Modifiable risk factors in the first 1000 days for subsequent risk of childhood overweight in an Asian cohort: significance of parental overweight status

Aris, Izzuddin M.; Bernard, Jonathan Y.; Chen, Ling‐Wei; Tint, Mya Thway; Pang, Wei Wei; Soh, Shu‐E; Sm, Saw; Shek, Lynette Pei‐Chi; Godfrey, Keith M.; Gluckman, Peter D.; Chong, Yap Seng; Yap, Fabian; Kramer, Michael S.; Lee, Yung Seng

doi:10.1038/ijo.2017.178

Cited by 49 publications

(50 citation statements)

References 55 publications

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“…We presented models adjusting for confounding variables, such as maternal ethnicity, maternal education level, maternal pregnancy BMI at ≤14 weeks gestation, child sex, child’s birth order and breastfeeding duration. These confounders were chosen for this analysis based on the associations with the exposure of maternal feeding practices [ 22 ], and outcomes of dietary intake and BMI[ 25 , 35 ] as previously reported from our studies using the GUSTO cohort. The graphical presentation of confounding in a directed acyclic graph(DAG) is available in S1 Fig .…”

Section: Methodsmentioning

confidence: 99%

Maternal feeding practices in relation to dietary intakes and BMI in 5 year-olds in a multi-ethnic Asian population

et al. 2018

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BackgroundIn Asia, little is known about how maternal feeding practices are associated with dietary intakes and body mass index (BMI) in preschoolers.ObjectiveTo assess the relationships between maternal feeding practices with dietary intakes and BMI in preschoolers in Asia using cross-sectional analysis in the GUSTO (Growing Up in Singapore Towards healthy Outcomes) cohort.Participant settingsMothers (n = 511) who completed the Comprehensive Feeding Practices Questionnaire (CFPQ) and a semi-quantitative Food Frequency Questionnaire (FFQ) when children were 5 years old.Statistical analysisAssociations between 12 maternal feeding practices (mean scores divided into tertiles) and children’s dietary intakes of seven food groups and BMI z-scores were examined using the general linear regression model. Weight and height of the child were measured, and dietary intakes derived from the FFQ.ResultsCompared to those in the low tertile, mothers in the high tertile of modelling healthy food intakes had children with higher intakes of vegetables[+20.0g/day (95%CI:11.6,29.5)] and wholegrains[+ 20.9g/day (9.67,31.1)] but lower intakes of sweet snacks[-10.1g/day (-16.3,-4.94)] and fast-foods[-5.84g/day (-10.2,-1.48)]. Conversely, children of mothers in the high tertile for allowing child control (lack of parental control) had lower intake of vegetables[-15.2g/day (-26.6,-5.21)] and wholegrains[-13.6g/day (-22.9,-5.27)], but higher intakes of sweet snacks[+13.7g/day (7.7, 19.8)] and fast-foods[+6.63g/day (3.55,9.72)]. In relation to BMI at 5 years, food restrictions for weight was associated with higher BMI z-scores [0.86SD (0.61,1.21)], while use of pressure was associated with lower BMI z-scores[-0.49SD(-0.78,-0.21)].Conclusions and implicationsModelling healthy food intakes by mothers was the key feeding practice associated with higher intakes of healthy foods and lower intakes of discretionary foods. The converse was true for allowing child control. Only food restrictions for weight and use of pressure were associated with BMI z-scores.

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Section: Methodsmentioning

confidence: 99%

Maternal feeding practices in relation to dietary intakes and BMI in 5 year-olds in a multi-ethnic Asian population

et al. 2018

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“…4,36 Previous studies suggest that the common risk alleles for obesity are associated with increased appetite and reduced satiety, and appropriate diet may be helpful in limiting or offsetting a genetic predisposition to obesity. [37][38][39] Recent studies further suggested that physical activity attenuated the effect of the obesity risk allele on the odds of obesity (27%) and on the odds of overweight (26%) in children, which may work through modified physiological mechanisms (elevated blood circulation, increased levels of neurotrophins, and neurotransmitters) that caused more energy consumption. 2,14,40,41 However, what roles the gene-environment interaction play in both cellular and molecular levels that remains to be explored.…”

Section: Potential Mechanismsmentioning

confidence: 99%

Polygenic risk, adherence to a healthy lifestyle, and childhood obesity

et al. 2018

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Summary Background Both polygenic and unhealthy lifestyle factors contribute to individual‐level risk of obesity during childhood. The extent to which increased polygenic risk can be offset by healthy lifestyle is unknown. Objective To examine whether increased polygenic risk of obesity is modified by a healthy lifestyle during childhood. Methods A total of 997 children (418 boys and 579 girls) who had complete DNA genotyping and body mass index (BMI) were eligible for the study were analyzed from an established prospective puberty cohort. The polygenic risk score (PRS) was computed based on 11 BMI‐increasing single nucleotide polymorphisms (SNPs) derived from a published genome‐wide association study (GWAS) for child obesity. Seven lifestyle factors were selected to determine a composite healthy lifestyle, such as food responsiveness, slowness in eating, satiety responsiveness, physical activity, screen time, sleep duration, and sugar‐sweetened beverages consumption, and which was classified as healthy (P75) lifestyle. Linear and logistic regression analyses were conducted. Results Children carrying additional BMI susceptibility alleles increased the BMI by 0.11 kg/m2, after adjusting gender, age and socio‐economic status (SES). A healthy lifestyle was associated with a substantially lower risk of obesity than an unhealthy lifestyle, regardless of the polygenic risk category. Among children at high polygenic risk, a healthy lifestyle was associated with an 85% lower risk of obesity than an unhealthy lifestyle (odds ratio, 0.15; 95% CI, 0.04 to 0.59; p = 0.007). Conclusions Our findings suggest that increased polygenic risk might be largely offset by healthy lifestyle as early as in childhood.

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“…Table 2 summarized and quantified the association between five peculiar interrelated behaviors, and overweight and obesity. We decided to look at parental overweight status before pregnancy, cesarean delivery, early infant feeding, short sleep duration, and physical activity, because these could be the five effective behaviors that play a role in pediatric overweight and obesity development [ 28 , 88 , 89 , 90 , 91 ].…”

Section: Discussionmentioning

confidence: 99%

“…This association is primarily related to the effect of lower diet quality on the body fat compartment of neonate, and this result is confirmed when the infant body fat is measured using precise and accurate body composition techniques [ 27 ]. Aris et al showed that paternal overweight status [95% CI: 9.6–11.6] had a large individual predicted probability of child overweight/obese [ 28 ]. In light of these findings, early-life and preconception intervention programs may be more effective in preventing overweight and obesity occurring later in life [ 28 ].…”

Section: Practice One: Both Mother and Father Behavior Are Importamentioning

confidence: 99%

“…Aris et al showed that paternal overweight status [95% CI: 9.6–11.6] had a large individual predicted probability of child overweight/obese [ 28 ]. In light of these findings, early-life and preconception intervention programs may be more effective in preventing overweight and obesity occurring later in life [ 28 ].…”

Section: Practice One: Both Mother and Father Behavior Are Importamentioning

confidence: 99%

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Nutrition in the First 1000 Days: Ten Practices to Minimize Obesity Emerging from Published Science

Pietrobelli

Agosti

2017

IJERPH

119

105

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The prevalence of childhood overweight and obesity has increased in most countries the last decades. Considering this in a simplistic way, we can say that obesity is the result of an imbalance between energy intake and energy expenditure. Moreover, the environment from conception to childhood could influence the child’s future health. The first 1000 days of life start with woman’s pregnancy, and offer a unique window of opportunity to contribute to obesity prevention. In light of the actual literature, the aim of our article is to discuss a proposal of 10 good practices to minimize obesity in the first 1000 days emerging from published science. (1) Both the mother’s and the father’s behaviors are important. A balanced diet with appropriate fat and protein intake, and favoring fruits and vegetables, is recommended for both parents during the conception period and pregnancy. Furthermore, overweight/obese women who are planning to become pregnant should reduce their weight before conception. (2) During pregnancy, at birth, and during early life, body composition measurements are crucial to monitor the baby’s growth. (3) Exclusive breastfeeding is recommended at the beginning of life until six months of age. (4) Four to six months of age is the optimal window to introduce complementary feeding. Until one year of age, breast milk or follow-on/commercial formula is the main recommended feeding source, and cow’s milk should be avoided until one year of age. (5) Fruit and vegetable introduction should begin early. Daily variety, diversity in a meal, and repeated exposure to the food, up to eight times, are efficient strategies to increase acceptance of food not well accepted at first. There is no need to add sugar, salt, or sugary fluids to the diet. (6) Respect the child’s appetite and avoid coercive “clean your plate” feeding practices. Adapt the portion of food and don’t use food as reward for good behavior. (7) Limit animal protein intake in early life to reduce the risk of an early adiposity rebound. Growing-up milk for children between one and three years of age should be preferred to cow’s milk, in order to limit intake and meet essential fatty acid and iron needs. (8) The intake of adequate fat containing essential fatty acids should be promoted. (9) Parents should be role models when feeding, with TV and other screens turned-off during meals. (10) Preventive interventions consisting of promoting physical activity and sufficient time dedicated to sleep should be employed. In fact, short sleep duration may be associated with increased risk of developing obesity. Based on literature reviews, and given the suggestions described in this manuscript, concerted public health efforts are needed to achieve the healthy objectives for obesity and nutrition, and to fight the childhood obesity epidemic.

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Modifiable risk factors in the first 1000 days for subsequent risk of childhood overweight in an Asian cohort: significance of parental overweight status

Abstract: Early-life risk factors added cumulatively to increase childhood adiposity and risk of overweight/obesity. Early-life and preconception intervention programmes may be more effective in preventing overweight/obesity if they concurrently address these multiple modifiable risk factors.

Cited by 49 publications

References 55 publications

Maternal feeding practices in relation to dietary intakes and BMI in 5 year-olds in a multi-ethnic Asian population

Maternal feeding practices in relation to dietary intakes and BMI in 5 year-olds in a multi-ethnic Asian population

Polygenic risk, adherence to a healthy lifestyle, and childhood obesity

Nutrition in the First 1000 Days: Ten Practices to Minimize Obesity Emerging from Published Science

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