Areas of Action against Later Childhood Obesity: Result of a 5 Years Prospective Study

Background: Obesity is one of the greatest public health challenges in the world with childhood prevalence rates between 20–26% and numerous associated health risks.

Objective: The aim of this study was to analyze a spectrum of factors contributing early in life to overweight and obesity in a Romanian paediatric population, followed from 1 to 6 years.

Methods: Data on breastfeeding, early feeding patterns, individual anthropometric measurements and social characteristics were collected in a population-based prospective cohort study among 382 children. Of the original sample, only 113 (29.5%) subjects participated in the 5-year follow-up.

Results: The distribution according to BMI in terms of underweight, normal weight, overweight/obese children were 11.5% (13), 74.3% (84) and 14.2% (16) respectively, at 12 months old, while the proportions were 3.5% (4), 73.5% (83), and 23% (26) respectively, at the age of 6. The BMI evolution for 1 year underweight children was to normal weight in 76.92% cases and to overweight/obesity in 15.38% subjects, while 1 individual remained underweight. Sixty two per cent (62.5%) of the 1 year obese infants were still obese after 5 years. Univariate predictors of BMI in subjects aged 6 were identified as: 12 months BMI (r=0.36, p=000), duration of breastfeeding (r=-0.45, p=0.000), timing of complementary feeding (r=-0.54, p=0.000), amount of meat during weaning (r=0.63, p=0.000), while living area, family income, maternal age or education had no impact.

Conclusion: Timing of introduction of solid foods and breastfeeding duration were associated with child obesity at 6 years in our sample. Since reducing obesity is a difficult task once it appeared, preventing interventions should be implemented in the first years of life.