Christine Elizabeth Papai
Date of Defense:
February 19, 2014
Objective: The aim of this study was to identify risk factors for obesity and severe obesity at age 4 identifiable during the first 3 years of life and investigate variations by race and ethnicity.
Methods: Analysis of records for 42,791 low- income children born between 2005 and 2008 who were enrolled in the Minnesota Special Supplemental Nutrition Program for Women, Infants, and Children. The outcome measures were obesity and severe obesity, defined as BMI-for-age at or above the 95t hand 97.5th percentile, respectively, at age 48- 59 months. Multivariate logistic regression was used to model the effects of various risk factors on both outcomes.
Results: Multivariate analyses found high birth weight ( ≥ 4000g) and breastfeeding duration to be the strongest significant predictors. High birth weight was strongest for American Indian Non-Hispanics (NH) (odds ratio (OR), 2.0; 95% confidence interval (CI), 1.6-2.5 for obesity and OR, 2.2; CI, 1.7- 2.9 for severe obesity) and Asian NH (OR, 2.2; CI, 1.5-3.2 and OR, 2.2; CI, 1.5-3.3). A dos e-response relationship between longer breastfeeding duration a nd reduced odds of obesity and severe obesity was seen in some groups. Breastfeeding duration beyond 26 week s was most protective for White NH (OR, 0.5; CI, 0.5-0.6 and OR, 0.5; CI, 0.4-0.5) and American Indian NH (OR, 0.6; CI, 0.5-0.7 and OR, 0.6; CI, 0.4-0.8), marginally protective for Hispanics, and in significant for Black NH.
Conclusions: Interventions focused on reducing high birth weight and increasing breastfeeding duration may decrease obesity in 4-year-olds an d reduce racial disparities.