The article titled ‘Early Predictors of Obesity and Cardiovascular Risk’ was authored by Sera Lindberg, Alexandra Adams and Ronald Prince, who are affiliated to the University of Wisconsin-Madison. It was published on the 9th issue of the Maternal & Child Health Journal in 2012. The article contains the details of the research conducted to investigate early predictors of obesity in American Indian children between the ages of 5 and 8. American Indians have the highest obesity prevalence rate in US. According to Leadership and Healthy Communities (2010), about 39% of American Indian and Alaska Native children between the ages of 2 and 5 are overweight. The obesity challenge among American Indian community provided the research problem that was worth investigating.
The main purpose of the research according to Lindberg, Adams & Prince (2012) was to examine the effects of early childhood development environment on American Indian children’s Body Mass Index (BMI) trajectories and cardiovascular risk markers. The research was intended to answer the question of whether there exist any early predictors of obesity. The study hypothesized that the prenatal and early postnatal environments shapes the future health outcomes related to obesity. This hypothesis was appropriate because it was based on the findings of other researches that have supported the position that early childhood environment factors play a significant role in obesity rates, in US. The article relied on the research conducted by Rooney, Mathiason & Schauberger titled ‘Predictors of Obesity in Childhood, Adolescents and Adulthood in Birth Cohort.”
The research produced findings that supported the hypothesis. It established that 47% of the participating children were overweight. The children Body Mass Index category was largely determined within the 1 year of the children’s life. Key predictors of BMI category at the age of 1 included macrosomania 4.38, prolonged gestation 1.64, and early withdrawal of breastfeeding OR 1.66. Children who had abnormal weight during their early infancy had had a greater probability odd of becoming overweight 3.42 or obese 3.36. They were also likely to have unhealthy levels of body fats 2.95 and LDL Cholesterol 1.6 at the ages of 5-8 years. In all the cases highlighted above the probability of a child becoming obese as a result of the existence of predictors and risk factors, was higher that the probability of a child not becoming overweight. Thus, the odds were greater than 1. Consequently, the hypothesis was correctly upheld by the authors of the article.
Although, the article had no comprehensive literature review, critical points, facts and insights concerning obesity among American Indian population was provided in the introduction section. The highlighted points were largely sourced from various studies relating to obesity in US. The literature revealed that that minority ethnic group in US had highest rates of obesity. America. The other key point highlighted in the introduction section is that the number of American Indians suffering from obesity is disproportional to their population. They are minority ethnic group yet they higher rate of obesity that majority groups that include Whites and Blacks. Again this section has highlighted various researches that have supported the view that early childhood development is a factor as far as obesity is concerned. Some of the prenatal and early postnatal obesity risk factors that have been confirmed by studies according to the article include maternal obesity, weight gain during pregnancy, gestation diabetes and maternal smoking.
This research on early predictors of obesity is current because obesity is global health problem. According to World Health Organization (WHO), the global obesity prevalence rate has double since 1980. Aprroximately, 1.4 billion adults in the world are overweight (“Obesity and Overweight”, 2013). Besides, another 40 million children under the age of 5 were obese according to WHO 2011 statistics. The obesity problem is more pronounced in industrialized nations than developing nations. According to Ogden, Carroll, Kit & Flegal (2012), two in every three American are overweight. Meaning many Americans are at risk of developing heart diseases and diabetes. A research on obesity is critical because it generates knowledge required for management of obesity.
The research on early predictors of obesity falls under observational studies. It involved observation of participants and measuring of outcomes. The glucose levels, total cholesterol, blood pressure and high density lipoprotein of each participant was measured as part of the observational process. There was no randomized assignment of treatment. Consequently, the study was non experimental because it lacked control group and manipulation independent variable. Non experimental design exposed the study to extraneous variables. However, the effects were minimized by the use of medical instruments and techniques that are very reliable. To this end, it can be concluded that the findings of the research were reliable and accurate. Observational studies have proved to a better design for epidemiological studies.
There were 471 American Indian children who participated in the study. 49.7% of these children were females while the rest were males. The participants were aged between 5 and 8. The tribes represented were Menominee 45.2%, La du Flambeau 38.4% and Bad River 16.3%. According to United States Census Bureau (October 2013), there are approximately 5.2 million American Indian and Alaskan native in US. Children accounts for about 31.6 percent of American Indian and Alaskan Natives (“American Indian Children and Families”, n.d). Meaning, the population are approximately 1.64 million AIs/ANs children. This population was represented by 471 participants. At 95% confidence level, the sample had a sampling error of ±4.51%. .
The study covered Wisconsin area of United States. It was also focused on one ethnic group. Consequently, the research was more practicable in community covered than any other community in United States. According to the authors, was to be used to strengthen community research partnership that addresses early determinants of obesity. This is an indication that generalizations of the study were specific to American Indian community. Given that other researchers have also established that prenatal and early postnatal factors are associated with obesity, the findings of the research can be used to make health decisions within US. The study established that breastfeeding habit was a factor in obesity. This finding can be used to strengthen maternal health care.
The study did not employ random sampling criterion. The participants were recruited from Wisconsin Nutrition and Growth Study (WINGS) participants. Consequently, the representativeness of the sample is in doubt. Subsequent studies can be improved by recruiting of participants by through random selection. Probability methods of recruiting sample are considered suitable means of getting representative samples. Moreover, the research relied on clinical data got from Women Infants and Children (WIC) centers. Some of the children had no consistent developmental data. The study can be improved by lengthening the data collection period. The children’s physiological and clinical data should be collected over a span of 10 years. This would ensure that all the required data is available for analysis.
The study concentrated on physiological and environmental aspects of early childhood. It did not cover the influence of psychological factors and hereditary. Future studies should focus on genes that cause overweight and obesity. This is because many theories that explain the causes of obesity are based on calories and energy intake and outtake. Other factors that are worth considering in future studies include maternal stress and depression. The same study can also be repeated by involving a higher number of American Indian children.
The article was written in simple and clear language that had few medical jargons. Consequently, it was comprehensible. The sentences, clauses, words and ideas have been arranged in a manner that encourages logical understanding of concepts. However, the study failed to explain technical terms that include Body Mass Index, macrosomania and the maternal gestation. These terms are not easily understood by people who are not involved in the provision of healthcare services. Besides, the authors did not explain the meaning of some statistical parameters. They include odds that were used to uphold the hypothesis.
In conclusion, it is worth mentioning that the research had all the main contents of scientific studies that included abstract, introduction, methods, results, discussion and conclusion. The abstract summarized the contents of the article while the introduction highlighted key concepts, points and insights of the study. The methods section discussed the sampling and procedure while the result section summarized the findings. The authors used the discussion section to interpret and explain the results. In summary, the article articulated all the key areas of research in a clear and simple language.
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References
Lindberg, S., Adams, A., & Prince, R. (2012). Early Predictors of Obesity and Cardiovascular Risk Among American Indian Children. Maternal & Child Health Journal, 16(9), 1879-1886. doi:10.1007/s10995-012-1024-9
American Indian Children and Families. (n.d.). - National Indian Child Welfare Association. Retrieved February 25, 2014, from http://www.nicwa.org/children_families/
Ogden, C. L., Carroll, M. D., Kit, B.K., & Flegal, K. M. (2012). Prevalence of obesity and trends in body mass index among U.S. children and adolescents, 1999-2010. Journal of the American Medical Association, 307(5), 483-490.
Leadership for Health Communities (2010, May 5). Robert Wood Johnson Foundation. RWJF. Retrieved February 27, 2014, from http://www.rwjf.org/en/research-publications/find-rwjf-research/2010/05/overweight-and-obesity-among-american-indian-and-alaska-native-y.html
Obesity and overweight. (2013, March 1). WHO. Retrieved February 23, 2014, from http://www.who.int/mediacentre/factsheets/fs311/en/
United States Census Bureau. (2013, October 31). Facts for Features: American Indian and Alaska Native Heritage Month: November 2013. Retrieved February 25, 2014, from http://www.census.gov/newsroom/releases/archives/facts_for_features_special_editions/cb13-ff26.html
