Original Article
Risk factors for childhood overweight: A prospective study from birth to 9.5 years

https://doi.org/10.1016/j.jpeds.2004.03.023Get rights and content

Abstract

Objectives

To ascertain risk factors for the development of overweight in children at 9.5 years of age.

Study design

This was a prospective study of 150 children from birth to 9.5 years of age, with assessment of multiple hypothesized risk factors drawn from research reports.

Results

Five independent risk factors for childhood overweight were found. The strongest was parent overweight, which was mediated by child temperament. The remaining risk factors were low parent concerns about their child's thinness, persistent child tantrums over food, and less sleep time in childhood. Possible mechanisms by which each of these factors influence weight gain are outlined. Two different pathways to childhood overweight/obesity were found, depending on degree of parental overweight.

Conclusions

There is evidence of considerable interaction between parent and child characteristics in the development of overweight. Several of the identified risk factors are amenable to intervention possibly leading to the development of early prevention programs.

Section snippets

Study population

Newborn infants (n = 216) and their parents were recruited from the well newborn nurseries at a university hospital, community hospital, and a health maintenance organization in the San Francisco Bay Area. Recruitment and eligibility procedures have been detailed elsewhere.15 This study was approved by the Stanford University Committee for the Protection of Human Subjects. Both parents gave written consent to participate in this study and also gave permission for the participation of their

Results

The demographics for the study sample and for those who dropped out of the study for whom an adequate data set was not available were evaluated. There was only one significant difference between these two groups, with the mothers of dropouts being somewhat less highly educated (χ2 = 11.3, P = .004).

Discussion

Risk factors for obesity must result in a positive energy balance through 1 or more of 3 pathways: a higher caloric intake than required to sustain normal growth; lower caloric output through physical activity; or an alteration in metabolism that affects caloric balance. Confirming previous observations,2., 3., 10. the most potent risk factor in this study was parental overweight. Parental overweight has a direct effect on childhood overweight, as has been described previously, as well as an

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    Dr McNicholas is now at University College, Dublin, Ireland.

    Supported by grant HD-25492 from the National Institute of Child Health and Development.

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