Breast feeding and resilience against psychosocial stress

BACKGROUND: Some early life exposures may result in a well controlled stress response, which can reduce stress related anxiety. Breast feeding may be a marker of some relevant exposures. AIMS: To assess whether breast feeding is associated with modification of the relation between parental divorce and anxiety. METHODS: Observational study using longitudinal birth cohort data. Linear regression was used to assess whether breast feeding modifies the association of parental divorce/separation with anxiety using stratification and interaction testing. Data were obtained from the 1970 British Cohort Study, which is following the lives of those born in one week in 1970 and living in Great Britain. This study uses information collected at birth and at ages 5 and 10 years for 8958 subjects. Class teachers answered a question on anxiety among 10 year olds using an analogue scale (range 0–50) that was log transformed to minimise skewness. RESULTS: Among 5672 non‐breast fed subjects, parental divorce/separation was associated with a statistically significantly raised risk of anxiety, with a regression coefficient (95% CI) of 9.4 (6.1 to 12.8). Among the breast fed group this association was much lower: 2.2 (−2.6 to 7.0). Interaction testing confirmed statistically significant effect modification by breast feeding, independent of simultaneous adjustment for multiple potential confounding factors, producing an interaction coefficient of −7.0 (−12.8 to −1.2), indicating a 7% reduction in anxiety after adjustment. CONCLUSIONS: Breast feeding is associated with resilience against the psychosocial stress linked with parental divorce/separation. This could be because breast feeding is a marker of exposures related to maternal characteristics and parent–child interaction

Breastfeeding and developmental delay: Findings from the Millennium Cohort Study

OBJECTIVE: We investigated whether the duration and exclusivity of breastfeeding affects the likelihood of gross and fine motor delay in infants and examined the effect of factors that might explain any observed differences. METHODS: The study sample included all term singleton infants who weighed > 2500 g at birth and were not placed in a special care infant unit and whose mothers participated in the first survey of the Millennium Cohort Study. Missing data reduced the sample to 14660 (94%) with complete data. RESULTS: Almost half (47%) of the infants initially were exclusively breastfed, but only 3.5% of these infants were still being fed exclusively on breast milk after 4 months of age, and 34% of infants were not breastfed at all; 9% of the infants were identified with delays in gross motor coordination and 6% with fine motor coordination delays at age 9 months. The proportion of infants who mastered the developmental milestones increased with duration and exclusivity of breastfeeding. Infants who had never been breastfed were 50% more likely to have gross motor coordination delays than infants who had been breastfed exclusively for at least 4 months (10.7% vs 7.3%). Any breast milk also was positively related to development: infants who had never been breastfed were 30% more likely to have gross motor delays than infants who were given some breast milk for up to 2 months (10.7% vs 8.4%). The odds ratios for gross motor delay were not attenuated after adjustment for biological, socioeconomic, or psychosocial factors. Infants who were never breastfed had at least a 40% greater likelihood of fine motor delay than infants who were given breast milk for a prolonged period. CONCLUSION: Our results suggest that the protective effect of breastfeeding on the attainment of gross motor milestones is attributable to some component(s) of breast milk or feature of breastfeeding and is not simply a product of advantaged social position, education, or parenting style, because control for these factors did not explain any of the observed association. In contrast, the association between breastfeeding and fine motor delay was explained by biological, socioeconomic, and psychosocial factors

Labour force sequences, unemployment spells and their effect on subjective well-being set points

Drawingupon recent psychological literature, we examine the effect of employment statuses pre- and post-unemployment on levels of subjective well-being (SWB),and the return to pre-unemployment levels, i.e. set points. Data came from the British Household Panel Survey. SWB was measured using the GHQ-12 and a question on life satisfaction; Employment status was self-reported. Multilevel, jointed, piecewise, growth curve regression models were used to explore associations by gender, specifically whether different labour force sequences produced different growth curves and rates of adaptation. Overall, there was a tendency for men and women to return to well-being set points for both outcomes. However, findings showed differences by labour force sequence and SWB measure. Women who experienced unemployment between spells of employment returned to their SWB setpoint at a faster rate of return for GHQ than for life satisfaction, while for men, the rates of return were similar to each other. Women who were employed prior to unemployment and then became economically inactive showed a return to their GHQ set point, but there was no return to their life satisfaction setpoint. Economically inactive participants pre-unemployment, who then gained employment, also showed a return to their well-being set point. After economic inactivity and then unemployment, only men experienced a significant increase in life satisfaction upon return to economic inactivity. The findings showed that following unemployment, return to subjective well-being setpoint was quicker for people who became employed than for people who became economically inactive. There were also differences in the return to SWB setpoint by type of economic inactivity upon exiting unemployment

Mixed ethnicity and behavioural problems in the Millennium Cohort Study

BACKGROUND: The population of mixed ethnicity individuals in the UK is growing. Despite this demographic trend, little is known about mixed ethnicity children and their problem behaviours. We examine trajectories of behavioural problems among non-mixed and mixed ethnicity children from early to middle childhood using nationally representative cohort data in the UK. METHODS: Data from 16 330 children from the Millennium Cohort Study with total difficulties scores were analysed. We estimated trajectories of behavioural problems by mixed ethnicity using growth curve models. RESULTS: White mixed (mean total difficulties score: 8.3), Indian mixed (7.7), Pakistani mixed (8.9) and Bangladeshi mixed (7.2) children had fewer problem behaviours than their non-mixed counterparts at age 3 (9.4, 10.1, 13.1 and 11.9, respectively). White mixed, Pakistani mixed and Bangladeshi mixed children had growth trajectories in problem behaviours significantly different from that of their non-mixed counterparts. CONCLUSIONS: Using a detailed mixed ethnic classification revealed diverging trajectories between some non-mixed and mixed children across the early life course. Future studies should investigate the mechanisms, which may influence increasing behavioural problems in mixed ethnicity children

Time trends in mental well-being: the polarisation of young people's psychological distress

PURPOSE: Previous research on time trends of young people's mental health in Britain has produced conflicting findings: evidence for deterioration in mental health during the late 20th century followed by stability and slight improvement during the early 21st century is contrasted with evidence showing continued deterioration. The present study adds to the evidence base by assessing time trends in means, variances, and both low and high psychological distress scores covering a similar period. METHODS: GHQ-12 (Likert scale) was regressed on time (adjusting for age) using a sample of young people aged 16-24 between 1991 and 2008 from the British Household Panel Study. Change in variance was assessed using Levene's homogeneity of variance test across 9-year intervals. Polarisation was assessed by a comparison of the prevalence of scores ≥1 standard deviation and ≥1.5 standard deviations above and below the pooled mean. RESULTS: There was a small but significant increase in mean GHQ-12 among young women (b 0.048; 95% CI 0.016, 0.080) only. Variance increased significantly (p < 0.05) across 9-year intervals in seven out of nine comparisons for women and in six out of nine comparisons for men. There were significant increases in low (OR: 1.19; 95% CI 1.05, 1.35), high (OR: 1.27; 95% CI 1.13, 1.42), and very high scores (OR: 1.42; 95% CI 1.23, 1.64) for young women, and increases in low (OR: 1.39; 95% CI 1.21, 1.59) and very low (OR: 1.53; 95% CI 1.21, 1.92) scores for young men. CONCLUSIONS: The evidence suggests a polarisation of the psychological distress of young women in Britain between 1991 and 2008

Why are poorer children at higher risk of obesity and overweight? A UK cohort study

There is limited evidence on which risk factors attenuate income inequalities in child overweight and obesity; whether and why these inequalities widen as children age. Method: Eleven thousand nine hundred and sixty five singletons had complete data at age 5 and 9384 at age 11 from the Millennium Cohort Study (UK). Overweight (age 5 : 15%; age 11 : 20%) and obesity (age 5 : 5%; age 11 : 6%) were defined using the International Obesity Taskforce body mass index cut-points. To measure socioeconomic inequalities, we used quintiles of family income and as risk factors, we considered markers of maternal health behaviours and of children’s physical activity, sedentary behaviours and diet. Binary and multinomial logistic regression models were used. Results: The unadjusted analyses revealed stark income inequalities in the risk of obesity at age 5 and 11. At age 5, children in the bottom income quintile had 2.0 (95% CI: 1.4–2.8) increased relative risk of being obese whilst at age 11 they had 3.0 (95% CI: 2.0–4.5) increased risk compared to children in the top income quintile. Similar income inequalities in the risk of overweight emerged by age 11. Physical activity and diet were particularly important in explaining inequalities. Income inequalities in obesity and overweight widened significantly between age 5 and 11 and a similar set of risk factors protected against upward and promoted downward movements across weight categories. Conclusions: To reduce income inequalities in overweight and obesity and their widening across childhood the results support the need of early interventions which take account of multiple risk factors

Gender-specific changes in well-being in older people with coronary heart disease: evidence from the English Longitudinal Study of Ageing

Objectives: The objective of this study is to investigate gender-specific trajectories in well-being among older people with coronary heart disease (CHD) and to compare them with those of healthy people. Method: The study included a sample of 4496 participants from the first three waves of the English Longitudinal Study of Ageing (2002–2003 to 2006–2007). We measured well-being using quality of life (CASP-19; ‘control’, ‘autonomy’, ‘pleasure’ and ‘self-realization’) and depressive caseness (three or more symptoms on the CESD-8; Centre for Epidemiologic Study Depression scale). Results: After adjustment, at two– and four–years follow-ups, women had three points higher quality of life than men (p < 0.001). When looking at each quality of life's domain we found that women reported higher scores of autonomy compared to men. The gender difference in the probability of having depressive caseness reduced to 7 percentage points at four-year follow-up from 13 percentage points in the previous occasions. Men's quality of life declined progressively over time by 3 points (p < 0.001) (equivalent to the effect of having diabetes) but no changes in prevalence of depressive caseness were found. Women's quality of life only declined after four-year follow-up by less than 2 points (p < 0.001), while in the same period their probability of reporting depressive caseness reduced by 6 percentage points (p < 0.001). Conclusion: Women had better quality of life than men in the two and four years following a CHD event, and were not more likely than men to report depressive caseness in the long term. Men's quality of life deteriorated progressively over time, among women it did not deteriorate in the first two years following a CHD event; women had a long-term improvement in depressive caseness

Domains and Measurements of Healthy Aging in Epidemiological Studies: A Review

Purpose of the Study: Few studies have recommended the essential domains of healthy aging and their relevant measurement to assess healthy aging comprehensively. This review is to fill the gap, by conducting a literature review of domains and measures of healthy aging in epidemiological studies. Design and Methods: A literature search was conducted up to March 31, 2017, supplemented by a search of references in all relevant articles in English. We made a final selection of 50 studies across 23 countries or regions. Results: Nineteen studies applied Rowe and Kahn’s three standards to assess healthy aging. Thirty-seven studies measured physical capabilities mainly by (instrumental) activities of daily living. Cognitive functions were included in 33 studies. Nineteen of them applied Mini-Mental State Examination (MMSE). Twenty-six studies considered metabolic and physiological health, but they mainly asked the self-reported absence of diseases. Twenty-four studies assessed psychological well-being by employing diverse scales. Questions about participation in social activities were mainly asked to measure social well-being in 22 studies. Sixteen studies considered individuals’ general health status, which was mainly measured by self-rated health. Security questions were asked in five studies. Health behaviors were taken into account by three studies. Fifteen studies either applied SF-12/36 or developed health indices to assess healthy aging. Implications: This review summarizes detailed scales or methods that have been used to assess healthy aging in previous epidemiological studies. It also discusses and recommends the essential domains of healthy aging, and the relevant instruments for further epidemiological research to use in the assessment of healthy aging

Drunkenness and heavy drinking among 11 year olds - findings from the UK Millennium Cohort Study

Heavy drinking among young people is linked to negative consequences including other risky behaviours, educational failure and premature mortality. There is a lack of research examining factors that influence heavy and binge drinking in early adolescence as prior work has focused on older teenagers. The objective of this paper was to identify individual and family factors associated with drunkenness and episodes of heavy drinking in early adolescence. We analysed data on 11,046 11year olds from the UK Millennium Cohort Study. Multivariate logistic regression was used to estimate odds ratios for associations. 1.2% of participants reported having been drunk, and 0.6% reported having had 5 or more drinks in a single episode. Participants who reported drunkenness were more likely to be boys (1.6% vs 0.7%, p<0.01), to have socioemotional difficulties (2.6% vs 1.0%, p<0.001), to report antisocial behaviours (none=0.6%, 1=2.0%, 2 or more=7.0%, p<0.001), report truancy (6.0% vs 1.0%, p<0.001), smoke cigarettes (12.0% vs 0.8%, p<0.001). Parental drinking did not appear to be associated with the odds of drunkenness. Associated with higher odds of drunkenness were: having friends who drank (OR=5.17); having positive expectancies towards alcohol (OR 2+=2.02); ever having smoked cigarettes (OR=5.32); the mother-child relationship not being close (OR=2.17). Associated with a reduced odds of drunkenness was having a heightened perception of harm from drinking 1-2 drinks daily (OR - some risk=0.48, great risk=0.40). Our findings support policies aimed at multiple levels, starting in the preadolescent years, which incorporate individual, family, and peer factors

Social influences on health-related behaviour clustering during adulthood in two British birth cohort studies

Building upon evidence linking socio-economic position (SEP) in childhood and adulthood with health-related behaviours (HRB) in adulthood, we examined how pre-adolescent SEP predicted membership of three HRB clusters: “Risky”, “Moderate Smokers” and “Mainstream” (the latter pattern consisting of more beneficial HRBs), that were detected in our previous work. Data were taken from two British cohorts (born in 1958 and 1970) in pre-adolescence (age 11 and 10, respectively) and adulthood (age 33 and 34). SEP constructs in pre-adolescence and adulthood were derived through Confirmatory Factor Analysis. Conceptualised paths from pre-adolescent SEP to HRB cluster membership via adult SEP in our path models were tested for statistical significance separately by gender and cohort. Adult SEP mediated the path between pre-adolescent SEP and adult HRB clusters. More disadvantaged SEP in pre-adolescence predicted more disadvantaged SEP in adulthood which was associated with membership of the “Risky” and “Moderate Smokers” clusters compared to the “Mainstream” cluster. For example, large positive indirect effects between pre-adolescent SEP and adult HRB via adult SEP were present (coefficient 1958 Women = 0.39; 1970 Women = 0.36, 1958 Men = 0.51; 1970 Men = 0.39; p < 0.01) when comparing “Risky” and “Mainstream” cluster membership. Amongst men we found a small significant direct association (p < 0.001) between pre-adolescent SEP and HRB cluster membership. Our findings suggest that associations between adult SEP and HRBs are not likely to be pre-determined by earlier social circumstances, providing optimism for interventions relevant to reducing social gradients in HRBs. Observing consistent findings across the cohorts implies the social patterning of adult lifestyles may persist across time