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Introduction The obesity rate in preschool children in the United States (US) is 13.9%, while even higher rates are associated with racial and ethnic minorities and children from low-income families. These prevalence patterns underscore the need to identify effective childhood obesity prevention programs.     Method A scoping review was conducted following Arksey and O’Malley’s framework to provide an overview of the types, effectiveness and cost-effectiveness of obesity prevention interventions and policies in children up to 6 years old. Inclusion criteria were studies at least 6- months duration; included a weight-based outcome, conducted in the US, English publications from January 2001 to February 2018. Exclusions: studies in  overweight/obese children and …

This is one of 26 chapters published in the Handbook of Life Course Health Development.   Abstract: One of the reasons for the intractability of childhood obesity is the underappreciation of the complexity and interconnectedness of contributing factors across the life course. A multilevel approach for obesity prevention takes into account individual risk factors that operate “above water” (family, neighborhood, policies) and the interaction with biology and “underwater” influences (genetics, epigenetics, physiology) and recognizes that these factors also interact across the life course, starting before birth. We organize this chapter to reflect phases of life course health development, prenatally through adolescence, that appear to be most important for the development of …

The prevalence of obesity is increasing at an alarming rate, across all populations and age groups. Estimates suggest that 20% of women will be obese by 2025—a sobering statistic, particularly considering that obesity during pregnancy increases risk of adverse health outcomes to both mother and child. What’s more, obesity during pregnancy increases the risk of life-long health problems in children, including obesity, type 2 diabetes, and heart disease. This Series in The Lancet Diabetes & Endocrinology examines the growing burden of maternal obesity worldwide in terms of its impact on clinical management and intergenerational health, and highlights the need for a focus on the pre-pregnancy period, along with a whole-of-society …

Background: Early life may be a “critical period” when appetite and regulation of energy balance are programmed, with lifelong consequences for obesity risk. Insight into the potential impact of modifying early-life risk factors on later obesity can be gained by evaluating their combined effects. Objective: The objective was to examine the relation between the number of early-life risk factors and obesity outcomes among children in a prospective birth cohort (Southampton Women’s Survey). Design: Five risk factors were defined: maternal obesity [prepregnant body mass index (BMI; in kg/m2) >30], excess gestational weight gain (Institute of Medicine, 2009), smoking during pregnancy, low maternal vitamin D status ( Results: Of the children, 148 …

Summary   Background Rapid weight gain in infancy has been established as a risk factor for the development of later obesity.   Objective We aimed to investigate the role of changes in infant body composition (assessed via total body electrical conductivity) on the development of overweight/obesity in mid-childhood.   Methods Fifty-three term infants were evaluated at birth, three times during infancy and in mid-childhood. Logistic regression was used to determine associations between rates of total weight gain, fat mass gain and lean mass gain during infancy and later overweight/obesity (defined as body mass index [BMI] ≥85th percentile), adjusted for birth weight and parent education.   Results At follow-up (age 9.0 ± 1.8 …

Epidemiological, clinical, physiological, cellular, and molecular evidence suggests that the origins of obesity and metabolic dysfunction can be traced back to intrauterine life and supports an important role for maternal nutrition prior to and during gestation in fetal programming. The elucidation of underlying mechanisms is an area of interest and intense investigation. In this perspectives paper we propose that in addition to maternal nutrition-related processes it may be important to concurrently consider the potential role of intrauterine stress and stress biology. We frame our arguments in the larger context of an evolutionary-developmental perspective that supports roles for both nutrition and stress as key environmental conditions driving natural selection and developmental …

Many of the most common and costly chronic adult health conditions have their origins in childhood and adolescence. This recognition is leading to both a profound shift in our understanding about the developmental origins of diseases such as hypertension, dyslipidemia, and type 2 diabetes mellitus (DM) and a greater focus on how different risk and protective factors influence the developmental pathways that determine optimal health across the life span. Scientific breakthroughs in the basic, clinical and epidemiological sciences reveal how different stressors and exposures during what are now termed “critical” or “sensitive” periods of development can affect growth, tissue differentiation and physiologic set points that influence an individual’s response to …

We tested whether early childhood risk exposures are related to weight gain in adolescence and evaluate an underlying mechanism, self-regulatory behavior, for the risk-obesity link. Nine-year-old children exposed to a greater accumulation of multiple risk factors show larger gains in adiposity over the next four year period, net of their initial BMI. These gains in BMI during early adolescence are largely accounted for by deteriorated self-regulatory abilities among children facing more cumulative risks. Early childhood risk exposure leads to larger gains in BMI in adolescence. Given the importance of childhood adiposity to the development of obesity later in life, understanding the underlying mechanisms that link early experience to weight gain …

An adverse environment in utero, including exposure to prenatal maternal stress (PNMS), can result in poor birth outcomes such as low birth weight, which increases risk of later cardiometabolic diseases such as hypertension and obesity. It is unclear to what extent PNMS influences obesity risk independent of its impact on birth characteristics, especially among humans. Our objective was to determine whether PNMS resulting from a natural disaster influenced risk of childhood obesity. Read full article