Developmental Contributions to Obesity: Nutritional Exposures in the First Thousand Days

Abstract

Obesity is prevalent and continuing to rise across all age groups, even children. As obesity is challenging to manage and treat, prevention is critical. Here, we highlight nutritional influences during periods of early developmental plasticity, namely the prenatal period and infancy, that have been shown to contribute to the development of obesity into childhood and beyond. We review recent research that examines maternal nutritional factors including dietary patterns and quality, as well as the infant diet, such as complementary foods and beverages, that influence long-term obesity risk. We end with recommendations for clinicians.

Keywords: Breastfeeding; Diet; Infant; Nutrition; Pregnancy; Sugar-sweetened beverages.

Figure 1.

Nutritional predictors of obesity in the first thousand days

Figure 2.

Predicted trajectories of child BMI-z from birth through adolescence from adjusted linear splines mixed-effect models according to quartiles of A) maternal Dietary Inflammatory Index (DII), B) Mediterranean Diet Score (MDS), and C) Alternate Healthy Eating Index for Pregnancy (AHEI-P) in pregnancy in 1,459 participants (25,016 BMI-z observations) in Project Viva, a cohort recruited from the Boston, Massachusetts, area in 1999–2002. From Monthé-Drèze C, Rifas-Shiman SL, Aris IM, et al. Maternal diet in pregnancy is associated with differences in child body mass index trajectories from birth to adolescence. Am J Clin Nutr. 2021;113(4):895–904. https://doi.org/10.1093/ajcn/nqaa398. By permission of Oxford University Press.

Figure 3.

The interaction of maternal dietary factors with early-life epigenetic mechanism and the gut microbiome in regulation of obesity in adult life. From Li Y. Epigenetic Mechanisms Link Maternal Diets and Gut Microbiome to Obesity in the Offspring. Front Genet. 2018;9. https://doi.org/10.3389/fgene.2018.00342. Licensed under CC BY 4.0.