Today’s post comes from Audrey St-Laurent. Audrey is a PhD student in the department of kinesiology at Laval University of Quebec City. She is also the communications director of the OC-SNP National Executive.
Childhood obesity is a known public health issue. In 2016, the worldwide prevalence of overweight and obesity in children and adolescents was more than four times higher than it was 40 years ago (OMS 2018). Moreover, it is known that obesity occurs at an early age (<6 years old) (Geserick et al. 2018) and that there exists a strong association between the number of years lived with obesity and the risk of cardiovascular disease mortality and all-cause mortality (Abdullah et al. 2011).
Genetics contributes substantially to the development of excessive adiposity during childhood. In fact, genetics could explain 47% to 80% of the body mass index variations during early life (Elks et al. 2012). In addition to genetic, many modifiable determinants may also be associated with the development of obesity in young children. This begs these questions: What are they? How can we prevent them?
A recent article published in Nature Reviews Endocrinology (Larqué et al. 2019) aimed to review the existing scientific evidence about the determinants of childhood obesity to provide clinically relevant strategies to prevent this issue from preconception to the end of the second year of life.
What are the modifiable risk factors of childhood obesity?
Figure 1. Modifiable factors associated with child adiposity
Larqué et al. (2019) identified 20 potential prenatal and postnatal determinants of childhood obesity. Among them, four modifiable risk factors (breastfeeding, macronutrient intake during infancy [in particular total fat intake], supplementation with prebiotics and probiotics and complementary feeding) could need more attention considering their inconclusive effect. It is also important to note that despite the inconclusive effect of breastfeeding on reducing obesity risk later in life, there is a consensus on that breastfeeding should be promoted owing to its many beneficial effects.
How to prevent the risk factors of childhood obesity?
- During pregnancy, health care providers should support strategies to ensure healthy maternal lifestyles, including practicing regular physical activity, consuming polyunsaturated fats, avoiding malnutrition/undernutrition or overnutrition, alcohol and smoking and limiting the consumption of free sugar intake to <10% of total energy.
- Healthy paternal lifestyles, in particular, a healthy diet and a regular physical activity practice should be promoted.
- Pregnant women should take antibiotics only after identification of bacterial infection.
- Caesarean delivery should be strictly limited to medical indications.
- Infant formula with a protein content <2.05g/100ml should be avoided.
- Children aged of <2 years should sleep more than 10.5 hours per day, including naps.
- Infants’ sedentary screen time should be limited
Table 1. Canadian guidelines of sedentary screen time during in early life (0-4 years)
|Infant (<1 year)||Toddlers (1-2 years)||Preschoolers (3-4 years)|
Source: Tremblay et al. (2017)
To conclude, in the context of preventing childhood obesity, pediatrics and health care professionals should provide personalized, evidence-based advice and information on healthy lifestyle behaviors (e.g. nutrition, physical activity and sleep) to parents during pregnancy, but optimally even before conception. Moreover, Larqué et al. (2019) reported that specific measurements of offspring adiposity and not only body mass index are required. The authors also recommend that national and local policies and institutions adopt health promotion actions that take into account the above identified early risk factors for childhood obesity in order to support families in the short- and long-term.
Do you have any ideas for promoting a healthy lifestyle at all ages? Please share them with us by emailing Audrey @ firstname.lastname@example.org!
For more information, you may consult the following article: Larqué, E., Labayen, I., Flodmark, C.-E., et al. (2019). From conception to infancy—early risk factors for childhood obesity. Nature Reviews Endocrinology, 1.
Abdullah, A. et al. (2011). The number of years lived with obesity and the risk of all- cause and cause- specific mortality. Int. J. Epidemiol. 40, 985–996.
Elks CE, den Hoed M, Zhao JH, Sharp SJ, Wareham NJ, Loos RJ, Ong KK. Variability in the heritability of body mass index: a systematic review and meta-regression. Front Endocrinol (Lausanne) 2012;3.
Geserick, M., Vogel, M., Gausche, R., et al. (2018). Acceleration of BMI in early childhood and Larqué, E., Labayen, I., Flodmark, C.-E., et al. (2019). From conception to infancy—early risk factors for childhood obesity. Nature Reviews Endocrinology, 1.
Tremblay, M. S., Chaput, J.-P., Adamo, K. B., et al. (2017). Canadian 24-hour movement guidelines for the early years (0–4 years): an integration of physical activity, sedentary behaviour, and sleep. BMC Public Health, 17(5), 874.
WHO. (2018). Obesity and overweight [Retrieved from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight]. Assessed on October 3, 2019.