Early Life Course Risk Factors for Childhood Obesity: The IDEFICS Case-Control Study

Abstract

BackgroundThe early life course is assumed to be a critical phase for childhood obesity; however the significance of single factors and their interplay is not well studied in childhood populations.ObjectivesThe investigation of pre-, peri- and postpartum risk factors on the risk of obesity at age 2 to 9.MethodsA case-control study with 1,024 1∶1-matched case-control pairs was nested in the baseline survey (09/2007–05/2008) of the IDEFICS study, a population-based intervention study on childhood obesity carried out in 8 European countries in pre- and primary school settings. Conditional logistic regression was used for identification of risk factors.ResultsFor many of the investigated risk factors, we found a raw effect in our study. In multivariate models, we could establish an effect for gestational weight gain (adjusted OR = 1.02; 95%CI 1.00–1.04), smoking during pregnancy (adjusted OR = 1.48; 95%CI 1.08–2.01), Caesarian section (adjusted OR = 1.38; 95%CI 1.10–1.74), and breastfeeding 4 to 11 months (adjusted OR = 0.77; 95%CI 0.62–0.96). Birth weight was related to lean mass rather than to fat mass, the effect of smoking was found only in boys, but not in girls. After additional adjustment for parental BMI and parental educational status, only gestational weight gain remained statistically significant. Both, maternal as well as paternal BMI were the strongest risk factors in our study, and they confounded several of the investigated associations.ConclusionsKey risk factors of childhood obesity in our study are parental BMI and gestational weight gain; consequently prevention approaches should target not only children but also adults. The monitoring of gestational weight seems to be of particular importance for early prevention of childhood obesity.

Effects of a Gestational Weight Gain Restriction Program for Obese Pregnant Women: Children's Weight Development during the First Five Years of Life

“…Similar results are reported in a European study which investigated ante-, peri-and postnatal risk factors on risk of obesity in children at 4r and 8 years of age [26]. GWG >25 kg posed after adjustment a twofold risk of obesity for the offspring.…”

“…An association between maternal BMI and/or GWG and the BMI of offspring have been investigated in some large cohort studies [25][26][27]. A Norwegian study found a positive association between both maternal pre-pregnancy BMI and GWG and the mean BMI of the offspring at 3 years of age [25].…”

Fit for Birth – the effect of weight changes in obese pregnant women on maternal and neonatal outcomes: a pilot prospective cohort study

“…Weight data were collected on 756 women. Only 385 women had weights measured in all three study assessment periods (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) weeks, 20+1 to 32 weeks and >32 weeks gestation) while 427 women had weights measured in Period 3. Individual…”

“…Based on limited data however correlations between gestational weight gain and offspring birth weight as well as childhood obesity have been demonstrated (11)(12)(13)(14).…”

Dietary micronutrient intake during pregnancy is a function of carbohydrate quality

“…This is conceivable because healthy pregnant women may compensate for much of the assumed increased energy needs by selecting less demanding physical activities (5). Recommending additional energy intake may therefore contribute to the increasing prevalence of excessive weight gain in pregnancy, a risk factor for gestational diabetes and offspring obesity (6)(7)(8)(9).…”