Kathryn V Dalrymple1, Angela C Flynn1, Paul T Seed1, Annette L Briley1,2, Majella O'Keeffe3, Keith M Godfrey4, Lucilla Poston1. 1. Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK. 2. College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia. 3. Department of Nutritional Sciences, School of Life Course Sciences, King's College London, London, UK. 4. MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
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/m2 ). 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.
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/m2 ). 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.
Authors: Kathryn V Dalrymple; John M D Thompson; Shahina Begum; Keith M Godfrey; Lucilla Poston; Paul T Seed; Lesley M E McCowan; Clare Wall; Andrew Shelling; Robyn North; Wayne S Cutfield; Edwin A Mitchell Journal: Pediatr Obes Date: 2019-06-24 Impact factor: 4.000
Authors: I M Aris; J Y Bernard; L-W Chen; M T Tint; W W Pang; S E Soh; S-M Saw; L P-C Shek; K M Godfrey; P D Gluckman; Y-S Chong; F Yap; M S Kramer; Y S Lee Journal: Int J Obes (Lond) Date: 2017-07-28 Impact factor: 5.095
Authors: Lucilla Poston; Ruth Bell; Helen Croker; Angela C Flynn; Keith M Godfrey; Louise Goff; Louise Hayes; Nina Khazaezadeh; Scott M Nelson; Eugene Oteng-Ntim; Dharmintra Pasupathy; Nashita Patel; Stephen C Robson; Jane Sandall; Thomas A B Sanders; Naveed Sattar; Paul T Seed; Jane Wardle; Melissa K Whitworth; Annette L Briley Journal: Lancet Diabetes Endocrinol Date: 2015-07-09 Impact factor: 32.069
Authors: Kathryn V Dalrymple; Florence A S Tydeman; Paul D Taylor; Angela C Flynn; Majella O'Keeffe; Annette L Briley; Paramala Santosh; Louise Hayes; Stephen C Robson; Scott M Nelson; Naveed Sattar; Melissa K Whitworth; Harriet L Mills; Claire Singh; Paul T Seed CStat; Sara L White; Deborah A Lawlor; Keith M Godfrey; Lucilla Poston Journal: Pediatr Obes Date: 2020-09-11 Impact factor: 4.000
Authors: Delphina Gomes; Lien Le; Ulrich Mansmann; Regina Ensenauer; Sarah Perschbacher; Nikolaus A Haas; Heinrich Netz; Uwe Hasbargen; Maria Delius; Kristin Lange; Uta Nennstiel; Adelbert A Roscher Journal: BMC Med Date: 2022-04-14 Impact factor: 8.775