BackgroundThe aims of this study were to 1) determine the distinct patterns of body mass index (BMI) trajectories in Japanese children, and 2) elucidate the maternal factors during pregnancy, which contribute to the determination of those patterns.Methodology/Principal FindingsAll of the children (1,644 individuals) born in Koshu City, Japan, between 1991 and 1998 were followed in a longitudinal study exploring the subjects’ BMI. The BMI was calculated 11 times for each child between birth and 12 years of age. Exploratory latent class growth analyses were conducted to identify trajectory patterns of the BMI z-scores. The distribution of BMI trajectories were best characterized by a five-group model for boys and a six-group model for girls. The groups were named “stable thin,” “stable average,” “stable high average,” “progressive overweight,” and “progressive obesity” in both sexes; girls were allocated to an additional group called “progressive average.” Multinomial logistic regression found that maternal weight, smoking, and skipping breakfast during pregnancy were associated with children included in the progressive obesity pattern rather than the stable average pattern. These associations were stronger for boys than for girls.Conclusions/SignificanceMultiple developmental patterns in Japanese boys and girls were identified, some of which have not been identified in Western countries. Maternal BMI and some unfavorable behaviors during early pregnancy may impact a child’s pattern of body mass development. Further studies to explain the gender and regional differences that were identified are warranted, as these may be important for early life prevention of weight-associated health problems.

BackgroundAutism spectrum disorder (ASD) is characterised by significant impairment in social communication and the presence of restrictive and repetitive behaviour or interest. Intervention during early childhood could decrease ASD symptoms. We aimed to identify the most effective intervention based on cognitive, developmental, and behavioural approaches and the factors that impact the effectiveness of the intervention.MethodsWe performed a systematic review and meta-analysis of existing interventions for ASD in preschool-aged children. Electronic databases were searched for related articles with randomised controlled trial (RCT) designs published between 2001 to 2015. Outcome measures were communication, behavioural and cognitive skills, reported as standardised mean differences (SMD) compared to a control group. A Random-effects model was utilised to calculate the pooled estimate effect. Between-study variability was also assessed. The registering number of this study is CRD42017035354.FindingsOut of the initial 5174 studies that were identified, there were 14 RCTs (746 children) that were included in the final systematic review and meta-analysis. Pooled estimate effect provided by random-effects model was 0.23 (95% confidence interval, CI [0.08–0.37]) with no between-study heterogeneity (I2 = 0.00%, p = 0.0018). Three studies of music therapy interventions provided the greatest outcome effects with a shorter duration and lower intensity. SMD for music therapies ranged from 0.40 to 0.62 with 95% CI [0.22 to 1.85]. The quality of the health care provider, the duration, and the intensity of intervention played an important role in the effectiveness of the intervention.InterpretationMusic therapy appears to be an effective tool for improving social interaction in preschool-aged children with ASD. However, more evidence-based trials are required to further validate the effectiveness of music therapy in ASD.

No abstract

IntroductionThere is a need for evidence-based measures to examine the risk factors for lifestyle-related diseases. In Japan, a 2-hour interval between dinner and sleep is recommended as a healthy practice. However, the effect of an appropriate duration between dinner and bedtime on glycated haemoglobin (HbA1c) levels remains unclear. This study aimed to identify the effect of a duration of 2 hours or shorter between dinner and bedtime on HbA1c levels in middle-aged and elderly Japanese individuals.MethodsA longitudinal analysis of health check-up data (2012, 2013 and 2014) was performed. Lifestyle and anthropometric data of individuals aged 40–74 years who did not have any pre-diabetic and diabetic conditions were collected for multilevel analysis. Univariate analysis was performed to assess the influence of each lifestyle variable. Then, two-level random intercept models were created using statistical software SAS 9.3 (SAS Institute Inc, Cary, NC, USA).ResultsThe cohort comprised 1573 individuals in 2012, two-thirds of whom were women. The mean HbA1c level was 5.20% in 2012 and 5.58% in 2013 and 2014. A total of 83 (16.1%) men and 70 (7.5%) women fell asleep within 2 hours after dinner. The influence of ensuring a 2-hour interval between dinner and bedtime did not have a remarkable effect on increasing HbA1c levels. The regression coefficient of 2-hour interval and HbA1c levels over time was −0.02 (p=0.45). Smoking (p=0.013), alcohol consumption (p=0.010) and higher body mass index (BMI) (p<0.001) may have influenced HbA1c trends.ConclusionDurations of 2 hours or shorter between dinner and bedtime did not influence HbA1c changes in middle-aged and elderly Japanese people. Instead, the focus should be on maintaining a normal BMI and abstaining from smoking and consuming alcohol to ensure stable HbA1c patterns in the long term.