A pinboard by
this curator

PhD student, Brown University


Longitudinal cohort studies, beginning in early childhood with repeated measures over time, are powerful tools for determining the antecedents of diseases that emerge in adolescence and adulthood. In this presentation we describe the development of a new child cohort study in Samoa designed to measure biological, nutritional, environmental and sociocultural contributors to the high burden of obesity and associated non-communicable diseases in Samoa. In 2015, wave one of data collection recruited 319 2-5 year olds and their mothers from 10 villages in Samoa. We detected a dual burden of malnutrition: clinically significant stunting was present in 25.5% of boys and 15.8% of girls and more than 30% of the sample were anemic, while 14.2% of children were already overweight or obese. Wave Two will be completed in 2017 and there are plans to continue to follow these children biannually into adulthood. The goal of the presentation is to present a study design that may be replicated in other settings and to encourage potential collaborators to contribute key questions to be pursued within the ongoing study.

Key Points:

  • Child cohort studies are powerful tools for determining the antecedents of adolescence and adult diseases
  • Dual burden of malnutrition can be detected among young children in Samoa

Learning Objectives:

  • Participants will be able to identify the potential of cohort studies to prospectively document disease burden and associated risk factors, which may be targeted by intervention and policy
  • Participants will gain awareness of the dual burden of malnutrition among young children in the Pacific Islands

Target Audience: Community members, health-related stakeholders, academics (including students), policy makers


Cohort profile: Pacific Islands Families (PIF) growth study, Auckland, New Zealand.

Abstract: This article profiles a birth cohort of Pacific children participating in an observational prospective study and describes the study protocol used at ages 14-15 years to investigate how food and activity patterns, metabolic risk and family and built environment are related to rates of physical growth of Pacific children.From 2000 to 2015, the Pacific Islands Families Study has followed, from birth, the growth and development of over 1000 Pacific children born in Auckland, New Zealand. In 2014, 931 (66%) of the original cohort had field measures of body composition, blood pressure and glycated haemoglobin. A nested subsample (n=204) was drawn by randomly selecting 10 males and 10 females from each decile of body weight. These participants had measurement of body composition by dual-energy X-ray absorptiometry, food frequency, 6 min walk test and accelerometer-determined physical activity and sedentary behaviours, and blood biomarkers for metabolic disease such as diabetes. Built environment variables were generated from individual addresses.Compared to the Centres for Disease Control and Prevention (CDC) reference population with mean SD scores (SDS) of 0, this cohort of 931 14-year-olds was taller, weighed more and had a higher body mass index (BMI) (mean SDS height >0.6, weight >1.6 and BMI >1.4). 7 of 10 youth were overweight or obese. The nested-sampling frame achieved an even distribution by body weight.Cross-sectional relationships between body size, fatness and growth rate, food patterns, activity patterns, pubertal development, risks for diabetes and hypertension and the family and wider environment will be examined. In addition, analyses will investigate relationships with data collected earlier in the life course and measures of the cohort in the future. Understanding past and present influences on child growth and health will inform timely interventions to optimise future health and reduce inequalities for Pacific people.

Pub.: 04 Nov '16, Pinned: 18 Jun '17

Child, maternal and household-level correlates of nutritional status: a cross-sectional study among young Samoan children.

Abstract: Young children are particularly vulnerable to malnutrition as nutrition transition progresses. The present study aimed to document the prevalence, coexistence and correlates of nutritional status (stunting, overweight/obesity and anaemia) in Samoan children aged 24-59 months.A cross-sectional community-based survey. Height and weight were used to determine prevalence of stunting (height-for-age Z-score +2) based on WHO growth standards. Anaemia was determined using an AimStrip Hemoglobin test system (Hb <110 g/l).Ten villages on the Samoan island of Upolu.Mother-child pairs (n 305) recruited using convenience sampling.Moderate or severe stunting was apparent in 20·3 % of children, 16·1 % were overweight/obese and 34·1 % were anaemic. Among the overweight/obese children, 28·6 % were also stunted and 42·9 % anaemic, indicating dual burden of malnutrition. Stunting was significantly less likely among girls (OR=0·41; 95 % CI 0·21, 0·79, P<0·01) than boys. Overweight/obesity was associated with higher family socio-economic status and decreased sugar intake (OR per 10 g/d=0·89, 95 % CI 0·80, 0·99, P=0·032). The odds of anaemia decreased with age and anaemia was more likely in children with an anaemic mother (OR=2·20; 95 % CI 1·22, 3·98, P=0·007). No child, maternal or household characteristic was associated with more than one of the nutritional status outcomes, highlighting the need for condition-specific interventions in this age group.The observed prevalences of stunting, overweight/obesity and anaemia suggest that it is critical to invest in nutrition and develop health programmes targeting early childhood growth and development in Samoa.

Pub.: 07 Feb '17, Pinned: 18 Jun '17