Lecorguillé Marion, Schipper Mireille C, O'Donnell Aisling, Aubert Adrien M, Tafflet Muriel, Gassama Malamine, Douglass Alexander, Hébert James R, de Lauzon-Guillain Blandine, Kelleher Cecily, Charles Marie-Aline, Phillips Catherine M, Gaillard Romy, Lioret Sandrine, Heude Barbara
Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France.
The Generation R Study Group (Na 29-15), Erasmus University Medical Center, CA, Rotterdam, Netherlands.
Front Nutr. 2023 May 18;10:1166981. doi: 10.3389/fnut.2023.1166981. eCollection 2023.
High prevalence of overweight and obesity already observed in preschool children suggests the involvement of early-life risk factors. Preconception period and pregnancy are crucial windows for the implementation of child obesity prevention interventions with parental lifestyle factors as relevant targets. So far, most studies have evaluated their role separately, with only a few having investigated their potential synergistic effect on childhood obesity. Our objective was to investigate parental lifestyle patterns in the preconception and pregnancy periods and their association with the risk of child overweight after 5 years.
We harmonized and interpreted results from four European mother-offspring cohorts participating in the EndObesity Consortium [EDEN, France; Elfe, France; Lifeways, Ireland; and Generation R, Netherlands] with data available for 1,900, 18,000, 1,100, and 9,500 families, respectively. Lifestyle factors were collected using questionnaires and included parental smoking, body mass index (BMI), gestational weight gain, diet, physical activity, and sedentary behavior. We applied principal component analyses to identify parental lifestyle patterns in preconception and pregnancy. Their association with risk of overweight (including obesity; OW-OB) and BMI -scores between 5 and 12 years were assessed using cohort-specific multivariable logistic and linear and regression models (adjusted for potential confounders including parental age, education level, employment status, geographic origin, parity, and household income).
Among the various lifestyle patterns derived in all cohorts, the two explaining the most variance were characterized by (1) "high parental smoking, low maternal diet quality (and high maternal sedentary behavior in some cohorts)" and, (2) "high parental BMI and low gestational weight gain." Patterns characterized by high parental BMI, smoking, low diet quality or high sedentary lifestyle before or during pregnancy were associated with higher risk of OW-OB in children, and BMI -score at any age, with consistent strengths of associations in the main cohorts, except for lifeways.
This project provides insight into how combined parental lifestyle factors in the preconception and pregnancy periods are associated with the future risk of child obesity. These findings are valuable to inform family-based and multi-behavioural child obesity prevention strategies in early life.
学龄前儿童中超重和肥胖的高患病率表明存在早期生活风险因素。孕前和孕期是实施以父母生活方式因素为相关目标的儿童肥胖预防干预措施的关键时期。到目前为止，大多数研究分别评估了它们的作用，只有少数研究调查了它们对儿童肥胖的潜在协同效应。我们的目的是调查孕前和孕期父母的生活方式模式及其与5年后儿童超重风险的关联。
我们整合并解读了参与EndObesity联盟的四个欧洲母婴队列（法国的EDEN；法国的Elfe；爱尔兰的Lifeways；荷兰的Generation R）的结果，各队列分别有1900、18000、1100和9500个家庭的数据可用。生活方式因素通过问卷收集，包括父母吸烟、体重指数（BMI）、孕期体重增加、饮食、身体活动和久坐行为。我们应用主成分分析来确定孕前和孕期父母的生活方式模式。使用特定队列的多变量逻辑回归、线性回归和回归模型（对包括父母年龄、教育水平、就业状况、地理来源、产次和家庭收入等潜在混杂因素进行了调整）评估它们与5至12岁超重（包括肥胖；OW-OB）风险和BMI评分的关联。
在所有队列得出的各种生活方式模式中，解释方差最大的两种模式的特点是：（1）“父母吸烟率高、母亲饮食质量低（在某些队列中母亲久坐行为多）”，以及（2）“父母BMI高且孕期体重增加少”。孕前或孕期以父母BMI高、吸烟、饮食质量低或久坐生活方式多为特征的模式与儿童OW-OB风险较高以及任何年龄的BMI评分较高相关，在主要队列中关联强度一致，但Lifeways队列除外。
本项目深入了解了孕前和孕期父母生活方式因素的综合作用与儿童未来肥胖风险之间的关联。这些发现对于为早期基于家庭和多行为的儿童肥胖预防策略提供信息具有重要价值。
