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Modifiable risk factors in the first 1000 days for subsequent risk of childhood overweight in an Asian cohort: Significance of parental overweight status

Modifiable risk factors in the first 1000 days for subsequent risk of childhood overweight in an Asian cohort: Significance of parental overweight status
Modifiable risk factors in the first 1000 days for subsequent risk of childhood overweight in an Asian cohort: Significance of parental overweight status

Background/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 childhood adiposity and risk of overweight/obesity in an Asian cohort.Methods:Six risk factors were examined: Maternal pre-pregnancy overweight/obesity (body mass index (BMI) ≥425 kg m-2), paternal overweight/obesity at 24 months post delivery, maternal excessive gestational weight gain, raised maternal fasting glucose during pregnancy (≥45.1 mmol l-1), breastfeeding duration <4 months and early introduction of solid foods (<4 months). Associations between number of risk factors and adiposity measures (BMI, waist-to-height ratio (WHtR), sum of skinfolds (SSFs), fat mass index (FMI) and overweight/obesity) at 48 months were assessed using multivariable regression models.Results:Of 858 children followed up at 48 months, 172 (19%) had none, 274 (32%) had 1, 244 (29%) had 2, 126 (15%) had 3 and 42 (5%) had ≥44 risk factors. Adjusting for confounders, significant graded positive associations were observed between number of risk factors and adiposity outcomes at 48 months. Compared with children with no risk factors, those with four or more risk factors had s.d. unit increases of 0.78 (95% confidence interval 0.41-1.15) for BMI, 0.79 (0.41-1.16) for WHtR, 0.46 (0.06-0.83) for SSF and 0.67 (0.07-1.27) for FMI. The adjusted relative risk of overweight/obesity in children with four or more risk factors was 11.1(2.5-49.1) compared with children with no risk factors. Children exposed to maternal pre-pregnancy (11.8(9.8-13.8)%) or paternal overweight status (10.6(9.6-11.6)%) had the largest individual predicted probability of child overweight/obesity.Conclusions:Early-life risk factors added cumulatively to increase childhood adiposity and risk of overweight/obesity. Early-life and preconception intervention programmes may be more effective in preventing overweight/obesity if they concurrently address these multiple modifiable risk factors.

0307-0565
44-51
Aris, I.M.
ee15a46e-ead3-4b4a-a208-d39038a85480
Bernard, J.Y.
1a5b77ae-6090-4f80-8db2-4918e444b429
Chen, L.W.
4f340f85-a5e8-465b-b5d9-63f3b641a37e
Tint, M.T.
02d6a006-3b94-4328-b3c3-147a618d66c3
Pang, W.W.
ea58c80d-6316-4143-ad93-113b3b0c2072
Soh, S.E.
00a5ad13-4c5b-4fad-aaa9-d080d9aa63e8
Saw, S.M.
0684517e-f27e-49f0-98c3-7630e8fd1bbd
Shek, L.P.C.
5239db80-078c-4143-8b3c-0d48dfe76c14
Godfrey, K.M.
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Gluckman, P.D.
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Chong, Y.S.
436a467c-1372-4c9c-857c-7a913ba5fcb8
Yap, F.
166590c9-89d7-41e3-ab73-1c555b39c3bf
Kramer, M.S.
89f86ceb-c49e-4402-a1e3-d79c406c178d
Lee, Y. S.
1bdb54fb-dd29-4857-8939-f4b0fba309b8
Aris, I.M.
ee15a46e-ead3-4b4a-a208-d39038a85480
Bernard, J.Y.
1a5b77ae-6090-4f80-8db2-4918e444b429
Chen, L.W.
4f340f85-a5e8-465b-b5d9-63f3b641a37e
Tint, M.T.
02d6a006-3b94-4328-b3c3-147a618d66c3
Pang, W.W.
ea58c80d-6316-4143-ad93-113b3b0c2072
Soh, S.E.
00a5ad13-4c5b-4fad-aaa9-d080d9aa63e8
Saw, S.M.
0684517e-f27e-49f0-98c3-7630e8fd1bbd
Shek, L.P.C.
5239db80-078c-4143-8b3c-0d48dfe76c14
Godfrey, K.M.
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Gluckman, P.D.
20557908-bee4-4c9f-bcca-950e8de3d704
Chong, Y.S.
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Yap, F.
166590c9-89d7-41e3-ab73-1c555b39c3bf
Kramer, M.S.
89f86ceb-c49e-4402-a1e3-d79c406c178d
Lee, Y. S.
1bdb54fb-dd29-4857-8939-f4b0fba309b8

Aris, I.M., Bernard, J.Y., Chen, L.W., Tint, M.T., Pang, W.W., Soh, S.E., Saw, S.M., Shek, L.P.C., Godfrey, K.M., Gluckman, P.D., Chong, Y.S., Yap, F., Kramer, M.S. and Lee, Y. S. (2018) Modifiable risk factors in the first 1000 days for subsequent risk of childhood overweight in an Asian cohort: Significance of parental overweight status. International Journal of Obesity, 42 (1), 44-51. (doi:10.1038/ijo.2017.178).

Record type: Article

Abstract

Background/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 childhood adiposity and risk of overweight/obesity in an Asian cohort.Methods:Six risk factors were examined: Maternal pre-pregnancy overweight/obesity (body mass index (BMI) ≥425 kg m-2), paternal overweight/obesity at 24 months post delivery, maternal excessive gestational weight gain, raised maternal fasting glucose during pregnancy (≥45.1 mmol l-1), breastfeeding duration <4 months and early introduction of solid foods (<4 months). Associations between number of risk factors and adiposity measures (BMI, waist-to-height ratio (WHtR), sum of skinfolds (SSFs), fat mass index (FMI) and overweight/obesity) at 48 months were assessed using multivariable regression models.Results:Of 858 children followed up at 48 months, 172 (19%) had none, 274 (32%) had 1, 244 (29%) had 2, 126 (15%) had 3 and 42 (5%) had ≥44 risk factors. Adjusting for confounders, significant graded positive associations were observed between number of risk factors and adiposity outcomes at 48 months. Compared with children with no risk factors, those with four or more risk factors had s.d. unit increases of 0.78 (95% confidence interval 0.41-1.15) for BMI, 0.79 (0.41-1.16) for WHtR, 0.46 (0.06-0.83) for SSF and 0.67 (0.07-1.27) for FMI. The adjusted relative risk of overweight/obesity in children with four or more risk factors was 11.1(2.5-49.1) compared with children with no risk factors. Children exposed to maternal pre-pregnancy (11.8(9.8-13.8)%) or paternal overweight status (10.6(9.6-11.6)%) had the largest individual predicted probability of child overweight/obesity.Conclusions:Early-life risk factors added cumulatively to increase childhood adiposity and risk of overweight/obesity. Early-life and preconception intervention programmes may be more effective in preventing overweight/obesity if they concurrently address these multiple modifiable risk factors.

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Accepted/In Press date: 14 July 2017
e-pub ahead of print date: 28 July 2017
Published date: 1 January 2018

Identifiers

Local EPrints ID: 417826
URI: https://eprints.soton.ac.uk/id/eprint/417826
ISSN: 0307-0565
PURE UUID: 588d9e60-fc3e-42c4-8594-2f6d00a7d376
ORCID for K.M. Godfrey: ORCID iD orcid.org/0000-0002-4643-0618

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Date deposited: 15 Feb 2018 17:30
Last modified: 06 Jun 2018 13:11

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Contributors

Author: I.M. Aris
Author: J.Y. Bernard
Author: L.W. Chen
Author: M.T. Tint
Author: W.W. Pang
Author: S.E. Soh
Author: S.M. Saw
Author: L.P.C. Shek
Author: K.M. Godfrey ORCID iD
Author: P.D. Gluckman
Author: Y.S. Chong
Author: F. Yap
Author: M.S. Kramer
Author: Y. S. Lee

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