Wei Wei Pang's research while affiliated with National University of Singapore and other places

Publications (35)

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‘Mixed Milk Feeding’ (MMF), whereby infants are fed with both breastmilk and infant formula during the same period, is a common feeding practice. Despite its high prevalence, knowledge regarding MMF practices and their association with (health) outcomes is limited, potentially because MMF behaviours are highly variable and difficult to standardise...
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Introduction: Infant gastroesophageal reflux disease (GERD) is a significant cause of concern to parents. This study seeks to describe GERD prevalence in infants, evaluate possible risk factors and assess common beliefs influencing management of GERD among Asian parents. Methods: Mother-infant dyads in the Singapore PREconception Study of long-T...
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Purpose There is altered breastmilk composition among mothers with gestational diabetes and conflicting evidence on whether breastfeeding is beneficial or detrimental to their offspring’s cardiometabolic health. We aimed to investigate associations between breastfeeding and offspring’s cardiometabolic health across the range of gestational glycemia...
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Background: Although most studies have reported unfavorable short-term effects of breastfeeding on early-childhood sleep-wake behaviors that potentially attenuate over time, findings have remained inconsistent. Objectives: We assessed associations of breastfeeding with longitudinal day-, night-, and total-sleep trajectories and with sleep-wake b...
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Objective To identify systolic blood pressure (SBP) percentile trajectories in children and to describe the early-life risk factors and cardiometabolic correlates of those trajectories. Study design Using age-, sex-, and height-specific SBP percentiles based on the American Academy of Pediatrics reference, we examined SBP trajectories using latent...
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Background: previous studies focusing on the association between gestational diabetes and breastfeeding duration have been inconclusive. Objectives: we aimed to determine whether maternal gestational hyperglycemia is associated with the duration of breastfeeding and the concentrations of markers linked to breastmilk production. Methods: data from...
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Purpose of the review: Individual differences in appetite and eating behaviours appear early in infancy. This review synthesizes recent research investigating the impact of feeding experiences during infancy on later appetite and energy intake regulation, and appraises the consistency and longevity of any effects. Recent findings: Three themes o...
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(1) Background: Breastfeeding has been shown to support glucose homeostasis in women after a pregnancy complicated by gestational diabetes mellitus (GDM) and is potentially effective at reducing long-term diabetes risk. (2) Methods: Data from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study were analyzed to understand the influenc...
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The Singapore Preconception Study of Long-Term Maternal and Child Outcomes (S-PRESTO) is a preconception, longitudinal cohort study that aims to study the effects of nutrition, lifestyle, and maternal mood prior to and during pregnancy on the epigenome of the offspring and clinically important outcomes including duration of gestation, fetal growth,...
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The human gut microbiota develops soon after birth and can acquire inter-individual variation upon exposure to intrinsic and environmental cues. However, inter-individual variation has not been comprehensively assessed in a multi-ethnic study. We studied a longitudinal birth cohort of 106 infants of three Asian ethnicities (Chinese, Malay, and Indi...
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Background: Several risk factors in the first 1000 d are linked with increased obesity risk in later childhood. The role of potentially modifiable eating behaviors in this association is unclear. Objectives: This study examined whether the association between cumulated risk factors in the first 1000 d and adiposity at 6 y is moderated by eating...
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Purpose To explore the associations between type of milk feeding (the “nutrients”) and mode of breast milk feeding (the “nursing”) with child cognition. Methods Healthy children from the GUSTO (Growing Up in Singapore Toward healthy Outcomes) cohort participated in repeated neurodevelopmental assessments between 6 and 54 months. For “nutrients”, w...
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Revised subscales of the Children’s Eating Behavior Questionnaire (CEBQ) have been proposed to be more appropriate for assessing appetitive traits in Singaporean 3 year-olds, but the CEBQ has not yet been validated in older children in this population. The current study aimed to validate the CEBQ at ages 5 (n = 653) and 6 (n = 449) in the ethnicall...
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Early childhood diet may have lifelong influences on health outcomes, yet development of indices to assess diet quality is scarce in toddlers, especially in Asian countries. We aimed to develop and evaluate a Diet Quality Index (DQI) in a multi-ethnic Asian mother–offspring cohort and identify perinatal correlates of early childhood diet. Based pri...
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Diet in the first month postpartum, otherwise known as "the confinement diet" in Asia, has unique characteristics that are influenced by traditions, cultures, and beliefs. We aimed to characterize dietary patterns during confinement period in a multi-ethnic Asian cohort and examined their associations with postpartum depression (PPD) and anxiety (P...
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We investigated body mass index (BMI) trajectories in the first 2 years of life in 1170 children from an Asian mother-offspring cohort in Singapore, and examined their predictors and associations with childhood cardio-metabolic risk measures at 5 years. Latent class growth mixture modelling analyses were performed to identify distinct BMI z-score (...
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OBJECTIVE: Many studies have identified early-life risk factors for subsequent childhood overweight/obesity, but few have evaluated how they combine to influence risk of childhood overweight/obesity. We examined associations, individually and in combination, of potentially modifiable risk factors in the first 1000 days after conception with childho...
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Background: Studies examining direct vs. expressed breast milk feeding are scarce. We explored the predictors of mode of breastfeeding and its association with breastfeeding duration in a multi-ethnic Asian population. Methods: We included 541 breastfeeding mother-infant pairs from the Growing Up in Singapore Toward healthy Outcomes cohort. Mode...
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Background: Improved maternal nutrition and glycaemic control before and during pregnancy are thought to benefit the health of the mother, with consequent benefits for infant body composition and later obesity risk. Maternal insulin resistance and glycaemia around conception and in early pregnancy may be key determinants of maternal physiology and...
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Background: Dietary protein may affect glucose metabolism through several mechanisms, but results from studies on dietary protein intake and risk of gestational diabetes mellitus (GDM) have been inconsistent. Objective: We examined the cross-sectional associations of dietary protein intake from different food sources during pregnancy with the risk...
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Background & aims: B-vitamins and homocysteine may contribute to the development of gestational diabetes mellitus (GDM), but existing studies are inconsistent. We examined the cross-sectional associations of plasma folate, vitamins B6, B12, and homocysteine concentrations with GDM and glycemia in a sample of multi-ethnic Asian pregnant women. Met...
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The Children's Eating Behaviour Questionnaire (CEBQ) was developed to measure eating behaviors related to obesity risk in children. However, this questionnaire has not been validated for use in South East Asia, where parenting practices are different from those in western countries and child obesity rates are increasing. The aim of this study was t...
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Background Confinement (restrictions placed on diet and practices during the month right after delivery) represents a key feature of Asian populations. Few studies, however, have focused specifically on ethnic differences in confinement practices. This study assesses the confinement practices of three ethnic groups in a multi-ethnic Asian populatio...
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The relation between infant feeding and growth has been extensively evaluated, but studies examining sex differences in the influence of infant milk feeding on growth are limited. OBJECTIVE: We examined the interaction of infant feeding and sex in relation to infant growth and compared growth trajectories in breastfed and formula-fed boys and girl...
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Background: Many countries in Asia report low breastfeeding rates and the risk factors for early weaning are not well studied. We assessed the prevalence, duration, and mode of breastfeeding (direct or expressed) among mothers of three Asian ethnic groups. Methods: Participants were 1,030 Singaporean women recruited during early pregnancy. Data...
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Full-text available
Background Appetitive traits in childhood such as food responsiveness and enjoyment of food have been associated with body mass index (BMI) in later childhood. However, data on appetitive traits during infancy in relation to BMI in later childhood are sparse. We aimed to relate appetitive traits in infancy to subsequent BMI and weight gain up to 24...
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Objective: Studies have demonstrated a relationship between lower omega-3 long-chain polyunsaturated fatty acid (LC-PUFA) status and anxiety and depression. It is uncertain whether similar associations occur in pregnant women, when anxiety and depression could have long-term effects on the offspring. We examined the associations between plasma LC-...
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Breastfeeding has been shown to enhance global measures of intelligence in children. However, few studies have examined associations between breastfeeding and specific cognitive task performance in the first 2 y of life, particularly in an Asian population. We assessed associations between early infant feeding and detailed measures of cognitive dev...

Citations

... Indeed, a recent study demonstrates that breastfed infants achieved a circadian rest-activity rhythm at 6th week age in contrast to 12 weeks in mixed, formula and breastmilk-fed babies (68). Exclusively breastfed infants had better sleep parameters in comparison to formula-fed infants (69). Infants at 2 months of age who were breastfed, in contrast to formula-fed infants, had a significantly lower frequency of colic attacks and severity of irritability attacks, which was associated with the night-time consumption of MEL through milk (70). ...
... There is evidence that continued breastfeeding after a pregnancy complicated by GDM reduces the risk Open Access *Correspondence: sharon.perrella@uwa.edu.au 1 School of Molecular Sciences, The University of Western Australia, Crawley, WA, Australia Full list of author information is available at the end of the article of developing T2D for women and their infants [6,7]. However, breastfeeding difficulties are common among women with GDM, with lower rates of predominant breastfeeding on hospital discharge [8,9] and shorter breastfeeding duration [10,11]. Indeed, results from a recent systematic review and meta-analysis indicate that GDM-exposed infants had 40% higher rates of formula supplementation in hospital, 1 month shorter duration of breastfeeding, and a 30% decrease in breastfeeding rates at 12 months [12]. ...
... 4 However, there are a scarcity of studies exploring differences in nutrient intake, eating behaviours, long-term patterns of eating or longerterm health parameters between weaning approaches. 9,[13][14][15] The definition of BLW for use in research is also not clear. 9 BLW appears to be an approach rather than a simple method and consists of several underlying principles. ...
... such as greater pre-pregnancy BMI (8,9), excessive weight gain (3), unhealthy dietary patterns (3), physical inactivity (3), and a short period of lactation (3,10). In the Asian population, there are also quite a few at-risk pre-natal maternal characteristics recently added to this pond of evidence, such as family history of diabetes (43), a higher degree of consanguineous marraiges (43), higher pre-pregnancy BMI (29,31,32,46), higher total cholesterol quartile at GDM diagnosis during the index pregnancy (47), younger age at delivery (<30 years) (46), and a short period of lactation (<6 months) (33). Post-natal risk such as missing medical assistance in the continuum of GDM care after delivery could be another risk for T2D progression among Asian mothers with a history of GDM (48). ...
... This index, can be used to identify specific influencing factors for fecundability as this would provide more credible evidence than infertility based case-control studies. Several popular studies have focused on TTP, including the Home Observation of Peri-conceptional Exposures study, [10] the Longitudinal Investigation of Fertility and the Environment study, [11] the Danish National Birth Cohort study, [12] the Norwegian Mother and Child Cohort, [13], and the Singapore Preconception Study of Long-Term Maternal and Child Outcomes study [14]. However, due to various limitations, TTP studies have not led to any significant advancements over the last 20 years. ...
... However, the impacts of ABO antigen and secretory phenotypes initially described from targeted microbiota characterizations in small cohorts were not confirmed in a study based on 16S sequencing of fecal microbiota from a much larger cohort that considered the overall structure of the microbiome, its diversity, and the relative abundance of the different taxa (Davenport et al., 2016). In line with this, no statistically significant association was found between microbiome composition and ethnicity, single-nucleotide polymorphisms, or overall genetic similarity in another study carried out in adults (Rothschild et al., 2018); similarly, the significant differences observed in early life between infants from three ethnic groups living in Singapore were no longer detectable at the age of 2 years (Xu et al., 2020). This latter study suggests that the environment is more influential than the host genetics. ...
... The same nutrient load can be consumed as harder or softer textures that differ in their eating rate and intake, though food texture in itself does not directly make a nutrient contribution. Faster eating rates (g/min) and energy intake rates (kcal/min) are a modifiable risk factor for obesity [5], and texture-driven faster eating has been shown to significantly influence energy intake to satiation and metabolic responses for nutrient-matched meals [6]. At a population level, eating at a faster rate is associated with higher daily energy intakes, BMI and adiposity, and increased cardio-metabolic risk [7][8][9]. ...
... Recent studies have analyzed eating behaviors in the context of early feeding factors; however, results are inconclusive [8,[20][21][22][23][24][25][26][27][28]. Moreover, previous studies sometimes focused on selected early feeding factors such as breastfeeding [24,28], complementary feeding [29,30] or mealtime habits [18,31,32] only. ...
... The current study found that DD was positively correlated with BMI. Although Quah et al. [38] reported that higher DD subscale scores at year 6 were associated with overweight in children, Sanlier et al. [31] and Domoff et al. [21] reported no association between BMI Z score and the DD subscale. The mechanism by which DD may be associated with weight status requires further investigation. ...
... This finding is supported by a study among Singapore families which demonstrated that the influence of ethnicity and culture on parenting styles is greater than parental education [35]. In addition, other studies in Singapore have also reported that Malay children have lower diet quality scores compared to other ethnic groups [36,37]. It is hypothesized that there may be limitations in culturally acceptable or available prudent food options for Malay families and this warrant further consideration in designing future interventions [36]. ...