Petur Benedikt Juliusson

Aim: To examine associations between gestational age (GA) and clinically recorded sleep outcomes at 6 months, 2 years and school entry. Methods: This population‐based study included 56 856 children. Sleep data from routine health examinations at 6 months, 2 years and school entry were linked to the Medical Birth Registry of Norway. Non‐satisfactory sleep, difficulties initiating sleep and night awakenings were recorded during routine consultations. Associations between GA and sleep outcomes were examined using logistic regression analyses. Results: The prevalence of non‐satisfactory sleep was 22.4%, 15.1% and 11.6% at 6 months, 2 years and school entry, respectively. Each additional week of GA was associated with higher odds of non‐satisfactory sleep at 6 months (adjusted OR 1.06, 95% CI 1.04–1.07). At 2 years and school entry, each additional week of GA was associated with lower odds of non‐satisfactory sleep (adjusted OR 0.97, 95% CI 0.96–0.99 and 0.95–0.98, respectively). Few associations were observed between GA and the other sleep outcomes, except for night awakenings at 6 months and difficulties initiating sleep at 2 years. Conclusion: Increasing GA was associated with lower odds of non‐satisfactory sleep at age 2 years and at school entry, whereas the opposite association was observed at 6 months. Sleep difficulties in children born preterm should remain a focus beyond infancy.

Large variability exists in outcome following Family‐based treatment (FBT) for severe obesity in youth. In the present study, we aimed to expand our understanding of how mental health impacts FBT outcomes. In total, 90 participants (58.9% girls) 5.9–18.6 years (mean ± SD: 13.2 ± 3.1) were enrolled in a 17‐session FBT‐programme. Baseline mean percentage above the IOTF threshold for overweight (%IOTF25) was 146 ± 13, and Body Mass Index standard deviation score (BMIz) was 3.02 ± 0.52. Mental health predictors were assessed using the Self‐Perception Profile for Children and the Child Behaviour Checklist. A multivariate multilevel Bayesian linear mixed‐effects model with repeated measures was utilized to estimate the effects of mental health predictors on BMI outcomes. Average change in BMI during FBT was −3.80 (%IOTF25) and −0.08 (BMIz) units. Higher scores of Attention Deficit/Hyperactivity (ADH) Problems were associated with a smaller reduction in BMI (0.31 units for %IOTF25 ( p = 0.02), 0.01 units for BMIz ( p = 0.03) for each one‐unit T‐score increase on the ADH problem scale). Self‐Worth, Emotional Dysregulation, Internalizing‐ and Externalizing problems were not associated with differences in BMI outcomes. Identifying children with higher ADH problems and incorporating additional family support strategies within FBT should be a focus for further treatment development.

Aim: This study examined age‐ and sex‐specific prevalence and trends in underweight among Norwegian children and adolescents during the pre‐pandemic period from 2010 to 2019 and COVID‐19 pandemic period from 2020 to 2022. Methods: Height and weight data from 78 024 children aged 2 to 13 years in Bergen from 2010 to 2022 were obtained from public health clinic and school health service records. Underweight grades 1 to 3 were defined using the International Obesity Task Force cut‐offs. Age‐ and sex‐specific prevalence was analysed longitudinally, and trends were assessed for boys and girls across age groups using regression analyses. Results: Underweight was most prevalent among 2‐year‐olds and declined with increasing age, more in girls than boys. Among girls, the prevalence decreased from 19.3% at age 2 years to 6.2% at age 13 years, and among boys from 13.3% to 8.6%. The interaction between sex and age was statistically significant. During the pre‐pandemic period, prevalence decreased significantly among 2‐year‐olds. During the pandemic period, increased prevalence of underweight was observed among 8‐year‐old girls. Conclusion: Underweight remains a relevant public health concern, with clear age‐ and sex‐specific patterns. These findings highlight the need for continued monitoring and targeted follow‐up in early childhood.

Purpose: To investigate eating disorder symptoms before and after family-based behavioral treatment for severe obesity in youth. Methods: Eating disorder symptoms were measured pre- and posttreatment in 74 youth (age: 10–18 years; 58% female; mean body mass index standard deviation score [BMI SDS]: 3.11) enrolled in a 17–session treatment for severe obesity. Symptoms were assessed using the Youth-Eating Disorder Examination Questionnaire (Y-EDE-Q), including a global score and sub-scales for dietary restraint, eating-, weight- and shape concerns. Robust linear mixed models and generalized mixed models were utilized to measure change over time. Results: There was no significant change in global eating disorder score over time (mean (SD) pre 1.82(1.07) and post 1.67(1.08); beta = − 0.16, p = 0.69). Before treatment, 20.3% of the youth scored above the clinical cut-off for eating disorder risk (> 2.5) on the Y-EDE-Q, compared to 13.5% after treatment (beta = − 0.81, p = 0.25). However, no one received a clinical eating disorder diagnosis at any time point. Before treatment, 4 youth reported ≥ 1 objective binge episode per week, compared to no one post-treatment. A significant reduction in shape concern was observed (beta = − 0.29, p = 0.036). No changes were found for dietary restraint, eating- or weight concerns. Global eating disorder- and dietary restraint scores pre-treatment did not predict changes in BMI SDS from pre- to post-treatment. Conclusion: There was no evidence of an increase in eating disorder symptoms in the sample overall during family-based behavioral treatment for severe obesity, and improvements were seen for shape concerns. Level of evidence: Level IV: Evidence obtained from multiple time series with intervention.

It is uncertain if age of menarche continues to decline. There has been no systematic meta-analysis of ages at menarche in Norway the past three decades. To conduct a systematic review and meta-analysis to assess secular trends in menarcheal age in Norway. A literature search was performed in PubMed, Web of Science, and Embase to identify studies including ages at menarche from healthy females. Re-analysis of data from 16 surveys were included together with 17 published studies in a meta-analysis using weighted regression analyses with fitted restricted cubic splines. Each study or dataset was given a random intercept to account for within-survey correlation. In total, 783,757 observations were included in the meta-analysis. Three distinct periods were identified. For women born 1840-1910, a large and stable decline with -0.14 to -0.20 years per decade (y/d) was observed, whilst in women born 1910-1950 this decline accelerated up to -0.30 y/d. The third period of women born 1950-2008 saw a small and stable decline with -0.06 to -0.08 y/d. Age at menarche declined throughout the study period from 1840-2008, but more rapidly in girls born between 1910-1950. Data suggest an ongoing, modest decline.

SUMMARY: Stature is a key indicator of pediatric health, yet the molecular and metabolic architecture governing childhood growth remains incompletely defined. We conducted genome-wide association analyses of stature from birth to childhood (574,580 measurements; 72,704 Norwegian children) and integrated UK Biobank data (age 10 and adulthood). We uncovered life-stage shifts in the genetics of stature, identifying novel childhood-specific effects including variants near GLP1R with BMI-independent effects, and reveal three temporal clusters - infancy and childhood clusters enriched for endocrine and metabolic pathways, and a lifetime growth cluster enriched for skeletal biology. Proteome analysis revealed that prepubertal height is associated with widespread changes in the circulation, identifying 106 height-associated proteins and linking IGF1, IGF2, and IGFBP3 levels to childhood-height polygenic scores. Mendelian randomization showed that reduced fetal growth and taller prepubertal height increase type 2 diabetes risk, independent of adult stature. These findings uncover developmental stage-specific genetic and proteomic influences on child-growth and links to adult metabolic health.

Aim: To describe the current approaches to surveillance and use of data on children's growth in the Nordic countries and to reach consensus on how this can be improved. Methods: Members of the Promoting Healthy Weight in Children (PromoKids) network and additional public health professionals from five Nordic countries described their respective national growth surveillance systems. The various approaches to data collection and consolidation were analysed and compared. Results: In Finland, Denmark, Norway, Sweden and Iceland, all children's weight and height are measured repeatedly at different intervals from birth by child and school health services. However, the data are not consistently registered centrally in all countries for use in public health planning, policymaking and research. Finland and Denmark had the most mature systems for data collection. Conclusion: A consensus was reached that surveillance of body weight and height should be a mandatory element of national action plans to prevent and manage growth disorders including obesity, and to identify susceptible population groups. Surveillance protocols should be designed to prevent stigmatisation of children with overweight. Nordic countries should collaborate to accomplish comprehensive data coverage to uncover social inequalities and evaluate societal actions to prevent obesity in children.

Objectives: Studies have shown that children develop a higher body weight during summer months. This has been demonstrated repeatedly using the body mass index (BMI), but the effect of season on other weight‐related anthropometric measurements is still unclear.Methods: Measurements of height, weight, waist circumference (WC), triceps, and subscapular skinfolds (TSF and SSF), collected from September till May in a cross‐sectional sample of 4–16‐year‐old children and adolescents (n = 4525) from the Bergen Growth Study 1 (BGS1). Differences in z‐score by season were tested with linear models adjusted for age group and separately for sex. Overall differences were tested with a one‐way between‐group analysis of variance.Results: The girls had higher BMIz (+0.12, p = .03) and WCz (+0.18, p = .002) in fall compared with spring. TSFz (−0.19, p < .001) and SSFz (−0.18, p < .001) were lower in winter in girls, and in boys both in fall (TSFz −0.10, p = .046; SSFz – 0.16, p < .001), and winter (TSFz −0.15, p = .004; SSFz −0.14, p = .003), when compared with spring.Conclusions: Seasonal variation was detected for all anthropometric measures, but differences in the direction of the effect between measures of global (BMI), central (WC) or subcutaneous (SF) adiposity suggest a more complex mechanism that needs further exploration.