Abstract
Objectives
To explore early life risk factors of overweight/obesity at age 6 years and their cumulative effects on overweight/obesity at ages 2, 4 and 6 years.
Methods
Altogether 1031 Spanish children were evaluated at birth and during a 6-year follow-up. Early life risk factors included: parental overweight/obesity, parental origin/ethnicity, maternal smoking during pregnancy, gestational weight gain, gestational age, birth weight, caesarean section, breastfeeding practices and rapid infant weight gain collected via hospital records. Cumulative effects were assessed by adding up those early risk factors that significantly increased the risk of overweight/obesity. We conducted binary logistic regression models.
Results
Rapid infant weight gain (OR 2.29, 99% CI 1.54–3.42), maternal overweight/obesity (OR 1.93, 99% CI 1.27–2.92), paternal overweight/obesity (OR 2.17, 99% CI 1.44–3.28), Latin American/Roma origin (OR 3.20, 99% CI 1.60–6.39) and smoking during pregnancy (OR 1.61, 99% CI 1.01–2.59) remained significant after adjusting for confounders. A higher number of early life risk factors accumulated was associated with overweight/obesity at age 6 years but not at age 2 and 4 years.
Conclusions
Rapid infant weight gain, parental overweight/obesity, maternal smoking and origin/ethnicity predict childhood overweight/obesity and present cumulative effects. Monitoring children with rapid weight gain and supporting a healthy parental weight are important for childhood obesity prevention.
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References
Bammann K, Peplies J, De Henauw S, Hunsberger M, Molnar D, Moreno LA, Tornaritis M, Veidebaum T, Ahrens W, Siani A (2014) Early life course risk factors for childhood obesity: the IDEFICS case-control study. PLoS One 13:e86914. https://doi.org/10.1371/journal.pone.0086914
Barros FC, Matijasevich A, Hallal PC, Horta BL, Barros AJ, Menezes AB, Santos IS, Gigante DP, Victora CG (2012) Cesarean section and risk of obesity in childhood, adolescence, and early adulthood: evidence from 3 Brazilian birth cohorts. Am J Clin Nutr 95:465–470. https://doi.org/10.3945/ajcn.111.026401
Cho WK, Suh BK (2016) Catch-up growth and catch-up fat in children born small for gestational age. Korean J Pediatr 59:1–7. https://doi.org/10.3345/kjp.2016.59.1.1
Danielzik S, Czerwinski-Mast M, Langnase K, Dilba B, Muller MJ (2004) Parental overweight, socioeconomic status and high birth weight are the major determinants of overweight and obesity in 5–7 year-old children: baseline data of the Kiel Obesity Prevention Study (KOPS). Int J Obes Relat Metab Disord 28:1494–1502. https://doi.org/10.1038/sj.ijo.0802756
Dennison BA, Edmunds LS, Stratton HH, Pruzek RM (2006) Rapid infant weight gain predicts childhood overweight. Obesity (Silver Spring) 14:491–499. https://doi.org/10.1038/oby.2006.64
Gillman MW, Rifas-Shiman S, Berkey CS, Field AE, Colditz GA (2003) Maternal gestational diabetes, birth weight, and adolescent obesity. Pediatrics 111(3):e221–e226
Gupta N, Goel K, Shah P, Misra A (2012) Childhood obesity in developing countries: epidemiology, determinants, and prevention. Endocr Rev 33:48–70. https://doi.org/10.1210/er.2010-0028
Heck KE, Braveman P, Cubbin C, Chavez GF, Kiely JL (2006) Socioeconomic status and breastfeeding initiation among California mothers. Public Health Rep 121:51–59. https://doi.org/10.1177/003335490612100111
Heppe DH, Kiefte-de Jong JC, Durmus B, Moll HA, Raat H, Hofman A, Jaddoe VW (2013) Parental, fetal, and infant risk factors for preschool overweight: the Generation R Study. Pediatr Res 73:120–127. https://doi.org/10.1038/pr.2012.145
Iguacel I, Fernández-Alvira JM, Labayen I, Moreno LA, Samper MP, Rodríguez G (2017) Social vulnerabilities as determinants of overweight in 2-, 4- and 6-year-old Spanish children. Eur J Public Health 27:788–796. https://doi.org/10.1093/eurpub/ckx095
Jornayvaz FR, Vollenweider P, Bochud M, Mooser V, Waeber G, Marques-Vidal P (2016) Low birth weight leads to obesity, diabetes and increased leptin levels in adults: the CoLaus study. Cardiovasc Diabetol 15:73–83. https://doi.org/10.1186/s12933-016-0389-2
Kuhle S, Tong OS, Woolcott CG (2015) Association between caesarean section and childhood obesity: a systematic review and meta-analysis. Obes Rev 16:295–303. https://doi.org/10.1111/obr.12267
Lefebvre CM, John RM (2014) The effect of breastfeeding on childhood overweight and obesity: a systematic review of the literature. J Am Assoc Nurse Pract 26:386–401. https://doi.org/10.1002/2327-6924.12036
Mamun AA, Mannan M, Doi SA (2014) Gestational weight gain in relation to offspring obesity over the life course: a systematic review and bias-adjusted meta-analysis. Obes Rev 15:338–347. https://doi.org/10.1111/obr.12132
Mangrio E, Hansen K, Lindström M, Köhler M, Rosvall M (2011) Maternal educational level, parental preventive behavior, risk behavior, social support and medical care consumption in 8-month-old children in Malmö, Sweden. BMC Public Health 11:891–900. https://doi.org/10.1186/1471-2458-11-891
Oken E, Levitan EB, Gillman MW (2008) Maternal smoking during pregnancy and child overweight: systematic review and meta-analysis. Int J Obes (Lond) 32:201–210. https://doi.org/10.1038/sj.ijo.0803760
Ong KK, Loos RJ (2006) Rapid infancy weight gain and subsequent obesity: systematic reviews and hopeful suggestions. Acta Paediatr 95:904–908. https://doi.org/10.1080/08035250600719754
Oves Suarez B, Escartin Madurga L, Samper Villagrasa MP, Cuadron Andres L, Alvarez Sauras ML, Lasarte Velillas JJ, Moreno Aznar LA, Rodriguez Martinez G (2014) Immigration and factors associated with breastfeeding. An Pediatr (Barc) 81:32–38. https://doi.org/10.1016/j.anpedi.2013.09.008
Parikka S, Maki P, Levalahti E, Lehtinen-Jacks S, Martelin T, Laatikainen T (2015) Associations between parental BMI, socioeconomic factors, family structure and overweight in Finnish children: a path model approach. BMC Public Health 15:271–281. https://doi.org/10.1186/s12889-015-1548-1
Parrino C, Vinciguerra F, La Spina N, Romeo L, Tumminia A, Baratta R, Squatrito S, Vigneri R, Frittitta L (2016) Influence of early-life and parental factors on childhood overweight and obesity. J Endocrinol Invest 39:1315–1321. https://doi.org/10.1007/s40618-016-0501-1
Reilly JJ, Armstrong J, Dorosty AR, Emmett PM, Ness A, Rogers I, Steer C, Sherriff A (2005) Early life risk factors for obesity in childhood: cohort study. BMJ 330:1357. https://doi.org/10.1136/bmj.38470.670903.E0
Robinson SM, Crozier SR, Harvey NC, Barton BD, Law CM, Godfrey KM, Cooper C, Inskip HM (2015) Modifiable early-life risk factors for childhood adiposity and overweight: an analysis of their combined impact and potential for prevention. Am J Clin Nutr 101:368–375. https://doi.org/10.3945/ajcn.114.094268
Salsberry PJ, Reagan PB (2005) Dynamics of early childhood overweight. Pediatrics 116:1329–1338. https://doi.org/10.1542/peds.2004-2583
Samura T, Steer J, Michelis LD, Carroll L, Holland E, Perkins R (2016) Factors associated with excessive gestational weight gain: review of current literature. Glob Adv Health Med 5:87–93. https://doi.org/10.7453/gahmj.2015.094
Serra-Majem L, Aranceta Bartrina J, Perez-Rodrigo C, Ribas-Barba L, Delgado-Rubio A (2006) Prevalence and determinants of obesity in Spanish children and young people. Br J Nutr 96:S67–S72
Sridhar SB, Darbinian J, Ehrlich SF, Markman MA, Gunderson EP, Ferrara A, Hedderson MM (2014) Maternal gestational weight gain and offspring risk for childhood overweight or obesity. Am J Obstet Gynecol 211:e1–e8. https://doi.org/10.1016/j.ajog.2014.02.030
Stettler N, Tershakovec AM, Zemel BS, Leonard MB, Boston RC, Katz SH, Stallings VA (2000) Early risk factors for increased adiposity: a cohort study of African American subjects followed from birth to young adulthood. Am J Clin Nutr 72:378–383
Tie HT, Xia YY, Zeng YS, Zhang Y, Dai CL, Guo JJ, Zhao Y (2014) Risk of childhood overweight or obesity associated with excessive weight gain during pregnancy: a meta-analysis. Arch Gynecol Obstet 289:247–257. https://doi.org/10.1007/s00404-013-3053-z
UNESCO, Institute for Statistics. UNESCO (1997) International Standard Classification of Education (ISCED). Montreal, QC, 2006. http://www.unesco.org/education/information/nfsunesco/doc/isced_1997.htm. Accessed 15 February 2017
Van Ansem WJ, Schrijvers CT, Rodenburg G, van de Mheen D (2014) Maternal educational level and children’s healthy eating behaviour: role of the home food environment (cross-sectional results from the INPACT study). Int J Behav Nutr Phys Act 11:113
Weng SF, Redsell SA, Swift JA, Yang M, Glazebrook CP (2012) Systematic review and meta-analyses of risk factors for childhood overweight identifiable during infancy. Arch Dis Child 97:1019–1026. https://doi.org/10.1136/archdischild-2012-302263
Whitaker RC, Wright JA, Pepe MS, Seidel KD, Dietz WH (1997) Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med 337:869–873. https://doi.org/10.1056/nejm199709253371301
White J, Rehkopf D, Mortensen LH (2016) Trends in socioeconomic inequalities in Body Mass Index, underweight and obesity among english children, 2007–2008 to 2011–2012. PLoS One 11:e0147614. https://doi.org/10.1371/journal.pone.0147614
Williams JE, Helsel B, Griffin SF, Liang J (2017) Associations between parental BMI and the family nutrition and physical activity environment in a community sample. J Community Health 42:1233–1239. https://doi.org/10.1007/s10900-017-0375-y
World Health Organization (2006) The WHO Child Growth Standards. http://www.who.int/childgrowth/standards/en/. Accessed 13 January 2016
World Health Organization (2007) Growth reference data for 5–19 years. http://www.who.int/growthref/en/. Accessed 13 January 2016
World Health Organization (2010) Indicators for assessing infant and young child feeding practices, part 2: measurement. http://www.who.int/nutrition/publications/infantfeeding/9789241599290/en/. Accessed 8 January 2016
Yan J, Liu L, Zhu Y, Huang G, Wang PP (2014) The association between breastfeeding and childhood obesity: a meta-analysis. BMC Public Health 14:1267–1278. https://doi.org/10.1186/1471-2458-14-1267
Yuan C, Gaskins AJ, Blaine AI, Zhang C, Gillman MW, Missmer SA, Field AE, Chavarro JE (2016) Association between cesarean birth and risk of obesity in offspring in childhood, adolescence, and early adulthood. JAMA Pediatr 170:e162385. https://doi.org/10.1001/jamapediatrics.2016.2385
Zhang T, Cai L, Ma L, Jing J, Chen Y, Ma J (2016) The prevalence of obesity and influence of early life and behavioral factors on obesity in Chinese children in Guangzhou. BMC Public Health 16:954–967. https://doi.org/10.1186/s12889-016-3599-3
Acknowledgements
This study has been supported by three grants from the Carlos III Health Institute: 1) PI08/0559: Aragon Health Sciences Institute for the project Growth and Feeding in Infants from Aragon (CALINA); 2) PI13/02359 Environmental factors influencing early development of obesity during childhood and body composition programming; and 3) RD12/0026: Maternal, Child Health and Development Network (Retic SAMID) RETICS funded by the PN I + D+I 2008-2011 (Spain), ISCIII- Sub-Directorate General for Research Assessment and Promotion and the European Regional Development Fund (ERDF). I. I was supported by the FPU Predoctoral Programs (grant reference FPU014/00922) of the Spanish Ministry of Education and Science. We thank the CALINA children and their parents who generously volunteered and participated in this project.
Crecimiento y Alimentación durante la Lactancia y la primera Infancia en Niños Aragoneses (CALINA) Collaborative Group. Instituto de Investigación Sanitaria (Institute of Health Research), Aragón.
Coordinators: José L. Olivares López and Gerardo Rodríguez Martínez.
Collaborators: Dori Adivinación Herrero, Roberto Alijarde Lorente, M. Jesús Álvarez Otazu, M. Luisa Álvarez Sauras, Teresa Arana Navarro, Esther Atance Melendo, Ariadna Ayerza Casas, Concepción Balagué Clemos, M. Victoria Baños Ledesma, M. Lucía Bartolomé Lalanza, Teresa Bartrés Soler, M. Jesús Blasco Pérez-Aramendia, Purificación Broto Cosculluela, M. Jesús Cabañas Bravo, Rosa Cáncer Raginal, M. Inmaculada Cebrián Gimeno, Teresa Cenarro Guerrero, M. Begoña Chicote Abadía, María Cleofé Crespo Mainar, María Duplá Arenaz, Luis Carlos Elviro Mayoral, Concha Esteban Herréiz, Ángeles Falcón Polo, Jesús Feliz de Vargas Pastor, M. Teresa Fondevilla Pérez, M. Desamparados Forés Catalá, Amparo Fuertes Domínguez, Jorge Fuertes Fernández-Espinar, José Galán Rico, José Galbe Sánchez-Ventura, Matilde Gallego Pérez, Nuria García Sánchez, César García Vera, Ana-Luz Garín Moreno, M. Asunción Gila Gajón, Carmen Júdez Molina, Beatriz Kojtych Trevijano, M. Lourdes Laín Ara, M. Jesús Lalaguna Puértolas, M. Pilar Lalana Josa, Elisa Lambán Casamayor, Juan José Lasarte Velillas, M.ª Isabel Lostal Gracia, Rosa Magallón Botalla, Mónica Marco Olloqui, M. Pilar Marín Ibáñez, José Luis Martínez Bueno, Laura Martínez Espligares, José M. Mengual Gil, Isabel Moneo Hernández, Mercedes Montaner Cosa, Luis A. Moreno Aznar, Ana Isabel Muñoz Campos, Elena Muñoz Jalle, Eva María Navarro Serrano, Luis Carlos Pardos Martínez, José Antonio Pinilla Fuentes, Carmen Puig García, Pascual Puyuelo del Val, M. Victoria Redondo Cuerpo, Rafael Ruiz Pastora, Pilar Samper Villagrasa, Javier Sánchez Gimeno, Asunción Sánchez Zapater, M. Flor Sebastián Bonel, M. Teresa Solans Bascuas, Jiménez, M. Carmen Viñas Viamonte, Gregorio Zarazaga Germes.
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The authors’ contributions were as follows: II carried out the statistical analysis and drafted the manuscript along with GR, LE, JF-A, IL, II, LAM, GR, and MPS collected the data, supervised the data procedure and read and critically reviewed the manuscript.
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Ethical approval was obtained from the regional Committee of Ethics (Comité Ético de Investigación Clínica de Aragón, CEICA).
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Iguacel, I., Escartín, L., Fernández-Alvira, J.M. et al. Early life risk factors and their cumulative effects as predictors of overweight in Spanish children. Int J Public Health 63, 501–512 (2018). https://doi.org/10.1007/s00038-018-1090-x
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DOI: https://doi.org/10.1007/s00038-018-1090-x