CDI Researcher Identifies Early Childhood Obesity Risks, Names Key Interventions

JAMA study points to child BMI paths as distinct obesity risk factors by age 3.5.

Children on a path to obesity can be identified by distinct weight development patterns as early as age 3.5, offering a critical new window for intervention, according to new research recently published in JAMA, the journal of the American Medical Association by a Hackensack Meridian Center for Discovery and Innovation (CDI) scientist and colleagues. 

The large-scale study followed 9,483 children, from toddlerhood to pre-adolescence, as part of a diverse population of over 57,000 children from varied racial, geographical, and socioeconomic backgrounds within The Environmental Influences on Child Health Outcomes (ECHO) study. The ECHO cohort is made up of 69 longitudinal pediatric cohorts from 44 states, and the U.S. territory, Puerto Rico. 

Hackensack Meridian Health physician-scientist Judy Aschner, M.D., CDI faculty member, and her co-authors in the study found two primary Body Mass Index (BMI) trajectories. 

A concerning 10.6 percent of children were on an "atypical" path: Their BMI, initially stable, began a rapid increase around age 3.5. By age nine, this group's average BMI exceeded the 99th percentile, indicating obesity, according to the findings. In contrast, 89.4 percent followed a "typical" pattern, where BMI declined until about age six before a healthier, gradual rise.

As a crucial element of its findings, the study pinpointed several modifiable early-life risk factors significantly associated with the atypical, high-risk trajectory toward childhood obesity. These include maternal smoking during pregnancy, a high maternal BMI before pregnancy, excessive maternal weight gain during pregnancy, and a high infant birthweight, according to the publication.

“Some of these high-risk factors are associated with underserved, high-risk populations,” said Dr. Aschner, “while others impact all populations, such as prenatal depression and anxiety.” 

Dr. Aschner and her collaborators emphasize these findings highlight "potential opportunities for preventing childhood obesity." The diverse nature of the study cohort enhances the broad relevance of the study’s findings.

This underscores the importance of early interventions, possibly starting even before conception or during pregnancy, focused on these specific risk factors. Such targeted efforts could help redirect unhealthy BMI trajectories, potentially playing a vital role in curbing the growing childhood obesity epidemic. 

“I’m endlessly thankful for our ECHO colleagues and staff, as well as the children and families participating in the ECHO cohort,” said Dr. Aschner. “Through engaged and widespread participation, we can find early solutions with lifelong rewards for children, nationally and globally.”