Longitudinal modeling of growth in children from birth to adolescence and the potential influence of diet

Obesity is a major public health challenge. Modeling growth and
identifying children at risk of being overweight in early life is
essential for effective prevention and intervention. To date,
longitudinal studies from birth to adolescent are rare, and crucial
period in childhood for overweight in future life is unclear. In
addition, apart from known risk factors of overweight or obesity,
further research on other potential risk factors is necessary. Even
though it is well accepted that obesity is mainly a consequence of
an unbalanced energy status, the impact of specific food item or
food group on growth has long been controversial, which calls for
more efforts. In order to contribute to the aforementioned
questions and research problems, we conducted a series of studies
using data from two ongoing German birth cohorts. 1) Using
longitudinal anthropometric data from birth to 5 years, we
established a 10-year-overweight prediction model. Our results
suggest that from 5 years onwards being overweight become
predictive for 10-year overweight. 2) We investigated the
association between mode of delivery and childhood obesity using
cross-sectional data at age 2, 6 and 10 years. Children delivered
by cesarean section were more likely to be obese at 2 years
compared to those delivered vaginally, but not at age 6 and 10
years. These results do not support the hypothesis that increasing
rates of cesarean section contribute to the childhood obesity
epidemic. 3) We analyzed data from food frequency questionnaires
which were completed during the 10-year follow-up, where we grouped
82 food items into 11 food groups. Our results suggest that intakes
of meat, fish and beverages are important correlates of body weight
status. In contrast, confectionery intake conversely associated
with being overweight. Further study on the influence of possible
reverse causation is needed. 4) We investigated the association
between maternal BMI and child food intake at the age of 10 years.
Our results suggest that maternal BMI and maternal overweight are
important correlates of a child’s intake of energy, meat and eggs.
Potential impact of mother’s weight status should be considered in
diet counseling. Moreover, mother’s participation in dietary
counseling might be helpful to improve offspring diet pattern and
weight status. These studies contributed to the current knowledge
on early identification of children at risk of overweight and the
potential influence of diet. In addition, our results suggest more
efforts on longitudinal studies and more attention on reverse
causation and misreport in dietary assessments in future studies.