The high rates of overweight and obesity (OWOB) in childhood are concerning, because childhood OWOB is linked to both adult OWOB and multiple health problems.
Because there is evidence that family-level factors may influence the risk of childhood OWOB, a group of investigators in Ireland, France, and the Netherlands, led by Adrien Aubert, PhD, from the University College Dublin, reviewed the data from the first 1000 days of life for >25,000 children from those 3 countries to assess the association of parental and child healthy lifestyle scores with child weight status. Their article, “Healthy Lifestyle in the First 1000 Days and Overweight and Obesity Throughout Childhood,” is being early released in Pediatrics this week (10.1542/peds.2024-066406).
For each child, data were collected to complete 3 healthy lifestyle scores (Maternal, Parental, and Infant) that looked at the following factors:
- Maternal: diet quality during pregnancy, physical activity during pregnancy, smoking and alcohol consumption during pregnancy, pre-pregnancy BMI
- Parental: all maternal lifestyle factors, plus father’s BMI during pregnancy
- Infant: duration of any breastfeeding, age of solid food introduction, exposure to passive smoking
Few families had positive lifestyle factors: Maximum scores for healthy lifestyle were attained by fewer than 10% for the maternal score, fewer than 4% for the parental score, and less than a quarter for the infant score.
While higher infant healthy lifestyle scores were not associated with lower rates of childhood OWOB, higher maternal and parental healthy lifestyle scores were highly associated with lower OWOB rates during early, mid, and late childhood.
Why might this be? The authors proposed several possible mechanisms:
- Genetic and epigenetic causes
- Intrauterine exposures
- Lifestyle habits acquired from parents
The authors conclude that we need to think about the entire family and child environment—and even look more broadly at communities to develop wide-ranging interventions that broadly impact multiple behaviors and start before conception. As we talk to our patients and families about healthy lifestyle choices, work with schools on physical activity and nutrition curriculum, and advocate in our communities, we will potentially not only affect our current patients but future generations.
