1 - MRC Integrative Epidemiology Unit at the University of Bristol, University of Bristol, Bristol, UK

Transcription

1 ONLINE-ONLY SUPPLEMENTARY MATERIAL Ethnic differences in risk fctors for obesity in New Zelnd infnts Lur D Howe* 1,2,3, Lis Ellison-Loschmnn 3, Neil Perce 3,4, Jeroen Douwes 3, Mon Jeffreys 2, Ridvn Firestone MRC Integrtive Epidemiology Unit t the University of Bristol, University of Bristol, Bristol, UK 2 - School of Socil nd Community Medicine, University of Bristol, Bristol, UK 3 - Centre for Public Helth Reserch, Mssey University, Wellington, New Zelnd 4 - London School of Hygiene nd Tropicl Medicine, London, UK * Corresponding uthor. MRC Integrtive Epidemiology Unit t the University of Bristol, Okfield House, Okfield Grove, Bristol BS8 2BN, UK. Emil: lur.howe@bristol.c.uk 1

2 Supplementry Tble 1. Distributions of vribles in the observed nd imputed dt. Vlues re % or men (SD) Imputed dt Observed dt N Socio-demogrphic vribles Child s ethnicity Europen 71.8% % Māori or Pcific 16.7% 16.7% Other 11.5% 11.5% Mother educted to less thn degree level 15.8% % Mother s ge <25 yers 9.1% % 25 to <35 yers 63.3% 64.6% 35 yers 27.7% 27.5% NZ Deprivtion Index (lowest deprivtion) 25.9% % % 27.9% % 19.5% % 16.9% 5 (highest deprivtion) 9.7% 9.6% Mternl, pregnncy nd delivery chrcteristics Mternl pre-pregnncy BMI <25 kg/m % % 25 to <30 kg/m % 27.2% 30 kg/m % 14.6% Mother did physicl ctivity pre-pregnncy 82.9% % Mother s diet in pregnncy* Processed foods (SD) 0.0 (1.0) (1.00) Sncks (SD) 0.0 (1.0) (1.00) Helthy foods (SD) 0.0 (1.0) (1.00) Sweet foods (SD) 0.0 (1.0) (1.00) Strchy foods (SD) 0.0 (1.0) (1.00) Hypertension in pregnncy 12.8% % Dibetes in pregnncy 3.8% % Infncy chrcteristics Child s weight in first (kg) 3.52 (0.58) (0.58) Child s weight t 3 months (kg) 6.06 (0.89) (0.89) Exclusive brestfeeding in first 3 dys 79.7% % Exclusive brestfeeding t 3 months 53.2% % Solid foods introduced by 3 months 30.0% % * Dietry pttern scores re stndrdised to hve men of zero nd vrince of one; vlues in this tble cn therefore be interpreted s stndrd devitions from the overll popultion men 2

3 Supplementry Tble 2. Chrcteristics of prticipnts. Vlues re men (SD) or number (%) Prticipnts with dt on ll vribles N=422 Prticipnts not included in complete cse nlysis due to missing dt on one or more vribles % with missing dt on this vrible P vlue* Socio-demogrphic vribles Child s ethnicity Europen 307 (72.8%) 22% 186 (70.2%) Māori or Pcific 64 (15.2%) 51 (19.3%) Other 51 (12.1%) 28 (10.6%) 0.35 Mother educted to less thn degree level 60 (14.2%) 52% 118 (19.3%) 0.03 Mother s ge <25 yers 31 (7.4%) 52% 84 (13.6%) 25 to <35 yers 277 (65.6%) 359 (58.2%) 35 yers 114 (27.0%) 174 (28.2%) NZ Deprivtion Index (lowest deprivtion) 109 (25.8%) 52% 167 (27.1%) (28.0%) 127 (20.6%) 3 84 (19.9%) 144 (23.4%) 4 73 (17.3%) 103 (16.7%) 5 (highest deprivtion) 38 (9.0%) 75 (12.2%) 0.05 Mternl, pregnncy nd delivery chrcteristics Mternl pre-pregnncy BMI <25 kg/m (58.1%) 49% 331 (56.8%) 25 to <30 kg/m (26.8%) 170 (29.2%) 30 kg/m 2 64 (15.2%) 82 (14.1%) 0.68 Mother did physicl ctivity pre-pregnncy** 354 (83.9%) 52% 506 (82.1%) 0.46 Mother s diet in pregnncy Processed foods (SD) (1.02) 43% 0.03 (1.02) 0.25 Sncks (SD) (1.00) 43% 0.05 (1.00) 0.08 Helthy foods (SD) 0.07 (1.00) 43% (1.00) 0.04 Sweet foods (SD) 0.00 (0.98) 43% 0.00 (1.02) 0.97 Strchy foods (SD) (1.01) 43% 0.01 (0.99) 0.77 Hypertension in pregnncy 50 (11.9%) 22% 38 (14.6%) 0.32 Dibetes in pregnncy 15 (3.6%) 22% 11 (4.2%) 0.68 Infncy chrcteristics Child s weight in first (kg) 3.54 (0.56) 21% 3.49 (0.60) 0.27 Child s weight t 3 months (kg) 6.05 (0.89) 18% 6.07 (0.88) 0.74 Exclusive brestfeeding in first 3 dys 340 (80.6%) 22% 203 (79.6%) 0.76 Exclusive brestfeeding t 3 months 225 (53.3%) 22% 139 (53.1%) 0.95 Solid foods introduced by 3 months 125 (29.6%) 22% 80 (30.8%)

4 *P vlue testing the null hypothesis tht the men or percentge does not differ between those included in nlyses nd those excluded due to missing dt; p vlues re generted from t-tests or chi-squred tests ** Dietry pttern scores re stndrdised to hve men of zero nd vrince of one; vlues in this tble cn therefore be interpreted s stndrd devitions from the overll popultion men 4

5 Supplementry Tble 3. Principl component nlysis of dietry dt; first five principl components Vlues re eigenvectors from rotted principl components, which cn be interpreted s weights ssigned to the food items within ech dietry pttern. For exmple in the high ft, low fruit & veg, high sugr dietry pttern, Pies hs lrge positive weight (0.2660) wheres fresh fruit hs low negtive weight ( ). Therefore the more often womn reports eting pies, the higher her score for the high ft, low fruit & veg, high sugr dietry pttern will be, nd vice vers for fresh fruit. Proportion of vrince explined Processed Sncks Helthy foods Sweet foods Strchy foods Boiled veg Stir fry veg Frozen veg Fresh fruit Ots Europen bred Brown bred Pulses Cheese Pies Susges Burgers Pizz Chips Bbq foods Fried foods Rice Pst Pudding Biscuits Cke Chocolte brs Chocolte Sweets Crips Fizzy drinks

6 Supplementry Tble 4. Assocition between child s ethnicity nd socio-demogrphic vribles in prticipnts with complete dt on ll vribles. N=422 Vlues re odds rtios (95% confidence intervls) compring Māori or Pcific children nd Other Ethnicity children to Europen children. Mother educted to less thn degree level Europen Māori or Pcific N=307 N=64 1 (ref) 1.67 (0.84 to 3.28) P=0.13 Mother s ge <25 yers 1 (ref) 2.65 (1.18 to 5.98) P=0.02 Other N= (0.06 to 1.04) P= (0.04 to 2.16) P= to <35 yers 1 (ref) 1 (ref) 1 (ref) 35 yers 1 (ref) 0.50 (0.24 to 1.05) P=0.07 NZ Deprivtion Index (lowest deprivtion) 1 (ref) 1 (ref) 1 (ref) 2 1 (ref) 2.05 (0.83 to 5.08) P= (ref) 2.48 (0.97 to 6.33) P= (ref) 5.81 (2.38 to 14.18) P< (highest deprivtion) 1 (ref) 3.13 (1.04 to 9.44) P= (0.39 to 1.50) P= (1.02 to 5.95) P= (0.71 to 5.10) P= (1.02 to 7.51) P= (0.67 to 7.41) P=0.19 6

7 Supplementry Tble 5. Assocition between child s ethnicity nd known risk fctors for lter obesity in prticipnts with complete dt on ll vribles (undjusted). N=422 Vlues re odds rtios or men differences (95% confidence intervls) compring Māori or Pcific children nd Other Ethnicity children to Europen children. Europen N=307 Māori or Pcific N=64 Other N=51 Ctegoricl risk fctors; odds rtios nd 95% confidence intervls Mternl pre-pregnncy BMI <25 kg/m 2 1 (ref) 1 (ref) 1 (ref) 25 to <30 kg/m 2 1 (ref) 1.28 (0.67 to 2.44) P= (0.69 to 2.53) P= kg/m 2 1 (ref) 2.16 (1.09 to 4.29) P= (0.19 to 1.66) P=0.30 Mother did physicl ctivity pre-pregnncy 1 (ref) 1.28 (0.59 to 2.74) P= (0.64 to 3.86) P=0.33 Hypertension in pregnncy 1 (ref) 1.59 (0.74 to 3.43) P= (0.69 to 3.70) P=0.27 Dibetes in pregnncy 1 (ref) 0.87 (0.19 to 4.01) P= (0.24 to 5.11) P=0.91 Exclusive brestfeeding in first 3 dys 1 (ref) 0.95 (0.49 to 1.86) P= (0.52 to 2.46) P=0.75 Exclusive brestfeeding t 3 months 1 (ref) 0.98 (0.57 to 1.68) P= (0.84 to 2.85) P=0.16 Solid foods introduced by 3 months 1 (ref) 1.42 (0.80 to 2.50) P= (0.55 to 2.02) P=0.88 Continuous risk fctors; men differences nd 95% confidence intervls Mother s diet in pregnncy* Processed foods (SD) 0 (ref) 0.10 (-0.16 to 0.37) P= (-0.39 to 0.18) P=0.48 Sncks (SD) 0 (ref) 0.25 (-0.02 to 0.52) P= (-0.48 to 0.11) P=0.22 Helthy foods (SD) 0 (ref) (-0.33 to 0.21) P= (-0.21 to 0.39) P=0.56 Sweet foods (SD) 0 (ref) (-0.56 to -0.03) P= (-0.30 to 0.28) P=0.94 Strchy foods (SD) 0 (ref) 0.23 (-0.04 to 0.50) P= (0.10 to 0.70) P=0.01 Child s weight in first (kg) 0 (ref) 0.04 (-0.12 to 0.19) P= (-0.27 to 0.06) P=0.21 Child s weight t 3 months (kg) 0 (ref) 0.13 (-0.11 to 0.37) P= (-0.23 to 0.30) P=0.79 * Dietry pttern scores re stndrdised to hve men of zero nd vrince of one; vlues in this tble cn therefore be interpreted s stndrd devitions from the overll popultion men 7

8 Supplementry Tble 6. Assocition between child s ethnicity nd known risk fctors for lter obesity in prticipnts with complete dt on ll vribles (with djustment for socio-demogrphic chrcteristics). N=422 Vlues re odds rtios or men differences (95% confidence intervls) compring Māori or Pcific children nd Other Ethnicity children to Europen children. Europen N=307 Māori or Pcific N=64 Other N=51 Ctegoricl risk fctors; odds rtios nd 95% confidence intervls Mternl pre-pregnncy BMI <25 kg/m 2 1 (ref) 1 (ref) 1 (ref) 25 to <30 kg/m 2 1 (ref) 1.22 (0.62 to 2.38) P= (0.68 to 2.57) P= kg/m 2 1 (ref) 2.06 (0.99 to 4.28) P= (0.19 to 1.73) P=0.32 Mother did physicl ctivity pre-pregnncy 1 (ref) 1.79 (0.79 to 4.06) P= (0.63 to 3.94) P=0.34 Hypertension in pregnncy 1 (ref) 1.71 (0.76 to 3.82) P= (0.69 to 3.84) P=0.26 Dibetes in pregnncy 1 (ref) 0.87 (0.18 to 4.25) P= (0.22 to 5.08) P=0.94 Exclusive brestfeeding in first 3 dys 1 (ref) 0.93 (0.46 to 1.87) P= (0.54 to 2.58) P=0.68 Exclusive brestfeeding t 3 months 1 (ref) 0.98 (0.56 to 1.72) 1.52 (0.82 to 2.82) Solid foods introduced by 3 months P= (ref) 1.46 (0.80 to 2.64) P=0.22 P= (0.60 to 2.25) P=0.66 Continuous risk fctors; men differences nd 95% confidence intervls Mother s diet in pregnncy* Processed foods (SD) 0 (ref) 0.02 (-0.25 to 0.29) P= (-0.41 to 0.17) P=0.42 Sncks (SD) 0 (ref) 0.24 (-0.03 to 0.52) P= (-0.51 to 0.08) P=0.15 Helthy foods (SD) 0 (ref) (-0.29 to 0.27) P= (-0.21 to 0.39) P=0.55 Sweet foods (SD) 0 (ref) (-0.53 to 0.01) P= (-0.32 to 0.26) P=0.82 Strchy foods (SD) 0 (ref) 0.26 (-0.02 to 0.54) P= (0.08 to 0.68) P=0.01 Child s weight in first (kg) 0 (ref) 0.03 (-0.13 to 0.19) P= (-0.26 to 0.08) P=0.28 Child s weight t 3 months (kg) 0 (ref) 0.11 (-0.14 to 0.36) P= (-0.22 to 0.32) P=0.73 * Dietry pttern scores re stndrdised to hve men of zero nd vrince of one; vlues in this tble cn therefore be interpreted s stndrd devitions from the overll popultion men 8

9 Supplementry Tble 7. Assocition between ethnicity nd infnt weight t ge 3 months, nd the degree to which this is explined by other risk fctors in prticipnts with complete dt on ll vribles. N=422 Vlues re men differences (95% confidence intervls) in infnt weight t ge 3 months (kg) from liner regression, compring ech ethnic group with the reference ctegory, Europen ethnicity Men difference (95% CI) in infnt weight t 3 months (kg) Europen N=493 Māori or Pcific N=115 Other N=79 Undjusted 0 (ref) 0.13 (-0.11 to 0.37) P= (-0.23 to 0.30) P=0.79 Adjusted for sociodemogrphic vribles* 0 (ref) 0.11 (-0.14 to 0.36) P= (-0.22 to 0.32) P=0.73 Adjusted for mternl pre-pregnncy BMI 0 (ref) 0.12 (-0.12 to 0.36) P= (-0.22 to 0.31) P=0.76 Adjusted for mternl dietry pttern scores** 0 (ref) 0.14 (-0.10 to 0.39) P= (-0.25 to 0.29) P=0.89 Adjusted for ll mesured potentil meditors*** 0 (ref) 0.09 (-0.16 to 0.33) P= (-0.26 to 0.27) P=0.99 * Adjusted for mternl eduction, mternl ge nd NZ deprivtion index ** Adjusted for scores for ll five dietry ptterns *** djusted for mternl eduction, mternl ge, NZ deprivtion index, mternl prepregnncy BMI, scores for ll five dietry ptterns, hypertension during pregnncy, dibetes during pregnncy, physicl ctivity during pregnncy, exclusive brestfeeding t 3 dys, exclusive brestfeeding t 3 months, nd erly introduction of solid foods 9

10 Supplementry Figure 1. Screeplot of Eigenvlues fter PCA of dietry dt Scree plot of eigenvlues fter pc Eigenvlues Number 10

11 Dietry intke questionnire used in the ELF study Diet 7.06 Since becoming pregnnt, how mny do you et? Never or rrely Once in 2 s More thn once dy Poultry EXAMPLE: Chicken, turkey Eggs Liver, pte, kidney, hert White fish EXAMPLE: Cod, fish fingers Other Fish EXAMPLE: Tun, mckerel Shellfish 7.06 () Do you et the ft on met? Yes, ll of it Yes, some of it No Never et met 11

12 7.07 Since becoming pregnnt wht sort of spreds nd suces do you use? Yes No Butter Unslted butter Polyunsturted mrgrine EXAMPLE: Flor, sunflower Butter nd mrgrine blend Olive oil spred EXAMPLE: Olivio Low slt mrgrine Reduced ft mrgrines Nutell Jm/honey Mrmite/vegemite Penut butter Myonnise/sld dressing Tomto suce/ketchup Grvy Other spreds/suces Plese describe 12

13 7.08 Since becoming pregnnt wht sort of ft do you minly use for frying, cooking or BBQ? Yes No Butter, dripping, lrd, solid cooking ft Polyunsturted mrgrine EXAMPLE: Flor, Sunflower, Olivio Sesme seed oil Sunflower, soy, corn, olive oil Other vegetble oil Other Plese describe Vegetbles & Fruit 7.09 Since becoming pregnnt, how mny do you et? Never or rrely Once in 2 s More thn once dy Bked bens Pes, sweetcorn, brod bens Cbbge, brussel sprouts, kle & other green lefy vegetbles Other green vegetbles EXAMPLE: Culiflower, runner bens, leeks Crrots Pottoes 13

14 Other root vegetbles EXAMPLE: Turnip, swede, prsnip Sld EXAMPLE: Lettuce, tomtoes, cucumber, etc Boiled vegetbles Stir-fried vegetbles Frozen vegetbles Processed fruit Frozen fruit Fresh fruit EXAMPLE: Apple, per, bnn, ornge, grpes etc Other fruit/veges not listed Grins 7.10 Since becoming pregnnt, how mny do you et? Never or rrely Once in 2 s More thn once dy Ot cerels EXAMPLE: Porridge, muesli Wholegrin/brn cerels EXAMPLE: Weetbix, All Brn, Brn Flkes, Fruit & Fibre Other cerels EXAMPLE: Cornflkes, Rice bubbles, Specil K 14

15 7.11 Since becoming pregnnt, how mny pieces of bred, rolls, chpptis & pit bred do you et on usul dy? Less thn or more 7.12 Wht types of bred do you et most dys? Multiple nswers possible Yes No Don t know White bred Brown/grnry bred Wholemel bred Chpptis, Nn bred Other types Plese describe Don t usully et ny bred 15

16 Legumes 7.13 Since becoming pregnnt, how mny do you et? Never or rrely Once in 2 s More thn once dy Pulses EXAMPLE: Dried bens, lentils Nuts, nut rost Ben curd (tofu) Thini EXAMPLE: Used to mke hummus, lmond butter, penut butter Soy met, vegeburgers Other legumes not listed 16

17 Diry Food 7.14 Since becoming pregnnt, how often hve you eten the following? Never Less thn once 1-6 More thn 6 Don t know Yoghurt (Full) Yoghurt (Lite) Yoghurt (Low ft) Crem (Full) Crem (Lite) Crem Cheese (Full) Cheese EXAMPLE: Edm, mozzrell 7.15 Do you drink milk? Yes IF YES PLEASE GO TO QUESTION 7.15() No IF NO PLEASE GO TO QUESTION

18 7.15 () Wht type of milks do you drink? Usully Some Not t ll Don t know Silver top (Full crem) Blue top (Common) Light Blue top (Lite) Drk Green top (Super trim) Ornge top (Vitmin A & D) Yellow top (Extr clcium) Purple top (Omeg 3 & Vitmin E) Soy milk Rice milk Got/sheep milk Milk powder Other 7.16 Since becoming pregnnt, do you drink fresh milk directly from frm? Yes IF YES PLEASE GO TO QUESTION 7.16() No IF NO PLEASE GO TO QUESTION () Do you normlly boil this milk? 18

19 Yes No 7.16 (b) Since becoming pregnnt, how mny glsses of fresh milk directly from frm hve you drunk? Glss per Other Food 7.17 Since becoming pregnnt, how mny do you et? Never or rrely Once in 2 s More thn once dy Pies, psties EXAMPLE: Pork, stek, met Susges Hmburgers Pizz Chips/fries BBQ food Fried food EXAMPLE: Fried fish, eggs, bcon, chops etc Rost pottoes (Cooked in ft) Boiled/mshed pottoes Rice (Boiled) Pst 19

20 EXAMPLE: Spghetti, noodles Other food not listed Sncks 7.18 Since becoming pregnnt, how mny do you et? Never or rrely Once in 2 s More thn once dy Pudding EXAMPLE: Fruit pie, crumble, cheese-cke, mousse, gteux Biscuits EXAMPLE: Digestives, shortbred, gingernuts, chocolte biscuits Cripbreds EXAMPLE: Ryvit, cbin bred Ckes or buns EXAMPLE: Fruit cke, sponge, tecke, buns, doughnuts, scones, custrd pie Chocolte brs EXAMPLE: Mrs, Twix, Moro, Picnic, Bounty, Crunchie Chocolte EXAMPLE: Diry milk, plin, drk, nut, fruit, filled Sweets EXAMPLE: Boiled lollies, toffees Crisps/potto chips Other sncks not listed 20

21 7.19 How mny do you et tke-wy foods for your min mels? Never or rrely or more 10 or more Sesoning 7.20 When you re eting, do you regulrly dd: Pepper Never Rrely Often Alwys Slt (Tble) Slt (Rock) Cheese Oil Soy suces Other suces Other spices/condiments EXAMPLE: Brewer s yest, se kelp grnules, fresh herbs 21

22 Drinks 7.21 Since becoming pregnnt, how mny do you drink? Never or rrely Once in 2 s More thn once dy Fizzy drinks (In cn) EXAMPLE: L&P, Sprite, Coc Col Fizzy drinks (In bottle) EXAMPLE: L&P, Sprite, Coc Col Bottled juice EXAMPLE: Keri juice Juice in crton EXAMPLE: Just Juice, Fresh up, Riben Wter Wter (Crbonted) EXAMPLE: Spring wter, H 2O sprkling drink Te Herbl tes (Non cffeine) Coffee Other drinks not listed 7.22 Do you regulrly drink te? 22

23 Yes IF YES PLEASE GO TO QUESTION 7.22() No IF NO PLEASE GO TO QUESTION () How mny cups of te do you drink in dy? Do not include Herbl tes Cups 7.22 (b) How mny cups of te you drink ech dy re decffeinted? Cups 7.23 Do you regulrly drink coffee? Yes IF YES PLEASE GO TO QUESTION 7.23() No IF NO PLEASE GO TO QUESTION () How mny cups of decffeinted coffee do you drink in dy? Cups 7.23 (b) How mny cups of instnt coffee do you drink ech dy? Cups 7.23 (c) How mny cups of rel coffee do you drink ech dy? Cups 23

24 7.24 How mny tespoons or honey or sugr do you dd to hot drinks? Never or rrely or more 7.25 Do you drink Herbl tes t ll? Yes, some or lwys IF YES PLEASE GO TO QUESTION 7.25() No, not t ll IF NO PLEASE GO TO QUESTION () Wht do you drink? Give exct nme if you cn 7.25 (b) In which Trimester period? Multiple nswers possible 1 st Trimester (ie 1 st 3 months) 2 nd Trimester (ie 2 nd 3 months) 3 rd Trimester (ie 3 rd 3 months) 24

25 7.25 (c) How mny dy did you drink this te? Times 25