Kerr JA, et al. - This trial sought to investigate which of the multiple early-life exposures speculated the onset or resolution of overweight/obesity, during a 9-year period. The strongest predictors of both onset and resolution of overweight/obesity between the primary school and adolescent years were discovered to be readily available baseline information (child/maternal body mass index (BMI), maternal age, education and child health). Perinatal, breastfeeding and lifestyle exposures did not appear to be strongly predictive. The yielded data could stimulate the development of algorithms detecting the children in dire need of targeted prevention or therapy.

Methods

• The enrollment comprised of three harmonised community-based cohorts enriched for overweight and obesity.
• Early-life exposures included child: Gestational age; delivery; birth weight; breast feeding; solids introduction; baseline body mass index (BMI); waist circumference; diet; activity; global, physical and psychosocial health.
• For mother, it included: Baseline BMI; education; age; neighbourhood disadvantage; concern for child's weight.
• The primary outcome was variation in BMI category.
• Analyses were performed through adjusted logistic regression.

Results

• The 363 eligible children (57% retention) were 6 and 15 years old at baseline and follow-up.
• Children were classified as ‘never’ overweight/obese (38%), ‘resolving’ overweight/obese (15%), ‘becoming’ overweight/obese (8%) or ‘always’ overweight/obese (39%).
• The odds of ‘becoming overweight/obese’ were greater with higher child (OR 2.33, 95% CI 1.02 to 5.29) and maternal BMI (OR 1.18, CI 1.07 to 1.31), and lower with higher maternal education (OR 0.09, CI 0.02 to 0.34), compared with ‘never overweight/obese’ children.
• In contrast with ‘always overweight/obese’ children, odds of ‘resolving overweight/obese’ appeared to be lower with higher maternal BMI (OR 0.87, CI 0.78 to 0.97), and higher with better child physical health (OR 1.06, CI 1.02 to 1.10) and higher maternal age (OR 1.11, CI 1.01 to 1.22) and education (OR 4.07, CI 1.02 to 16.19).