Mya Thway Tint

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David Pierre Leibovitz

Carleton University

Catarina Dutilh Novaes

University of Groningen

Marc Champagne

Kwantlen Polytechnic University

Remo Caponi

University of Cologne

Axel Barceló

UNAM Universidad Nacional Autónoma de México

Gil Sagi

University of Haifa

Eduardo Barrio

National Scientific and Technical Research Council

Lilian Bermejo-Luque

Universidad de Granada

Daniele Chiffi

Politecnico di Milano

Gemmo Iocco

University of Parma

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Papers by Mya Thway Tint

Breastfeeding Duration and Bone Mineral Density in Childhood: A Prospective Study within GUSTO Cohort

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Joint modelling of association networks and longitudinal biomarkers: an application to child obesity

arXiv (Cornell University), Nov 11, 2021

The prevalence of chronic non-communicable diseases such as obesity has noticeably increased in t... more The prevalence of chronic non-communicable diseases such as obesity has noticeably increased in the last decade. The study of these diseases in early life is of paramount importance in determining their course in adult life and in supporting clinical interventions. Recently, attention has been drawn on approaches that study the alteration of metabolic pathways in obese children. In this work, we propose a novel joint modelling approach for the analysis of growth biomarkers and metabolite concentrations, to unveil metabolic pathways related to child obesity. Within a Bayesian framework, we flexibly model the temporal evolution of growth trajectories and metabolic associations through the specification of a joint non-parametric random effect distribution which also allows for clustering of the subjects, thus identifying risk sub-groups. Growth profiles as well as patterns of metabolic associations determine the clustering structure. Inclusion

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Modifiable risk factors in the first 1000 days for subsequent risk of childhood overweight in an Asian cohort: significance of parental overweight status

International Journal of Obesity, Jul 28, 2017

Objective-Many studies have identified early-life risk factors for subsequent childhood overweigh... more Objective-Many studies have identified early-life risk factors for subsequent childhood overweight/obesity, but few have evaluated how they combine to influence risk of childhood overweight/obesity. We examined associations, individually and in combination, of potentially modifiable risk factors in the first 1000 days after conception with childhood adiposity and risk of overweight/obesity in an Asian cohort. Methods-Six risk factors were examined: maternal pre-pregnancy overweight/obesity (body mass index (BMI) ≥25 kg/m 2 ), paternal overweight/obesity at 24 months post-delivery, maternal

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Prediction of fat-free mass in young children using bioelectrical impedance spectroscopy

European Journal of Clinical Nutrition

Background Bioimpedance devices are practical for measuring body composition in preschool childre... more Background Bioimpedance devices are practical for measuring body composition in preschool children, but their application is limited by the lack of validated equations. Objectives To develop and validate fat-free mass (FFM) bioimpedance prediction equations among New Zealand 3.5-year olds, with dual-energy X-ray absorptiometry (DXA) as the reference method. Methods Bioelectrical impedance spectroscopy (SFB7, ImpediMed) and DXA (iDXA, GE Lunar) measurements were conducted on 65 children. An equation incorporating weight, sex, ethnicity, and impedance was developed and validated. Performance was compared with published equations and mixture theory prediction. Results The equation developed in ~70% (n = 45) of the population (FFM [kg] = 1.39 + 0.30 weight [kg] + 0.39 length2/resistance at 50 kHz [cm2/Ω] + 0.30 sex [M = 1/F = 0] + 0.28 ethnicity [1 = Asian/0 = non-Asian]) explained 88% of the variance in FFM and predicted FFM with a root mean squared error of 0.39 kg (3.4% of mean FFM)....

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Relationships between the Intakes of Human Milk Components and Body Composition of Breastfed Infants: A Systematic Review

Nutrients

Human milk provides all of the elements necessary for infant growth and development. Previous stu... more Human milk provides all of the elements necessary for infant growth and development. Previous studies have reported associations between breastfeeding and a reduced risk of developing obesity and late-onset metabolic disorders; however, the underlying mechanisms are poorly understood. Recently, intakes of human milk components have been associated with infant body composition, which is likely partially implicated in the reduced risk of developing childhood obesity among breastfed infants. In this systematic review, we searched electronic bibliographic databases for studies that explored relationships between the 24 h intakes of human milk macronutrients and bioactive components and infant body composition and/or growth parameters. Of 13 eligible studies, 10 assessed relationships of infant body composition and growth outcomes with human milk macronutrients, while 8 studies assessed relationships with human milk bioactive components. Significant time-dependent relationships with infa...

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Effect of Human Milk Components on Infant Growth and Body Composition

More Than Just Milk Lactation Science Symposium

Human milk (HM) is an important source of nutrition for infants that provides all elements necess... more Human milk (HM) is an important source of nutrition for infants that provides all elements necessary for their growth and development. Previous studies have reported associations between breastfeeding and a reduced risk of developing obesity and late metabolic diseases, such as type 2 diabetes. However, the underlying mechanisms are poorly understood. Recently, intakes of HM components have been associated with infant body composition (BC), which might be implicated in the reduced risk of childhood obesity among breastfed infants. In this systematic review, electronic bibliographic databases were searched for studies that explored associations between the 24 h intakes of HM macronutrients and bioactive molecules and infant BC and/or growth parameters. Two independent reviewers screened reference lists, extracted and analysed the data and assessed the risk of bias using the National Institute for Clinical Excellence methodological checklist. Of 13 eligible studies, 10 assessed the relationships of infant BC and growth outcomes with HM macronutrients, and eight studies assessed the relationships with HM bioactive components. Significant differential associations with infant anthropometrics and BC were found for intakes and not for concentrations of several HM components, such as lactose, fat and adiponectin. This highlights that measuring concentrations of HM components without quantifying the intake by the infant may be misleading when analysing the relationships of HM components with infant outcomes. Future studies investigating the effect of HM components on infant growth and BC should consider measuring the actual intakes of HM components.

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Time-to-conception and clinical pregnancy rate with a myo-inositol, probiotics, and micronutrient supplement: secondary outcomes of the NiPPeR randomized trial

Fertility and Sterility

Associations of maternal and foetoplacental factors with prehypertension/hypertension in early childhood

Journal of Hypertension

Longitudinal characterization of determinants associated with obesogenic growth patterns in early childhood

International Journal of Epidemiology

Background Longitudinal assessment of the determinants of obesogenic growth trajectories in child... more Background Longitudinal assessment of the determinants of obesogenic growth trajectories in childhood can suggest appropriate developmental windows for intervention. Methods Latent class growth mixture modelling was used to identify body mass index (BMI) z-score trajectories from birth to age 6 years in 994 children from a prospective mother–offspring cohort (Chinese, Indian and Malay ethnicities) based in Singapore. We evaluated the early-life determinants of the trajectories as well as their associations with cardiometabolic risk markers at age 6 years. Results Five BMI z-score trajectory patterns were identified, three within the healthy weight range, alongside early-acceleration and late-acceleration obesogenic trajectories. The early-acceleration pattern was characterized by elevated fetal abdominal circumference growth velocity, BMI acceleration immediately after birth and crossing of the obesity threshold by age 2 years. The late-acceleration pattern had normal fetal growth a...

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Brown adipose tissue influences adiponectin and thyroid hormone changes during Graves’ disease therapy

Adipocyte

Associations of maternal periconceptional alcohol consumption with offspring prehypertension/hypertension at age 6 years: the Growing Up in Singapore Towards healthy Outcomes prospective mother-offspring cohort study

Journal of Hypertension

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Supplementary data_JCEM_R1

Supplementary file for manuscript jc.2021-02418 (clean)

Individualized body geometry correction factor (K B) for use when predicting body composition from bioimpedance spectroscopy

Physiological Measurement, 2022

Objective. Prediction of body composition from bioimpedance spectroscopy (BIS) measurements using... more Objective. Prediction of body composition from bioimpedance spectroscopy (BIS) measurements using mixture theory-based biophysical modelling invokes a factor (K B) to account for differing body geometry (or proportions) between individuals. To date, a single constant value is commonly used. The aim of this study was to investigate variation in K B across individuals and to develop a procedure for estimating an individualized K B value. Approach. Publicly available body dimension data, primarily from the garment industry, were used to calculate K B values for individuals of varying body sizes across the life-span. The 3D surface relationship between weight, height and K B, was determined and used to create look-up tables to enable estimation of K B in individuals based on height and weight. The utility of the proposed method was assessed by comparing fat-free mass predictions from BIS using either a constant K B value or the individualized value. Results. Computed K B values were wel...

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Breastfeeding may benefit cardiometabolic health of children exposed to increased gestational glycemia in utero

European Journal of Nutrition, 2022

There is altered breastmilk composition among mothers with gestational diabetes and conflicting e... more There is altered breastmilk composition among mothers with gestational diabetes and conflicting evidence on whether breastfeeding is beneficial or detrimental to their offspring’s cardiometabolic health. We aimed to investigate associations between breastfeeding and offspring’s cardiometabolic health across the range of gestational glycemia. We included 827 naturally conceived, term singletons from a prospective mother–child cohort. We measured gestational (26–28 weeks) fasting plasma glucose (FPG) and 2-h plasma glucose (2 hPG) after an oral glucose tolerance test as continuous variables. Participants were classified into 2 breastfeeding categories (high/intermediate vs. low) according to their breastfeeding duration and exclusivity. Main outcome measures included magnetic resonance imaging (MRI)-measured abdominal fat, intramyocellular lipids (IMCL), and liver fat, quantitative magnetic resonance (QMR)-measured body fat mass, blood pressure, blood lipids, and insulin resistance at 6 years old (all continuous variables). We evaluated if gestational glycemia (FPG and 2 hPG) modified the association of breastfeeding with offspring outcomes after adjusting for confounders using a multiple linear regression model that included a ‘gestational glycemia × breastfeeding’ interaction term. With increasing gestational FPG, high/intermediate (vs. low) breastfeeding was associated with lower levels of IMCL (p-interaction = 0.047), liver fat (p-interaction = 0.033), and triglycerides (p-interaction = 0.007), after adjusting for confounders. Specifically, at 2 standard deviations above the mean gestational FPG level, high/intermediate (vs. low) breastfeeding was linked to lower adjusted mean IMCL [0.39% of water signal (0.29, 0.50) vs. 0.54% of water signal (0.46, 0.62)], liver fat [0.39% by weight (0.20, 0.58) vs. 0.72% by weight (0.59, 0.85)], and triglycerides [0.62 mmol/L (0.51, 0.72) vs. 0.86 mmol/L (0.75, 0.97)]. 2 hPG did not significantly modify the association between breastfeeding and childhood cardiometabolic risk. Our findings suggest breastfeeding may confer protection against adverse fat partitioning and higher triglyceride concentration among children exposed to increased glycemia in utero.

Cardiometabolic Profile of Different Body Composition Phenotypes in Children

The Journal of Clinical Endocrinology & Metabolism, 2021

Context Cardiometabolic profiles of different body composition phenotypes are poorly characterize... more Context Cardiometabolic profiles of different body composition phenotypes are poorly characterized in young children, where it is well established that high adiposity is unfavorable, but the role of lean mass is unclear. Objective We hypothesized that higher lean mass attenuates cardiometabolic risk in children with high fat mass. Methods In 6-year-old children (n = 377) from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) prospective birth cohort, whole-body composition was measured by quantitative magnetic resonance, a novel validated technology. Based on fat mass index (FMI) and lean mass index (LMI), 4 body composition phenotypes were derived: low FMI-low LMI (LF-LL), low FMI-high LMI (LF-HL), high FMI-low LMI (HF-LL), high FMI-high LMI (HF-HL). Main Outcome Measures Body mass index (BMI) z-score, fasting plasma glucose, insulin resistance, metabolic syndrome risk score, fatty liver index, and blood pressure Results Compared with the LF-HL group, children in both hi...

Trajectories of Systolic Blood Pressure in Children: Risk Factors and Cardiometabolic Correlates

The Journal of Pediatrics, 2021

OBJECTIVE To identify systolic blood pressure (SBP) percentile trajectories in children and to de... more OBJECTIVE To identify systolic blood pressure (SBP) percentile trajectories in children and to describe the early-life risk factors and cardiometabolic correlates of those trajectories. STUDY DESIGN Using age-, sex-, and height-specific SBP percentiles based on the American Academy of Pediatrics reference, we examined SBP trajectories using latent class mixed models from ages 3 to 8 years (n=844) from the GUSTO-study, a Singaporean mother-offspring cohort study. We analyzed associations between SBP trajectories and early-life risk factors using multinomial logistic regression and differences across trajectories in cardiometabolic outcomes using multiple linear regression. RESULTS Children were classified into one of four SBP percentile trajectories: "low increasing" (15%), "high stable" (47%), "high decreasing" (20%), "low stable" (18%). Maternal hypertension during early pregnancy was a predictor of the "high stable" and "low increasing" SBP trajectories. Rapid child weight gain in the first two years of life was only associated with the "high stable" trajectory. Compared with children in the "low stable" trajectory, children in the "high stable" SBP trajectory had higher BMI z-scores, sum of skinfold thicknesses, waist circumference from ages 3 to 8 years and abdominal adipose tissue (mL) at 4.5 years (adjusted mean difference [95%CI]: superficial and deep subcutaneous abdominal adipose tissue: 115.2[48.1,182.3] and 85.5[35.2,135.8]). Their fat mass (kg) (1.3[0.6,2.0]), triglyceride levels (mmol/L) (0.10[0.02,0.18]), HOMA1-IR (0.28[0.11,0.46]) at age 6 years were also higher but not their arterial thickness and stiffness. CONCLUSION Reducing maternal BP during pregnancy and infant weight gain in the first two years of life might help to prevent the development of high SBP.

Associations of Childcare Arrangements with Adiposity Measures in a Multi-Ethnic Asian Cohort: The GUSTO Study

International Journal of Environmental Research and Public Health, 2021

Childcare arrangements shape behavioural patterns that influence the risk of childhood obesity. H... more Childcare arrangements shape behavioural patterns that influence the risk of childhood obesity. However, little is known of its influence on childhood obesity in Singapore. We aim to examine the associations between childcare arrangements at the age of 5 years and childhood adiposity at age 6 years. Children from the GUSTO study were grouped into three childcare arrangements at age 5: full-time centre-based childcare (FC), partial centre-based with parental care (PCP), and partial centre-based with non-parents (grandparents and domestic helpers) as caregivers (PCN). Diet, physical activity and sedentary behaviour information were collected at age 5, while anthropometric measurements were collected at age 6. Associations were analysed using multivariable regression models. Among 540 children, those in PCN had higher BMI z-scores (β: 0.34; 95% CI: 0.01, 0.66), greater sum of skinfold thicknesses (mm) (β: 3.75; 95% CI: 0.53, 6.97) and were 3.55 times (95% CI: 1.78, 7.05) more likely to...

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Dietary patterns of 5-year-old children and their correlates: findings from a multi-ethnic Asian cohort

British Journal of Nutrition, 2021

There is limited data on the dietary patterns of 5-year-old children in Asia. The study examined ... more There is limited data on the dietary patterns of 5-year-old children in Asia. The study examined childhood dietary patterns and their maternal and child correlates in a multi-ethnic Asian cohort. Based on caregiver-reported 1-month quantitative FFQ of 777 children from the Growing Up in Singapore Towards healthy Outcomes cohort, cluster analysis identified two mutually exclusive clusters. Children in the ‘Unhealthy’ cluster (43·9 %) consumed more fries, processed meat, biscuits and ice cream, and less fish, fruits and vegetables compared with those in the ‘Healthy’ cluster (56·1 %). Children with mothers of lower educational attainment had twice the odds of being assigned to the ‘Unhealthy’ cluster (adjusted OR (95 % CI) = 2·19 (95 % CI 1·49–3·24)). Children of Malay and Indian ethnicities had higher odds of being assigned to the ‘Unhealthy’ cluster (adjusted OR = 25·46 (95 % CI 15·40, 42·10) and 4·03 (95 % CI 2·68–6·06), respectively), relative to Chinese ethnicity. In conclusion, ...

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Maternal height, gestational diabetes mellitus and pregnancy complications

Diabetes Research and Clinical Practice, 2021

AIMS To explore the glucose-overload hypothesis of artefactual gestational diabetes (GDM) diagnos... more AIMS To explore the glucose-overload hypothesis of artefactual gestational diabetes (GDM) diagnosis in shorter women during oral glucose tolerance testing (OGTT), by investigating associations between height and maternal glycemia; and GDM and pregnancy complications in height-groups. METHODS Women from GUSTO (n=1100, 2009-2010) and NUH (n=4068, 2017-2018) cohorts underwent a mid-gestation two and three time-point 75g 2-hour OGTT, respectively. GDM-related complications (hypertensive disorders of pregnancy, preterm delivery, emergency cesarean section, neonatal intensive care unit admission, macrosomia, birthweight) were compared within shorter and taller groups, dichotomized by ethnic-specific median height. RESULTS Using WHO-1999 criteria, 18.8% (GUSTO) to 22.9% (NUH) of women were diagnosed with GDM-1999; and by WHO-2013 criteria, 21.9% (NUH) had GDM-2013. Each 5-cm height increment was inversely associated with GDM-1999 (adjusted odds ratio [aOR, 95%CI]=0.81 [0.76-0.87], 2h-glycemia (adjusted β [95%CI]=-0.171mmol/L [-0.208,-0.135]) and 1h-glycemia (aβ=-0.160mmol/L [-0.207,-0.112]). The inverse association between height and 2h-glycemia was most marked in "Other" ethnicities (Eurasians/Caucasians/mixed/other Asians) and Indians, followed by Chinese, then Malays. Compared with non-GDM, GDM-1999 was associated with preterm delivery (aOR=1.76 [1.19-2.61]) and higher birthweight (aβ=57.16g [20.95,93.38]) only among taller but not shorter women. CONCLUSIONS Only taller women had an increased odds of GDM-related pregnancy complications. An artefactual GDM diagnosis due to glucose-overload among shorter women is plausible.

Maternal glycemia during pregnancy and offspring abdominal adiposity measured by MRI in the neonatal period and preschool years: The Growing Up in Singapore Towards healthy Outcomes (GUSTO) prospective mother–offspring birth cohort study

The American Journal of Clinical Nutrition, 2020

Background Gestational diabetes is associated with unfavorable body fat distribution in offspring... more Background Gestational diabetes is associated with unfavorable body fat distribution in offspring. However, less is known about the effects across the range of maternal gestational glycemia on offspring abdominal adiposity (AA) in infancy and early childhood. Objectives This study determined the association between gestational glycemia and offspring AA measured by MRI in the neonatal period and during the preschool years. Methods Participants were mother–offspring pairs from the GUSTO (Growing Up in Singapore Towards healthy Outcomes) prospective cohort study. Children who underwent MRI within 2 wk postdelivery (n = 305) and/or at preschool age, 4.5 y (n = 273), and whose mothers had a 2-h 75-g oral-glucose-tolerance test (OGTT) at 26–28 weeks of gestation were included. AA measured by adipose tissue compartment volumes—abdominal superficial (sSAT), deep subcutaneous (dSAT), and internal (IAT) adipose tissue—was quantified from MRI images. Results Adjusting for potential confounders...

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Breastfeeding Duration and Bone Mineral Density in Childhood: A Prospective Study within GUSTO Cohort

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Joint modelling of association networks and longitudinal biomarkers: an application to child obesity

arXiv (Cornell University), Nov 11, 2021

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Modifiable risk factors in the first 1000 days for subsequent risk of childhood overweight in an Asian cohort: significance of parental overweight status

International Journal of Obesity, Jul 28, 2017

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Prediction of fat-free mass in young children using bioelectrical impedance spectroscopy

European Journal of Clinical Nutrition

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Relationships between the Intakes of Human Milk Components and Body Composition of Breastfed Infants: A Systematic Review

Nutrients

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Effect of Human Milk Components on Infant Growth and Body Composition

More Than Just Milk Lactation Science Symposium

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Time-to-conception and clinical pregnancy rate with a myo-inositol, probiotics, and micronutrient supplement: secondary outcomes of the NiPPeR randomized trial

Fertility and Sterility

Associations of maternal and foetoplacental factors with prehypertension/hypertension in early childhood

Journal of Hypertension

Longitudinal characterization of determinants associated with obesogenic growth patterns in early childhood

International Journal of Epidemiology

Download

Brown adipose tissue influences adiponectin and thyroid hormone changes during Graves’ disease therapy

Adipocyte