As with all risk factors, these do not cause obesity:
they add an element of risk and may act in synergy with other risk factors
or susceptibility genes. Their risk promoting ability may be increased
or decreased by these other factors.
Environmental risk factors and medical conditions
associated with Childhood obesity
Ongoing clinical trails, worldwide, can be interrogated at
ClinicalTrials.Gov a service of the US National Institutes of Health
Genes: It is often difficult to separate
traits (for example lipid levels) from obesity, or genetically distinguish
obesity from body mass index, size, growth etc, or to distinguish obesity
from childhood obesity: These genes have been associated with obesity
and sometimes with underlying traits. As with most genetic (and risk factor)
studies, associations are often contested.
The association between FAIM2 , NPC1, FTO , MC4R or BDNF and obesity
risk was only observed in children who had moderate-to-low physical activity
levels or engaged in sedentary behavior, regardless of which risk alleles
they carried.Xi
et al, 2011 See also Beyerlein
et al, 2011
For
KEGG pathways Yellow =
obesity genes: Blue = compounds whose levels change, or which are toxic
(glutamate/fructose)
The bifidobacterial
numbers (microbiome) in faecal samples during infancy is lower in obese
children, while Staphylococcus aureus presence is higher Kalliomaki
et al, 2008
Absence of Helicobacter
pylori infection, especially during childhood, may increase the
risk of the subsequent development of obesity Wu
et al, 2005
Higher levels of infections in childhood were associated with a low
level of high density lipoprotein , higher level of triglycerides, plasma
glucose, waist circumference, and obesity, but not hypertensionMargolis
2010
A higher number of bacteria in the oral microbiome has been associated
with adolescent obesity: Campylobacter rectus and Neisseria mucosa were
present in sixfold higher amounts among obese subjects Zeigler
et al, 2012
Gut colonization with methanobrevibacter smithii is associated with childhood
weight Mbakwa
et al, 2016
Autoimmunity
Anti tetanus Immunoglobulin G antibodies heve been reported to be
lower in overweight children Eliakim
et al, 2006
Antithyroid antibodies have been observed in some groups and some
show ultrasound features of Hashimoto's
thyroiditis, where thyroid destruction is a result of an auitoimmune
process Radetti
et al, 2008
High birth weight has been related to childhood obesity and diabetes
Wei
et al, 2007.
Antibiotics during the first 6 months of life increased the risk of
overweight among children of normal weight mothers and decreased the
risk of overweight among children of overweight mothers: An effect possibly
related to the gut microbiome Ajslev
et al, 2011.
Antibiotic use during the first 12 months of life has been associated
with a small increase in BMI in boys aged 5 to 8 years Murphy
et al, 2013
Higher maternal prenatal omega-3 polyunsaturated fatty acids are associated
with lower rates of later childhood obesity Donahue
et al, 2011
Early gut microbiota modulation with the probiotic Lactobacillus rhamnosus
, in pregnant mothers may modify the growth pattern of the child and
restrain excessive weight gain during the first years of life Luoto
et al, 2010
Maternal diabetes is a risk factor for the development of obesity
in childhood Temple
et al, 2011
Gestational diabetes associated with childhood obesity Zhao
et al, 2015
Adiposity at birth predicts overweight at the age of 5 years Winter
et al, 2010.
Prolonged bottle feeding in infants has been linked to childhood obesity
Gooze
et al, 2011
Caesarian section may increase the likelihood of developing obesity
in later life Goldani
et al, 2011
First born status may increase the risk of developing obesity in later
life Stettler
et al, 2000
Antibiotics during the first 6 months of life increased the risk of
overweight among children of normal weight mothers and a decreased the
risk of overweight among children of overweight mothers (effects attributed
to the microbiome ) Ajslef
et al, 2011
A higher rate of growth during the first month after birth (peak weight
velocity) was associated with obesity at 4 years old Mook-Kanamori
et al, 2011
Prenatal gene methylation at birth (NOS3, RXRA) was associated with
adiposity : RXRA but not NOS3 methylation was associated with lower
maternal carbohydrate intake in early pregnancy Godfrey
et al, 2011
Prenatal exposure to natural disasters increases risk for obesity
in 5½-year-old children Dancause
et al, 2012
Prenatal exposure to high magnetic fields has been associated with
obesity Li
et al, 2012
Maternal vitamin D deficiency in pregnancy has been linked to the
development of adiposity in the offspring Crozier
et al, 2012
Obese mothers transfer less 25-hydroxyvitamin D to their offspring
during pregnancy Josefson
et al, 2013
Polycyclic aromatic hydrocarbon exposure during pregnancy has been
associated with obesity in the offspring Rundle
et al, 2012,
Prenatal Dieldrin levels have shown a slight associationwith childhood
obesity Cupul-Uicab
et al, 2013
Prenatal pesticide exposure associated with childhood obesity (gene/environment
interaction with PON1) Tinggaard
et al, 2016
Tobacco smoke exposure before, during, and after pregnancy is a risk
factor for the development of childhood overweight Raum
et al, 2011.
Premature male children of mothers with pre-eclampsia are prone to
obesity Washburn
et al, 2013
DDT has been associated with obesity in boys and polychlorinated biphenyls
and dichlorodiphenyldichloroethylene (DDE) in girls Valvi
et al, 2012
Associations between prenatal exposure to DDT and DDE and several
measures of obesity at 9 years of age in boys but not in girls Warner
et al, 2014
High levels of DDE and hexachlorobenzene in first trimester maternal
serum associated with subsequent childhood obesity Vafeiadi
et al, 2015
Maternal hyperglycemia during pregnancy predicts adiposity of the
offspring Kubo
et al, 2014
in-utero exposure to caffeine is associated with an increased risk
of childhood obesity Li
et al, 2014
Prenatal exposure to systemic antibacterials is associated with an
increased risk of overweight and obesity at school age Mor
et al, 2015
Maternal fasting plasma glucose predicts childhood obesity at 7 years
of age Zhu
et al, 2016
The maternal use of artificial sweeteners during pregnancy increases
the risk of childhood obesity at 7 years of age (Danish National Birth
Cohort) Zhu
et al, 2017
Dietary factors
Aspartame has been linked with obesity RSS
feed See toxins below
Proximity to fast food outlets predicts fatness in boys Chiang
et al, 2011
:Intakes of protein, meat and fruit at age 18 months associate with
measures of adiposity at age 8 years
Garden et al, 2011
Overweight in Jamaican 15-19-year-olds is associated with increased
consumption of sweetened beverages. High waist circumference in women
is related to low consumption of fruits and vegetables Francis
et al, 2009
Childhood obesity is associated with excessive consumption of soft drinks,
fast food, and excessive television watching Wen
et al, 2010 and with sugar sweetened beverages Bucher
Della Torre et al, 2016
Frequent consumption of sweets/candy and carbonated drinks relate to obesity
in Saudi Arabia Amin
et al, 2008
Lack of breastfeeding, high infantile energy intake (among formula
or mixed-fed infants ) and high intake of sugar-sweetened beverages
contribute to obesity development Moreno
and Rodrigues, 2007.
Consumption of rice, bread, pasta, fast foods and fat/salty snacks
was associated with childhood body mass index in Iran Kelishadi
et al, 2003
Improvements in fitness from childhood to adolescence are associated
with a lower risk of becoming overweight/obese in adolescence Ortega
et al, 2011.
The factors with the greatest effect on obesity were family history
of obesity: both parents (Odds ratio = 11.2), mother but not father
(Odds ratio = 9.1), father but not mother (Odds ratio = 6.1), siblings
Odds ratio = 2.7); and eating between meals (Odds ratio= 2.5) and consumption
of sweets and soft drinks >2 times/week (Odds ratio = 2.0). The highest
protection effect was found for five meals per day (Odds ratio = 0.5),
the regular consumption of breakfast (Odds ratio = 0.5) and for eating
fruit for dessert (Odds ratio = 0.6). Sedentary habits did not appear
as important Zurriaga
et al, 2011.
Children whose diet contains olive oil are less at risk for obesity
Haro-Mora
et al, 2011
Early gut microbiota modulation with probiotics may modify the growth
pattern of the child by restraining excessive weight gain during the
first years of life Luoto
et al, 2010.
The use of antibiotics in infancy influences the risk of overweight
in later childhood (microbiome related) Ajslev
et al, 2011. Exposure to antibiotics during the first 6 months of
life is associated with consistent increases in body mass from 10 to
38 months. Trasande
et al, 2012
Antibiotic exposure before 6 months of age, or repeatedly during infancy,
associated with increased body mass in healthy children Saari
et al, 2015.
Childhood obesity is less of a problem in families who spent more
time engaged with each other during the meal, expressed more positive
communication, and considered mealtimes more important and meaningful
Fiese
et al, 2012
Adequate intakes of milk and fruit and vegetable juice may reduce
the risk of excess body fat in later childhood and adolescence Hasnain
et al, 2014
Higher chocolate consumption associated with lower total and central
fatness in European adolescents Cuenca-García
et al, 2014 .
Epidemiology
Childhood obesity is associated with the father's body mass index,
and mother's or child's dieting, or a rapid increase in body weight
during the first year of life Vogels
et al, 2006
Birthweight = 2.5 kg and = 4 kg, early introduction of solid foods
and low physical activity were associated with obesity as were Maternal
and grandmother's obesity, fewer children in the household, higher parental
education, household income and the presence of familial obesity Saker
et al, 2011
Short sleep duration was shown to be a risk factor for obesity in
7 year old children Nixon
et al, 2008
disturbances of sleep and circadian rhythms in children and young
adults are risk factors for the development of lifelong obesity Broussard
and Van Cauter, 2016
Higher rates of overweight and obesity have been observed in girls
aged four to nine whose parents were single : Children in single-parent
households watched more television, ate more fat and sugar and less
fresh fruit and vegetables Byrne
et al, 2011
Encouraging less sedentary behavior and higher levels of physical
activity could alleviate the influence of risk alleles on the genetic
predisposition to childhood obesity (noted for BDNF and MC4R) Xi
et al, 2011 and for FTO Kilpeläinen
et al, 2011
Childhood obesity has been related to standing posture Smith
et al, 2011
Childhood sexual abuse has been associated with a higher risk of dyslipidemia
and abdominal obesity van
Reedt Dortland et al, 2011.
Deficiency of the essential metal zinc decreases adiposity in humans
and rodent models, and deficiencies of chromium, copper, iron, and magnesium
increases adiposity : Barium and thallium levels positively associated
with obesity : Lead, cadmium, cobalt and cesium were negatively correlated
with obesity Padilla
et al, 2010
Adolescent participation in summer camps including regular physical
activity reduces the subsequent risk of obesity Mahoney,
2011
Informal child care has been associated with childhood obesity Lin
et al, 2011
improvements in fitness from childhood to adolescence are associated
with a lower risk of becoming overweight/obese in adolescence Ortega
et al, 2011.
The vicinity of healthy food outlets associates with a decrease in
the likelihood of a child being overweight or obese Miller
et al, 2013
Association with other diseases
Asthma among children and adolescents has been associated with obesity
The association was stronger in nonatopic children than in atopic children
Visness
et al, 2010
obesity precedes, and is associated with, the persistence and
intensity of asthma symptoms Noal
et al, 2011.
Childhood obesity associated with the later development of atopic
dermatitis Silverberg
et al, 2011 Atopic dermatitis has also been associated with
obesity in a large Spanish study Suárez-Varela
et al, 2010
Obesity is associated with an increased risk of allergic disease
in childhood Murray
et al, 2011.
Juvenile psoriasis can be associated with increased rates of hyperlipidaemia,
obesity, hypertension, diabetes mellitus, rheumatoid arthritis and Crohn
disease Augustin
et al, 2010
Eczema has been associated with lower risk of obesity in 6-7 year
old girls, and 13-14 year old boys Violante
et al, 2005
Childhood obesity can lead to the metabolic syndrome, atherosclerosis,
dyslipidemia, hypertension and type 2 diabetes Halpern
et al, 2010
The metabolic syndrome is prevalent in childhood obesity, particularly
in pubertal patients Sangun
et al, 2011
Childhood obesity increases the risk of obstructive sleep apnea syndrome
Kohler
et al, 2009
Maternal smoking during pregnancy and maternal and paternal heavy
smoking increase the risk of childhood obesity and short stature Koshy
et al, 2011
Childhood obesity and maternal smoking, increase the risk of developing
Attention Deficit Hyperactivity Disorder Koshy
et al, 2011
Obesity can be associated with bronchitis and with the use of antibiotics
Wijka
et al, 2010
Childhood obesity can lead to the cardiometabolic syndrome and increased
cardiovascular risk in adulthood.Allcock
et al, 2009
childhood obesity is associated with higher blood pressures and greater
circulating cholesterol levels independently of physical activity McMurray
et al, 1995
It can also lead to nonalcoholic liver disease type pathology Wiegand
et al, 2010
Abdominal obesity in diabetic children is higher than in the general population
Szadkowska et al, 2009
Studies in obese humans or animals show impaired immune function,
decreased cytokine production, or response to antigen/mitogen stimulation,
reduced macrophage , dendritic cell and natural killer cell function.
This leads to increased susceptibility to infection including tuberculosis,
influenza, Mycobacterium tuberculosis, coxsackievirus, Helicobacter
pylori and the encephalomyocarditis virus Carlsson
and Beck, 2010.
Chronic otitis
media (ear inflammation with bacterial infection ) affects taste
sensation and can contribute to obesity Medscape
Early menarche can be a consequence of childhood obesity Mumbi
et al, 2011
Certain childhood cancers and particularly survivors of craniopharyngioma
can be associated with childhood obesity
Iughetti et al, 2011
Gastroesophageal reflux disease is associated with extreme childhood
obesity Koebnick
et al, 2011
Developmental coordination disorder has been associated with childhood
obesity Wagner
et al, 2011
Height and obesity during childhood was associated with increased
risk of colorextal adenoma later in life in women Nimptsch
et al, 2011
Childhood obesity has been associated with an increased risk of idiopathic
intracranial hypertension Brara
et al, 2012
Association with atention deficit hyperactivity disorder Koshy
et al, 2011
Childhood obesity may lead to increased morbidity from multiple sclerosis
and clinically isolated syndrome, particularly in adolescent girls Langer-Gould
et al, 2013.
Childhood-adolescence obesity has been reported as risk factor for
adult depression Sanchez-Villegas
et al, 2013.
Childhood obesity associated with the subsequent development of diabetes
in adulthood Hou
et al, 2016
Biochemistry
Blood pressure and fasting insulin and cholesterol concentrations
are higher in obese children St
Onge et al, 2003
Increased serum leptin, decreased adiponectin and resistin levels
and reduced PON1 activity in obesity Seres
et al, 2010
Serum VLDL, Triglyceride G, insulin, PAI-1 and TNFalpha levels were higher,
and HDL and TGFbeta levels were lower in childhood obesity: Kinik
et al, 2008
Increased endothelin 1 plasma levels have been noted in obese children
Glowinska
et al, 2004
Obese subjects with insulin resistance but without metabolic syndrome
have higher serum C-reactive protein ( CRP ) fibrinogen, IL-6, and plasminogen
activator inhibitor-1 serum levels Mauras
et al, 2010
Obese children had higher levels of prostaglandin F-2 alpha and CRP, fasting
insulin levels and HOMA index compared to healthy subjects: They also
had increased carotid intima thickness, a marker of atherosclerosis Giannini
et al, 2008 (The HOMA-IR value is the product of the patient's blood
glucose and insulin serum levels after fasting, divided by a constant
value) Plasma pro brain natriuretic peptide concentrations are lower
in male childhood obesity , compared to normal normotensive controls but
higher in the obese hypertensive than the obese normotensive group Pervanidou
et al, 2010.
Higher CRP levels associated with higher body mass and overweight/obesity
risk in a large population of European children Nappo
et al, 2013.
Vitamin A insufficiency among Chongqing urban school-age children
was found to be associated with obesity, hypertriglyceridemia and multiple
sclerosis Wei
et al, 2016.
Decreased circulating levels of Spexin in obese children Kumar
et al, 2016
Toxins
Aspartame High concentrations of aspartame
in weanling mice can induce neuronal lesions in the hypothalamic arcuate
nuclei: water-restricted weanling mice lose their ability to regulate
drinking behavior, and consume high aspartame concentrations whose osmolarity
or sweetness would normally be aversive
Takasaki et al, 1981 ( The arcuate nucleus controls appetite )
A rise in obesity coincides with an increased use of non-caloric artificial
sweeteners, such as aspartame Yang,
2010
Long term consumption of aspartame leads to hepatic injury and alterations
in liver antioxidant glutahione status Abhilash
et al, 2011.
Excessive intake of caloric sports drinks can substantially increase
the risk for overweight or obesity in children and adolescents .
Pediatrics 2011 COMMITTEE ON NUTRITION AND THE COUNCIL ON SPORTS
MEDICINE AND FITNESS
The addition of artificial sweeteners to a yeast extract, peptone,
and tryptone medium without supplemented sugar increased the growth
rate and final biomass of Lactobacillus delbrueckii subsp. bulgaricus
Manca
de Nadra et al, 2007
Aspartame and other artificial sweeteners activate TRPV1 Riera
et al, 2007
Monosodium glutamate destroys neurons of the arcuate hypothalamic
nucleus in rats and produces hyperinsulinemic and hypophagic obesity
Scallett
and Olney, 1986.
Organochlorine chemicals and peroxisome proliferator-activated receptor
agonists have ben identified as risk factors La
Merrill and Birnbaum 2011
Chronic lead exposure in childhood may result in obesity that persists
into adulthood Kim
et al, 1995