Background: The fungi in the gastrointestinal tract, the gut mycobiota, are now recognised as a significant part of the gut microbiota, and they may be important to human health. In contrast to the adult gut mycobiota, the establishment of the early gut mycobiota has never been described, and there is little knowledge about the fungal transfer from mother to offspring. Methods: In a prospective cohort, we followed 298 pairs of healthy mothers and offspring from 36 weeks of gestation until 2 years of age (1516 samples) and explored the gut mycobiota in maternal and offspring samples. Half of the pregnant mothers were randomised into drinking probiotic milk during and after pregnancy. The probiotic bacteria included Lactobacillus rhamnosus GG (LGG), Bifidobacterium animalis subsp. lactis Bb-12 and Lactobacillus acidophilus La-5. We quantified the fungal abundance of all the samples using qPCR of the fungal internal transcribed spacer (ITS)1 segment, and we sequenced the 18S rRNA gene ITS1 region of 90 high-quantity samples using the MiSeq platform (Illumina). Results: The gut mycobiota was detected in most of the mothers and the majority of the offspring. The offspring showed increased odds of having detectable faecal fungal DNA if the mother had detectable fungal DNA as well (OR = 1.54, p = 0.04). The fungal alpha diversity in the offspring gut increased from its lowest at 10 days after birth, which was the earliest sampling point. The fungal diversity and fungal species showed a succession towards the maternal mycobiota as the child aged, with Debaryomyces hansenii being the most abundant species during breast-feeding and Saccharomyces cerevisiae as the most abundant after weaning. Probiotic consumption increased the gut mycobiota abundance in pregnant mothers (p = 0.01). Conclusion: This study provides the first insight into the early fungal establishment and the succession of fungal species in the gut mycobiota. The results support the idea that the fungal host phenotype is transferred from mother to offspring. Trial registration: Clinicaltrials.gov NCT00159523

From a life-course perspective, genetic and environmental factors driving childhood obesity may have a lasting influence on health later in life. However, how obesity trajectories vary throughout the life-course remains unknown. Recently, Richardson et al. created powerful early life and adult gene scores for body mass index (BMI) in a comprehensive attempt to separate childhood and adult obesity. The childhood score was derived using questionnaire-based data administered to adults aged 40–69 regarding their relative body size at age 10, making it prone to recall and misclassification bias. We therefore attempted to validate the childhood and adult scores using measured BMI data in adolescence and adulthood among 66 963 individuals from the HUNT Study in Norway from 1963 to 2019. The predictive performance of the childhood score was better in adolescence and early adulthood, whereas the predictive performance of the adult score was better in adulthood. In the age group 12–15.9 years, the variance explained by the childhood polygenic risk score (PRS) was 6.7% versus 2.4% for the adult PRS. In the age group 24–29.9 years, the variance explained by the adult PRS was 3.9% versus 3.6% for the childhood PRS. Our findings support that genetic factors driving BMI differ at young age and in adulthood. Within the framework of multivariable Mendelian randomization, the validated childhood gene score can now be used to determine the consequence of childhood obesity on later disease.

Background/Objectives: Qualitative child-centered research on pediatric obesity treatment and body image remains limited. This study aimed to explore children’s and adolescents’ experiences with hospital-based obesity treatment and how these experiences relate to body image. Methods: A full-day workshop including three main participatory tasks was conducted in two groups of children (9–13 years) and adolescents (14–18 years), focusing on their experiences with obesity treatment and body image. Data were audiotaped, transcribed verbatim, and analyzed using reflexive thematic analysis. Results: Four main themes emerged, reflecting different aspects of participants’ experiences. The first theme, Talk with me and not my parents, encompassed participants’ desire for greater agency, as children described lacking information and feeling excluded from consultations. The second theme, Experiences of communication with healthcare professionals (HCPs) about obesity, concerned participants’ perceptions of trust, support, and non-judgmental communication, with some adolescents expressing a need for additional psychological support. The third theme, Internalization of lifestyle advice, indicated that healthy diet was viewed as the primary focus of obesity treatment, while physical activity received less attention. The final theme, Perceptions of the body, conveyed mixed experiences with weighing and most participants perceived weight loss as success in treatment and weight gain as failure. The participants shared experiences of weight-based bullying, perceived stigma, and challenges with maintaining a positive body image in a society with stereotypical thin and muscular body ideals. Conclusions: Body image was influenced by HCPs’ emphasis on health and body size, and by their own internalized perceptions, influenced by societal ideals and experiences of stigma.

03.02.2023: Debatt - Det eneste effektive legemiddelet mot alvorlig fedme hos ungdom i Norge ble fjernet fra blåreseptforskriften 1.