Modifiable early-life risk factors for childhood adiposity and overweight: an analysis of their combined impact and potential for prevention
Year: 2014
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Early life may be a "critical period" when appetite and regulation of energy balance are programmed, with lifelong consequences for obesity risk. Insight into the potential impact of modifying early-life risk factors on later obesity can be gained by evaluating their combined effects. OBJECTIVE: The objective was to examine the relation between the number of early-life risk factors and obesity outcomes among children in a prospective birth cohort (Southampton Women's Survey). DESIGN: Five risk factors were defined: maternal obesity [prepregnant body mass index (BMI; in kg/m(2)) >30], excess gestational weight gain (Institute of Medicine, 2009), smoking during pregnancy, low maternal vitamin D status (<64 nmol/L), and short duration of breastfeeding (none or <1 mo). Obesity outcomes examined when the children were aged 4 and 6 y were BMI, dual-energy X-ray absorptiometry-assessed fat mass, overweight, or obesity (International Obesity Task Force). Data were available for 991 mother-child pairs, with children born between 1998 and 2003. RESULTS: Of the children, 148 (15%) had no early-life risk factors, 330 (33%) had 1, 296 (30%) had 2, 160 (16%) had 3, and 57 (6%) had 4 or 5. At both 4 and 6 y, there were positive graded associations between number of early-life risk factors and each obesity outcome (all P < 0.001). After taking account of confounders, the relative risk of being overweight or obese for children who had 4 or 5 risk factors was 3.99 (95% CI: 1.83, 8.67) at 4 y and 4.65 (95% CI: 2.29, 9.43) at 6 y compared with children who had none (both P < 0.001). CONCLUSIONS: Having a greater number of early-life risk factors was associated with large differences in adiposity and risk of overweight and obesity in later childhood. These findings suggest that early intervention to change these modifiable risk factors could make a significant contribution to the prevention of childhood obesity.
Institutions: Nuffield Orthopaedic Centre, University Hospital Southampton NHS Foundation Trust, National Institute for Health and Care Research, University of Oxford, NIHR Southampton Biomedical Research Centre, MRC Lifecourse Epidemiology Unit, University of Southampton, University College London, Medical Research Council
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $5,200
Awards: G1277089031, G2473961061, G3207356259, G393177772, Sarcopenia, Frailty and Clinical Practice in Older People, RENEWAL: Maternal and epigenetic determinants of cardiovascular structure and function, NIHR Senior Investigator Award, G5605571342, G5702163051, Lifecourse Determinants of Bone and Joint Disease, NIHR Senior Investigator Award, Nutrition, Development and Lifelong Health: Studies in European Populations, Long-term effects of early nutrition on later health
OpenAlex ID: W2128188104