Early Life Factors for Overweight Risk Among Infants of Hispanic Immigrant Mothers.

INTRODUCTION: This study examined postpartum depression, food insecurity, and underestimation of infant size as potential early life factors for overweight risk at 12 months among infants of Hispanic immigrant mothers. METHOD: Weight-for-length (WFL) measurements and face-to-face interviews were completed during well child visits. Regression models estimated the impact of early life factors (0-6 months) on overweight risk at 1 year. RESULTS: WFL ≥ 85th percentile was found among 2.4% at birth and 42.7% at 1 year. Most mothers (78.6%) experienced food insecurity, a factor that increased the likelihood of infant overweight risk by 2.29 times (1.03-5.09). Maternal underestimation of infant size increased the likelihood of overweight risk 5.07 times (2.57-9.99). Postpartum depression risk did not contribute to infant weight status. DISCUSSION: Assessment for maternal food insecurity and underestimation of infant weight status during early infancy may help reduce overweight risk and subsequent obesity for this vulnerable population.

Institute of Medicine Early Infant Feeding Recommendations for Childhood Obesity Prevention: Implementation by Immigrant Mothers From Central America.

PURPOSES: Describe implementation of Institute of Medicine (IOM) early infant feeding recommendations for child obesity prevention by immigrant mothers from Central America; examine potential relationships with food insecurity and postpartum depressive symptoms. DESIGN AND METHODS: Using a cross-sectional, descriptive design, face-to-face interviews were conducted with 318 mothers of 2month old infants at a large pediatric setting for low income families. Logistic regression models assessed feeding practices, food insecurity and postpartum depressive symptoms. RESULTS: Exclusive breastfeeding rates were low (9.4%); most mothers (62.7%) both breastfed and bottle fed their infants. Mothers who bottle fed at moderate and high intensity were twice as likely to affirm that if you give a baby a bottle, you should always make sure s/he finishes it (OR=2.30, 95% CI=1.13, 4.69; OR=2.29, 95% CI=1.26, 4.14). Food insecurity was experienced by 57% of mothers but postpartum depressive symptoms were low (Possible range=0-30; M=2.96, SD =3.6). However, for each increase in the postpartum depressive symptoms score, the likelihood of affirming a controlling feeding style increased by 11-13%. CONCLUSIONS: Immigrant mothers from Central America were more likely to both breastfeed and bottle feed (las dos cosas) than implement exclusive breastfeeding. Bottle feeding intensity was associated with a controlling feeding style. PRACTICE IMPLICATIONS: Infant well visits provide the ideal context for promoting IOM recommendations for the prevention of obesity among children of immigrant mothers from Central America.

Sensitive Timing for Risk of Overweight Among Infants of Low-Income Hispanic Immigrants.

INTRODUCTION: This study examined the association between early weight gain (0-6 months) and risk for overweight, as defined by the Institute of Medicine, at 1 year among infants of low-income Hispanic immigrant mothers. METHOD: Weight-for-age data were extracted from electronic medical records of 335 infants with gestations of 37 weeks or longer and birthweights appropriate for gestational age and without medical problems likely to interfere with growth or feeding. Logistic regression models were constructed to examine the impact of early weight changes on weight status at 1 year. RESULTS: By 12 months, 36.7% of infants had crossed weight-for-age of 84.1% or greater on World Health Organization growth charts. In adjusted models, infants had 20.8 (95% confidence interval = [19.8, 44.0]) times the odds of reaching this benchmark at 1 year for each z score increase at 0 to 6 months. DISCUSSION: The study highlights a time-sensitive opportunity for interventions to reduce risk for overweight for this vulnerable population.

An opinion and practice survey on the structure and management of data and safety monitoring boards.

There is little to no empirical data available on how data and safety monitoring boards (DSMBs) are structured and how they operate. The purpose of this study was to provide data on this. To accomplish this goal, we administered a random survey on current structure and management practices and opinions as reported by principal investigators (PIs) and biostatisticians. We also surveyed Institutional Review Board (IRB) community members, as proxies for the public, as to their opinions on how DSMBs should be structured and managed. A final purpose was to compare opinions about what should be taking place to what is actually happening.

Loss aversion is an affective forecasting error.

Loss aversion occurs because people expect losses to have greater hedonic impact than gains of equal magnitude. In two studies, people predicted that losses in a gambling task would have greater hedonic impact than would gains of equal magnitude, but when people actually gambled, losses did not have as much of an emotional impact as they predicted. People overestimated the hedonic impact of losses because they underestimated their tendency to rationalize losses and overestimated their tendency to dwell on losses. The asymmetrical impact of losses and gains was thus more a property of affective forecasts than a property of affective experience.

The pleasures of uncertainty: prolonging positive moods in ways people do not anticipate.

The authors hypothesized that uncertainty following a positive event prolongs the pleasure it causes and that people are generally unaware of this effect of uncertainty. In 3 experimental settings, people experienced a positive event (e.g., received an unexpected gift of a dollar coin attached to an index card) under conditions of certainty or uncertainty (e.g., it was easy or difficult to make sense of the text on the card). As predicted, people's positive moods lasted longer in the uncertain conditions. The results were consistent with a pleasure paradox, whereby the cognitive processes used to make sense of positive events reduce the pleasure people obtain from them. Forecasters seemed unaware of this paradox; they overwhelmingly preferred to be in the certain conditions and tended to predict that they would be in better moods in these conditions.