Preventing Obesity Across Generations: Evidence for Early Life Intervention

Abstract

To prevent the intergenerational transfer of obesity and end the current epidemic, interventions are needed across the early life stages, from preconception to prenatal to infancy through the age of 2 years. The foundation for obesity is laid in early life by actions and interactions passed from parent to child that have long-lasting biologic and behavioral consequences. The purpose of this paper is to examine the best evidence about (a) factors in parents and offspring that promote obesity during the early life stages, (b) the social determinants and dimensions of obesity in early life, (c) promising and effective interventions for preventing obesity in early life, and (d) opportunities for future research into strategies to disrupt the intergenerational cycle of obesity that begins early in life. The pathway for halting the intergenerational obesity epidemic requires the discovery and development of evidence-based interventions that can act across multiple dimensions of influence on early life.

Perinatal programming of adolescent nonalcoholic fatty liver disease: A case for gender inequality?

“…Early life factors such as prepregnancy obesity, maternal obesity, and abnormal gestational weight gain have been associated with increased rates of obesity in the offspring . However, little is known about how adverse metabolic environments in perinatal life may affect postnatal development of NAFLD.…”

The association between parental overweight and obesity before pregnancy and the development of offspring overweight and obesity in childhood, adolescence and young adulthood

“…It provides an insight into the role of parental nutritional status in early life, particularly prior to pregnancy that may predict offspring BMI and risk of overweight and obesity later in life. There is a need of a huge shift in prevention strategies [56]. When considering the optimal time for preventing obesity, our data suggests that interventions should start before pregnancy.…”

“…Future obesity interventions programs to reduce the continuing increase in obesity prevalence should focus on families with offspring who are at risk in early life [56]. Tackling adult obesity, in general, is likely to be important both for the health benefit of adult and for that of their offspring.…”

“…Most of the cross-sectional studies have demonstrated this association-primarily in childhood [38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53], while some have reported this association during adolescence [43,54,55]. For example, a large population-based cross-sectional study by Whitaker et al reported that the risk of childhood obesity was predicted by having obese parents with odds of 22.3 (95%CI: 10.3-48.4) compared to children who had normalweight parents [56]. They also reported that maternal BMI (beta-coefficient: 0.27) had a stronger association than paternal BMI (beta-coefficient: 0.23) with childhood BMI, after adjusting for offspring age, sex, family socio-economic factors and clustering by family.…”

“…Most studies, including cross-sectional [32][33][34][35][36][37][38][39][40][41], longitudinal [42][43][44][45][46], birth-cohort [10,[47][48][49][50][51][52][53][54][55][56][57][58][59][60], and case-control designs [61,62], have consistently found that parental OW/OB are strongly associated with offspring OW/OB. When both parents are OW/OB, the risk of OW/OB offspring is greater than when one parent is OW/OB [10,48,54,63].…”