Obesity intervention needed even before pregnancy, researchers say

Most efforts to combat childhood obesity focus on children and adolescents – but perhaps those efforts should start much earlier, even before conception, researchers say.

With 10% of U.S. preschoolers obese and another 10% overweight, obesity clearly begins early – in fact, before pregnancy, the researchers say in the June issue of Childhood Obesity. Markers for later heart disease appear in 3-year-olds, they say.

A multidisciplinary approach to break the cycle of obesity moving from generation to generation is needed, say the researchers, six experts from institutions across the country who conducted a review of more than 1,000 studies and discussions about efforts underway.

“High-risk adolescent girls become high-risk mothers who have high-risk infants, who in turn become high-risk children and adolescents,” the researchers write.

To break the cycle, the researchers propose two ideas: First, intervene before, during and after pregnancy and with very young children. Second, use a “systems” approach that would combine efforts in various settings and account for behavior and environmental factors.

A systems approach “focuses on the interconnections between different aspects of the environment and between individuals and the environment,” rather than a traditional approach with several components, the researchers say. That would mean aligning priorities in such settings as schools and health agencies.

They note several “whole community” efforts, such as the Shape Up Somerville (Mass.) program, and say aiming such efforts much earlier should be tested. Behind the efforts is evidence of many contributors to obesity: parental weight, weight gain during pregnancy, rapid weight gain in infancy, lack of activity and others.

Meanwhile, a grant from the California Raisin Marketing Board funded a study about what children ages 8 to 11 eat for after-school snacks. Perhaps it’s not a surprise that the study, announced recently at the Canadian Nutrition Society conference, showed that kids ate fewer calories and felt full when they ate raisins as opposed to some other foods, including cookies and chips.