. Notably, reduced levels of A. muciniphila have been observed in patients with inflammatory bowel diseases (mainly ulcerative colitis) and metabolic disorders, which suggests it may have potential anti-inflammatory properties. The aims of this review are to summarize the existing data on the intestinal distribution of A. muciniphila in health and disease, to provide insight into its ecology and its role in founding microbial networks at the mucosal interface, as well as to discuss recent research on its role in regulating host functions that are disturbed in various diseases, with a specific focus on metabolic disorders in both animals and humans. (C) 2016 Elsevier Ltd. All rights reserved.
  • Piirtola, Maarit; Jelenkovic, Aline; Latvala, Antti; Sund, Reijo; Korhonen, Maila Tellervo; Kaprio, Jaakko; Silventoinen, Karri; collaboration group, CODATwins (2018)
    Background Smokers tend to weigh less than never smokers, while successful quitting leads to an increase in body weight. Because smokers and non-smokers may differ in genetic and environmental family background, we analysed data from twin pairs in which the co-twins differed by their smoking behaviour to evaluate if the association between smoking and body mass index (BMI) remains after controlling for family background. Methods and findings The international CODATwins database includes information on smoking and BMI measured between 1960 and 2012 from 156,593 twin individuals 18–69 years of age. Individual-based data (230,378 measurements) and data of smoking discordant twin pairs (altogether 30,014 pairwise measurements, 36% from monozygotic [MZ] pairs) were analysed with linear fixed-effects regression models by 10-year periods. In MZ pairs, the smoking co-twin had, on average, 0.57 kg/m2 lower BMI in men (95% confidence interval (CI): 0.49, 0.70) and 0.65 kg/m2 lower BMI in women (95% CI: 0.52, 0.79) than the never smoking co-twin. Former smokers had 0.70 kg/m2 higher BMI among men (95% CI: 0.63, 0.78) and 0.62 kg/m2 higher BMI among women (95% CI: 0.51, 0.73) than their currently smoking MZ co-twins. Little difference in BMI was observed when comparing former smoking co-twins with their never smoking MZ co-twins (0.13 kg/m2, 95% CI 0.04, 0.23 among men; -0.04 kg/m2, 95% CI -0.16, 0.09 among women). The associations were similar within dizygotic pairs and when analysing twins as individuals. The observed series of cross-sectional associations were independent of sex, age, and measurement decade. Conclusions Smoking is associated with lower BMI and smoking cessation with higher BMI. However, the net effect of smoking and subsequent cessation on weight development appears to be minimal, i.e. never more than an average of 0.7 kg/m2.
  • Salmela, Jatta Helena; Mauramo, Elina; Lallukka, Tea; Rahkonen, Ossi; Kanerva, Noora (2019)
    Objective: Childhood disadvantage is associated with a higher risk of adult obesity, but little is known about its associations with body mass index (BMI) trajectories during adulthood. This study aimed first to identify adulthood BMI trajectories, and second to investigate how childhood disadvantage is associated with trajectory group membership. Methods: Data from the Helsinki Health Study, a longitudinal cohort study of initially 40- to 60-year-old employees of the City of Helsinki in Finland, were used. The baseline survey was conducted in 2000–2002, and similar follow-up surveys in 2007, 2012, and 2017. Based on self-reported BMI, participants’ (n =5,266; 83% women) BMI trajectories, including their retrospectively reported BMI at the age of 25 years, were examined. Data on childhood disadvantage, including parental education and 7 types of childhood adversity (their own serious illness; parental divorce, death, mental disorder, or alcohol problems; economic difficulties at home; and peer group bullying) before the age of 16 years, were obtained from the baseline survey. Group-based trajectory modeling was used to identify BMI trajectories, and multinomial logistic regression to analyze the odds for trajectory group membership for the disadvantage variables. Results: Four ascending BMI trajectories in women and men were found: persistent normal weight (trajectory 1; women 35% and men 25%), normal weight to overweight (trajectory 2; women 41% and men 48%), normal weight to class I obesity (trajectory 3; women 19% and men 23%) and overweight to class II obesity (trajectory 4; women 5% and men 4%). Compared to trajectory 1, women with multiple adversities and repetitive peer bullying in childhood had greater odds of belonging to trajectories 3 and 4, whereas men with parental alcohol problems had greater odds of belonging to trajectory 4. For women and men, a low level of parental education was associated with a higher-level BMI trajectory. Conclusions: Low parental education for both genders, multiple adversities and repetitive peer bullying in childhood among women, and parental alcohol problems among men increased the odds of developing obesity during adulthood. Further studies are needed to clarify how gender differences modify the effects of childhood disadvantage on adult BMI trajectories.
  • Seppä-Lassila, Leena; Oksanen, Jarkko; Herva, Tuomas; Dorbek-Kolin, Elisabeth; Kosunen, Heli; Parviainen, Laura; Soveri, Timo; Orro, Toomas (2018)
    Efficient dairy-beef production relies on good quality of purchased calves, defined by breed, health, and growth characteristics. Several management factors, such as commingling of calves and large group size, predispose calves to diseases. Acute phase proteins are sensitive detectors of calf diseases. We studied the associations between group size, serum acute phase proteins, immunoglobulin G (IgG), calf morbidity and growth of dairy-beef calves in a random field trial in a calf-rearing unit in Finland. The randomized trial was carried out at a calf rearing unit, where approximately 80 dairy or crossbred calves were allocated either into a single group of 40 calves or into four groups of 10 on arrival at the calf-rearing unit (at age 24.1 SD +/- 9.2 days). The study was carried out on 6 arrival batches: 476 calves. Calves were clinically examined and blood sampled on arrival (day 0), and haptoglobin (Hp), serum amyloid A (SAA), albumin and IgG were determined. Calves were weighed on arrival (day 0, average age 24.1 days), at the end of the milk feed period (day 49), at approximately 200 days of age and at slaughter (carcass weight) at 15-18 months of age. During the rearing calves were observed by the farm workers and treated, if necessary, according to pre-determined instructions of the veterinary surgeon. All NSAID and antimicrobial treatments were recorded and used as morbidity indicators in statistical analysis. There were no differences in the numbers of antimicrobial treatments or growth among the groups. The majority (84.1%) of antimicrobial treatments were used against respiratory tract infections. Higher concentrations of albumin and IgG on arrival extended the time before the first and the second antimicrobial treatments. Complex relationships between group size, morbidity, concentrations of serum acute phase proteins and IgG at arrival, and growth of calves were explored. Group size of 10 calves did not protect calves from respiratory tract infections, when the small groups were sharing the air space with a large group. An increased SAA concentration on arrival was associated with poorer average daily gain at two rearing periods and with lower carcass weight at slaughter. Serum proteins could be valuable health indicators for purchased calves because they have numerous and variable associations with health and growth. The mechanisms that connect increased SAA concentration and poorer average daily gain over the long term remain unclear.
  • Piirtola, Maarit; Kaprio, Jaakko; Svedberg, Pia; Silventoinen, Karri; Ropponen, Annina (2020)
  • Suomela, Emmi; Oikonen, Mervi; Pitkanen, Niina; Ahola-Olli, Ari; Virtanen, Johanna; Parkkola, Riitta; Jokinen, Eero; Laitinen, Tomi; Hutri-Kahonen, Nina; Kahonen, Mika; Lehtimaki, Terho; Taittonen, Leena; Tossavainen, Paivi; Jula, Antti; Loom, Britt-Marie; Mikkila, Vera; Telama, Risto; Viikari, Jorma S. A.; Juonala, Markus; Raitakari, Olli T. (2016)
    Background & Aims: Fatty liver is a potentially preventable cause of serious liver diseases. This longitudinal study aimed to identify childhood risk factors of fatty liver in adulthood in a population-based group of Finnish adults. Methods: Study cohort included 2,042 individuals from the Cardiovascular Risk in Young Finns Study aged 3-18 years at baseline in 1980. During the latest follow-up in 2011, the liver was scanned by ultrasound. In addition to physical and environmental factors related to fatty liver, we examined whether the genetic risk posed by a single nucleotide polymorphism in the patatin-like phospholipase domain-containing protein 3 gene (PNPLA3) (rs738409) strengthens prediction of adult fatty liver. Results: Independent childhood predictors of adult fatty liver were small for gestational age, (odds ratio = 1.71, 95% confidence interval = 1.07-2.72), variant in PNPLA3 (1.63, 1.29-2.07 per one risk allele), variant in the transmembrane 6 superfamily 2 gene (TM6SF2) (1.57, 1.08-2.30), BMI (1.30, 1.07-1.59 per standard deviation) and insulin (1.25, 1.05-1.49 per standard deviation). Childhood blood pressure, physical activity, C-reactive protein, smoking, serum lipid levels or parental lifestyle factors did not predict fatty liver. Risk assessment based on childhood age, sex, BMI, insulin levels, birth weight, TM6SF2 and PNPLA3 was superior in predicting fatty liver compared with the approach using only age, sex, BMI and insulin levels (C statistics, 0.725 vs. 0.749; p = 0.002). Conclusions: Childhood risk factors on the development of fatty liver were small for gestational age, high insulin and high BMI. Prediction of adult fatty liver was enhanced by taking into account genetic variants in PNPLA3 and TM6SF2 genes. Lay summary: The increase in pediatric obesity emphasizes the importance of identification of children and adolescents at high risk of fatty liver in adulthood. We used data from the longitudinal Cardiovascular Risk in Young Finns Study to examine the associations of childhood (3-18 years) risk variables with fatty liver assessed in adulthood at the age of 34-49 years. The findings suggest that a multifactorial approach with both lifestyle and genetic factors included would improve early identification of children with a high risk of adult fatty liver. (C) 2016 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
  • Loo, Evelyn Xiu Ling; Zhang, Yuqing; Yap, Qai Ven; Yu, Guoqi; Soh, Shu E.; Loy, See Ling; Lau, Hui Xing; Chan, Shiao-Yng; Shek, Lynette Pei-Chi; Luo, Zhong-Cheng; Yap, Fabian Kok Peng; Tan, Kok Hian; Chong, Yap Seng; Zhang, Jun; Eriksson, Johan Gunnar (2021)
    Background Gestational diabetes mellitus (GDM) has been associated with adverse health outcomes for mothers and offspring. Prevalence of GDM differs by country/region due to ethnicity, lifestyle and diagnostic criteria. We compared GDM rates and risk factors in two Asian cohorts using the 1999 WHO and the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. Methods The Shanghai Birth Cohort (SBC) and the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort are prospective birth cohorts. Information on sociodemographic characteristics and medical history were collected from interviewer-administered questionnaires. Participants underwent a 2-h 75-g oral glucose tolerance test at 24-28 weeks gestation. Logistic regressions were performed. Results Using the 1999 WHO criteria, the prevalence of GDM was higher in GUSTO (20.8%) compared to SBC (16.6%) (p = 0.046). Family history of hypertension and alcohol consumption were associated with higher odds of GDM in SBC than in GUSTO cohort while obesity was associated with higher odds of GDM in GUSTO. Using the IADPSG criteria, the prevalence of GDM was 14.3% in SBC versus 12.0% in GUSTO. A history of GDM was associated with higher odds of GDM in GUSTO than in SBC, while being overweight, alcohol consumption and family history of diabetes were associated with higher odds of GDM in SBC. Conclusions We observed several differential risk factors of GDM among ethnic Chinese women living in Shanghai and Singapore. These findings might be due to heterogeneity of GDM reflected in diagnostic criteria as well as in unmeasured genetic, lifestyle and environmental factors.
  • Mendelian Randomization Dairy Cons; Huang, Tao; Kähönen, Mika; Mikkilä, Vera; Viikari, Jorma; Raitakari, Olli; Lehtimäki, Terho (2018)
    BACKGROUND: Associations between dairy intake and body mass index (BMI) have been inconsistently observed in epidemiological studies, and the causal relationship remains ill defined. METHODS: We performed Mendelian randomization (MR) analysis using an established dairy intake-associated genetic polymorphism located upstream of the lactase gene (LCT-13910 C/T, rs4988235) as an instrumental variable (IV). Linear regression models were fitted to analyze associations between (a) dairy intake and BMI, (b) rs4988235 and dairy intake, and (c) rs4988235 and BMI in each study. The causal effect of dairy intake on BMI was quantified by IV estimators among 184802 participants from 25 studies. RESULTS: Higher dairy intake was associated with higher BMI (beta = 0.03 kg/m(2) per serving/day; 95% CI, 0.00-0.06; P = 0.04), whereas the LCT genotype with 1 or 2 T allele was significantly associated with 0.20 (95% CI, 0.14-0.25) serving/day higher dairy intake (P = 3.15 x 10(-12)) and 0.12 (95% CI, 0.06-0.17) kg/m(2) higher BMI (P = 2.11 x 10(-5)). MR analysis showed that the genetically determined higher dairy intake was significantly associated with higher BMI (beta = 0.60 kg/m(2) per serving/day; 95% CI, 0.27-0.92; P = 3.0 x 10(-4)). CONCLUSIONS: The present study provides strong evidence to support a causal effect of higher dairy intake on increased BMI among adults. (c) 2017 American Association for Clinical Chemistry
  • Mendelian Randomization Dairy Cons; CHARGE Consortium; Huang, Tao; Kahonen, Mika; Mikkilä, Vera; Havulinna, Aki S.; Viikari, Jorma; Raitakari, Olli; Lehtimäki, Terho; Helminen, Mika; Kanerva, Noora (2019)
    BACKGROUND: Associations between dairy intake and body composition and cardiometabolic traits have been inconsistently observed in epidemiological studies, and the causal relationship remains ill-defined. METHODS: We performed Mendelian randomization analysis using an established genetic variant located upstream of the lactase gene (LCT- 13910 C/T, rs4988235) associated with dairy intake as an instrumental variable (IV). The causal effects of dairy intake on body composition and cardiometabolic traits (lipids, glycemic traits, and inflammatory factors) were quantified by IV estimators among 182041 participants from 18 studies. RESULTS: Each 1 serving/day higher dairy intake was associated with higher lean mass [beta (SE) = 0.117 kg (0.035); P = 0.001], higher hemoglobin A(1c) [0.009% (0.002); P <0.001], lower LDL [-0.014 mmol/L (0.006); P = 0.013], total cholesterol (TC) [-0.012 mmol/L (0.005); P = 0.023], and non-HDL [- 0.012 mmol/L (0.005); P = 0.028]. The LCT- 13910 C/T CT + TT genotype was associated with 0.214 more dairy servings/day (SE = 0.047; P = 0.001), 0.284 cm higher waist circumference (SE = 0.118; P = 0.017), 0.112 kg higher lean mass (SE = 0.027; P = 3.8 X 10(-5)), 0.032 mmol/L lower LDL (SE = 0.009; P = 0.001), and 0.032 mmol/L lower TC (SE = 0.010; P = 0.001). Genetically higher dairy intake was associated with increased lean mass [0.523 kg per serving/day (0.170); P = 0.002] after correction for multiple testing (0.05/18). However, we find that genetically higher dairy intake was not associated with lipids and glycemic traits. CONCLUSIONS: The present study provides evidence to support a potential causal effect of higher dairy intake on increased lean mass among adults. Our findings suggest that the observational associations of dairy intake with lipids and glycemic traits may be the result of confounding. (C) 2019 American Association for Clinical Chemistry
  • Grotenfelt, N. E.; Wasenius, N.; Eriksson, J. G.; Huvinen, E.; Stach-Lempinen, B.; Koivusalo, S. B.; Rönö, K. (2020)
    Aim. - To assess in women at high risk of gestational diabetes mellitus (GDM) the effect of a lifestyle intervention on the metabolic health of their offspring around 5 years after delivery. Methods. - For the original Finnish gestational diabetes prevention study (RADIEL), 720 women with a prepregnancy body mass index (BMI) >= 30 kg/m(2) and/or previous GDM were enrolled before or during early pregnancy and allocated to either an interventional (n = 126) or conventional (n = 133) care group. The present 5-year follow-up substudy assessed the metabolic health outcomes of their offspring. Ageand gender-standardized residuals of metabolic health components (waist circumference, mean arterial pressure, high-density lipoprotein and triglyceride levels, and fasting insulin/glucose ratio) were also combined to determine the accumulation of metabolic effects. Body composition was assessed by electrical bioimpedance. Results. - Offspring of women in the intervention group had a less optimal metabolic profile after the 5-year follow-up compared with offspring in the usual care group (P = 0.014). This difference in metabolic health was primarily related to lipid metabolism, and was more prominent among boys (P = 0.001) than girls (P = 0.74). Neither GDM, gestational weight gain, prepregnancy BMI, offspring age nor timing of randomization (before or during pregnancy) could explain the detected difference, which was also more pronounced among the offspring of GDM pregnancies (P= 0.010). Offspring body composition was similar in both groups (P> 0.05). Conclusion. - The lifestyle intervention aimed at GDM prevention was associated with unfavourable metabolic outcomes among offspring at around 5 years of age. (C) 2019 Elsevier Masson SAS. All rights reserved.
  • Tan, Xiao; Alen, Markku; Wang, Kun; Tenhunen, Jarkko; Wiklund, Petri; Partinen, Markku; Cheng, Sulin (2016)
    Growing evidence suggests that diet alteration affects sleep, but this has not yet been studied in adults with insomnia symptoms. We aimed to determine the effect of a six-month diet intervention on sleep among overweight and obese (Body mass index, BMI >= 25 kg/m(2)) men with chronic insomnia symptoms. Forty-nine men aged 30-65 years with chronic insomnia symptoms were randomized into diet (n = 28) or control (n = 21) groups. The diet group underwent a six-month individualized diet intervention with three face-to-face counseling sessions and online supervision 1-3 times per week; 300-500 kcal/day less energy intake and optimized nutrient composition were recommended. Controls were instructed to maintain their habitual lifestyle. Sleep parameters were determined by piezoelectric bed sensors, a sleep diary, and a Basic Nordic sleep questionnaire. Compared to the controls, the diet group had shorter objective sleep onset latency after intervention. Within the diet group, prolonged objective total sleep time, improved objective sleep efficiency, lower depression score, less subjective nocturnal awakenings, and nocturia were found after intervention. In conclusion, modest energy restriction and optimized nutrient composition shorten sleep onset latency in overweight and obese men with insomnia symptoms.
  • Konttinen, Hanna (2020)
    Stress and other negative emotions, such as depression and anxiety, can lead to both decreased and increased food intake. The term 'emotional eating' has been widely used to refer to the latter response: a tendency to eat in response to negative emotions with the chosen foods being primarily energy-dense and palatable ones. Emotional eating can be caused by various mechanisms, such as using eating to cope with negative emotions or confusing internal states of hunger and satiety with physiological changes related to emotions. An increasing number of prospective studies have shown that emotional eating predicts subsequent weight gain in adults. This review discusses particularly three lines of research on emotional eating and obesity in adults. First, studies implying that emotional eating may be one behavioural mechanism linking depression and development of obesity. Secondly, studies highlighting the relevance of night sleep duration by showing that adults with a combination of shorter sleep and higher emotional eating may be especially vulnerable to weight gain. Thirdly, an emerging literature suggesting that genes may influence body weight partly through emotional eating and other eating behaviour dimensions. The review concludes by discussing what kind of implications these three avenues of research offer for obesity prevention and treatment interventions.
  • Cuthbertson, Daniel J.; Koskinen, Juha; Brown, Emily; Magnussen, Costan G.; Hutri-Kahonen, Nina; Sabin, Matthew; Tossavainen, Paivi; Jokinen, Eero; Laitinen, Tomi; Viikari, Jorma; Raitakari, Olli T.; Juonala, Markus (2021)
    Aims To investigate the association between overweight/obesity and fatty liver index (FLI) on the odds of incident prediabetes/type 2 diabetes and non-alcoholic fatty liver disease (NAFLD) in 2020 participants after 10 years follow up. Methods At baseline (in 2001) 2020 participants, males and females, aged 24-39 years, were stratified according to body mass index (BMI), normal weight (= 25-= 30 kg/m(2)) and FLI (as high FLI >= 60 or low FLI
  • Kaseva, Nina; Vääräsmäki, Marja; Sundvall, Jouko; Matinolli, Hanna-Maria; Sipola, Marika; Tikanmäki, Marjaana; Heinonen, Kati; Lano, Aulikki; Wehkalampi, Karoliina; Wolke, Dieter; Ruokonen, Aimo; Andersson, Sture; Järvelin, Marjo-Riitta; Räikkönen, Katri; Eriksson, Johan G.; Kajantie, Eero (2019)
    Context: Maternal gestational diabetes mellitus (GDM) and prepregnancy overweight/obesity [body mass index (BMI) >= 25 kg/m(2)] might adversely affect offspring cardiometabolic health. Objective: To assess the associations between maternal GDM and prepregnancy overweight/obesity with adult offspring cardiometabolic risk factors. Design: Longitudinal cohort study (ESTER Maternal Pregnancy Disorders Study and the Arvo Ylppo Longitudinal Study). Setting: Province of Uusimaa and Northern Finland. Participants: At a mean age of 24.1 +/- 1.3 years, we classified offspring as offspring of mothers with GDM regardless of the prepregnancy BMI (OGDM; n = 193); normoglycemic mothers with pre pregnancy overweight/obesity (ONO; n = 157); and normoglycemic mothers with prepregnancy BMI Main Outcome Measures: We assessed the cardiometabolic biomarkers from blood and measured the blood pressure at rest and heart rate. Results: Compared with the controls, the OGDM and ONO groups had greater fasting glucose (1.6%; 95% CI, 0.1% to 3.1%; and 2.3%; 95% CI, 0.5% to 4.3%, respectively) and insulin (12.7%; 95% CI, 4.4% to 21.9%; and 8.7%; 95% CI, 0.2% to 17.8%). These differences attenuated to nonsignificance when adjusted for confounders and/or current offspring characteristics, including BMI or body fat percentage. The OGDM group had lower SHBG (men, 12.4%; 95% CI, 20.2% to 3.9%; women, 33.2%; 95% CI, 46.3% to 16.8%), high-density lipoprotein (-6.6%; 95% CI, 10.9% to 2.2%), and apolipoprotein Al (-4.5%; 95% CI, 7.5% to 1.4%). These differences survived the adjustments. The heart rate and other biomarkers were similar among the groups. Conclusions: Adult offspring of mothers with GDM have increased markers of insulin resistance and a more atherogenic lipid profile. These were only partly explained by confounders or current offspring adiposity. Maternal prepregnancy overweight/obesity was associated with impaired offspring glucose regulation, which was explained by confounders and/or current adiposity.
  • Meinila, Jelena; Valkama, Anita; Koivusalo, Saila B.; Stach-Lempinen, Beata; Lindstrom, Jaana; Kautiainen, Hannu; Eriksson, Johan G.; Erkkola, Maijaliisa (2016)
    Background: The aim was to develop and validate a food-based diet quality index for measuring adherence to the Nordic Nutrition Recommendations (NNR) in a pregnant population with high risk of gestational diabetes (GDM). Methods: This study is a part of the Finnish Gestational Diabetes Prevention Study (RADIEL), a lifestyle intervention conducted between 2008 and 2014. The 443 pregnant participants (61 % of those invited), were either obese or had a history of GDM. Food frequency questionnaires collected at 1st trimester served for composing the HFII; a sum of 11 food groups (available score range 0-17) with higher scores reflecting higher adherence to the NNR. Results: The average HFII of the participants was 10.2 (SD 2.8, range 2-17). Factor analysis for the HFII component matrix revealed three factors that explained most of the distribution (59 %) of the HFII. As an evidence of the component relevance 9 out of 11 of the HFII components independently contributed to the total score (item-rest correlation coefficients Conclusions: The HFII components reflect the food guidelines of the NNR, intakes of relevant nutrients, and characteristics known to vary with diet quality. It largely ignores energy intake, its components have independent contribution to the HFII, and it exhibits reproducibility. The main shortcomings are absence of red and processed meat component, and the validation in a selected study population. It is suitable for ranking participants according to the adherence to the NNR in pregnant women at high risk of GDM.
  • Suvisaari, Jaana; Mantere, Outi; Keinänen, Jaakko; Mäntylä, Teemu; Rikandi, Eva; Lindgren, Maija; Kieseppä, Tuula; Raij, Tuukka T. (2018)
    The outcome of first-episode psychosis (FEP) is highly variable, ranging from early sustained recovery to antipsychotic treatment resistance from the onset of illness. For clinicians, a possibility to predict patient outcomes would be highly valuable for the selection of antipsychotic treatment and in tailoring psychosocial treatments and psychoeducation. This selective review summarizes current knowledge of prognostic markers in FEP. We sought potential outcome predictors from clinical and sociodemographic factors, cognition, brain imaging, genetics, and blood-based biomarkers, and we considered different outcomes, like remission, recovery, physical comorbidities, and suicide risk. Based on the review, it is currently possible to predict the future for FEP patients to some extent. Some clinical features-like the longer duration of untreated psychosis (DUP), poor premorbid adjustment, the insidious mode of onset, the greater severity of negative symptoms, comorbid substance use disorders (SUDs), a history of suicide attempts and suicidal ideation and having non-affective psychosis-are associated with a worse outcome. Of the social and demographic factors, male gender, social disadvantage, neighborhood deprivation, dysfunctional family environment, and ethnicity may be relevant. Treatment non-adherence is a substantial risk factor for relapse, but a small minority of patients with acute onset of FEP and early remission may benefit from antipsychotic discontinuation. Cognitive functioning is associated with functional outcomes. Brain imaging currently has limited utility as an outcome predictor, but this may change with methodological advancements. Polygenic risk scores (PRSs) might be useful as one component of a predictive tool, and pharmacogenetic testing is already available and valuable for patients who have problems in treatment response or with side effects. Most blood-based biomarkers need further validation. None of the currently available predictive markers has adequate sensitivity or specificity used alone. However, personalized treatment of FEP will need predictive tools. We discuss some methodologies, such as machine learning (ML), and tools that could lead to the improved prediction and clinical utility of different prognosticmarkers in FEP. Combination of differentmarkers inMLmodels with a user friendly interface, or novel findings from e.g., molecular genetics or neuroimaging, may result in computer-assisted clinical applications in the near future.
  • Piirtola, Maarit; Kaprio, Jaakko; Waller, Katja; Heikkila, Kauko; Koskenvuo, Markku; Svedberg, Pia; Silventoinen, Karri; Kujala, Urho M.; Ropponen, Annina (2017)
    Background: We investigated the stability and change of leisure-time physical inactivity in adult men and women during a 35-year follow-up. We also analysed the impact of long-term physical inactivity on the development of body mass index (BMI). Methods: In this population-based cohort study, 5254 Finnish twin individuals (59% women) participated in four surveys in 1975, 1981, 1990 and 2011. Mean age at baseline was 23.9 years. Individual long-term leisure-time physical activity (LTPA) was categorized into seven classes varying from 'persistently inactive' to 'persistently active'. We used the multivariate multilevel mixed-effects linear regression model and paired-sample t-test in the analyses. Co-twin control design was used for examining within-pair associations. Results: Of men 11%, and of women 8%, were persistently inactive. Among both sexes, the mean BMI slope trajectories were steeper among the persistently inactive and those who became inactive than among those who were persistently active. Overall, the inactive participants gained 1.4 kg/m(2) [95% confidence interval (CI) 1.2 to 1.7] more in weight than did the active participants from 1975 to 2011. Among twin pairs discordant for LTPA, the corresponding difference was 1.4 kg/m(2) (95% CI 0.83 to 2.0) in dizygotic pairs and 0.68 kg/m(2) (95% CI 0.05 to1.3) in monozygotic pairs. Conclusions: Over a 35-year time span from young adulthood, persistently inactive participants and those who had become inactive had greater weight increases than those who were persistently active. This association was also found in twin-pair analyses, although attenuated in monozygotic pairs. This may support the importance of LTPA in weight management, although further causal inference is required.
  • Keinänen, Jaakko; Suvisaari, Jaana; Reinikainen, Jaakko; Kieseppä, Tuula; Lindgren, Maija; Mantyla, Teemu; Rikandi, Eva; Sundvall, Jouko; Torniainen-Holm, Minna; Mantere, Outi (2018)
    Psychosis is associated with low-grade inflammation as measured by high-sensitivity C-reactive protein (hs-CRP), a risk factor for cardiovascular events and mortality in the general population. We investigated the relationship between hs-CRP and anthropometric and metabolic changes in first-episode psychosis (FEP) during the first treatment year. We recruited 95 FEP patients and 62 controls, and measured longitudinal changes in hs-CRP, weight, waist circumference, insulin resistance, and lipids. We used linear mixed models to analyze the longitudinal relationship between hs-CRP and clinical, anthropometric and metabolic measures. At baseline, patients with FEP had higher levels of insulin resistance, total and low-density lipoprotein cholesterol, apolipoprotein B, and triglycerides. Baseline weight, waist circumference, hs-CRP, fasting glucose, and high-density lipoprotein cholesterol were similar between patients and controls. Marked increases in anthropometric measures and hs-CRP were observed in FEP during the 12-month follow-up. However, glucose and lipid parameters did not change significantly. In the mixed models, waist circumference and female sex were significant predictors of hs-CRP levels in FEP. Prevention of the early development of abdominal obesity in FEP is crucial, as abdominal obesity is accompanied by chronic low-grade inflammation, which increases further the cardiovascular risk in this vulnerable population.