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Early life may be a "critical period" when appetite and regulation of energy balance are programmed, with lifelong consequences for obesity risk. Insight into the potential impact of modifying early-life risk factors on later obesity can be gained by evaluating their combined effects.The objective was to examine the relation between the number of early-life risk factors and obesity outcomes among children in a prospective birth cohort (Southampton Women's Survey).Five risk factors were defined: maternal obesity [prepregnant body mass index (BMI; in kg/m(2)) >30], excess gestational weight gain (Institute of Medicine, 2009), smoking during pregnancy, low maternal vitamin D status (<64 nmol/L), and short duration of breastfeeding (none or <1 mo). Obesity outcomes examined when the children were aged 4 and 6 y were BMI, dual-energy X-ray absorptiometry-assessed fat mass, overweight, or obesity (International Obesity Task Force). Data were available for 991 mother-child pairs, with children born between 1998 and 2003.Of the children, 148 (15%) had no early-life risk factors, 330 (33%) had 1, 296 (30%) had 2, 160 (16%) had 3, and 57 (6%) had 4 or 5. At both 4 and 6 y, there were positive graded associations between number of early-life risk factors and each obesity outcome (all P < 0.001). After taking account of confounders, the relative risk of being overweight or obese for children who had 4 or 5 risk factors was 3.99 (95% CI: 1.83, 8.67) at 4 y and 4.65 (95% CI: 2.29, 9.43) at 6 y compared with children who had none (both P < 0.001).Having a greater number of early-life risk factors was associated with large differences in adiposity and risk of overweight and obesity in later childhood. These findings suggest that early intervention to change these modifiable risk factors could make a significant contribution to the prevention of childhood obesity.

Type

Journal article

Journal

The American journal of clinical nutrition

Publication Date

02/2015

Volume

101

Pages

368 - 375

Addresses

From the Medical Research Council (MRC) Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom (SMR, SRC, NCH, BDB, KMG, CC, and HMI); the National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and Southampton University Hospitals NHS Trust, Southampton, United Kingdom (SMR, NCH, KMG, and CC); NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Nuffield Orthopaedic Centre, Oxford, United Kingdom (CC); and UCL Institute of Child Health, London, United Kingdom (CML).

Keywords

Humans, Weight Gain, Vitamin D, Absorptiometry, Photon, Body Mass Index, Linear Models, Risk Factors, Prospective Studies, Body Composition, Breast Feeding, Nutritional Status, Pregnancy, Adult, Child, Child, Preschool, Female, Overweight, Maternal Nutritional Physiological Phenomena, Pediatric Obesity, Surveys and Questionnaires