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  • Pediatric Review
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Nature and strength of epidemiological evidence for origins of childhood and adulthood obesity in the first year of life

Abstract

Increased interest in early life origins of chronic disease, a concept often referred to as programming, has resulted in several studies investigating the origins of childhood or adulthood obesity during infancy. Rapid infancy weight gain as a risk factor and breastfeeding as a protective factor for later obesity have been most thoroughly studied. The association between rapid infancy weight gain and later obesity is supported by several observational studies, but not by the two, relatively small, randomized trials. This association is strong, suggests a dose–response effect and has biological plausibility, but is not consistent between study designs. Rapid infancy weight gain as a risk factor for later obesity has been experimentally reproduced in animal models, but not in humans. The protective effect of breastfeeding on obesity is also supported by several observational studies, but randomized trials are not available. Considering the potential for residual confounding factors, current evidence is insufficient to demonstrate origins of obesity during infancy or to change public health recommendations, but the potential for obesity prevention during infancy is promising.

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Acknowledgements

I thank Shiriki K Kumanyika, PhD, MPH and Hillary L Burdette, MD, MS for reviewing earlier versions of the manuscript and to Edmund M Weisberg, MS for his editorial support. Nicolas Stettler, MD, MSCE is supported in part by the National Institutes of Health Grants K23RR016073 and R01HL084056 and by the Department of Pediatrics of the University of Pennsylvania School of Medicine at The Children's Hospital of Philadelphia.

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Correspondence to N Stettler.

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Nicolas Stettler, MD, MSCE has been a consultant for Wyeth Nutritional and for the Dannon Institute.

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Stettler, N. Nature and strength of epidemiological evidence for origins of childhood and adulthood obesity in the first year of life. Int J Obes 31, 1035–1043 (2007). https://doi.org/10.1038/sj.ijo.0803659

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