In conjunction with National Childhood Obesity Month, we are zeroing in on what obesity looks like in the U.S. and how infant and young child feeding (IYCF) and other perinatal factors influence the obesity epidemic. Here’s the next installment of Our Milky Way’s roundup of contributors’ work relating to childhood obesity.
Picking back up with Sylvia Metzger’s, MPH, MSN, RN, CNL, IBCLC, LCCE work, her research has also informed us on how paternal health affects babies’ weight. “Every baby’s destiny can actually begin before conception, reflecting both the paternal and maternal health status,” Metzger explains. “Dad’s lifestyle and health before conception actually matter, and can also pre-program a baby’s health trajectory. It is not just the mom’s intrauterine environment. Paternal obesity prior to conception, for example, can increase the incidence of obesity and metabolic disorders in offspring, independently from the maternal status. But how much do we focus on fathers during preventative care visits?”
Dana Dabelea’s, MD, PhD work exploring gestational diabetes (GDM) has shown that GDM diagnosis increases the risk of diabetes and obesity in a mother’s offspring. Dabelea and colleagues studied fuels that feed the growing baby – such as fats of various types and sugars- all of which come through the placenta and umbilical cord to nourish the fetus. “It turns out that fatter babies (measured with an instrument called the PedPod®) had mothers with higher glucose levels during pregnancy, even if these levels were still considered in the “normal” range,” she reports. “We followed the offspring and looked at what influence postnatal feeding had as well. It turns out that breast-feeding for at least 6 months largely reverses the effects of GDM on fatness in children. I think this was exciting, since it meant that there are things that can be done very early in life that can reduce the later risk of obesity and diabetes….One additional thing of great interest – in studies of stem cells grown from the umbilical cords of these babies by my basic science colleagues, they have shown that obese mothers unknowingly ‘program’ these stem cells to be more likely to turn into fat cells than muscle or bone cells – some of the first human evidence of a possible pathway that changes how an infant responds to their environment.”
Dabelea’s research illuminates epigenetic and racial disparity components too. The SEARCH for Diabetes in Youth study has shown diabetes to disproportionately affect minority children. Dabelea explains: “Type 1 diabetes (juvenile diabetes) is actually most common among non-Hispanic white youth, although recently we are seeing increasing trends in minority groups, especially Hispanics. There are several factors at work in type 2 diabetes, but we don’t yet know all of the story. First, a higher proportion of minority youth are overweight or obese, which is the major risk factor for later diabetes. Second, many of these are offspring of mothers who themselves have diabetes, GDM, or even just obesity as they enter pregnancy. Such women pass to their babies an increased susceptibility for obesity and diabetes, a phenomenon called the “vicious cycle” – where the risk of obesity and diabetes are passed to the next generation without involving genetics. Lack of breastfeeding, or only a short duration of breastfeeding likely also plays a role, since it appears that breastfeeding reduces both obesity and diabetes among offspring.”
Dabelea and colleagues conducted a pilot randomized controlled trial of obesity prevention among American Indian children aged 7 to 10, called Tribal Turning Point. They found that a combination of parent-child sessions aimed at behavioral motivation for change, along with a toolbox of community activities, cooking classes and fun things for kids to do, resulted in lower weight gain among the group that got the intervention. “This kind of work is aimed at helping stem the tide of the epidemic in the highest risk group – American Indians,” she says. “But counter forces are strong – an abundance of calories, often of poor quality, the ease with which we can live without much physical activity and potential environmental factors such as air pollution and endocrine disrupting chemicals, are all promoting dangerous levels of obesity.”
More, recent research on childhood obesity:
Exclusive breastfeeding can attenuate body-mass-index increase among genetically susceptible children: A longitudinal study from the ALSPAC cohort— This research shows that exclusive breastfeeding (EBF) to five months has substantial effect in decreasing BMI among children at higher genetic risks. It suggests that interventions aimed at reducing the risks of overweight and obesity across the lifespan should start in very early childhood to be impactful, which makes EBF a key candidate intervention.
Why and how human donor milk may curb obesity in preterm infants— This work explores why and how donor breast milk may be more beneficial than pre-term artificial milk.
Childhood Obesity and Breastfeeding Rates in Pennsylvania Counties—Spatial Analysis of the Lactation Support Landscape— This work explores the inverse relationship between geographic access to professional Lactation support providers (LSPs) and childhood obesity in Pa. counties.