Lifecourse Approach to Racial/Ethnic Disparities in Childhood Obesity

Abstract

Eliminating racial/ethnic disparities in health and health care is a national priority, and obesity is a prime target. During the last 30 y in the United States, the prevalence of obesity among children has dramatically increased, sparing no age group. Obesity in childhood is associated with adverse cardio-metabolic outcomes such as hypertension, hyperlipidemia, and type II diabetes and with other long-term adverse outcomes, including both physical and psychosocial consequences. By the preschool years, racial/ethnic disparities in obesity prevalence are already present, suggesting that disparities in childhood obesity prevalence have their origins in the earliest stages of life. Several risk factors during pregnancy are associated with increased risk of offspring obesity, including excessive maternal gestational weight gain, gestational diabetes, smoking during pregnancy, antenatal depression, and biological stress. During infancy and early childhood, rapid infant weight gain, infant feeding practices, sleep duration, child's diet, physical activity, and sedentary practices are associated with the development of obesity. Studies have found substantial racial/ethnic differences in many of these early life risk factors for childhood obesity. It is possible that racial/ethnic differences in early life risk factors for obesity might contribute to the high prevalence of obesity among minority preschool-age children and beyond. Understanding these differences may help inform the design of clinical and public health interventions and policies to reduce the prevalence of childhood obesity and eliminate disparities among racial/ethnic minority children.

Racial and Ethnic Differences Associated With Feeding- and Activity-Related Behaviors in Infants

“…49 If these behaviors are truly "obesogenic," however, families from all races and ethnicities studied need early counseling, and the findings here also underscore the likely need for culturally sensitive health behavior counseling during early infancy. Particularly actionable are the specific behaviors that may be most sensitive to culturally adapted interventions: (1) infant exposure to television and other visual media; (2) breastfeeding initiation and exclusivity; and (3) encouraging infants to finish bottles.…”

An international comparison of dietary patterns in 9–11-year-old children

“…4 Moreover, the translation of the findings across populations with different geographic and/or sociocultural backgrounds is uncertain. 6 Diet is an important determinant of the non-communicable diseases risk. 1 Food consumption has been in rapid transition during the recent decades, for example, the consumption of meat and sugar has increased in many low-and middle-income countries.…”

Pediatric Obesity-Related Asthma: The Role of Metabolic Dysregulation

“…4 Similar environmental factors including increased built area with decreased outdoor play, increased screen time, increased intake of high-calorie foods, and caregiver food choices play a role in high childhood obesity prevalence. 5 Over the past decade, many cross-sectional and prospective epidemiologic studies have found an association between pediatric obesity and asthma. [6][7][8][9][10][11][12] A recent meta-analysis, including 6 prospective cohort studies on the effect of body weight on future risk of asthma, found a twofold increased risk in obese children compared with normal-weight children, 12 suggesting that obesity is an independent risk factor for childhood asthma.…”