Environment and obesity in the National Children's Study.
OBJECTIVE
In this review we describe the approach taken by the National Children's Study (NCS), a 21-year prospective study of 100,000 American children, to understanding the role of environmental factors in the development of obesity.


METHODS
We review the literature with regard to the two core hypotheses in the NCS that relate to environmental origins of obesity and describe strategies that will be used to test each hypothesis.


RESULTS
Although it is clear that obesity in an individual results from an imbalance between energy intake and expenditure, control of the obesity epidemic will require understanding of factors in the modern built environment and chemical exposures that may have the capacity to disrupt the link between energy intake and expenditure. The NCS is the largest prospective birth cohort study ever undertaken in the United States that is explicitly designed to seek information on the environmental causes of pediatric disease.


CONCLUSIONS
Through its embrace of the life-course approach to epidemiology, the NCS will be able to study the origins of obesity from preconception through late adolescence, including factors ranging from genetic inheritance to individual behaviors to the social, built, and natural environment and chemical exposures. It will have sufficient statistical power to examine interactions among these multiple influences, including gene-environment and gene-obesity interactions. A major secondary benefit will derive from the banking of specimens for future analysis.
Trasande
Leonardo
L
Department of Community and Preventive Medicine, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1043, New York, NY 10029 USA. leo.trasande@mssm.edu
Cronk
Chris
C
Durkin
Maureen
M
Weiss
Marianne
M
Schoeller
Dale A
DA
Gall
Elizabeth A
EA
Hewitt
Jeanne B
JB
Carrel
Aaron L
AL
Landrigan
Philip J
PJ
Gillman
Matthew W
MW
D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D002149:Energy Intake; D004734:Energy Metabolism; D004781:Environmental Exposure / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D009765:Obesity / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult