Maternal and Early Childhood Determinants of Women's Body Size in Midlife: Overall Cohort and Sibling Analyses

Abstract

Observational evidence suggests that adult body size has its roots earlier in life, yet few life-course studies have data on siblings with which to control for family-level confounding. Using prospective data from the Early Determinants of Mammographic Density Study (n = 1,108; 1959-2008), we examined the association of maternal prepregnancy body mass index (BMI; weight (kg)/height (m)2), gestational weight gain (GWG), birth size, and childhood growth factors with adult BMI in daughters at midlife using quantile, linear, and logistic regression models. We compared overall cohort findings (n = 1,108) with sibling differences (n = 246 sibling sets). Results derived by all 3 regression methods supported positive and independent associations of prepregnancy BMI, GWG, and percentile change in early childhood growth with BMI in daughters at midlife. Sibling analyses demonstrated that higher GWG was independently related to a higher adult BMI in daughters, particularly for the highest 90th quantile of adult BMI (β = 0.64 (standard error, 0.26) BMI units). Greater increases in weight percentiles between 1 and 4 years of age within siblings were also associated with higher adult BMI in the 75th quantile (β = 0.06 (standard error, 0.03) kg). Thus, even after consideration of the role of family-level fixed effects, maternal GWG and childhood weight gain are associated with adult body size in midlife.

Age-specific breast cancer risk by body mass index and familial risk: prospective family study cohort (ProF-SC)

“…The genetically driven protective role of BMI on breast cancer risk in early adulthood appears to be of little consequence in terms of absolute risk and is overtaken by an environmentally driven deleterious role of greater adult BMI in later life that is even more important for women at increased genetic risk. Given that age-adjusted BMI is correlated between early and mid-adulthood [ 60 ], maintaining a healthy weight throughout adult life is of clinical significance for all women, and especially those with a family history of breast cancer.…”

Consistency, now what?

“…The consistent inverse association between early-life body size and breast cancer risk is matched by a similarly consistent association between larger adult body size and increased breast cancer risk. Given the positive association between large body size in adulthood and breast cancer as well as many other cancers and chronic diseases, and the fact that adult body size is shaped by growth trajectories much earlier in life [ 10 ], the consistent inverse association with larger body size during childhood and adolescence has largely been ignored from a public health perspective. Unraveling the opposing effects of body size on breast cancer risk requires more evidence from in vitro and animal studies as well as prospective studies in humans that can measure changes in breast tissue characteristics.…”

Associations of Nativity, Age at Migration, and Percent of Life in the U.S. with Midlife Body Mass Index and Waist Size in New York City Latinas

“…Additionally, the majority of research has examined migration influences on the mean BMI when considering continuous measures in linear regression models or odds of obesity when considering categorical measures in logistic regression models. However, emerging recent evidence using quantile regression methods suggests that exposures in earlier life periods, such as maternal pregnancy characteristics, and birth and childhood body size and growth, can have differential associations with midlife body size for larger and smaller women [11][12][13]. This question has not been investigated in relation to nativity and migration timing but can provide additional information that extends the available findings on the association between migration and body size estimated from standard linear and logistic regression methods.…”