Influences on Child Eating and Weight Development From a Behavioral Genetics Perspective

Tanja V. E. Kral, PhD; Myles S. Faith, PhD

J Pediatr Psychol. 2009;34(6):596-605.

Parental Obesity Status Predicts Child Overweight Status: The Familial Association

"Obesity in one or both parents probably influences the risk of obesity in their offspring because of shared genes or environmental factors within families" (Whitaker, Wright, Pepe, Seidel, & Dietz, 1997). The notion that "obesity runs in families" has been supported by cross sectional and longitudinal studies (Gibson et al., 2007; Maffeis, Talamini, & Tato, 1998; Schaefer-Graf et al., 2005; Wang, Patterson, & Hills, 2002; Whitaker et al., 1997). These studies provided evidence that parental overweight (defined as a BMI ≥25 kg/m²) and obesity (defined as a BMI ≥30 kg/m²) are significant risk factors for overweight in their offspring. Data from two cross sectional studies showed that parental overweight or obesity was an independent risk factor for childhood obesity (Wang et al., 2002) and that maternal BMI, in particular, was a significant predictor of BMI z-scores in children ages 6-13 years (Gibson et al., 2007). Data from several longitudinal studies confirmed these findings and showed that children of obese parents were at increased risk for developing obesity later in their life (Maffeis et al., 1998; Schaefer-Graf et al., 2005; Whitaker et al., 1997). For example, Whitaker and colleagues (1997) showed that after 6 years of age, the probability of a child becoming an obese adult exceeded 50% for obese children, as compared with ~10% for nonobese children. In addition, results showed that the risk of adult obesity was significantly greater if either the child's mother or father was obese (Table I). That is, parental obesity more than doubled the risk for children, obese or nonobese, to become obese adults. This risk especially applied to children who were under 10 years of age. The authors note that among nonobese 1- and 2-year-olds, those with at least one obese parent had a greater chance of being obese as adults compared to those without an obese parent (28% vs. 10%). Among obese 3- to 5-year-olds, the chance of developing adult obesity increased from 24% if neither parent was obese to 62% if at least one parent was obese (Whitaker et al., 1997).

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Abstract and Introduction
Parental Obesity Status Predicts Child Overweight Status: The Familial Association
Parent (Eating) Behaviors and Food Preferences Predict Child Eating Behaviors and Food Preferences: The Familial Association
EAH: A Behavioral Eating Trait
Summary and Limitations
Conclusions
References

Table I. Odds Ratios for Obesity in Young Adulthood According to the Child's Age and the Obesity Status of the Child and the Parents
	No. of subjects obese as adults/Total No. (%)	Odds ratio (95% CI)*
Subject's age and mother's obesity status
1-2 years
Mother not obese	73/575 (13)	1.0
Mother obese	29/85 (34)	3.6 (2.1-5.9)
3-5 years
Mother not obese	77/597 (13)	1.0
Mother obese	36/104 (35)	3.6 (2.2-5.7)
6-9 years
Mother not obese	76/611 (12)	1.0
Mother obese	42/131 (32)	3.3 (2.2-5.1)
10-14 years
Mother not obese	73/594 (12)	1.0
Mother obese	53/177 (30)	3.1 (2.0-4.6)
15-17 years
Mother not obese	65/549 (12)	1.0
Mother obese	64/233 (27)	2.8 (1.9-4.1)
Subject's age and father's obesity status
1-2 years
Father not obese	55/455 (12)	1.0
Father obese	28/98 (29)	2.9 (1.7-4.9)
3-5 years
Father not obese	56/475 (12)	1.0
Father obese	34/123 (28)	2.9 (1.8-4.6)
6-9 years
Father not obese	60/497 (12)	1.0
Father obese	40/149 (27)	2.7 (1.7-4.2)
10-14 years
Father not obese	62/505 (12)	1.0
Father obese	46/184 (25)	2.4 (1.6-3.7)
15-17 years
Father not obese	54/491 (11)	1.0
Father obese	56/221 (25)	2.7 (1.8-4.1)

Table II. Genetic and Non-genetic Factors Affecting EAH
Characteristic	Findings	Studies
Heritability	EAH shown to be a heritable eating trait	Fisher, Cai et al., 2007
	EAH shown to be more pronounced in boys born at high risk for obesity compared to those born at low risk for obesity	Faith et al., 2006
	EAH shown to share similarities to disinhibition in adults, a trait which has been found to be heritable	Cutting et al., 1999; Provencher et al., 2005; Steinle et al., 2002
Environment	EAH shown to be exacerbated by restrictive feeding practices and monitoring	Birch et al., 2003; Fisher & Birch, 1999a; Francis & Birch, 2005
Stability	EAH shown to be an eating trait which is stable over time	Fisher & Birch, 2002; Francis & Birch, 2005
Energy intake	EAH shown to be associated with increased energy intake	Fisher & Birch, 1999b, 2000
Body weight	EAH shown to be predictive of increased weight gain among children	Birch et al., 2003; Fisher & Birch, 2002; Shunk & Birch, 2004

For all odds ratios, the nonobese group served as the reference group. The subject's obesity status during childhood is based on the mean z-score for the child's; BMI during the age interval, as follows: not obese, z < 1.036 (corresponding to the 85th percentile for a normal population of the same age and sex); obese, z ≥ 1.036 (85th percentile); and very obese, mean z ≥ 1.645 (95th percentile).

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