Examining a
Developmental Approach
to Childhood Obesity
The Fetal and Early Childhood Years
Workshop Summary
Leslie A. Pray, Rapporteur
Food and Nutrition Board
INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
THE NATIONAL ACADEMIES PRESS
Washington, D.C.
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001
NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.
This activity was supported by Contract No. 10002193 between the National Academy of Sciences and the Robert Wood Johnson Foundation, Contract No. 10001718 between the National Academy of Sciences and the U.S. Department of Agriculture—Agricultural Research Service, with additional support from the American Academy of Pediatrics. Additional support for this activity was provided by the W.K. Kellogg Foundation Fund. The views presented in this publication do not necessarily reflect the views of the organizations or agencies that provided support for the activity.
International Standard Book Number-13: 978-0-309-37695-2
International Standard Book Number-10: 0-309-37695-5
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Suggested citation: IOM (Institute of Medicine). 2015. Examining a developmental approach to childhood obesity: The fetal and early childhood years: Workshop summary. Washington, DC: The National Academies Press.
“Knowing is not enough; we must apply.
Willing is not enough; we must do.”
—Goethe
INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
Advising the Nation. Improving Health.
THE NATIONAL ACADEMIES
Advisers to the Nation on Science, Engineering, and Medicine
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PLANNING COMMITTEE ON UNDERSTANDING THE DYNAMIC
RELATIONSHIP BETWEEN BIOLOGY, ENVIRONMENT, AND
EARLY CHILDHOOD DEVELOPMENT ON RISK OF OBESITY1
SHARI BARKIN (Chair), William K. Warren Family Foundation Chair in Medicine, Professor of Pediatrics, Monroe Carell Jr. Children’s Hospital at Vanderbilt
LEANN L. BIRCH, William P. (Bill) Flatt Professor, Department of Foods and Nutrition, University of Georgia
STEPHEN R. DANIELS, Chairman and Pediatrician-in-Chief, Department of Pediatrics, University of Colorado School of Medicine
ESA DAVIS, Assistant Professor, Center for Research on Health Care, Department of Medicine, University of Pittsburgh Medical Center
MATTHEW W. GILLMAN, Professor of Medicine and Director, Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and the Harvard Pilgrim Health Care Institute, Professor of Nutrition, Harvard School of Public Health
DEBRA HAIRE-JOSHU, Professor and Associate Dean for Research, and Director, Center for Obesity Prevention and Policy Research and the Washington University Center for Diabetes Translation Research, George Warren Brown School of Social Work–Public Health, Washington University in St. Louis
KAREN A. LILLYCROP, Professor of Epigenetics, Centre for Biological Sciences, Faculty of Natural and Environmental Sciences, University of Southampton
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1 Institute of Medicine planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published workshop summary rests with the workshop rapporteur and the institution.
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Reviewers
This workshop summary has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published workshop summary as sound as possible and to ensure that the workshop summary meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this workshop summary:
Rachel Ballard-Barbash, National Institutes of Health, National Cancer Institute
Sandra Hassink, Institute for Healthy Childhood Weight, American Academy of Pediatrics
James Ntambi, University of Wisconsin–Madison
Catherine Spong, National Institutes of Health, National Institute of Child Health and Human Development
Although the reviewers listed above have provided many constructive comments and suggestions, they did not see the final draft of the workshop summary before its release. The review of this workshop summary was overseen by Joanne Lupton, Texas A&M University. Appointed by the National Research Council and the Institute of Medicine, she was respon-
sible for making certain that an independent examination of this workshop summary was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this workshop summary rests entirely with the rapporteur and the institution.
Contents
2 CONCEPTUAL OVERVIEW OF THE ROLE OF EPIGENETICS IN CHILDHOOD OBESITY
Conceptual Model of Epigenetic Influence on Obesity Risk
Panel Discussion with Speakers
3 ETIOLOGY AND CAUSAL INFERENCE
Epigenetic Mechanisms for Obesity Risk
The Role of Disparity in the Origins of Obesity Risk
The Father’s Early Contribution to the Birth of the Child: The Role of Paternal RNAs
Maternal Influences on Offspring’s Epigenetics and Later Body Composition
Panel Discussion with Speakers
4 OPPORTUNITIES FOR INTERVENTION AND PREVENTION
Developmental Plasticity: Sensitive Periods and Risk of Obesity
Maternal Health and Diet’s Effect on Offspring’s Metabolic Functioning
Early Infant Rapid Weight Gain and the Epigenetics of Leptin
Therapies to Reverse Metabolic Disturbances Arising as a Consequence of Developmental Programming
The Epigenetics of the Microbiome
Toxic Stress and Childhood Obesity
Panel Discussions with Speakers
Prenatal Exposure to Under-Nutrition and Obesity Risk in Adulthood
Messages to Women About Epigenetics and Childhood Obesity
Panel Discussion with Speakers
6 DATA GAPS AND FUTURE DIRECTIONS
Facilitated Discussion on Data Gaps and Future Research
Facilitated Discussion on Opportunities and Challenges in Epigenetics Research
