Abstract
BackgroundChildhood obesity remains a significant public health problem. To date, most research on the causes and correlates of obesity has focused on a small number of direct predictors of obesity rather than testing complex models that address the multifactorial nature of the origins of obesity in early development. We describe the rationale and methods of iGrow (Infant Growth and Development Study) which will test multiple pathways by which (a) prenatal maternal psychobiological risk predicts infant weight gain over the first 6 months of life, and (b) this early weight gain confers risk for obesity at age 2. Infant hormonal and psychobiological risk are proposed mediators from prenatal risk to early weight gain, though these are moderated by early maternal sensitivity and obesogenic feeding practices. In addition, higher maternal sensitivity and lower obesogenic feeding practices are proposed predictors of adaptive child self-regulation in the second year of life, and all three are proposed to buffer/reduce the association between high early infant weight gain and obesity risk at age 2.MethodsiGrow is a prospective, longitudinal community-based study of 300 diverse mothers and infants to be followed across 5 data waves from pregnancy until children are age 2. Key measures include (a) maternal reports of demographics, stress, well-being, feeding practices and child characteristics and health; (b) direct observation of maternal and infant behavior during feeding, play, and distress-eliciting tasks during which infant heart rate is recorded to derive measures of vagal withdrawal; (c) anthropometric measures of mothers and infants; and (d) assays of maternal prenatal blood and infant saliva and urine. A host of demographic and other potential confounds will be considered as potential covariates in structural equation models that include tests of mediation and moderation. Efforts to mitigate the deleterious effects of COVID-19 on study success are detailed.DiscussionThis study has the potential to inform (1) basic science about early life processes casually related to childhood obesity and (2) development of targeted intervention and prevention approaches that consider mother, infant, and family risks and resources.
Highlights
Childhood obesity remains a significant public health problem
We propose that obesogenic feeding practices after 6 months predict obesity risk at the age of 2 and moderate the link between infant weight gain and obesity risk at age 2; children who are already predisposed to weight problems will be at even greater risk for obesity when mothers engage in obesogenic feeding practices [63, 64]
We propose that higher child self-regulation will be associated with lower obesity risk at age 2, and that children who demonstrate a propensity toward greater infant weight gain, but go on to develop adaptive self-regulation skills, will be buffered from later obesity risk because they are less likely to turn to food for comfort and more likely to respond to their satiety cues
Summary
The iGrow Study will make several important conceptual, methodological, and translational advances in understanding the complex pathways to infant early weight gain and childhood obesity. The study will make important empirical advances by incorporating complex biological and behavioral measures that have rarely been studied during infancy This approach is invaluable because emerging data suggest that the biological and behavioral processes involved in childhood obesity begin to operate quite early in development. This is a key distinction between the current study and prior work in this area Without specifying how these factors work in the context of one another, it is difficult to identify specific points of entry and appropriate targets for prevention and intervention. This was the conclusion of the working paper on childhood obesity [5] and our study is uniquely poised to make such a contribution
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