IJE Advance Access originally published online on June 9, 2006
International Journal of Epidemiology 2006 35(4):1101; doi:10.1093/ije/dyl110
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Letter to the Editor |
Treatment and prevention of obesity—are there critical periods for intervention?
Centre for Paediatric Epidemiology and Biostatistics, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
* Corresponding author. E-mail: s.hawkins{at}ich.ucl.ac.uk
Lawlor and Chaturvedi's1 editorial, from the special themed issue on obesity, reviewed the evidence on treatments for obesity and considered whether there are critical periods for preventing obesity. We concur with the authors about the importance of identifying critical periods to inform interventions; however, in contrast to them, we believe that there is a substantial body of evidence to support infancy and early childhood as potentially important periods for obesity prevention.
A recent systematic review by Baird et al.2 found that infants who were the ‘biggest’ or grew rapidly over the first 2 years of life were at the greatest risk for later obesity. Infant growth may reflect programming in utero, post-natal environmental factors, or a combination of both. Three recently published systematic reviews on breastfeeding and later obesity found evidence for a protective effect of breastfeeding3–5 and support for a dose–response relationship.3,4 The systematic review by Owen et al., which Lawlor and Chaturvedi cite, examined the impact of breastfeeding on mean BMI. Despite finding limited evidence for a relationship, they concluded that ‘it remains possible that breastfeeding provides some protection against obesity’.6 While there is a relatively small body of research on risk factors in preschool children for subsequent obesity, behaviours in early life may place children at risk. For example, television viewing in children under age 5 years is a risk factor for obesity in childhood7 and adulthood.8
We would argue that interventions for obesity prevention should focus on early childhood when health-related behaviours are developing. However, additional research will be needed to develop and evaluate interventions targeting infancy and early childhood.
References
1 Lawlor DA, Chaturvedi N. Treatment and prevention of obesity—are there critical periods for intervention? Int J Epidemiol 2006;35:3–9.
2 Baird J, Fisher D, Lucas P, Kleijnen J, Roberts H, Law C. Being big or growing fast: systematic review of size and growth in infancy and later obesity. BMJ 2005; doi:10.1136/bmj.38586.411273.E0 (published 14 October 2005).
3 Owen CG, Martin RM, Whincup PH, Smith GD, Cook DG. Effect of infant feeding on the risk of obesity across the life course: a quantitative review of published evidence. Pediatrics 2005;115:1367–77.
4 Harder T, Bergmann R, Kallischnigg G, Plagemann A. Duration of breastfeeding and risk of overweight: a meta-analysis. Am J Epidemiol 2005;162:397–403.
5 Arenz S, Ruckerl R, Koletzko B, von Kries R. Breast-feeding and childhood obesity—a systematic review. Int J Obes 2004;28:1247–56.[CrossRef][ISI][Medline]
6 Owen CG, Martin RM, Whincup PH, Davey-Smith G, Gillman MW, Cook DG. The effect of breastfeeding on mean body mass index throughout life: a quantitative review of published and unpublished observational evidence. Am J Clin Nutr 2005;82:1298–307.
7 Dennison BA, Erb TA, Jenkins PL. Television viewing and television in bedroom associated with overweight risk among low-income preschool children. Pediatrics 2002;109:1028–35.
8 Viner RM, Cole TJ. Television viewing in early childhood predicts adult BMI: a longitudinal birth cohort study. J Pediatr 2005;147:429–35.[CrossRef][ISI][Medline]
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  D. A LAWLOR and N. CHATURVEDI Author's response to comments by Pallan, Cheng and Adab, and Hawlins and Law Int. J. Epidemiol., August 1, 2006; 35(4): 1102 - 1102. [Full Text] [PDF]
|
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||