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Child Health Publications

If you can not access any of the full publications, please contact Nicola Hawley.

1. Child, maternal, and household level correlates of nutritional status: a cross-sectional study among Samoan children.

Choy C.C., Desai, M.M., Park, J.J., Frame, E.A., Thompson A.A., Naseri, T., Reupena, M.S., Duckham, R.L., Deziel, N.C., & Hawley, N.L. (2017). Public Health Nutrition 20 (7): 1235-1247.

This study aimed to document the prevalence, coexistence and correlates of nutritional status (stunting, overweight/obesity and anaemia) in Samoan children aged 24-59 months. Using a cross-section community-based survey in ten villages on the Samoan island of Upolu, we found—in a sample of 305 mother-child pairs—stunted growth in 20.3% of children, obesity/overweight status in 16.1% of children, and anaemia in 34.1% of children. These findings—observed prevalences of stunting, overweight/obesity and anaemia—suggest that it is critical to invest in nutrition and develop health programmes targeting early childhood growth and development in Samoa.

2. Dietary patterns are associated with child, maternal, and household-level characteristics and overweight/obesity among young Samoan children.

Choy, C.C., Wang, D., Baylin, A., Soti-Ulberg, C., Naseri, T., Reupena, M.S., Thompson, A.A., Duckham, R.L. & Hawley, N.L. Public Health Nutrition (in press).

This study aimed to identify dietary patterns among 24-59-month-old Samoan children and evaluate their association with: child, maternal and household characteristics, and nutritional status indicators (stunting, overweight/obesity, anaemia). We identified two dietary patterns: modern (loaded with “westernized foods”) and neo-traditional. Moderns diets were associated with urban residence, greater maternal educational attainment, higher socioeconomic status, lower vitamin C intake and higher sugar intake and neo-traditional diets were associated with rural residence, lower socioeconomic status, higher vitamin C intake and lower sugar intake. These findings recommend further longitudinal monitoring and evaluation of early childhood growth and development in Samoa.

3. Nutrient intake among Samoan children aged 2 to 4 years in 2015.

Choy, C.C., Thompson, A.A., Soti-Ulberg, C., Naseri, T., Reupena, M.S., Duckham, R.L. & Hawley, N.L. Annals of Human Biology (in press).

This study aimed to examine the adequacy of macro- and micronutrient intake among Samoan children ages 2 to 4.99. Using a 117-item food frequency questionnaire, we found most children met or exceeded recommendations for carbohydrate, fat, and protein intake, but did not meet the Recommended Dietary Allowances for calcium, potassium, and Vitamin and E. The findings show inadequate dietary micronutrient intake to be more common among older children (4-4.99 years) and those in the rural regions, and recommend interventions be targeted at those groups.

4. Gender differences in the associations of physical activity and nutritional intake with child body composition: a cross-sectional study of 3-7 year-olds in Samoa.

Thompson, A.A., Duckham, R.L, Desai, M.M., Choy, C.C., Sherar, L.B., Naseri, T., Soti-Ulberg, C., Reupena, S., Wetzel, A. & Hawley, N.L. Pediatric Obesity (in press).

The purpose of this cross-sectional study was to examine gender differences in the impact of nutritional and physical activity factors on the body composition of Samoan children through dual energy x-ray absorptiometry (DXA.) Studying a sample of 83 children between the ages of 3 and 7, the researchers tracked physical activity, using accelerometers, and nutritional intake, via questionnaires filled out by the childrens’ mothers. The team found that body composition differed by gender at 3-7 years of age. In girls, carbohydrate intake was negatively associated with percent body fat and positively associated with percent lean mass. In boys, physical activity was negatively associated with trunk to peripheral fat ratio. Additionally, though there was a significant interaction between gender and carbohydrates, physical activity did not attenuate the effect of carbohydrate intake on body composition in either boys or girls. This study highlights important gender differences in the effect of nutrition and physical activity on body composition among Samoan children, and recommends further research on the topic.

5. Piloting a food photo sorting activity in Samoa to assess maternal beliefs and their role in child diet.

Tanawattanacharoen,V.K., Choy, C.C., Anesi, T.J., Naseri, T., Soti-Ulberg, C., Reupena, M.S., & Hawley N.L. Maternal and Child Nutrition (in press).

The purpose of this study was to test a tool to understand how mothers make decisions about their children’s dietary intake. Forty-four Samoan mothers sorted photographs of 26 foods commonly consumed in children in Samoa by cost, social status, and nutritional value (healthfulness). We then looked at the association of these beliefs about food with what children actually consumed (using a food frequency questionnaire). Samoan mothers showed that they had strong nutritional knowledge - their responses about the healthfulness of the 26 foods matched closely with nutritional experts. Mothers also had a good understanding of cost. The perceived cost of food was more strongly associated with child dietary intake than either healthfulness or social status, with decreasing consumption reported with increasing food cost. Our findings contradicted the notion that the high social status of imported foods may be contributing to increased intake and rising prevalence of childhood obesity in this developing country setting. Despite their nutritional knowledge, Samoan mothers may need additional support in applying their knowledge/beliefs to provide a healthy child diet, including support for access to reasonably priced healthy foods.

6. A missense variant in CREBRF is associated with taller stature in Samoans.

Carlson, J.C.*, Rosenthal, S.L.*, Russell, E.M., Hawley, N.L., Sun, G., Cheng, H., Naseri, T., Reupena, M.S., Deka, R., McGarvey, S.T., Weeks, D.E. & Minster, R.L. American Journal of Human Biology (in press)

The purpose of this study was to determine whether the minor allele of rs373863828, a missense variant in the CREBRF gene, was associated with height in a Samoam population. The researchers measured this association in two adult cohorts and in a separate cohort of children (age 5–18 years old) using linear mixed modeling. The team found evidence of a strong relationship between rs373863828 and a greater mean height in Samoan adults—0.77 cm greater average height for each copy of the minor allele—with the same direction of effect in Samoan children. These results suggest that the missense variant rs373863828 in the CREBRF gene, which was first identified through its association with larger BMI, may be related to an underlying biological mechanism affecting overall body size, including stature.