Examining a Developmental Approach to Childhood Obesity The Fetal and Early Childhood Years: Workshop in Brief (2015) / Chapter Skim
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Examining a Developmental Approach to Childhood Obesity: The Fetal and Early Childhood Years-Workshop in Brief
Examining a Developmental Approach to Childhood Obesity: The Fetal and Early Childhood Years-Workshop in Brief
Pages 1-8
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Opening Remarks In her welcome remarks, Shari Barkin, Monroe Carell Jr. Children's Hospital at Vanderbilt University, emphasized the dynamic nature of the multiple external and internal factors that interact to cause childhood obesity and encouraged workshop participants to consider how scientists' growing knowledge of these dynamic interactions, with differing degrees of influence depending on the stage of child development, can shed light on where to target childhood obesity prevention efforts during periods of plasticity and potential reversibility (see Figure 1)
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Department of Agriculture, reminded workshop participants of the long history of studying genes in their broader context and referred workshop participants to the "forgotten father" of epigenetics, Ernest Just, an embryologist of the early 20th century. Conceptual Overview of the Role of Epigenetics in Pediatric Obesity Much of the workshop discussion revolved around the emerging nature of the evidence for epigenetics as a key component of the "early origins of obesity" model (featured in Figure 1, the workshop infographic)
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Friedman explained that maternal fuels crossing the placenta have nowhere to go but into the fetal liver and suggested that this fatty liver trans-generational effect of maternal obesity may be mediated by epigenetic changes in offspring liver cells. Postnatally, evidence from breastfeeding mothers indicates that maternal obesity has an effect on the infant microbiome in a way that may, via epigenetic mechanisms, increase infant adiposity.
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She gave numerous examples and considered ways to improve those steps, including refined measures of maternal obesity, an increased awareness of the pitfalls of association studies, and the use of triangulation of evidence built on multiple research study design types to infer causality. Opportunities for Intervention and Prevention Moderated by Leann Birch, University of Georgia, Session 3 speakers discussed potential opportunities for intervention and prevention based on the rapidly advancing knowledge of the role of epigenetics and other factors in the early origins of obesity.
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Convit considered how metabolic dysregulation in adolescents leads to impaired cognitive tasks and reduced hippocampal volume, with insulin resistance being the primary driver. He suggested that retinal arterial width be considered as a potentially useful biomarker for metabolic dysfunction in the brain and identified exercise and sleep, because of their known associations to improve insulin resistance and metabolic dysfunction, as two "easy public health handles" for obesity intervention in adolescents.
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providing group visits or health coaching calls to pregnant women to maximize appropriate nutrition and gestational weight gain and during the post-pregnancy period to support appropriate weight loss after delivery, and (2) delivering behavioral interventions focused on families rather than on children.
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Another wondered if a systems science approach may be helpful. In her concluding remarks, Barkin reiterated that epigenetics is only one of several potential mechanisms mediating the dynamic relationship between early exposure and the development of childhood obesity.
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Children's Hospital at Vanderbilt University; Leann L Birch, University of Georgia; Esa Davis, University of Pittsburgh Medical Center; Stephen R
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