Background/Aims: Childhood obesity tracks into adulthood, and may increase diabetes and cardiovascular disease risk in adulthood. Prospective analyses may better define the pathways between early life factors and greater childhood body mass index (BMI), a measure of obesity. Methods: The Diabetes Autoimmunity Study in the Young (DAISY) prospectively follows children from birth that are at increased genetic risk for type 1 diabetes. We examined longitudinal data for 1,178 DAISY subjects (mean age at last follow-up: 6.59 years (range: 2.0–11.5 years). Birth size and diabetes exposure in utero were collected in the enrollment interview. Infant diet information was collected via interviews throughout infancy. Infant weight gain and childhood BMI were measured at clinic visits. Results: Female gender, diabetes exposure in utero, larger size for gestational age, shorter breastfeeding duration, and more rapid infant weight gain predicted higher childhood BMI. Formal mediation analysis suggests the effect of shorter breastfeeding duration on childhood BMI may be mediated by more rapid infant weight gain. Also, the effect of diabetes exposure in utero on childhood BMI may be mediated by larger size for gestational age. Conclusion: We identified strong interrelationships between early life factors and childhood BMI. Understanding these pathways may aid childhood obesity prevention efforts.
© 2009 S. Karger AG, Basel
- Breastfeeding duration
- Infant weight gain
- Diabetes exposure in utero
- Birth size
- Ogden CL, Flegal KM, Carroll MD, Johnson CL: Prevalence and trends in overweight among US children and adolescents, 1999–2000. JAMA 2002;288:1728–1732.
- Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM: Prevalence of overweight and obesity in the United States, 1999–2004. JAMA 2006;295:1549–1555.
- Burke V, Beilin LJ, Simmer K, Oddy WH, Blake KV, Doherty D, Kendall GE, Newnham JP, Landau LI, Stanley FJ: Predictors of body mass index and associations with cardiovascular risk factors in Australian children: a prospective cohort study. Int J Obes Relat Metab Disord 2005;1:15–23.
- Freedman DS, Dietz WH, Srinivasan SR, Berenson GS: The relation of overweight to cardiovascular risk factors among children and adolescents: the Bogalusa Heart Study. Pediatrics 1999;103:1175–1182.
- Weiss R, Dziura J, Burgert TS, Tamborlane WV, Taksali SE, Yeckel CW, Allen K, Lopes M, Savoye M, Morrison J, Sherwin RS, Caprio S: Obesity and the metabolic syndrome in children and adolescents. N Engl J Med 2004;350:2362–2374.
- Serdula MK, Ivery D, Coates RJ, Freedman DS, Williamson DF, Byers T: Do obese children become obese adults? A review of the literature. Prev Med 2005;22:167–177.
- Srinivasan SR, Bao W, Wattigney WA, Berenson GS: Adolescent overweight is associated with adult overweight and related multiple cardiovascular risk factors: the Bogalusa Heart Study. Metabolism 1996;45:235–240.
- US Surgeon General: Overweight and Obesity: Health Consequences. Washington, US Department of Health & Human Services, 2005.
- Cole TJ, Bellizzi MC, Flegal KM, Dietz WH: Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000;320:1240–1243.
- Huang JS, Lee TA, Lu MC: Prenatal programming of childhood overweight and obesity. Matern Child Health J 2007;11:461–473.
- von Kries R, Toschke AM, Koletzko B, Slikker W: Maternal smoking during pregnancy and childhood obesity. Am J Epidemiol 2002;156:954–961.
- Moschonis G, Grammatikaki E, Manios Y: Perinatal predictors of overweight at infancy and preschool childhood: the GENESIS study. Int J Obes 2008;32:39–47.
- Reilly JJ, Armstrong J, Dorosty AR, Emmett PM, Ness A, Rogers I, Steer C, Sherriff A, Avon Longitudinal Study of Parents and Children Study Team: Early life risk factors for obesity in childhood: cohort study. BMJ 2005;330:1357.
- Ong KK: Size at birth, postnatal growth and risk of obesity. Horm Res 2006;65:65–69.
- Ong KK, Ahmed ML, Emmett PM, Preece MA, Dunger DB: Association between postnatal catch-up growth and obesity in childhood: prospective cohort study. BMJ 2000;320:967–971.
- Adair LS: Child and adolescent obesity: epidemiology and developmental perspectives. Physiol Behav 2008;94:8–16.
- Dubois L, Girard M: Early determinants of overweight at 4.5 years in a population-based longitudinal study. Int J Obes Relat Metab Disord 2006;30:610–617.
- Hediger ML, Overpeck MD, Kuczmarski RJ, Ruan WJ: Association between infant breastfeeding and overweight in young children. JAMA 2001;285:2453–2460.
- Mayer-Davis EJ, Rifas-Shiman SL, Zhou L, Hu FB, Colditz GA, Gillman MW: Breast-feeding and risk for childhood obesity: does maternal diabetes or obesity status matter? Diabetes Care 2006;29:2231–2237.
- Horta BL, Bahl R, Martines JC, Victoria CG, and World Health Organization: Evidence on the long-term effects of breastfeeding. Systematic reviews and meta-analysis. Geneva, World Health Organization, 2007, pp 1–52.
- Gillman MW, Rifas-Shiman SL, Camargo CA, Berkey CS, Frazier AL, Rockett HR, Field AE, Colditz GA: Risk of overweight among adolescents who were breastfed as infants. JAMA 2001;285:2461–2467.
- Rewers M, Bugawan TL, Norris JM, Blair A, Beaty B, Hoffman M, McDuffie RS Jr, Hamman RF, Klingensmith G, Eisenbarth GS, Erlich HA: Newborn screening for HLA markers associated with IDDM: diabetes autoimmunity study in the young (DAISY). Diabetologia 1996;39:807–812.
- Davies JL, Kawaguchi S, Bennett ST, Copeman JB, Cordell HJ, Pritchard P: A genome-wide search for human type 1 diabetes susceptibility genes. Nature 1994;371:130–136.
- Lambert AP, Gillespie KM, Thomson G, Cordell HJ, Todd JA, Gale EA, Bingley PJ: Absolute risk of childhood-onset type 1 diabetes defined by human leukocyte antigen class II genotype: a population-based study in the United Kingdom. J Clin Endocrinol Metab 2004;89:4037–4043.
- Norris JM, Barriga K, Klingensmith G, Hoffman M, Eisenbarth G, Erlich HA, Rewers M: Timing of initial cereal exposure in infancy and risk of islet autoimmunity. JAMA 2003;290:1713–1720.
- Oken E, Kleinman KP, Rich-Edwards J, Gillman MW: A nearly continuous measure of birth weight for gestational age using a United States national reference. BMC Pediatr 2003;8:6.
- Taylor SJ, Whincup PH, Hindmarsh PC, Lampe F, Odoki K, Cook DG: Performance of a new pubertal self-assessment questionnaire: a preliminary study. Paediatr Perinat Epidemiol 2001;15:88–94.
- Cnaan A, Laird NM, Slasor P: Using the general mixed model to analyze unbalanced repeated measures and longitudinal data. Stat Med 1997;16:2349–2380.
- Baron RM, Kenny DA: The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol 1986;51:1173–1182.
- MacKinnon DP, Krull JL, Lockwood CM: Equivalence of the mediation, confounding and suppression effect. Prev Sci 2000;1:173–181.
- Sobel ME: Asymptotic confidence intervals for indirect effects in structural equation models; in Leinhardt S (ed): Sociological Methodology. Washington, American Sociological Association, 1982, pp 290–293.
- Gillman MW, Rifas-Shiman SL, Berkey CS, Frazier AL, Rockett HR, Camargo CA, Field AE, Colditz GA: Breast-feeding and overweight in adolescence. Epidemiology 2006;17:112–114.
- Rolland-Cachera MF, Deheeger M, Maillot M, Bellisle F: Early adiposity rebound: causes and consequences for obesity in children and adults. Int J Obes Relat Metab Disord 2006;30:S11–S17.
- Lucas A, Sarson DL, Blackburn AM, Adrian TE, Aynsley-Green A, Bloom SR: Breast vs. bottle: endocrine responses are different with formula feeding. Lancet 1980;1:1267–1269.
- Kramer MS, Guo T, Platt RW, Vanilovich I, Sevkoskaya Z, Dzikovich I, Michaelsen KF, Dewey K: Feeding effects on growth during infancy. J Pediatr 2004;145:600–605.
- Ong KK, Preece MA, Emmett PM, Ahmed ML, Dunger DB, ALSPAC study team: size at birth and early childhood growth in relation to maternal smoking, parity and infant breast-feeding: longitudinal birth cohort study and analysis. Pediatr Res 2002;52:863–867.
- Scholtens S, Gehring U, Brunekreef B, Smit HA, de Jongste JC, Kerkhof M, Gerritsen J, Wijga AH: Breastfeeding, weight gain in infancy, and overweight at seven years of age: the prevention and incidence of asthma and mite allergy birth cohort study. Am J Epidemiol 2007;165:919–926.
- Catalano PM, Thomas A, Huston-Presley L, Amini SB: Increased fetal adiposity: a very sensitive marker of abnormal in utero development. Am J Obstetr Gynecol 2003;189:1698–1704.
- Dabelea D, Hanson RL, Lindsay RS, Pettitt DJ, Imperatore G, Gabir MM, Roumain J, Bennett PH, Knowler WC: Intrauterine exposure to diabetes conveys risks for type 2 diabetes and obesity: a study of discordant sibships. Diabetes 2000;49:2208–2211.
- Malcolm JC, Lawson ML, Gaboury I, Lough G, Keely E: Glucose tolerance of offspring of mother with gestational diabetes mellitus in a low-risk population. Diabet Med 2006;23:565–570.
- Pettitt DJ, Knowler WC, Bennett PH, Aleck KA, Baird HR: Obesity in offspring of diabetic Pima Indian women despite normal birth weight. Diabetes Care 1987;10:76–80.
- Touger L, Looker HC, Krakoff J, Lindsay RS, Cook V, Knowler WC: Early growth in offspring of diabetic mothers. Diabetes Care 2005;28:585–589.
Dr. Jill M. Norris, MPH, PhD
University of Colorado Denver
13001 E. 17th Place, B119, Bldg. 500, Room W3139
Aurora, CO 80045 (USA)
Tel. +1 303 724 4428, Fax +1 303 724 4489, E-Mail email@example.com
Received: March 4, 2009
Accepted after revision: October 2, 2009
Published online: November 27, 2009
Number of Print Pages : 7
Number of Figures : 1, Number of Tables : 2, Number of References : 42
Additional supplementary material is available online - Number of Parts : 1
Annals of Nutrition and Metabolism (Journal of Nutrition, Metabolic Diseases and Dietetics)
Vol. 56, No. 1, Year 2010 (Cover Date: February 2010)
Journal Editor: Elmadfa I. (Vienna)
ISSN: 0250-6807 (Print), eISSN: 1421-9697 (Online)
For additional information: http://www.karger.com/ANM
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.