Rozenn Nedelec1, Jouko Miettunen1,2, Minna Männikkö3, Marjo-Riitta Järvelin4,5,6,7,8, Sylvain Sebert1. 1. Center for Life Course Health Research, University of Oulu, Oulu, Finland. 2. Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland. 3. Infrastructure for Population Studies, Northern Finland Birth Cohorts, Faculty of Medicine, University of Oulu, Oulu, Finland. 4. Center for Life Course Health Research, University of Oulu, Oulu, Finland. m.jarvelin@imperial.ac.uk. 5. Unit of Primary Care, Oulu University Hospital, Oulu, Finland. m.jarvelin@imperial.ac.uk. 6. Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK. m.jarvelin@imperial.ac.uk. 7. MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK. m.jarvelin@imperial.ac.uk. 8. Department of Life Sciences, College of Health and Life Sciences, Brunel University London, London, UK. m.jarvelin@imperial.ac.uk.
Abstract
BACKGROUND/ OBJECTIVE: Children BMI is a longitudinal phenotype, developing through interplays between genetic and environmental factors. Whilst childhood obesity is escalating, we require a better understanding of its early origins and variation across generations to prevent it. SUBJECTS/ METHODS: We designed a cross-cohort study including 12,040 Finnish children from the Northern Finland Birth Cohorts 1966 and 1986 (NFBC1966 and NFBC1986) born before or at the start of the obesity epidemic. We used group-based trajectory modelling to identify BMI trajectories from 2 to 20 years. We subsequently tested their associations with early determinants (mother and child) and the possible difference between generations, adjusted for relevant biological and socioeconomic confounders. RESULTS: We identified four BMI trajectories, 'stable-low' (34.8%), 'normal' (44.0%), 'stable-high' (17.5%) and 'early-increase' (3.7%). The 'early-increase' trajectory represented the highest risk for obesity. We analysed a dose-response association of maternal pre-pregnancy BMI and smoking with BMI trajectories. The directions of effect were consistent across generations and the effect sizes tended to increase from earlier generation to later. Respectively for NFBC1966 and NFBC1986, the adjusted risk ratios of being in the early-increase group were 1.08 (1.06-1.10) and 1.12 (1.09-1.15) per unit of pre-pregnancy BMI and 1.44 (1.05-1.96) and 1.48 (1.17-1.87) in offspring of smoking mothers compared to non-smokers. We observed similar relations with infant factors including birthweight for gestational age and peak weight velocity. In contrast, the age at adiposity peak in infancy was associated with the BMI trajectories in NFBC1966 but did not replicate in NFBC1986. CONCLUSIONS: Exposures to adverse maternal predictors were associated with a higher risk obesity trajectory and were consistent across generations. However, we found a discordant association for the timing of adiposity peak over a 20-year period. This suggests the role of residual environmental factors, such as nutrition, and warrants additional research to understand the underlying gene-environment interplay.
BACKGROUND/ OBJECTIVE: Children BMI is a longitudinal phenotype, developing through interplays between genetic and environmental factors. Whilst childhood obesity is escalating, we require a better understanding of its early origins and variation across generations to prevent it. SUBJECTS/ METHODS: We designed a cross-cohort study including 12,040 Finnish children from the Northern Finland Birth Cohorts 1966 and 1986 (NFBC1966 and NFBC1986) born before or at the start of the obesity epidemic. We used group-based trajectory modelling to identify BMI trajectories from 2 to 20 years. We subsequently tested their associations with early determinants (mother and child) and the possible difference between generations, adjusted for relevant biological and socioeconomic confounders. RESULTS: We identified four BMI trajectories, 'stable-low' (34.8%), 'normal' (44.0%), 'stable-high' (17.5%) and 'early-increase' (3.7%). The 'early-increase' trajectory represented the highest risk for obesity. We analysed a dose-response association of maternal pre-pregnancy BMI and smoking with BMI trajectories. The directions of effect were consistent across generations and the effect sizes tended to increase from earlier generation to later. Respectively for NFBC1966 and NFBC1986, the adjusted risk ratios of being in the early-increase group were 1.08 (1.06-1.10) and 1.12 (1.09-1.15) per unit of pre-pregnancy BMI and 1.44 (1.05-1.96) and 1.48 (1.17-1.87) in offspring of smoking mothers compared to non-smokers. We observed similar relations with infant factors including birthweight for gestational age and peak weight velocity. In contrast, the age at adiposity peak in infancy was associated with the BMI trajectories in NFBC1966 but did not replicate in NFBC1986. CONCLUSIONS: Exposures to adverse maternal predictors were associated with a higher risk obesity trajectory and were consistent across generations. However, we found a discordant association for the timing of adiposity peak over a 20-year period. This suggests the role of residual environmental factors, such as nutrition, and warrants additional research to understand the underlying gene-environment interplay.