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Maternal adherence to healthy lifestyle reduces risk of offspring obesity

Stephen Padilla
10 Jul 2018
Powering it through: Patients battling with obesity need more than just exercise and a healthy diet.

Mothers who adhere to a healthy lifestyle during their offspring’s childhood and adolescence appear to substantially lower the risk of obesity in their children, suggests a recent study. Of note, observing a healthy lifestyle in both mothers and their children leads to an even lower risk of offspring obesity.

“Our findings highlight the potentially critical role of maternal lifestyle choices in the aetiology of childhood obesity and lend support to family- or parent-based intervention strategies for reducing childhood obesity risk,” researchers said.

Over a median follow-up of 5 years, there were 1,282 (5.3 percent) offspring who became obese. Risk of incident obesity was lower among children whose mothers maintained a healthy body mass index of 18.5–24.9 kg/m2 (relative risk [RR], 0.44; 95 percent CI, 0.39–0.50), engaged in at least 150 min/week of moderate/vigorous physical activities (RR, 0.79; 0.69–0.91), did not smoke (RR, 0.69; 0.56–0.86) and consumed alcohol moderately (1.0–14.9 g/day; RR, 0.88; 0.79–0.99), as compared with the rest. [BMJ 2018;362:k2486]

No significant association existed between maternal high-quality diet (top 40 percent of the Alternate Healthy Eating Index 2010 diet score) and the risk of obesity in offspring (RR, 0.97; 0.83–1.12). Simultaneous consideration of all healthy lifestyle factors showed a 75-percent lower obesity risk among offspring of mothers who adhered to all five low-risk lifestyle factors vs children of women who did not adhere to any low-risk factor (RR, 0.25; 0.14–0.47).

Such association persisted regardless of sex and age, and in subgroups of children with various risk profiles defined by factors such as pregnancy complications, birth weight, gestational age and gestational weight gain.

The lifestyle of children appeared to have no impact on the association between maternal lifestyle and offspring obesity risk. However, the risk of developing obesity decreased further when both mothers and their children maintained a healthy lifestyle (RR, 0.18; 0.09–0.37).

“The mechanisms underlying our observations are not completely understood, although the effect of mothers’ lifestyle and behaviours could exert a critical impact on their children’s lifestyle and diet and subsequently modulate offspring’s obesity risk,” researchers said. [J Pediatr 1991;118:215-219; Sports Med 2006;36:79-97; J Am Diet Assoc 2011;111:1314-1321; J Am Diet Assoc 2011;111:1301-1305]

Furthermore, findings of the present study are consistent with those of a recent large-scale clinical study showing that parent-only interventions are as effective as family-based interventions to promote weight loss in children. This stresses the role of parental behaviours in the aetiology of offspring obesity risk. [JAMA Pediatr 2017;171:622-628; J Public Health (Oxf) 2014;36:476-489]

In this prospective cohort studies of mother-child pairs (Nurses’ Health Study II [NSHII] and Growing Up Today Study [GUTS] in the US), a total of 24,289 GUTS participants aged 9–14 years at baseline who were free of obesity and born to 16,945 NHSII women were included.

Primary outcome measure was obesity in childhood and adolescence, defined by age- and sex-specific cutoff points from the International Obesity Task Force. Offspring obesity risk was assessed using multivariable log-binomial regression models with generalized estimating equations and an exchangeable correlation structure.

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