The development of childhood obesity is complex and complicated. While it is difficult to point to one thing that accounts for childhood obesity (which makes it very similar to adult obesity), there are also no simple solutions.
Nevertheless, it is certainly important to understand if there are indeed factors that are associated with the increased risk for childhood obesity – especially risk factors that can potentially be ameliorated.
This was the subject of a paper by Sylvana Cote and colleagues from the University of Montreal, just published in the Archives of Pediatric and Adolescent Medicine.
The researchers studied the developmental trajectories of BMI in early childhood in an 8-year longitudinal study consisting of a representative sample of over 2000 children selected through birth registries for the Quebec Longitudinal Study of Child Development.
Three trajectories of BMI were identified: low-stable (54.5% of children), moderate (41.0%), and high-rising (4.5%).
The high-rising group, characterized by an increasing average BMI, which exceeded international cutoff values for obesity by age 8 years, was associated with two maternal risk factors: maternal BMI (with a 6-fold higher odds ration if the mother was herself obese) and maternal smoking during pregnancy (odds ration 2.28).
If these risk factors are indeed causally linked to childhood obesity (and not just surrogates for other aspects of maternal or family behaviour), then they may be amenable to intervention. Clearly, not smoking during pregnancy should by now be something that everyone should realize bears risks for both mother and offspring (and not just risk for obesity).
How to better manage weight before and during pregnancy will likely prove to ba a far greater challenge.
However, as the authors point out:
“Children continuing on an elevated BMI trajectory leading to obesity in middle childhood can be distinguished from children on a normative BMI trajectory as early as age 3.5 years. Important and preventable risk factors for childhood obesity are in place before birth.”
This means that the most effective approaches to preventing childhood obesity may well precede the birth of the child – once born, not dissimilar to managing adult obesity, all interventions are likely to be palliative.
AMS
Edmonton, Alberta
Pryor LE, Tremblay RE, Boivin M, Touchette E, Dubois L, Genolini C, Liu X, Falissard B, & Côté SM (2011). Developmental trajectories of body mass index in early childhood and their risk factors: an 8-year longitudinal study. Archives of pediatrics & adolescent medicine, 165 (10), 906-12 PMID: 21969392
In The News
October 11th, 2011 at 11:43 am
Isn’t it a little disingenuous to fail to mention the heritability of body size in a post like this? Of course heavy moms tend to have kids who are built like they are. In my case, however, the fat genes came from my dad’s side of the family. My mom’s a thin non-smoker. My dad, like me, was fat from childhood onward.
It’s also worth noting that both maternal and paternal under-nutrition (dieting as well as famine?) may trigger obesity genes in fetuses. A good summary of the research can be found in this article. Sorry for not providing links to the original studies, but you must already be aware of them.
October 16th, 2011 at 12:51 pm
Thanks a lot Dr Sharma, agian.
Its Very complex as you say. Recently at J of Clin Endocrinol, other article display that factors like overnutrition and undernutrition in utero, influences post natal overweigh.
Other authors says that this can be related and printed not only in utero but few weeks of postnatal life, and besides, the brest fedding sseems protect against it agaianst artificial lactation.
Can you tell us more about alterations beetween smoking and weight in mother and babies?
My best regards for you., Fram San Luis Potosi. Mexico.