Future Risk Of Obesity Research Articles

Determinants of Adiposity Rebound Timing in Children

Adiposity rebound (AR) or BMI (body mass index) rebound refers to the increase in BMI following the minimum BMI in early childhood. Early AR (before age 5) is predictive of adult obesity. To determine how 4 domains - demographics, maternal BMI, food security, and behavioral characteristics - may affect timing of AR. A total of 248 children, ages 2.5-3.5 years, in Latino farmworker families in North Carolina were examined at baseline and every 3 months for 2 years. BMI was plotted serially for each child and the onset of BMI rebound was determined by visual inspection of the graphs. Given the ages of the children, all rebounds were detected before age 5 years and were deemed "early," whereas other children were classified as "nonrebounders." Classes were then compared in terms of the 4 domains with the use of bivariate analyses and linear mixed models. A total of 131 children demonstrated early rebound, 59 children were nonrebounders, and a further 35 had inconclusive data. Parents of early rebounders were less likely to have documentation permitting legal residence in the US. Mothers of early rebounders were on average 3 BMI units heavier. Sex, household food security, diet quality, caloric intake, and daily activity did not differ between classes. In multivariable analysis, female sex, limited maternal education, increased maternal BMI, and increased caloric intake were significant predictors of early rebound. High maternal BMI was the strongest predictor of early BMI rebound, but increased caloric intake also was significant. Limiting excess calories could delay premature AR and lower the risk of future obesity.

A role for maternally derived myokines to optimize placental function and fetal growth across gestation.

Exercise during pregnancy is associated with improved health outcomes for both mother and baby, including a reduced risk of future obesity and susceptibility to chronic diseases. Overwhelming evidence demonstrates a protective effect of maternal exercise against fetal birth weight extremes, reducing the rates of both large- and small-for-gestational-age infants. It is speculated that this protective effect is mediated in part through exercise-induced regulation of maternal physiology and placental development and function. However, the specific mechanisms through which maternal exercise regulates these changes remain to be discovered. We hypothesize that myokines, a collection of peptides and cytokines secreted from contracting skeletal muscles during exercise, may be an important missing link in the story. Myokines are known to reduce inflammation, improve metabolism and enhance macronutrient transporter expression and activity in various tissues of nonpregnant individuals. Little research to date has focused on the specific roles of the myokine secretome in the context of pregnancy; however, it is likely that myokines secreted from exercising skeletal muscles may modulate the maternal milieu and directly impact the vital organ of pregnancy-the placenta. In the current review, data in strong support of this potential role of myokines will be presented, suggesting myokine secretion as a key mechanism through which maternal exercise optimizes fetal growth trajectories. It is clear that further research is warranted in this area, as knowledge of the biological roles of myokines in the context of pregnancy would better inform clinical recommendations for exercise during pregnancy and contribute to the development of important therapeutic interventions.

Increased fetal adiposity prior to diagnosis of gestational diabetes in South Asians: more evidence for the \u2018thin\u2013fat\u2019 baby

Aims/hypothesisGestational diabetes mellitus (GDM) is associated with an increased future risk of obesity in the offspring. Increased adiposity has been observed in the newborns of women with GDM. Our aim was to examine early fetal adiposity in women with GDM.MethodsObstetric and sonographic data was collated for 153 women with GDM and 178 controls from a single centre in Chennai, India. Fetal head circumference (HC), abdominal circumference (AC), femur length (FL) and biparietal diameter (BPD) were recorded at 11, 20 and 32 weeks. Anterior abdominal wall thickness (AAWT) as a marker of abdominal adiposity at 20 and 32 weeks was compared between groups. Adjustments were made for maternal age, BMI, parity, gestational weight gain, fetal sex and gestational age.ResultsFetuses of women with GDM had significantly higher AAWT at 20 weeks (β 0.26 [95% CI 0.15, 0.37] mm, p < 0.0001) despite lower measures of HC, FL, BPD and AC. AAWT remained higher in the fetuses of women with GDM at 32 weeks (β 0.48 [0.30, 0.65] mm, p < 0.0001) despite similar measures for HC, FL, BPD and AC between groups. Both groups had similar birthweights at term. There was an independent relationship between fasting plasma glucose levels and AAWT after adjustment as described above.Conclusions/interpretationA ‘thin but fat’ phenotype signifying a disproportionate increase in adiposity despite smaller or similar lean body mass was observed in the fetuses of mothers with GDM, even at 20 weeks, thus pre-dating the biochemical diagnosis of GDM. Increased AAWT may serve as an early marker of GDM.

Pre-Pregnancy Maternal Exposure to Persistent Organic Pollutants and Gestational Weight Gain: A Prospective Cohort Study.

Persistent organic pollutants (POPs) have been implicated in the development of obesity in non-pregnant adults. However, few studies have explored the association of POPs with gestational weight gain (GWG), an important predictor of future risk of obesity in both the mother and offspring. We estimated the association of maternal pre-pregnancy levels of 63 POPs with GWG. Data are from women (18–40 years; n = 218) participating in a prospective cohort study. POPs were assessed using established protocols in pre-pregnancy, non-fasting blood samples. GWG was assessed using three techniques: (1) total GWG (difference between measured pre-pregnancy weight and final self-reported pre-delivery weight); (2) category based on pre-pregnancy body mass index (BMI)-specific Institute of Medicine (IOM) recommendations; and (3) area under the GWG curve (AUC). In an exploratory analysis, effects were estimated separately for women with BMI < 25 kg/m2 versus BMI ≥ 25 kg/m2. Multivariable polytomous logistic regression and linear regression were used to estimate the association between each chemical or congener and the three GWG outcomes. p,p’-dichlorodiphenyl trichloroethane (p,p’-DDT) was significantly inversely associated with AUC after adjustment for lipids and pre-pregnancy BMI: beta {95% confidence interval (CI)}, −378.03 (−724.02, −32.05). Perfluorooctane sulfonate (PFOS) was significantly positively associated with AUC after adjustment for lipids among women with a BMI < 25 kg/m2 {beta (95% CI), 280.29 (13.71, 546.86)}, but not among women with a BMI ≥ 25 kg/m2 {beta (95% CI), 56.99 (−328.36, 442.34)}. In summary, pre-pregnancy levels of select POPs, namely, p,p’-DDT and PFOS, were moderately associated with GWG. The association between POPs and weight gain during pregnancy may be more complex than previously thought, and adiposity prior to pregnancy may be an important effect modifier.

Protein intakes and their nutritional sources during the first 2 years of life: secondary data evaluation from the European Childhood Obesity Project.

High protein intake in infancy affects future obesity risk and other health outcomes. We aim to describe total protein intake and its sources in a birth cohort in five European countries over the first 2 years of life. A total of 746 formula-fed infants were included. Three-day weighed dietary records at 6, 7, 8, 9, 12, 18 and 24 months of age were used. Kruskal-Wallis, ANOVA and Friedman's tests were used to assess possible differences in nutritional intake among countries and over time. Dairy products were the main components of the infants' diets. Cow's milk was rarely introduced before 12 months of age, whereas infants' formula was the main contributor of protein intake. Food choices and protein intake differed among countries (P<0.001). Protein intake often exceeded European recommendations from 9 months onwards, partly because of the substitution of dairy protein (mainly infant formula) by meat protein. Two nutritional patterns were identified that were characterised by differences in energy, fat, protein and animal protein intake. Finally, food consumption was not always in line with protein intakes, and thus infants from some countries showed high consumption of specific food groups but relatively low protein intakes. During weaning, over-limited substitution of dairy products with other sources (especially meat) resulted in relatively high protein intakes in formula-fed infants. Differences in preferences of specific protein sources from complementary foods existed among European countries. Great opportunities in improving early nutrition were revealed, although cultural and geographical differences should always be considered.

Effects on postpartum weight retention after antenatal lifestyle intervention - a secondary analysis of a randomized controlled trial.

High weight retention after pregnancy is related to an increased risk of future obesity. The objective was to evaluate whether an antenatal intervention, compared with standard care, could reduce postpartum weight retention (PPWR). Women with body mass index >19, age ≥18 years, knowledge of Swedish, and pregnancy ≤16 weeks' gestation were randomized. Standard care was compared with a composite intervention including a personalized weight graph, education on recommended weight gain, prescription of exercise, and monitoring of weight until 1 year after delivery. Mean (kg) PPWR was compared between the groups and risk estimates (odds ratio) for excessive weight retention were calculated. Of 445 women randomized, 267 remained for analysis at ≤16 weeks postpartum and 168 at 1 year postpartum. The intervention group had a significantly lower mean PPWR at ≤16 weeks [1.81 kg (standard deviation, SD, 4.52) vs. 3.19 kg (SD 4.77), p = 0.016]. At one year postpartum, mean retention was still 0.7 kg lower in the intervention group [0.30 kg (SD 5.52) vs. 1.00 kg (SD 5.46)]; the difference was not statistically significant (p = 0.414). Gestational weight gain above Institute of Medicine recommendations was a significant risk factor for excessive weight retention (>5 kg) one year after delivery (OR 2.44; 95% CI 1.08-5.52, p = 0.029). A composite lifestyle intervention during pregnancy reduced short-term weight retention, but the effect of the intervention did not remain at 1 year postpartum. A gestational weight gain above Institute of Medicine recommendations increases the risk of excessive long-term weight retention.

Do Anxiety Disorders Play a Role in Adolescent Obesity?

There have been few prospective studies on the association between anxiety disorders and adolescent obesity; none examine potential reciprocal effects. The purpose of this paper is to examine the prospective association between anxiety disorders and obesity among adolescents. Using data from a two-wave, prospective study of 3134 adolescents, we examined reciprocal effects between body weight and DSM-IV anxiety disorders. Weight status did not increase future risk of anxiety disorders nor did anxiety disorders at baseline increase risk of future obesity in the overall sample. Stratifying by gender revealed an increased risk of overweight and obesity in males with anxiety disorders, but not for females. Major depression did not mediate these associations. Similar to prospective studies of depression, it appears anxiety disorders may increase risk of obesity. However, more research is needed on the role of psychopathology in adolescent obesity, in particular anxiety disorders and possible moderators (such as gender) and mediators.

Pregnancy Weight Gain, Postpartum Weight Retention, and Obesity

Obesity is a significant health problem associated with specific risks during pregnancy. Overweight and obese women are at increased risk for gaining weight in excess of pregnancy weight gain guidelines. Excessive gestational weight gain (EGWG) is associated with postpartum weight retention (PPWR) and can negatively impact the health of developing offspring, including increasing the risk of future obesity and diabetes. For all women, pregnancy may serve as an inciting factor that leads to increased body weight 15 to 20 years postpartum. Decreased exercise, increased consumption of unhealthy foods, and smoking cessation are associated with EGWG while increased exercise and breastfeeding are associated with reduced PPWR. A variety of interventions in limited settings have been successful at reducing EGWG and promoting postpartum weight loss. More research is needed on optimal ways to educate women about weight gain recommendations and incorporate interventions into routine care to improve maternal and child outcomes.

Association between hyperglycaemia and adverse perinatal outcomes in south Asian and white British women: analysis of data from the Born in Bradford cohort

SummaryBackgroundDiagnosis of gestational diabetes predicts risk of infants who are large for gestational age (LGA) and with high adiposity, which in turn aims to predict a future risk of obesity in the offspring. South Asian women have higher risk of gestational diabetes, lower risk of LGA, and on average give birth to infants with greater adiposity than do white European women. Whether the same diagnostic criteria for gestational diabetes should apply to both groups of women is unclear. We aimed to assess the association between maternal glucose and adverse perinatal outcomes to ascertain whether thresholds used to diagnose gestational diabetes should differ between south Asian and white British women. We also aimed to assess whether ethnic origin affected prevalence of gestational diabetes irrespective of criteria used.MethodsWe used data (including results of a 26–28 week gestation oral glucose tolerance test) of women from the Born in Bradford study, a prospective study that recruited women attending the antenatal clinic at the Bradford Royal Infirmary, UK, between 2007 and 2011 and who intended to give birth to their infant in that hospital. We studied the association between fasting and 2 h post-load glucose and three primary outcomes (LGA [defined as birthweight >90th percentile for gestational age], high infant adiposity [sum of skinfolds >90th percentile for gestational age], and caesarean section). We calculated adjusted odds ratios (ORs) and their 95% confidence intervals (CIs) for a 1 SD increase in fasting and post-load glucose. We established fasting and post-load glucose thresholds that equated to an OR of 1·75 for LGA and high infant adiposity in each group of women to identify ethnic-specific criteria for diagnosis of gestational diabetes.FindingsOf 13 773 pregnancies, 3420 were excluded from analyses. Of 10 353 eligible pregnancies, 4088 women were white British, 5408 were south Asian, and 857 were of other ethnic origin. The adjusted ORs of LGA per 1 SD fasting glucose were 1·22 (95% CI 1·08–1·38) in white British women and 1·43 (1·23–1·67) in south Asian women (pinteraction with ethnicity = 0·39). Results for high infant adiposity were 1·35 (1·23–1·49) and 1·35 (1·18–1·54; pinteraction with ethnicity=0·98), and for caesarean section they were 1·06 (0·97–1·16) and 1·11 (1·02–1·20; pinteraction with ethnicity=0·47). Associations between post-load glucose and the three primary outcomes were weaker than for fasting glucose. A fasting glucose concentration of 5·4 mmol/L or a 2 h post-load level of 7·5 mmol/L identified white British women with 75% or higher relative risk of LGA or high infant adiposity; in south Asian women, the cutoffs were 5·2 mmol/L or 7·2 mml/L; in the whole cohort, the cutoffs were 5·3 mmol/L or 7·5 mml/L. The prevalence of gestational diabetes in our cohort ranged from 1·2% to 8·7% in white British women and 4% to 24% in south Asian women using six different criteria. Compared with the application of our whole-cohort criteria, use of our ethnic-specific criteria increased the prevalence of gestational diabetes in south Asian women from 17·4% (95% CI 16·4–18·4) to 24·2% (23·1–25·3).InterpretationOur data support the use of lower fasting and post-load glucose thresholds to diagnose gestational diabetes in south Asian than white British women. They also suggest that diagnostic criteria for gestational diabetes recommended by UK NICE might underestimate the prevalence of gestational diabetes compared with our criteria or those recommended by the International Association of Diabetes and Pregnancy Study Groups and WHO, especially in south Asian women.FundingThe National Institute for Health Research.

Is there an association between adolescent sleep restriction and obesity

ObjectiveThis is the first prospective study of the reciprocal association between sleep restriction and weight among adolescents. Evidence on sleep duration and obesity in youth is sparse and the results have been equivocal. MethodsData are from a community-based, two-wave cohort study. The setting was a metropolitan area with a population of over 4 million. The cohort consisted of 4175 youths 11–17 at baseline and 3134 of these followed up a year later. Obesity was defined as body mass index >95th percentile for children of the same age and sex. Sleep restriction was defined as 6 or fewer hours of sleep per night on weeknights or on both weekends and weeknights. Covariates examined were age, gender, family income and depression. ResultsResults clearly demonstrated that there was no association between sleep restriction and obesity at baseline. In prospective analyses, sleep restriction did not increase future risk of obesity, nor did obesity increase risk of future sleep restriction. ConclusionsThese findings call into question previous research based primarily on cross-sectional data suggesting a positive correlation between sleep restriction and obesity. However, the results for adolescents in this study are supported by one study of adolescents and by studies of adults using prospective designs. At this point, there appears to be little evidence for a temporal relation between sleep duration and obesity among adults or adolescents.

Dieting Increases the Likelihood of Subsequent Obesity and BMI Gain: Results from a Prospective Study of an Australian National Sample.

Diet is a major determinant of obesity; however, findings from the studies examining how dieting to lose weight affects weight gain have been inconclusive. Our aim was to examine the longitudinal association of frequency of dieting for weight loss with (a) obesity status and (b) body mass index (BMI) change. We used data from Waves 9 (2009) and 10 (2010) of the Household Income and Labour Dynamics in Australia (HILDA) survey. Binominal logistic regression estimated the association of frequency of dieting in 2009 on probability of obesity in 2010. Multinomial logistic regression estimated the association of frequency of dieting in 2009 on the probability of BMI gain versus BMI maintenance and BMI loss between 2009 and 2010. The analysis sample size was 8824. Compared to those who were never on a diet in the previous year, the odds of obesity were 1.9, 2.9, and 3.2 times higher among those who were on a diet once, more than once, and always, respectively. Similarly, the odds of BMI gain versus BMI maintenance and also versus BMI loss were higher among those who dieted than those who did not. Dieting to lose weight can contribute to the risk of future obesity and weight gain. Losing weight requires a commitment to change one's lifestyle and a sustained effort to maintain a healthy diet and engage in physical activity.

Diabetes in Socioeconomically Vulnerable Populations.

Diabetes in Socioeconomically Vulnerable Populations.

Does exposure to hyperglycaemia in utero increase the risk of obesity and diabetes in the offspring? A critical reappraisal.

The idea that exposure to hyperglycaemia in utero is an important factor in the development of obesity and diabetes in the offspring has become entrenched as popular belief. To appraise the literature supporting this hypothesis in the light of recent studies that have clarified the main drivers of obesity in children and adolescents. A review of published evidence from animal studies, human observational studies, systematic reviews and experimental trials that address the impact of diabetes (Types 1 and 2, genetic or gestational) on the future risk of obesity and/or glucose intolerance in the offspring. Some animal studies support a relationship between exposure to hyperglycaemia in utero and future development of obesity and diabetes, but the results are inconsistent. Most of the human studies claiming to show a relationship have not taken into account important known confounders, such as maternal and paternal BMI. Evidence supporting a dose-response relationship between maternal hyperglycaemia exposure and obesity and diabetes in the offspring is weak, and there is no convincing evidence that treating gestational diabetes reduces the later risk of offspring obesity or glucose intolerance. Exposure to hyperglycaemia in utero has minimal direct effect on the later risk of obesity and Type 2 diabetes. The increased risk of obesity in the offspring of women with Type 2 or gestational diabetes can be explained by confounding factors, such as parental obesity.

Appetite and Growth

Identifying early markers of future obesity risk can help target preventive interventions. Several studies have shown that a heartier appetite in infancy is a risk factor for more rapid weight gain, but to date no investigations have been able to rule out familial confounding. To use a sibling design (data from same-sex, dizygotic twin pairs) to test the hypothesis that sibling differences in infant appetite predicted differential weight gain during childhood. Gemini is a population-based twin cohort among the general United Kingdom population born between March 1, 2007, and December 15, 2007. Growth trajectories were analyzed from birth to age 15 months. Appetite-discordant pairs were selected from 800 nonidentical, same-sex twin pairs. Appetite during the first 3 months of life was assessed with the food responsiveness (FR) and satiety responsiveness (SR) subscales from the Baby Eating Behaviour Questionnaire. Discordance was defined as a within-pair difference of at least 1 SD. A mean of 11.5 weight measurements per child were available between birth and age 15 months. Multilevel models, adjusted for sex and birth weight, compared growth curves for the higher-appetite vs lower-appetite twins. In total, 172 pairs were discordant for SR and 121 pairs for FR. Within-pair analyses showed that those with higher FR and those with lower SR grew faster than their sibling. At age 6 months, those with higher FR were 654 (95% CI, 395-913) g heavier and at age 15 months were 991 (95% CI, 484-1498) g heavier. For sibling pairs discordant for SR, the weight differences between siblings were 637 (95% CI, 438-836) g at age 6 months and 918 (95% CI, 569-1267) g at age 15 months. A heartier appetite (indexed with higher FR or lower SR) in early infancy is prospectively associated with more rapid growth up to age 15 months in a design controlling for potential familial confounding, supporting a causal role for appetite in childhood weight gain. Appetite could be an early marker for risk of weight gain in the current obesogenic environment and might be a potential target for preventive interventions.

Child eating behavior outcomes of an early feeding intervention to reduce risk indicators for child obesity: The NOURISH RCT

The objective was to describe parent-reported child eating behavior and maternal parenting impact outcomes of an infant feeding intervention to reduce child obesity risk. An assessor masked Randomized Controlled Trial (RCT) with concealed allocation of individual mother-infant dyads. The NOURISH RCT enrolled 698 first-time mothers (mean age 30.1 years, SD = 5.3) with healthy term infants (51% female) aged 4.3 months (SD = 1.0) at baseline. Outcomes were assessed 6 months post-intervention when the children were 2 years old. Mothers reported on child eating behaviors using the Children's Eating Behavior Questionnaire (CEBQ), food preferences, and dietary intake using a 24-hour telephone recall. Parenting was assessed using five scales validated for use in Australia. Intervention effects were evident on the CEBQ overall (MANOVA P = 0.002) and 4/8 subscales: child satiety responsiveness (P = 0.03), fussiness (P = 0.01), emotional overeating (P < 0.01), and food responsiveness (P = 0.06). Intervention children "liked" more fruits (P < 0.01) and fewer non-core foods and beverages (P = 0.06, 0.03). The intervention mothers reported greater "autonomy encouragement" (P = 0.002). Anticipatory guidance on protective feeding practices appears to have modest positive impacts on child eating behaviors that are postulated to reduce future obesity risk.

Pregnancy and Neonatal Diabetes Outcomes in Remote Australia (PANDORA) study

BackgroundDiabetes in pregnancy carries an increased risk of adverse pregnancy outcomes for both the mother and foetus, but it also provides an excellent early opportunity for intervention in the life course for both mother and baby. In the context of the escalating epidemic of chronic diseases among Indigenous Australians, it is vital that this risk is reduced as early as possible in the life course of the individual. The aims of the PANDORA Study are to: (i) accurately assess rates of diabetes in pregnancy in the Northern Territory (NT) of Australia, where 38% of babies are born to Indigenous mothers; (ii) assess demographic, clinical, biochemical, anthropometric, socioeconomic and early life development factors that may contribute to key maternal and neonatal birth outcomes associated with diabetes in pregnancy; and (iii) monitor relevant post-partum clinical outcomes for both the mothers and their babies.Methods/DesignEligible participants are all NT women with diabetes in pregnancy aged 16 years and over. Information collected includes: standard antenatal clinical information, diagnosis and management of diabetes in pregnancy, socio-economic status, standard clinical birth information (delivery, gestational age, birth weight, adverse antenatal and birth outcomes). Cord blood is collected at the time of delivery and detailed neonatal anthropometric measurements performed within 72 hours of birth. Information will also be collected regarding maternal post-partum glucose tolerance and cardio-metabolic risk factor status, breastfeeding and growth of the baby up to 2 years post-partum in the first instance.DiscussionThis study will accurately document rates and outcomes of diabetes in pregnancy in the NT of Australia, including the high-risk Indigenous Australian population. The results of this study should contribute to policy and clinical guidelines with the goal of reducing the future risk of obesity and diabetes in both mothers and their offspring.

Obesity in prematurely born children and adolescents: follow up in pediatric clinic

BackgroundUnderstanding associated risk for obesity is a prerequisite to develop early life interventions to arrest the increasing epidemic of metabolic syndrome and obesity among preterm born children and adolescents.FindingsA retrospective review of 160 charts was conducted to determine the associated risk of being obese during childhood and adolescent period in preterm children. Birth weight, gestational age, weight gain, demographics, maternal health, socioeconomics, and clinical factors during early neonatal life were evaluated. The number of obese children increased with age and was observed more in the adolescent population. Obese children were significantly heavier at age 24 months old compared to their peers (p = 0.001). Analysis of associated risk for maternal demographics, maternal age, maternal marital status or race, prenatal factors, maternal substance abuse or diabetes, neonatal factors, weight for gestational age or birth weight did not show any statistically significant risk for future obesity. Duration of gestational age (OR 1.6; p = 0.017) and heavier birth weight (OR 3.2; p = 0.001) were associated with risk of obesity.ConclusionAmong preterm born babies in the study, the highest risk of developing excessive weight during childhood and adolescent periods are babies born at more advanced gestational age. Strong positive association was found between birth weight and body weight in childhood. By 24 months old, there was a distinguished group of toddlers, who were heavier than their peers and remained with excessive weight as they got older. Primary care pediatricians should draw attention to premature babies, overweight infants and toddlers.

Predicting adult obesity from measures in earlier life

BackgroundAs most obese adults were not overweight as children, the prediction of adult obesity from childhood body size alone is limited. We constructed a two-way, multifactor risk assessment framework for...

990 Ethnic Differences in Neonatal Body Composition and the Impact of Parental Size. a Population-Based Cohort Study

Background and AimNeonatal size, and especially a relative “thinness”, is associated with future risk of obesity and type 2 diabetes. The aim was to explore ethnic differences in neonatal body...

Commentary on "estimation of newborn risk for child or adolescent obesity: lessons from longitudinal birth cohorts".

Childhood obesity is an increasingly prevalent problem, associated with obesity later in life, and a sequalae of health problems such as metabolic syndrome and an increased risk of coronary heart disease. Poor nutrition and a lack of physical activity are said to be causes of obesity development, with genetic factors and heritability also implicated. However, there are established, identifiable risk factors associated with the future development of obesity, both in childhood, and adolescence. These include parental weight before pregnancy, gestational weight gain, pre-pregnancy maternal smoking, as well as numerous socioeconomic factors.1–4 Studies have also shown that once obese, children can find it very difficult to lose the excess weight,5 with long-term management methods having shown poor efficacy.5 Therefore, preventative strategies are becoming a high priority to battle the ever-increasing epidemic of childhood obesity. This study by Morandi et al.6 is the first longitudinal study to analyse the predictive properties of early life risk factors for obesity, and propose a subsequent predictive algorithm to identify newborns most at risk of becoming obese in childhood and adolescence.Morandi et al.’s study aimed to develop a clinically useful formula, which could be used to identify the risk of future obesity in newborns, thereby enabling more efficient implementation of prevention strategies.6 The lifetime Northern Finland Birth Cohort 1986 (NFBC 1986) was used to form predictive equations for both childhood and adolescent obesity, based on established risk factors: parental BMI, birth weight, maternal gestational weight gain, and socioeconomic factors. A genetic score was also created based on 39 BMI/obesity-associated polymorphisms. Validation studies were performed on both a retrospective cohort of children from Veneto, Italy, and a prospective cohort of children from Massachusetts, USA.