Abstract
Mothers who underwent bariatric surgery (BS) before pregnancy have worrisome eating habits, but little is known about the eating habits of their offspring. EFFECTOR is a cross-sectional, long-term follow-up study of 4–11-year-old children born from mothers that underwent bariatric surgery before pregnancy (n = 36), mothers with overweight/obesity (OW/OB) in a control group (n = 71), and mothers with a normal weight (NW) in a second control group (n = 35). Data on anthropometry and on eating habits obtained through a Food Frequency Questionnaire were collected prospectively. The children’s body mass index (BMI) scores significantly correlated with maternal pre-pregnancy BMI. The prevalence of overweight and obesity was the highest in children of the BS group (38.9% vs. 15.5% for children of the OW/OB group and 5.7% for those of the NW group; p = 0.004). Meal-skipping behavior was comparable between the groups. There was no difference in fruit and vegetable consumption. The BS group consumed more low-calorie sweetened beverages compared to the NW group (p = 0.01) but less fruit juice compared to the NW and OW/OB groups (p = 0.01). Our results may indicate a sugar-avoiding behavior in children of the BS group, fitting dietary maternal habits in a strategy to prevent dumping syndrome. In conclusion, maternal pre-pregnancy bariatric surgery does not alter unhealthy eating behaviors and the risk of development of overweight during childhood in their children.
Highlights
Parental obesity is a known risk factor for the development of childhood obesity and contributes to a complex interaction between different biological, environmental, socio-economical, and behavior factors [1,2,3]
Parental education levels were lower in the bariatric surgery (BS) group compared to the normal-weight control group (p < 0.001)
Children of the BS group had the lowest absolute values of height (p < 0.001), weight (p < 0.001), and neck (p < 0.001), waist (p = 0.02), and hip circumferences (p < 0.001) in comparison to the groups with normal weight and with overweight/obesity; these differences can be explained by the age difference between the groups
Summary
Parental obesity is a known risk factor for the development of childhood obesity and contributes to a complex interaction between different biological, environmental, socio-economical, and behavior factors [1,2,3]. The family food environment plays a role in the development of certain food preferences and eating habits that might lead to obesity in children [1,2]. Obesity during certain critical periods, such as pregnancy, has been suggested to be more influential than in other periods of life [3]. Maternal obesity during pregnancy results in an increased risk for obesity in her children [4,5,6,7,8,9,10]. Since lifestyle interventions are often insufficient to obtain sustainable weight loss, bariatric surgery has gained more popularity in women at childbearing age [11,12]
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