Both birth weight and head circumference at birth are inversely related to systolic blood pressure. The relationship is present in adolescence but attenuated compared to both the pre- and post-adolescence periods. Accelerated postnatal growth is also associated with raised blood pressure.

No abstract

It is not known what constitutes an optimal diet in infancy. There are relatively few studies of weaning practice in the UK, and there is a need for prospective data on the effects of infant diet and nutrition on health in later life. We describe the dietary patterns, defined using principal components analysis of FFQ data, of 1434 infants aged 6 and 12 months, born between 1999 and 2003. The two most important dietary patterns identified at 6 and 12 months were very similar. The first pattern was characterised by high consumption of fruit, vegetables and home-prepared foods (‘infant guidelines’ pattern). The second pattern was characterised by high consumption of bread, savoury snacks, biscuits and chips (‘adult foods’ pattern). Dietary pattern scores were correlated at 6 and 12 months (r 0·46 ‘infant guidelines’; r 0·45 ‘adult foods’). These patterns, which reflect wide variations in weaning practice, are associated with maternal and family characteristics. A key influence on the infant diet is the quality of the maternal diet. Women who comply with dietary recommendations, and who have high intakes of fruit and vegetables, wholemeal bread and rice and pasta, are more likely to have infants who have comparable diets – with high ‘infant guidelines’ pattern scores. Conversely, women whose own diets are characterised by high intakes of chips, white bread, crisps and sweets are more likely to have infants who have high ‘adult foods’ pattern scores. The effects of these patterns on growth and development, and on long-term outcomes need to be investigated.

Objective-To use an ecological systems approach to examine individual-, family-, community-, and area-level risk factors for overweight (including obesity) in 3-year-old children. Design-Prospective nationally representative cohort studySetting-England, Wales, Scotland, Northern Ireland Participants-13 188 singleton children age three in the Millennium Cohort Study, born between 2000 and 2002, who had complete height/weight data Main outcome measure-Childhood overweight (including obesity) defined by the International Obesity TaskForce cut-offs for body mass index Results-23.0% of 3-year-old children were overweight or obese. In the fully adjusted model, primarily individual-and family-level factors were associated with early childhood overweight: birthweight z-score (adjusted odds ratio, 1.36, 95% CI 1.30 to 1.42), Black ethnicity (1.41, 1.11 to 1.80) (compared to white), introduction to solid foods <4 months (1.12, 1.02 to 1.23), lone motherhood (1.32, 1.15 to 1.51), smoking during pregnancy (1-9 cigarettes daily: 1.34, 1.17 to 1.54; 10-19: 1.49, 1.26 to 1.75; 20+: 1.34, 1.05 to 1.70), parental overweight (both: 1.89, 1.63 to 2.19; father only: 1.45, 1.28 to 1.63; mother only: 1.37, 1.18 to 1.58), prepregnancy overweight (1.28, 1.14 to 1.45), and maternal employment ≥21 hours/week (1.23, 1.10 to 1.37) (compared to never worked). Breastfeeding ≥4 months (0.86, 0.76 to 0.97) (compared to none) and Indian ethnicity (0.63, 0.42 to 0.94) were associated with a decreased risk of early childhood overweight. Children from Wales were also more likely to be overweight than children from England.Conclusions-Most risk factors for early childhood overweight are modifiable or would allow at-risk groups to be identified. Policies and interventions should focus on parents and providing them with an environment to support healthy behaviours for themselves and their children. Competing interests All authors have no competing interests to declare. CopyrightThe Corresponding Author has the right to grant on behalf of all authors and does grant on behalf of all authors, an exclusive licence (or non exclusive for government employees) on a worldwide basis to the BMJ Publishing Group Ltd and its Licensees to permit this article (if accepted) to be published in JECH and any other BMJPGL products to exploit all subsidiary rights, as set out in our licence. Nearly one quarter of children from resource-rich countries are already overweight or obese by age five, [1][2][3] suggesting that preventing obesity needs to begin in early life. However, there is little evidence on how to prevent obesity in preschool children,[4-6] so identification of modifiable risk factors is essential to inform the development of effective interventions. Europe PMC Funders Group[7]Researchers and policy makers have advocated for an ecological systems approach to addressing obesity rather than focusing on risk factors in isolation. [8][9][10] In this approach, obesity is conceptualised as being influenced by factors across multiple levels: individual an...

Study objective-The aim was to determine whether abdominal fatness in adult men is associated with retarded growth in fetal life and infancy.Design-This was a follow up study of (1) men born during 1920-30 whose birthweights and weights at one year were recorded at the time by health visitors; and (2) men born during 1935-43 whose size at birth was measured in detail. The main outcome measure was the ratio of waist circumference to hip girth.Setting-Hertfordshire and Preston, England.Subjects-Subjects were 845 men born in east Hertfordshire who still live there; and 239 men born in Preston who still live in or close to the city.Main results-After allowing for body mass index, mean waist to hip ratio fell with increasing birthweight and rose as the ratio of placental weight to birthweight increased. These trends were independent of duration of gestation and therefore reflected retarded fetal growth. Waist to hip ratio also fell with increasing weight at one year. All these trends were independent of adult height, alcohol consumption, smoking, social class, and age.Conclusions-The tendency to store fat abdominally, which is known to increase the risk of cardiovascular disease and diabetes independently of obesity, may be a persisting response to adverse conditions and growth failure in fetal life and infancy.

Risk for the insulin resistance syndrome may be partially established through low maternal body mass before pregnancy and consequent fetal undernutrition. This risk is independent of that associated with adult obesity. In developing countries such as China, improved nutrition in girls and young women may offer long-term benefits to offspring.

These findings suggests that the intra-uterine environment, as measured by fetal size at birth, has long-lasting effects on the function of the hypothalamo-pituitary-adrenal axis.

If the growth of a female fetus is constrained by lack of nutrients, there are persisting changes in her physiology and metabolism which lead to reduced fetal growth and raised blood pressure in the next generation. Public health policies to improve fetal growth in one generation may therefore benefit succeeding generations as well.