Modifiable early life exposures associated with adiposity and obesity in 3-year old children born to mothers with obesity
Modifiable early life exposures associated with adiposity and obesity in 3-year old children born to mothers with obesity
Background: Children born to mothers with obesity are at increased risk of obesity. Influences underlying this predisposition include in-utero exposures, genetic predisposition and a shared family environment. Effective intervention strategies are needed to prevent obesity in these high-risk children; this requires evaluation of modifiable pregnancy and early-life risk factors. Objectives: To assess the individual and cumulative contributions of maternal and early-life modifiable exposures on childhood adiposity and obesity outcomes in 3-year-old children born to women with obesity. Methods: We used adjusted regression to assess the individual and cumulative contributions of six exposures (early pregnancy BMI, excessive gestational weight gain, mode of infant feeding and three measures of childhood eating habits [food responsiveness, slowness in eating and a processed/snacking dietary pattern score]) on body composition in 495 three-year-old children. Outcomes included BMI z-score, arm circumference and overweight/obesity (BMI≥25.0 kg/m
2). Results: While the UPBEAT intervention did not influence adiposity outcomes in 3-year-old children, the six modifiable exposures combined incrementally to increase childhood adiposity and obesity. For each additional exposure, children had a higher BMI z-score (β = 0.35SD [95% confidence interval: 0.23, 0.47]), arm circumference (β = 0.59 cm [0.40, 0.79]) and risk of overweight/obesity (relative risk 1.49 [1.26, 1.77]). Compared to no exposures, children with four or more exposures had a higher BMI z-score (1.11SD [0.65, 1.58]), arm circumference (2.15 cm [1.41, 2.89]) and risk of overweight/obesity (3.01 [1.67, 5.41]) (all P < 0.001). Conclusion: Our findings suggest that complex interventions targeting preconception, pregnancy, perinatal and early childhood exposures offer a potential strategy for prevention of pre-school obesity.
childhood obesity, dietary intake, early-life determinants, in-utero determinants, maternal obesity
Dalrymple, Kathryn V.
8ef94198-4e90-44a9-b77d-19d35d013cde
Flynn, Angela
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Seed, Paul T.
d3eda3f4-0e4c-4c17-9efd-dc75b583e79a
Briley, Annette
43bc174a-0d1b-48c3-a87a-a809de2e2544
O’Keeffe, Majella
fc08e6b3-50af-4e2b-97a7-72dcf0f3e911
Godfrey, Keith
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Poston, Lucilla
916aced2-462e-445f-9efa-83ed4b7b3a9f
November 2021
Dalrymple, Kathryn V.
8ef94198-4e90-44a9-b77d-19d35d013cde
Flynn, Angela
02bcba40-29da-4e1d-a94e-cc3fac438183
Seed, Paul T.
d3eda3f4-0e4c-4c17-9efd-dc75b583e79a
Briley, Annette
43bc174a-0d1b-48c3-a87a-a809de2e2544
O’Keeffe, Majella
fc08e6b3-50af-4e2b-97a7-72dcf0f3e911
Godfrey, Keith
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Poston, Lucilla
916aced2-462e-445f-9efa-83ed4b7b3a9f
Dalrymple, Kathryn V., Flynn, Angela, Seed, Paul T., Briley, Annette, O’Keeffe, Majella, Godfrey, Keith and Poston, Lucilla
(2021)
Modifiable early life exposures associated with adiposity and obesity in 3-year old children born to mothers with obesity.
Pediatric Obesity, 16 (11), [e12801].
(doi:10.1111/ijpo.12801).
Abstract
Background: Children born to mothers with obesity are at increased risk of obesity. Influences underlying this predisposition include in-utero exposures, genetic predisposition and a shared family environment. Effective intervention strategies are needed to prevent obesity in these high-risk children; this requires evaluation of modifiable pregnancy and early-life risk factors. Objectives: To assess the individual and cumulative contributions of maternal and early-life modifiable exposures on childhood adiposity and obesity outcomes in 3-year-old children born to women with obesity. Methods: We used adjusted regression to assess the individual and cumulative contributions of six exposures (early pregnancy BMI, excessive gestational weight gain, mode of infant feeding and three measures of childhood eating habits [food responsiveness, slowness in eating and a processed/snacking dietary pattern score]) on body composition in 495 three-year-old children. Outcomes included BMI z-score, arm circumference and overweight/obesity (BMI≥25.0 kg/m
2). Results: While the UPBEAT intervention did not influence adiposity outcomes in 3-year-old children, the six modifiable exposures combined incrementally to increase childhood adiposity and obesity. For each additional exposure, children had a higher BMI z-score (β = 0.35SD [95% confidence interval: 0.23, 0.47]), arm circumference (β = 0.59 cm [0.40, 0.79]) and risk of overweight/obesity (relative risk 1.49 [1.26, 1.77]). Compared to no exposures, children with four or more exposures had a higher BMI z-score (1.11SD [0.65, 1.58]), arm circumference (2.15 cm [1.41, 2.89]) and risk of overweight/obesity (3.01 [1.67, 5.41]) (all P < 0.001). Conclusion: Our findings suggest that complex interventions targeting preconception, pregnancy, perinatal and early childhood exposures offer a potential strategy for prevention of pre-school obesity.
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Accepted/In Press date: 7 April 2021
Published date: November 2021
Additional Information:
Supported by the European Union's 7th Framework Programme (FP7/2007-2013), project EarlyNutrition; grant agreement no. 289346 and the National Institute for Health Research (NIHR) (UK) Programme Grants for Applied Research Programme (RP-0407-10 452). Support was also provided by the Chief Scientist Office Scotland, Guy's and St Thomas' Charity and Tommy's Charity (Registered charity no. 1060508). KMG is supported by the UK Medical Research Council (MC_UU_12011/4), the European Union (Erasmus+ Capacity-Building ENeASEA (573651-EPP-1-2016-1-DE-EPPKA2-CBHE-JP) and ImpENSA (598488-EPP-1-2018-1-DE-EPPKA2-CBHE-JP) projects), the US National Institute On Aging of the National Institutes of Health (Award No. U24AG047867) and the UK ESRC and BBSRC (Award No. ES/M00919X/1). LP, ACF an ALB are funded by Tommy's Charity and KVD is supported by the British Heart Foundation (FS/17/71/32953). PTS is partly funded by King's Health Partners Institute of Women and Children's Health (KHP), Tommy's and by ARC South London (NIHR). KMG is an NIHR Senior Investigator (NF-SI-0515-10 042) and LP is an NIHR Senior Investigator Emeritus (NI-SI-0512-10 104). KMG is supported by the NIHR Southampton Biomedical Research Centre and LP is supported by the NIHR Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust and King's College London.
Keywords:
childhood obesity, dietary intake, early-life determinants, in-utero determinants, maternal obesity
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Local EPrints ID: 448877
URI: http://eprints.soton.ac.uk/id/eprint/448877
ISSN: 2047-6302
PURE UUID: 4e5e3dbd-a99f-4857-b480-3155f579ec8b
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Date deposited: 07 May 2021 16:33
Last modified: 17 Mar 2024 06:32
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Contributors
Author:
Kathryn V. Dalrymple
Author:
Angela Flynn
Author:
Paul T. Seed
Author:
Annette Briley
Author:
Majella O’Keeffe
Author:
Lucilla Poston
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