Risk factors in first 1,000 days predict obesity, metabolic risk in early adolescence

Early-life risk factors in the first 1,000 days are significantly associated with higher adiposity and cardiometabolic risk in early adolescence, suggests a study.

A total of 1,038 mother–child pairs in Project Viva were included in the analysis. Six modifiable early-life risk factors previously associated with child adiposity or metabolic health in the cohort were selected: smoking during pregnancy (yes vs no), gestational weight gain (excessive vs nonexcessive), sugar-sweetened beverage consumption during pregnancy (≥0.5 vs <0.5 servings/d), breastfeeding duration (<12 vs ≥12 mo), timing of complementary food introduction (<4 vs ≥4 mo), and infant sleep duration (<12 vs ≥12 h/d).

The authors computed risk factor scores by calculating the cumulative number of risk factors for each child and measured indicators of adiposity (body mass index [BMI], fat mass index [FMI], and trunk FMI) in early adolescence (median, 13.1 years). They also calculated childhood overweight/obesity prevalence and metabolic syndrome (MetS) risk z score of adolescents.

Seventy-one percent of the 1,038 adolescents had more than one early-life risk factor. Covariate-adjusted models demonstrated positive monotonic increases in BMI, FMI, trunk FMI, and MetS z scores with increasing risk factor score. Those with five to six risk factors (compared with zero to one risk factor) were at greatest risk of overweight/obesity (risk ratio [RR], 2.53, 95 percent confidence interval [CI], 1.63–3.91) and of being in the highest MetS quartile (RR, 2.46, 95 percent CI, 1.43–4.21).

The predicted probability of overweight/obesity in adolescence ranged from 9.4 percent (favourable levels for all factors) to 63.6 percent (adverse levels for all factors). For being in the highest MetS quartile, the range was 9.6 percent to 56.6 percent.

“Intervention strategies to prevent later obesity and cardiometabolic risk may be more effective if they concurrently target multiple modifiable factors,” the authors said.