Stephanie Brandt

Universität Ulm, Ulm, Baden-Württemberg, Germany

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Publications (7)12.9 Total impact

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    ABSTRACT: The cardiovascular risk factor profile of a child as well as the development of body weight are influenced by genetic and childhood factors. Circulating insulin concentrations reflect the metabolic cardiovascular risk and may trigger weight gain. We aimed at identifying parental and childhood factors which may influence fasting plasma insulin concentrations in children. The Ulm Birth Cohort study (UBCS) is a prospective birth cohort study. At baseline, birth characteristics, maternal pre-pregnancy body mass index (BMI) values as well as parental socioeconomic parameters were obtained. At the 8-yr follow-up examination, weights, heights, and fasting plasma insulin concentrations in n = 422 children and their parents were measured. Offspring of women with gestational diabetes mellitus were excluded from statistical analysis. Fasting plasma insulin concentrations of children were significantly correlated with maternal pre-pregnancy BMI values (r = 0.16) as well as with maternal (r = 0.26) but not with paternal fasting plasma insulin concentrations (r = 0.11) at the 8-yr follow-up examination. The risk for high fasting plasma insulin concentrations (≥75th internal percentile) was 2.30 (1.34-3.92) in children who also had high plasma insulin concentrations in umbilical cord blood compared to children having lower plasma insulin concentrations (<75th internal percentile) in umbilical cord blood. In addition, we observed that children with high fasting plasma insulin concentrations at the age of 8 had an altered BMI trajectory in childhood, characterized by higher BMI values from the age of 1 onwards, compared to children with lower insulin concentrations. Our observations support the hypothesis of perinatal programming of offspring insulin concentrations and BMI values by maternal pre-pregnancy BMI values.
    Pediatric Diabetes 01/2014; · 2.08 Impact Factor
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    ABSTRACT: Background and Aims Diverse waist circumference thresholds for assessment of metabolic and cardiovascular risk in Caucasians are recommended by different health professional organizations. We aimed to determine optimal sex-specific thresholds for anthropometric measures showing the strongest association with cardiovascular risk factors in a cohort of middle-aged Germans. Methods and Results Statistical analyses are based on data from 426 mothers and 267 fathers of participants of the Ulm Birth Cohort Study undergoing a clinical follow-up examination in 2008 (median age 41 years) using logistic regression analyses. The prevalence of many cardiometabolic risk factors was significantly higher in men than in women; hypertension: 45%/17% (p<0.0001), apolipoprotein ratio B/A1>0.72: 35%/9% (<0.0001), hyperglycemia: 11%/14% (p=0.3), which is in contrast to the predicted cardiovascular risk of 52%/70% and 24%/36% based on thresholds for waist circumference proposed by International Diabetes Federation and American Heart Association, respectively. We determined optimal thresholds for waist circumference between 90 and 95cm for men and women. Using a threshold of 92cm the prevalence of abdominal obesity was 59% in men and 24% in women, which was in agreement with the higher prevalence of overweight and obesity in men than in women (Body Mass Index (BMI)>25: 64%/35%). The prediction of cardiometabolic risk factors by waist circumference and waist-to-height ratio did not outperform the prediction by BMI. In contrast to BMI, waist circumference was correlated with body height independent of sex. Conclusion Currently proposed thresholds for waist circumference spuriously overestimate the cardiovascular risk in women, but not in men in a German population.
    Nutrition, Metabolism and Cardiovascular Diseases. 01/2014;
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    ABSTRACT: Childhood obesity is one of the greatest public health challenges in Western countries. Abnormal eating behavior is thought to be a developmental trajectory to obesity. The Eating Pattern Inventory for Children (EPI-C) has not been used for children as young as eight years, and possible associations with body weight have not yet been established. Five hundred and twenty-one children of the Ulm Birth Cohort Study (UBCS; age eight) filled out the EPI-C and BMI was assessed. Adequacy of the scales was tested with confirmatory factor analysis and a MANOVA and cluster analysis established associations between eating patterns and BMI. The factor structure of the EPI-C was confirmed (GFI = .968) and abnormal eating behavior was associated with overweight (χ2(8) = 79.29, p<.001). The EPI-C is a valid assessment tool in this young age group. Overweight children consciously restrain their eating.
    PLoS ONE 01/2014; 9(8):e105303. · 3.73 Impact Factor
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    ABSTRACT: Comorbidity between childhood atopic eczema (AE) and attention-deficit/hyperactivity disorder (ADHD) has been observed, but temporal relationships remain unclear. We analyzed data of a population-based, prospective birth cohort study among 770 children included at baseline in 2000/2001 with follow-up up to age 11. Information on age at diagnosis of AE, rhinoconjunctivitis, and ADHD was obtained by questionnaires administered to parents and for AE also to caring physicians. Adjusted relative risks (aRR) with 95% confidence intervals (95% CI) were modeled with a modified Poisson regression. Early AE up to age 4 yr was reported for 14.8% of the children by the parents and for 26.0% by the physicians with only fair agreement between these reports (kappa = 0.36). Based on parental reports, the association of early AE with early ADHD was strong (aRR: 5.17, 95% CI: 2.18; 12.28), but absent for late ADHD [aRR: 0.50 (0.13; 2.02)]. The association of late AE with late ADHD [aRR: 3.03 (0.75; 12.29)] was not statistically significant. This pattern was independent of the presence of rhinoconjunctivitis. The observed comorbidity between AE and ADHD may indicate vulnerability to develop ADHD symptoms in response to AE symptoms or through a common underlying mechanism. This vulnerability seems to decrease with time since AE onset and may be greater in early life. These temporal relationships should be considered in future research investigating mechanisms linking both diseases and in clinical efforts to screen for and prevent ADHD symptoms in children with AE.
    Pediatric Allergy and Immunology 12/2013; · 3.38 Impact Factor
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    ABSTRACT: What is already known about this subject Maternal smoking during pregnancy is associated with offspring overweight, but it is still unclear whether this association is due to confounding by parental lifestyle habits or caused by direct effects of intrauterine tobacco smoke exposure. What this study adds Maternal smoking during pregnancy was validated by cord serum cotinine measurements and the offspring body mass index was assessed at various ages. Maternal smoking during pregnancy was significantly associated with offspring body mass index at 8 years of age with a trend for increased body mass index from 4 years of age onwards. Paternal smoking and smoking of both parents at pre- and post-natal periods was positively associated with offspring body mass index, which suggests residual confounding by lifestyle habits in smoking families rather than intrauterine effects. BACKGROUND: Although many epidemiological studies have shown an association between maternal smoking during pregnancy and offspring overweight, it is still under debate whether intrauterine tobacco smoke exposure directly affects offspring obesity or if the association is rather due to confounding by lifestyle factors. OBJECTIVES: The association of parental smoking habits at pre- and post-natal periods with offspring body mass index (BMI) was investigated, whereas maternal smoking during pregnancy was validated by cord serum cotinine measurements. METHODS: Multivariable linear regression analysis, based on the German Ulm Birth Cohort Study of 1045 children born in 2000 with annual/biennial follow-up until the age of 8 years (n = 609), was conducted. RESULTS: BMI of offspring from mothers who smoked during pregnancy and non-smoking mothers differed significantly at 8 years. Maternal smoking during pregnancy was associated with an increase in BMI of 0.73 kg m(-2) [95% confidence interval: 0.21-1.25] in 8-year-old children after adjustment for multiple potential confounding variables. Both pre- and post-natal smoking of fathers (0.34 [0.01-0.66]/0.45 [0.08-0.81]) and of both parents (1.03 [0.43-1.63]/0.56 [0.14-0.98]) were likewise significantly associated with offspring BMI. CONCLUSIONS: The observed patterns suggest that residual confounding by living conditions in smoking families rather than specific intrauterine exposure to tobacco smoke may account for the increased risk of offspring overweight.
    Pediatric Obesity 02/2013; · 2.28 Impact Factor
  • S Brandt, A Moss, S Berg, M Wabitsch
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    ABSTRACT: The prevalence of obesity for children and adolescents in Germany has increased during the past 20 years. Because the success rate of therapy is low, prevention seems to be the only solution. Prevention should begin early in life. School is an ideal setting for the implementation of prevention strategies. The aim of this review was to compare results of school-based prevention programs and to identify effective methods. A systematic literature search for studies published between 1990 and 2009 was conducted. A total of 22 studies were considered for inclusion. Combined interventions including nutrition, physical activity, and television viewing modification are effective. The intervention should last for at least one year. Installation of water fountains in schools, implementation of the topics "sugar-containing drinks" and "television viewing" in the curriculum, modification of existing physical education and more physical activity during the school day are effective prevention strategies.
    Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 02/2010; 53(2):207-20. · 0.72 Impact Factor
  • S. Brandt, A. Moß, S. Berg, M. Wabitsch
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    ABSTRACT: Die Prävalenz der Adipositas im Kindes- und Jugendalter ist in Deutschland in den letzten 20Jahren angestiegen. Da eine Therapie oft nicht erfolgreich ist, erscheint die Prävention als einzige Lösung. Diese sollte bereits in jungen Jahren beginnen. Ein idealer Ort hierfür ist die Schule. Ziel der vorliegenden Übersichtsarbeit ist es, die Ergebnisse schulbasierter Präventionsprogramme zu vergleichen und wirkungsvolle Maßnahmen zu identifizieren. Hierzu wurde eine systematische Literaturrecherche durchgeführt. 22Studien, die zwischen 1990 und 2009 zu diesem Thema veröffentlicht wurden, wurden in die Analyse einbezogen. Eine kombinierte Intervention über Ernährung, Bewegung und Modifikation des TV-Verhaltens ist effektiv. Diese sollte mindestens über ein Schuljahr erfolgen. Das Aufstellen von Wasserspendern im Schulgebäude, die Aufnahme der Themen zuckerhaltige Getränke und Fernsehen in den Unterricht, die Modifizierung des bestehenden Sportunterrichts sowie die Förderung von Bewegung im Schulalltag sind wirksame Präventionsmaßnahmen. The prevalence of obesity for children and adolescents in Germany has increased during the past 20 years. Because the success rate of therapy is low, prevention seems to be the only solution. Prevention should begin early in life. School is an ideal setting for the implementation of prevention strategies. The aim of this review was to compare results of school-based prevention programs and to identify effective methods. A systematic literature search for studies published between 1990 and 2009 was conducted. A total of 22 studies were considered for inclusion. Combined interventions including nutrition, physical activity, and television viewing modification are effective. The intervention should last for at least one year. Installation of water fountains in schools, implementation of the topics “sugar-containing drinks” and “television viewing” in the curriculum, modification of existing physical education and more physical activity during the school day are effective prevention strategies.
    Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 01/2010; 53(2):207-220. · 0.72 Impact Factor