We have all heard it before, maybe even said it, “it’s genetic”, “the whole family is big boned”. What is fact  versus fiction when it comes to causes, and explanations for childhood obesity? What factors truly make your child more likely to become “overweight “or obese?

Myths:

• Obesity is mostly genetic and hormones are to blame.
• Video games are to blame for the obesity epidemic.
• Fast food and sugary drinks are to blame.
• Obesity is a socioeconomic problem.
• Parents are solely to blame for their child’s obesity.

“If you do not breastfeed you are increasing your child’s risk factors for developing obesity and weight related problems later in life.”

World Health Organization (WHO) published findings in 2007 reporting links between prolonged breastfeeding and reduction in childhood obesity. The studies WHO referenced have been shown to use inconsistent controls and did not use long term or sibling follow-up analysis, which would have provided more reliable information.

The American Journal of Clinical Nutrition published a follow-up study in December of 2007 indicating a lack of information supporting the WHO’s findings. The study followed infants from birth through 6.5 years of age, who were exclusively breast fed. By comparing BMI, blood pressure, cholesterol levels, and height studies of over 13,000 children were unable to establish a link between exclusive breastfeeding and an overall reduction in childhood obesity or obesity later in life.

“I am eating for two!”

While it is important to gain weight during pregnancy, too much weight gain may have negative effects on both mother’s and babies overall health. An organization called Project Viva has begun to study and follow pregnant women and their children from gestation through early adolescence to conduct long term studies researching childhood obesity and its connection to weight gain during pregnancy.

Studies found women who gained more than recommended weight (table 1)  during pregnancy were four times more likely to have children who were considered to be overweight by the age of 3 years old. The recommendations for weight gained during pregnancy is determined by pre-pregnancy BMI, ranging from a high of 35lb and lows near 11lbs. This implies that having a birth mother who is overweight prior to conception does not guarantee an obese child. However, having a mother who gains an excessive amount weight during pregnancy has shown a relationship to obesity in childhood.

“It’s genetic, everyone in our family is large, there is nothing that we can do about it.”

While it is true that there are some people with an increased predisposition to excessive weight gain, it does not mean that we must succumb to this as our fate or the fate of future generations. There are some diseases that impact weight gain, but hormonal dysfunctions are responsible for far fewer cases of weight gain than we think. Genetic diseases associated with childhood obesity have not grown exponentially over the last three decades, but childhood obesity has more than doubled.

One literature review  of 35 papers found there is a significant connection between parenting style (as it related to food consumption) and weight gain throughout childhood. Studies of parents who use food as rewards, are too free with their child’s choices of food, or are overly restrictive/controlling with feeding practices have shown a significant connection to increased childhood BMI.

“It’s because they are cutting physical education programs from our children’s schools.”

There are many studies that show a direct correlation between obesity and sedentary lifestyles, across the lifespan. In children it is more natural to explore, run jump and participate in pure “play”. Many children are spending increased time in front of electronic devices, being bussed or driven to school or sitting for hours daily doing school work; all factors limiting active lifestyle.

The CDC suggests children participate in 60 min of (aerobic) physical activity daily, at least 30 minutes of vigorous activity three times each week and participate in bone strengthening activities such as running and jumping three times per week as well.

What does this all mean?

Childhood obesity is on the rise, it is a multifactorial epidemic, there is no one  component that is “to blame”.

If you are pregnant or planning to get pregnant and are not at a healthy weight, change unhealthy habits, no binge eating or crash dieting, or excessive exercising.

Ditch the “clear your plate” mentality when it comes to meals with your child. Start with small portions, if that’s enough for your child, stop there, or allow for more if they are still hungry.

Provide healthy snacks from an early age and encourage children to try nutrient dense foods (flavorful fruits, vegetables, proteins) rather than calorie dense foods (foods high in calories, sugar and fillers, low in nutrients).

Encourage movement and play.

Lastly, lead by example!

https://www.youtube.com/

References:

Horta, B. L., Bahl, R., Martinés, J. C., Victora, C. G., & World Health Organization. (2007). Evidence on the long-term effects of breastfeeding: systematic review and meta-analyses.Chicago

Institute of Medicine. Nutrition during pregnancy: part I: weight gain, part II: nutrient supplements. Washington, D.C.: National Academy Press, 1990.

Institute of Medicine. Weight gain during pregnancy: reexamining the guidelines. Washington, D.C.: National Academy Press, 2009.

Kramer, Matush, Vanilovich, Platt, Bogdanovich, Sevkovskaya, Promotion of Breastfeeding Intervention Trial (PROBIT) Study Group; Effects of prolonged and exclusive breastfeeding on child height, weight, adiposity, and blood pressure at age 6.5 y: evidence from a large randomized trial, The American Journal of Clinical Nutrition, Volume 86, Issue 6, 1 December 2007, Pages 1717–1721, https://doi.org/10.1093/ajcn/86.6.1717

Ludwig DS, Currie J. The association between pregnancy weight gain and birthweight: a within-family comparison. Lancet. 2010; 376:984-90.

Oken E, Taveras EM, Kleinman KP, Rich-Edwards JW, Gillman MW. Gestational weight gain and child adiposity at age 3 years. Am J Obstet Gynecol. 2007; 196:322 e1-8.

Shloim, N., Edelson, L. R., Martin, N., & Hetherington, M. M. (2015). Parenting Styles, Feeding Styles, Feeding Practices, and Weight Status in 4-12 Year-Old Children: A Systematic Review of the Literature. Frontiers in psychology, 6, 1849. doi:10.3389/fpsyg.2015.01849

US Department of Health and Human Services. Physical Activity Guidelines for Americans, 2nd edition. Washington, DC: US Department of Health and Human Services; 2018.