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Modifiable early-life risk factors for childhood adiposity and overweight: an analysis of their combined impact and potential for prevention

Modifiable early-life risk factors for childhood adiposity and overweight: an analysis of their combined impact and potential for prevention
Modifiable early-life risk factors for childhood adiposity and overweight: an analysis of their combined impact and potential for prevention
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/m2) >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.
adiposity, childhood obesity, early life, obesity, lifecourse, prevention
0002-9165
368-375
Robinson, S.M.
ba591c98-4380-456a-be8a-c452f992b69b
Crozier, Sarah
9c3595ce-45b0-44fa-8c4c-4c555e628a03
Harvey, N.C.
ce487fb4-d360-4aac-9d17-9466d6cba145
Barton, B.D.
3b282ece-178b-4f8c-bc7b-5e9b0de0442b
Law, C.M.
dea86924-3c5e-472b-bfd4-a54cccc9fe90
Godfrey, K.M.
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Inskip, H.M.
5fb4470a-9379-49b2-a533-9da8e61058b7
Robinson, S.M.
ba591c98-4380-456a-be8a-c452f992b69b
Crozier, Sarah
9c3595ce-45b0-44fa-8c4c-4c555e628a03
Harvey, N.C.
ce487fb4-d360-4aac-9d17-9466d6cba145
Barton, B.D.
3b282ece-178b-4f8c-bc7b-5e9b0de0442b
Law, C.M.
dea86924-3c5e-472b-bfd4-a54cccc9fe90
Godfrey, K.M.
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Inskip, H.M.
5fb4470a-9379-49b2-a533-9da8e61058b7

Robinson, S.M., Crozier, Sarah, Harvey, N.C., Barton, B.D., Law, C.M., Godfrey, K.M., Cooper, C. and Inskip, H.M. (2015) Modifiable early-life risk factors for childhood adiposity and overweight: an analysis of their combined impact and potential for prevention. American Journal of Clinical Nutrition, 101 (2), 368-375. (doi:10.3945/ajcn.114.094268).

Record type: Article

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/m2) >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.

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More information

Accepted/In Press date: 12 November 2014
e-pub ahead of print date: 3 December 2014
Published date: January 2015
Keywords: adiposity, childhood obesity, early life, obesity, lifecourse, prevention
Organisations: Human Development & Health, Medical Research Council

Identifiers

Local EPrints ID: 374072
URI: http://eprints.soton.ac.uk/id/eprint/374072
ISSN: 0002-9165
PURE UUID: 179b1b8d-0816-4e65-9cdf-6e9a45d47de0
ORCID for S.M. Robinson: ORCID iD orcid.org/0000-0003-1766-7269
ORCID for Sarah Crozier: ORCID iD orcid.org/0000-0002-9524-1127
ORCID for N.C. Harvey: ORCID iD orcid.org/0000-0002-8194-2512
ORCID for K.M. Godfrey: ORCID iD orcid.org/0000-0002-4643-0618
ORCID for C. Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for H.M. Inskip: ORCID iD orcid.org/0000-0001-8897-1749

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Date deposited: 03 Feb 2015 10:48
Last modified: 18 Mar 2024 02:58

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Contributors

Author: S.M. Robinson ORCID iD
Author: Sarah Crozier ORCID iD
Author: N.C. Harvey ORCID iD
Author: B.D. Barton
Author: C.M. Law
Author: K.M. Godfrey ORCID iD
Author: C. Cooper ORCID iD
Author: H.M. Inskip ORCID iD

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