Environment and Obesity in the National Children’s Study

Abstract

ObjectiveIn this review we describe the approach taken by the National Children’s Study (NCS), a 21-year prospective study of 100,000 American children, to understanding the role of environmental factors in the development of obesity.Data sources and extractionWe review the literature with regard to the two core hypotheses in the NCS that relate to environmental origins of obesity and describe strategies that will be used to test each hypothesis.Data synthesisAlthough it is clear that obesity in an individual results from an imbalance between energy intake and expenditure, control of the obesity epidemic will require understanding of factors in the modern built environment and chemical exposures that may have the capacity to disrupt the link between energy intake and expenditure. The NCS is the largest prospective birth cohort study ever undertaken in the United States that is explicitly designed to seek information on the environmental causes of pediatric disease.ConclusionsThrough its embrace of the life-course approach to epidemiology, the NCS will be able to study the origins of obesity from preconception through late adolescence, including factors ranging from genetic inheritance to individual behaviors to the social, built, and natural environment and chemical exposures. It will have sufficient statistical power to examine interactions among these multiple influences, including gene–environment and gene–obesity interactions. A major secondary benefit will derive from the banking of specimens for future analysis.

Chemical and non-chemical stressors affecting childhood obesity: a systematic scoping review

“…187 Studies like the perinatal prospective longitudinal study at Duke University, the Newborn Epigenetic STudy (NEST), and the CHAMACOS study are representative of the types of longitudinal cohort studies needed to examine the effects of environmental exposures and nutrition, both in utero and during childhood. 167,188 Researchers suggest that childhood obesity may be an early adaptive response to epigenetic mechanisms that guide gene expression involved with energy balance through DNA methylation.…”

How Much Should We Invest In Preventing Childhood Obesity?

“…This will include additional research to identify preventable risk factors; educational interventions in schools, homes, and other settings; improvements in nutrition labeling; new guidelines for marketing foods to youth; and changes in the "built environment"-houses, neighborhoods, and cities. 27 Our results suggest that additional research into interventions is necessary and that even some costly interventions of uncertain efficacy may be worth pursuing. As debate about health reform continues, this analysis underscores the need to focus on preventing childhood obesity and overweight as a cost-effective way to improve the nation's health.…”

“…26 IDENTIFYING EFFECTIVE INTERVENTIONS Effective interventions to prevent childhood obesity and overweight have not been readily identified. 27 This is in part because obesity is not simply a matter of taking in more calories than are burned in physical activity. 28 Although continued research into prevention and treatment is needed, estimating the economic benefits of successful intervention is not premature, because it enables policy makers to determine what level of investment would be worth considering in the context of developing interventions.…”

The impact of a Smarter Lunchrooms Makeover on children's food choice and consumption

“…This in turn has increased their exposure to advertisements pertaining to unhealthy food, and encourages consumption of products with high-fat and high-sugar content. (Trasande et al, 2009).…”

“…One study in elementary school children observed that 20.5% of boys and 24.4 % of girls were inactive, and that activity levels declined with age in both genders (O'Loughlin, Paradis, Kishchuk, Barnett, & Renaud, 1999). Limited access to recreational space, due to neighborhood safety also influences physical activity (Trasande et al, 2009). Both of these limitations can contribute to increased energy intake and decreased energy expenditure, elevating risk for obesity.…”