Most childhood obesity prevention efforts have focused on school-age children and adolescents and have had limited success. We argue that the first years of life, including the prenatal period, the postnatal suckling period and the transition to the modified adult diet, may provide opportunities for preventive interventions. These early periods are characterized by high plasticity and rapid transitions, and parents have a high degree of control over children's environments and experiences. Observational and experimental evidence reveal persistent effects of early environments on eating behavior and obesity risk, suggesting that interventions should be tested during these early periods. The central task parents have in early development points to their potential as key targets and agents of change in early preventive interventions. In this paper, we review evidence of early environmental effects on children's eating and obesity risk, highlighting ways that parental feeding practices and parents' own behaviors impact these outcomes and calling for further experimental research to elucidate whether these factors are indeed promising targets for childhood obesity preventive interventions.

More than 20% of US children between ages 2 and 5 years are overweight suggesting efforts to prevent obesity must begin earlier. This study tested the independent and combined effects of two behavioral interventions delivered to parents, designed to promote healthy infant growth in the first year. Mother–newborn dyads intending to breastfeed were recruited from a maternity ward. With a 2 × 2 design, 160 dyads were randomized into one of four treatment cells to receive both, one, or no interventions delivered at two nurse home visits. The first intervention (“Soothe/Sleep”) instructed parents on discriminating between hunger and other sources of infant distress. Soothing strategies were taught to minimize feeding for non-hunger-related fussiness and to prolong sleep duration, particularly at night. The second intervention (“Introduction of Solids”) taught parents about hunger and satiety cues, the timing for the introduction of solid foods, and how to overcome infants’ initial rejection of healthy foods through repeated exposure. A total of 110 mother–infant dyads completed the year-long study. At 1 year, infants who received both interventions had lower weight-for-length percentiles (P = 0.009). Participants receiving both interventions had a mean weight-for-length in the 33rd percentile; in contrast, those in other study groups were higher first intervention only—50th percentile; second intervention only—56th percentile; control group—50th percentile).This suggests that multicomponent behavioral interventions may have potential for long-term obesity prevention (ClinicalTrials.gov number, NCT00359242).

Objective-A priority for research is to identify individuals early in development who are particularly susceptible to weight gain in the current, obesogenic environment. This longitudinal study investigated whether early individual differences in inhibitory control, an aspect of temperament, predicted weight outcomes and whether parents' restrictive feeding practices moderated this relation.Study design-Participants included 197 non-Hispanic White girls and their parents; families were assessed when girls were 5, 7, 9, 11, 13, and 15 years old. Measures included mothers' reports of girls' inhibitory control levels, girls' reports of parental restriction in feeding, girls' body mass indexes (BMIs), and parents' BMIs, education, and income.Results-Girls with lower inhibitory control at age 7 had higher concurrent BMIs, greater weight gain, higher BMIs at all subsequent time points, and were 1.95 times more likely to be overweight at age 15. Girls who perceived higher parental restriction exhibited the strongest inverse relation between inhibitory control and weight status.Conclusion-Variability in inhibitory control could help identify individuals who are predisposed to obesity risk; the current findings also highlight the importance of parenting practices as potentially modifiable factors which exacerbate or attenuate this risk. Keywords temperament; obesity; individual differences; self-regulation; feeding practices; restriction; goodness of fit Inhibitory control is defined as the ability to restrain a dominant response and execute a subdominant response (1). This behavioral construct is an aspect of temperament that overlaps with impulse control, self-regulation, and executive function and has implications for social, intellectual, and behavioral outcomes which represent important developmental goals in childhood. Specifically, lower inhibitory control has been linked to difficulties with prosocial development, moral development, and memory performance (2,3) and a higher likelihood of unintentional injury and later substance dependence (4,5). Thus, inhibitory control is an The authors declare no potential conflicts of interest.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. important contributor to many aspects of healthy development. However, little is known about its implications for child weight outcomes in the current environment. NIH Public AccessThe current environment has been conceptualized as obesogenic, promoting excessive intake and sedentary behavior in many individuals (6). Individual differences in behavioral styles could help to explain why some i...

Abstract— Currently, children are developing in an obesity‐promoting, or obesogenic, environment, which has emerged within the past 3 decades. This rapid change provides a rare opportunity to investigate the phenotypic outcomes that result from the expression of human genetic predispositions in a new environment. Unfortunately, the environmental changes that have occurred are associated with epidemic obesity rates in all age groups. Using a developmental perspective, this article argues that this probabilistic outcome is not predetermined, however. The article also provides examples of learning paradigms—familiarization and associative and observational learning—that present opportunities for parents and caregivers to restructure children’s environments in early life, increasing the likelihood of healthy weight‐status outcomes in the context of the current obesogenic environment.

An inverse association between sleep duration and BMI has been previously reported for both adults and children. In addition, other research has revealed positive relations between screen time or TV time and BMI. We investigated whether the association between screen time and BMI could be mediated by sleep duration in sample of 165 13‐year‐old non‐Hispanic, White girls. Sleep duration was coded from girls' self reports, which also included information about school day time spent in TV viewing and computer use. A measure of screen time was calculated as the sum of TV time and computer time. BMI was calculated from measured heights and weights. Results provide additional evidence that shorter sleep duration is associated with higher BMI. Sleep duration significantly predicted BMI, β = −.16, t(164) = −2.08, p < .05. In addition, screen time significantly predicted sleep duration, β = −.34, t(164) = −4.64, p < .0001. The method of Baron and Kenny (2006) was used to test for mediation by sleep duration (Figure ). Results were consistent with the mediation of the relation between screen time and BMI by sleep duration, although our use of cross‐sectional data cannot rule out reverse causality. Supported by NIH HD32973 and M01RR10732 1 Sleep Duration Mediation Model (n = 165) *p < .05, ***p < .0001.