Early life risk factors predict higher obesity, cardiometabolic disease risk

Early life risk factors in the first 1,000 days cumulatively predict higher obesity and cardiometabolic risk in early adolescence, according to new research led by the Harvard Pilgrim Health Care Institute and published in the American Journal of Clinical Nutrition.

The study evaluated the combined influence of early life risk factors with direct measures of adiposity, including body mass index and fat-mass index, and metabolic risk in early adolescence. The rapid rise in the global prevalence of childhood obesity, a strong predictor of metabolic syndrome and related diseases such as type 2 diabetes mellitus, is an important public health challenge, the researchers said. The first 1,000 days, spanning from conception to age 24 months, represents an important period of risk for the development of later childhood obesity, they said. Certain prenatal and postpartum factors encompassing this period have been shown to be associated with subsequent risk of childhood obesity, the researchers said.

For the study, the researchers studied 1,038 mother-child pairs in Project Viva, a prospective, observational pre-birth cohort study of gestational factors, pregnancy outcomes, and offspring health, based in eastern Massachusetts. They measured six modifiable risk factors: smoking during pregnancy; gestational weight gain; sugar-sweetened beverage consumption during pregnancy; breastfeeding duration; timing of complementary food introduction; and infant sleep duration.

After adjusting for sociodemographic characteristics and parental body mass index, the researchers found increases in indicators of adiposity such as body mass index and fat-mass index as well as increases in metabolic risk markers such as triglyceride levels and insulin resistance with increasing number of risk factors. Children with five to six risk factors versus those with zero to one risk factors also had the highest risk of overweight or obesity and being in the highest metabolic risk score quartile in early adolescence, according to the study.

"Our study findings not only suggest targets for future early life interventions,” said Emily Oken, MD, MPH, senior author and professor of Population Medicine at the Harvard Pilgrim Health Care Institute and Harvard Medical School, in a statement, “they also indicate that interventions to prevent later obesity and cardiometabolic risk may be more effective if conducted early in the life course and target multiple factors.”