Systematic review and meta-analyses of risk factors for childhood overweight identifiable during infancy

Abstract

ObjectiveTo determine risk factors for childhood overweight that can be identified during the first year of life to facilitate early identification and targeted intervention.DesignSystematic review and meta-analysis.Search strategyElectronic database search of MEDLINE, EMBASE, PubMed and CAB Abstracts.Eligibility criteriaProspective observational studies following up children from birth for at least 2 years.ResultsThirty prospective studies were identified. Significant and strong independent associations with childhood overweight were identified for maternal pre-pregnancy overweight, high infant birth weight and rapid weight gain during the first year of life. Meta-analysis comparing breastfed with non-breastfed infants found a 15% decrease (95% CI 0.74 to 0.99; I2=73.3%; n=10) in the odds of childhood overweight. For children of mothers smoking during pregnancy there was a 47% increase (95% CI 1.26 to 1.73; I2=47.5%; n=7) in the odds of childhood overweight. There was some evidence associating early introduction of solid foods and childhood overweight. There was conflicting evidence for duration of breastfeeding, socioeconomic status at birth, parity and maternal marital status at birth. No association with childhood overweight was found for maternal age or education at birth, maternal depression or infant ethnicity. There was inconclusive evidence for delivery type, gestational weight gain, maternal postpartum weight loss and ‘fussy’ infant temperament due to the limited number of studies.ConclusionsSeveral risk factors for both overweight and obesity in childhood are identifiable during infancy. Future research needs to focus on whether it is clinically feasible for healthcare professionals to identify infants at greatest risk.

Tracking of body size from birth to 7 years of age and factors associated with maintenance of a high body size from birth to 7 years of age – the Norwegian Mother and Child Cohort study (MoBa)

“…In the present study, increasing parental education was significantly associated with lower odds of a stable high body size from birth to 7 years of age in univariate analysis, but this association was lost in multivariate analyses. This is in line with the review by Weng et al (13) where no association with childhood overweight was found for maternal education at birth, but in contrast to the findings of Shrewsbury and Wardle in their systematic review (37) where the level of parental education was inversely associated with adiposity in fifteen out of twenty studies.…”

“…Infant feeding practices have been associated with development of childhood overweight and obesity. Previous reviews have reported that a history of breast-feeding is associated with a reduced risk of overweight and obesity later in life (13,35,36) , while this was not observed for adult obesity (5) . Further, Weng et al (13) reported in their review that 'there was some evidence supporting the early introduction of solid foods as a risk factor for later overweight'.…”

The role of infant nutrition in the global epidemic of non-communicable disease

“…Thus, early nutritional practices have not been backed by rigorous experimental evidence of efficacy and safety, which is expected in other areas of public health; and have the potential to cause harm. For example, 'intuitive' attempts to promote growth in small, growth-retarded newborns could significantly increase later CVD and obesity (3)(4)(5)(8)(9)(10)(11)(12)(13)(14) . This lack of a sound evidence-base has prevented changes to nutritional and public health practice in infancy in order to prevent later NCD.…”

“…For instance, faster weight gain in infancy (upward centile crossing for weight) is associated with a greater risk of later obesity in more than thirty studies (summarised in five systematic reviews, (8)(9)(10)(11)(12) including an individual-level meta-analysis in 47 661 participants from ten cohorts (11) ). This association is seen for the main components of the metabolic syndrome, in breast-fed and formula-fed populations, in high-and low-income countries representing many different ethnic groups (7)(8)(9)(10)(11)(12) , and is consistent for cohorts during the past 80 years (8) . The association is biologically plausible and experimentally reproducible in several animal models (7) .…”

Perinatal and lifestyle factors mediate the association between maternal education and preschool children's weight status: the ToyBox study

“…Moreover, evidence suggests that there are marked differences in this trend among socioeconomic groups and regions across Europe, as well as among families with overweight/ obese parents [1][2][3]. In addition, previous studies have further highlighted the multifactorial etiology of obesity in preschool childhood, with several risk factors reported to exert their effect on the manifestation of the obesity phenotype from very early developmental stages, such as during the perinatal period or through energy balance-related behaviors (EBRBs) adopted in the preschool years [4][5][6][7].…”