Association of Weight Trajectory With Severe Obesity: A Case-Control Study.

Background: Early childhood weight trajectory is associated with future risk for obesity. However, little is known about the association of birth weight and weight trajectories before age 5.5 years with severe adult obesity. Methods: This study used a nested case-control design of 785 matched sets of cases and controls matched 1:1 on age and gender from a 1976 to 1982 birth cohort in Olmsted County, Minnesota. Cases with severe adult obesity were defined as individuals with a BMI ≥40 kg/m2 after 18 years of age. There were 737 matched sets of cases and controls for the trajectory analysis. Weight and height data from birth through 5.5 years were abstracted from the medical records, and weight-for-age percentiles were obtained from the CDC growth charts. Results: A two-cluster weight-for-age trajectory solution was identified as optimal, with cluster 1 having higher weight-for-age before age 5.5 years. While there was no association between birth weight and severe adult obesity, the odds of being in cluster 1, which includes children with higher weight-for-age percentiles, was significantly increased for cases compared with controls [odds ratio (OR) 1.99, 95% confidence interval (CI) 1.60-2.47]. The association between cluster membership and case-control status persisted after adjusting for maternal age and education (adjusted OR 2.08, 95% CI 1.66-2.61). Conclusions: Our data suggest that early childhood weight-for-age trajectories are associated with severe obesity status in adult life. Our results add to growing evidence that it is critical to prevent excess early childhood weight gain.

The Association Between Parent and Child ACEs is Buffered by Forgiveness of Others and Self-Forgiveness.

The purpose of the present study was to examine intergenerational transmission of adverse childhood experiences (ACEs) from parents to children and examine the buffering influence of forgiveness of oneself and others. Participants were 150 parents and children enrolled in Head Start in an upper midwestern, rural state who volunteered to complete questionnaires measuring ACEs and levels of forgiveness of oneself and others. Multiple correlation and regression were used to examine the associations between parent-reported parent and child ACEs and self-forgiveness and forgiveness of others. Analyses revealed that parental ACEs and child ACEs were positively correlated. Parents with low and medium levels of self-forgiveness and forgiveness of others had a stronger positive correlation between their own experience of ACEs and their child's, whereas, for parents with high levels of self-forgiveness and forgiveness of others, the correlation between parent and child ACEs was reduced statistically to zero. The cycle of intergenerational transmission of ACEs may be interrupted, or at very least notably buffered, by forgiving oneself and others.

The Effect of Depression and Rurality on Diabetes Control.

BACKGROUND: Having depression and living in a rural environment have separately been associated with poor diabetes outcomes, but there little is known about the interaction between the 2 risk factors. This study investigates the association of depression and rurality with glycemic control in adults, as well as their interaction. METHODS: This is a repeated cross-sectional study with data collected from 2010 to 2017 (n = 1,697,173 patient-year observations), comprising a near-complete census of patients with diabetes in Minnesota. The outcome of interest was glycemic control defined as hemoglobin A1c under 8%. We used a logit model with clinic-level random effects to predict glycemic control as a function of depression, patient rurality, and their interaction, adjusted for differences in observed characteristics of the patient, clinic, and patient's neighborhood. RESULTS: Having depression was associated with lower probability of achieving glycemic control (P < .001). Although rurality alone had no association with glycemic control, significant interactions existed between depression and rurality. Living in a small rural town mitigated the negative association between depression and glycemic control (P < .001). CONCLUSION: Although patients with depression had poorer glycemic control, living in a small rural town reduced the negative association between depression and glycemic control.