Lifestyle Patterns, Early Influences Play Role in Risk of Obesity, BMI Trajectory in Childhood

Miaobing Zheng, PhD

Using multi-trajectory modeling, researchers are providing new insight into the impact of lifestyle patterns and early life influences have on BMI and the overall health of children.

Conducted by a team from Deakin University and other Australian institutions, results of the study indicate lifestyle patterns in early life, such as maternal dietary patterns and television viewing time, had a major influence on obesity scores in early life.

"The findings will inform early childhood obesity prevention intervention and policy, and will be of great interest to pediatricians, researchers, policymakers and the general public," said Miaobing Zheng, PhD, study investigator and research fellow at the Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences at Deakin University, in a statement.

With the obesity epidemic’s growth expected to continue booming in the US and abroad, opportunities for early intervention represent could help attenuate the societal burden of the ongoing crisis. To develop a greater understanding of how early lifestyle patterns impact BMI z score trajectory, investigators designed their study as an assessment of data from children within the Melbourne Feeding Activity and Nutrition Trial (InFANT) program, which included a longitudinal cohort of children followed for 15 months as part of parent-focused cluster RCT.

The InFANT program was created with the goal of reducing obesity risk behaviors in children until 18 months of age. The program also included multiple additional follow-ups without interventions for children aged 42-60 months. Using data from these patients, investigators hope to use multi-trajectory modeling

Investigators identified 3 unique trajectory groups based on lifestyle patterns and BMI z scores defined as: Unhealthy lifestyle patterns and low BMI z, healthy lifestyle pattern and mid BMI z, and unhealthy lifestyle and high BMI z. Overall, 439 patients from the program reached the 60-month follow-up. Among these children 30% had unhealthy lifestyle patterns and a low BMII z, 53% had healthy lifestyle patterns and mid BMI z, and 17% had unhealthy lifestyle patterns and high BMI z.

Upon analysis, investigators found child birth weight (OR, 1.89; 95% CI, 1.28- 2.79) and maternal “fruit and vegetables” dietary pattern score (OR 1.22; 95% CI, 1.01- 1.47) were associated with higher odds of placement into the healthy lifestyle pattern and mid BMI z group compared to the unhealthy lifestyle patterns and low BMI z group. Additionally, child birth weight maternal prepregnancy BMI, and higher maternal television-viewing time were associated with greater odds of placement into the unhealthy lifestyle pattern and high BMI z group.

Investigators pointed out sex, breastfeeding duration, maternal country of birth, maternal “cereal and sweet foods” and “high-energy snack and processed foods” dietary pattern scores, and maternal physical activity were not associated with placement into any specific trajectory group. Further analysis into duration of breastfeeding investigators pointed out no associations were observed related to breastfeeding duration and the trajectory groups.

“There is no doubt that children copy the behaviors observed in the presence of parents: healthy and unhealthy," said Liliana Aguayo, PhD, MPH, The Obesity Society member and research assistant professor from the Hubert Department of Global Health at Emory University, in the aforementioned statement. Of note, Aguayo was not associated with this study. "Evidence from this study highlights the importance of early childhood as a critical period for development of obesity. More research is needed to identify effective approaches to simultaneously address parent and child health behaviors."

This study, “Association Between Longitudinal Trajectories of Lifestyle Pattern and BMI in Early Childhood,” was published in Obesity.