Early-life exposures and childhood obesity and overweight in Türkiye

Year 2023, Volume: 21 Issue: 3, 371 - 382, 15.12.2023

Rengin Aktar

https://doi.org/10.20518/tjph.1299861

Abstract

Objective: Childhood overweight and obesity have seen a dramatic increase in Turkey and other middle-income countries over the last decades. By using anthropometric data, this study examines the influence of early-life exposures during pregnancy and infancy on young children’s risk of developing overweight and obesity.

Methods: Study uses five cross-sections of Demographic and Health Surveys (DHS) conducted in Turkey between 1993 and 2013. A total of 9719 children between the ages of 2 and 5 are used to estimate the prevalence rates of obesity and overweight. In addition, a logistic regression model is applied to 5013 children in order to assess the main determinants of obesity and overweight.

Results: There is a notable increase in the prevalence rates of obesity and overweight in children between 1993 and 2013, the peak prevalence has been reached in 2008. Results of the logistic regression reveal that early-life factors; maternal obesity and high birth weight are significantly associated with the risk of obesity and overweight in young children. Among socio-economic variables, living both in the richest and poorer households are positively and significantly associated with the risk of obesity and overweight.

Conclusion: Public health efforts to prevent childhood obesity and overweight would be incomplete without considerations of maternal health and nutrition during pregnancy.

Keywords

Childhood obesity, childhood overweight, fetal programming, breastfeeding, chronic diseases

References

• Williams DP, Going SB, Lohman TG, et al. Body fatness and risk for elevated blood-pressure, total cholesterol, and serum-lipoprotein ratios in children and adolescents. Am J Public Health 1992;82(3): 358-363.
• Black RE, Victora CG, Walker SP, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. The Lancet 2013;382(9890): 427-451.
• Gupta N, Goel K, Shah P, Misra A. Childhood obesity in developing countries: epidemiology, determinants, and prevention. Endocrine Reviews 2012;33(1): 48-70.
• Cornette RE. The emotional impact of obesity on children. In: Debasis Bagchi, editor. Global perspectives on childhood obesity. Academic Press; 2011, p. 257-264.
• Hesketh K, Wake M, & Waters E. Body mass index and parent reported self esteem in elementary school children: Evidence of a causal relationship. Int J of Obesity 2004;28: 1233-1237.
• Sahoo K, Sahoo B, Choudhury AK, Sofi NY, Kumar R, & Bhadoria AS. Childhood obesity: causes and consequences. J Family Medicine and Primary Care 2015;4(2): 187-192.
• Freedman DS, Khan LK, Serdula MK, Dietz WH, Srinivasan SR, & Berenson GS. The relation of childhood BMI to adult adiposity: the Bogalusa Heart Study. Pediatrics 2005;115(1), 22-27.
• Power C, Lake JK, Cole TJ. Measurement and longterm health risks of child and adolescent fatness. Int J Obes Relat Metab Disord 1997;21: 507–526.
• Whitaker RC, Wright JA, Pepe MS, Seidel KD, & Dietz WH. Predicting obesity in young adulthood 381 Childhood overweight and obesity in Turkey Turk J Public Health 2023;21(3) from childhood and parental obesity. New Eng J Med 1997;337(13): 869-873.
• Eriksson J, Forsen T, Osmond C, & Barker D. Obesity from cradle to grave. Int J Obes 2013;27(6): 722-727.
• Freedman DS, Khan LK, Dietz WH, Srinivasan SR, & Berenson GS. Relationship of childhood obesity to coronary heart disease risk factors in adulthood: the Bogalusa Heart Study. Pediatrics 2001;108(3): 712- 718.
• Must A. Does overweight in childhood have an impact on adult health? Nutr Rev 2003;61: 139–142.
• Must A, Strauss RS. Risks and consequences of childhood and adolescent obesity. Int J Obes Relat Metab Disord 1999;23: S2–S11.
• Maffeis C, Tato L. Long-term effects of childhood obesity on morbidity and mortality. Horm Res 2001;55: 42–45.
• De Onis M, Blössner M, & Borghi E. Global prevalence and trends of overweight and obesity among preschool children. Am J Clinic Nutrit 2010;92(5): 1257-1264.
• Martorell R, Khan LK, Hughes ML, & Grummer-Strawn LM. Obesity in Latin American women and children. J Nutrit 1998;128(9): 1464-1473.
• Martorell R, Khan LK, Hughes ML, & Grummer-Strawn LM. Overweight and obesity in preschool children from developing countries. Int J Obes 2000;24(8): 959-967
• Popkin BM, Adair LS, & Ng SW. Global nutrition transition and the pandemic of obesity in developing countries. Nutrit Rev 2012;70(1): 3-21.
• Bereket A, Atay Z. Current status of childhood obesity and its associated morbidities in Turkey. J Clin Res Pediatr Endocrinol 2012;4(1):1–7.
• Atay Z, Turan S, Guran T, Haliloglu B, & Bereket A. The change in obesity prevalence in 8 year-interval in 6–16 years old girls living in Istanbul. Proceedings of XIV. National Pediatric Endocrinology Congress. P54, Sarigerme-Mugla, 2010.
• Kondolot M, Balci E, Ozturk A, et al. Body mass index percentiles for Turkish children aged 0–84 months, Ann. Hum. Biol 2011;38: 676–680.
• Yardim M, Ozcebe L, Araz O, et al. Prevalence of childhood obesity and related parental factors across socioeconomic strata in Ankara, Turkey. Eastern Mediter Health J 2019;25(6): 374-384.
• UNICEF/WHO/World Bank Joint Child Malnutrition Estimates Expanded Database: Overweight (Survey Estimates), May 2023, New York. Available at: https://data.unicef.org/resources/dataset/malnutrition-data/
• UNICEF/WHO/World Bank Joint Child Malnutrition Estimates Expanded Database: Overweight (Survey Estimates), May 2023, New York. Available at: https:// data.unicef.org/resources/dataset/malnutrition-data/
• Barker DJ. The fetal and infant origins of adult disease. Brit Med J 1990;301(6761): 1111.
• Barker DJ, Clark PM. Fetal undernutrition and disease in later life. Reviews of reproduction 1997;2(2): 105-112.
• Fall CH. Evidence for the intra-uterine programming of adiposity in later life. Annals Human Bio 2011;38(4): 410-428.
• Gluckman PD, Hanson M, Zimmet P, & Forrester T. Losing the war against obesity: the need for a developmental perspective. Sci Trans Med 2011; 3(93): Commentary 1-4.
• Gluckman PD, Hanson MA. Developmental and epigenetic pathways to obesity: an volutionarydevelopmental perspective. Int J Obes 2009;32(7): S62-S71.
• Godfrey KM, Gluckman PD, & Hanson MA. Developmental origins of metabolic disease: life course and intergenerational perspectives. Trends Endocrinol & Metab 2010;21(4): 199-205.
• Schroeder DG, Martorell R. Poor fetal and child growth and later obesity and chronic disease: relevance for Latin America. Scientific Publication – PanAmerican Health Org 2000; 103-116.
• Catalano PM, Shankar K. Obesity and pregnancy: mechanisms of short term and long term adverse consequences for mother and child. Bmj, 2017, 356.
• Baidal JAW, Locks LM, Cheng ER, Blake-Lamb TL, Perkins ME, & Taveras EM. Risk factors for childhood obesity in the first 1,000 days: a systematic review. American J Prev Med 2016; 50(6): 761-779.
• Larqué E, Labayen I, Flodmark CE, Lissau I, Czernin S, Moreno LA, ... & Widhalm K. From conception to infancy—early risk factors for childhood obesity. Nature Rev Endoc 2019; 15(8): 456-478.
• Kelly AC, Powell TL, & Jansson T. Placental function in maternal obesity. Clinical Sci 2020; 134(8): 961-984.
• Gaudet L, Ferraro ZM, Wen SW, & Walker M. Maternal obesity and occurrence of fetal macrosomia: a systematic review and meta-analysis. BioMed Res Int 2014.
• Catalano PM, Farrell K, Thomas A, et al. Perinatal risk factors for childhood obesity and metabolic dysregulation. Am J Clinic Nutrit 2009;90(5): 1303-1313.
• Oken E. Maternal and child obesity: the causal link. Obstet Gynec Clinics 2009;36(2): 361-377
• Harder T, Bergmann R, Kallischnigg G, & Plagemann A. Duration of breastfeeding and risk of overweight: a Aktar R. Turk J Public Health 2023;21(3) 382 meta-analysis. Am J Epidemio 2005;162(5): 397-403
• Arenz S, Rückerl R, Koletzko B, & von Kries R. (2004). Breast-feeding and childhood obesity—a systematic review. Int J Obes 2004;28(10): 1247-1256