The article, “The Impact of Pregnancy Nutrition on Offspring Obesity” by Jami Josefson, MD, focuses on possible factors for childhood obesity as linked to maternal nutrition during gestation. Obesity in pregnancy is cited as a culprit in immediate and long-term battles with obesity for… both mother and child. The problem is hard to quell as more middle class preschoolers are being added to the ranks of obese youth in the United States. The problem arises as the risk of adulthood obesity is doubled when children are classified as obese at this young an age. The factors the author attributes to this trend in childhood obesity include; maternal obesity, excessive gestational weight gain, and birth weight and neonatal body composition. Maternal obesity and excessive weight gain during pregnancy are both well-documented factors contributing to not only maternal obesity postpartum, but also as a risk fact for the child. The Gestational Diabetes Mellitus (GDM), also correlated with maternal obesity and excessive weight gain, poses a threat as a higher obesity factor for the offspring. Interestingly though, even if a woman does not quite meet the criterion to be considered having GDM, if insulin resistance /impaired glucose tolerance is present in an obese pregnant mother, some infants have displayed “some features of infants of diabetic mothers, such as increased body fat at birth.” Also mentioned, were altered lipid and inflammatory pathways of the mother, as these also contribute to fetal fat deposition.

The latter factor, birth weight and neonatal body composition, seems to be the more tell-tale of signs for childhood, adolescent and adult onset obesity. According to studies, “babies born large at birth are more likely to become obese”. However, “most obese children had a normal birth weight”. Babies born to mothers who are obese or who have developed GDM are more prone to being obese later on in life not only because of their insulin status, as previously thought, but because of the level of adiposity. This higher level of adiposity combined with a higher insulin status, studies have shown, “usually persisted into adolescence”. It would seem that newborn adiposity “is a potential indicator of obesity risk”.

There is an upside to this discovery, however. Obese mothers who lose weight prior to becoming pregnant greatly reduce their risk of having a child who is predisposed to being obese. The author suggests lifestyle changes, exercise, weight loss before conception, behavior modification counseling, and individualized weight grain recommendations as starting points to help curtail what is becoming an epidemic in the United States.

This article was quite interesting in that the author brought in the idea of fetal/infant adiposity as being a stronger indicator of childhood obesity. Other studies have merely said that obesity and/or GDM status in pregnancy is a high risk factor for these children, not actually mentioning why it is that childhood obesity is the result. I believe that if more studies were done to further this research, we may have yet another weapon in the fight against childhood obesity.  I really appreciate the fact that he mentioned behavior modification as a pathway to help mothers who are obese or overweight. I’ve been pregnant and, while it is easy to modify your lifestyle to make sure that there is the best possible environment to grow your child, food habits are the hardest to modify. (Quitting smoking when I found out I was pregnant was easier than cutting out foods I loved (i.e. Sushi).)

Josefson J. The Impact of Pregnancy Nutrition on Offspring Obesity. J Am Diet Assoc. 2011;111:50-52.