Racial/ethnic differences in early-life risk factors for childhood obesity

Abstract

Objective: By the preschool years, racial/ethnic disparities in obesity prevalence are already present. The objective of this study was to examine racial/ethnic differences in early-life risk factors for childhood obesity.

Methods: A total of 1343 white, 355 black, and 128 Hispanic mother-child pairs were studied in a prospective study. Mother's reported child's race/ethnicity. The main outcome measures were risk factors from the prenatal period through 4 years old that are known to be associated with child obesity.

Results: In multivariable models, compared with their white counterparts, black and Hispanic children exhibited a range of risk factors related to child obesity. In pregnancy, these included higher rates of maternal depression (odds ratio [OR]: 1.55 for black, 1.89 for Hispanic); in infancy more rapid weight gain (OR: 2.01 for black, 1.75 for Hispanic), more likely to introduce solid foods before 4 months of age (OR: 1.91 for black, 2.04 for Hispanic), and higher rates of maternal restrictive feeding practices (OR: 2.59 for black, 3.35 for Hispanic); and after 2 years old, more televisions in their bedrooms (OR: 7.65 for black, 7.99 for Hispanic), higher intake of sugar-sweetened beverages (OR: 4.11 for black, 2.48 for Hispanic), and higher intake of fast food (OR: 1.65 for black, 3.14 for Hispanic). Black and Hispanic children also had lower rates of exclusive breastfeeding and were less likely to sleep at least 12 hours/day in infancy.

Conclusions: Racial/ethnic differences in risk factors for obesity exist prenatally and in early childhood. Racial/ethnic disparities in childhood obesity may be determined by factors that operate at the earliest stages of life.

Figure

Odds of each childhood obesity risk factor in black and Hispanic participants, relative to whites. Data from 1826 Mother-Infant Pairs in Project Viva. Odds ratios adjusted for maternal age, education, parity, pre-pregnancy BMI; paternal BMI; household income; and child sex. Models predicting maternal risk factors are not adjusted for paternal BMI. Bars show 95% confidence limits.