Racial/ethnic differences in early-life risk factors for childhood obesity.
OBJECTIVE
By the preschool years, racial/ethnic disparities in obesity prevalence are already present. The objective of this study was to examine racial/ethnic differences in early-life risk factors for childhood obesity.


METHODS
A total of 1343 white, 355 black, and 128 Hispanic mother-child pairs were studied in a prospective study. Mother's reported child's race/ethnicity. The main outcome measures were risk factors from the prenatal period through 4 years old that are known to be associated with child obesity.


RESULTS
In multivariable models, compared with their white counterparts, black and Hispanic children exhibited a range of risk factors related to child obesity. In pregnancy, these included higher rates of maternal depression (odds ratio [OR]: 1.55 for black, 1.89 for Hispanic); in infancy more rapid weight gain (OR: 2.01 for black, 1.75 for Hispanic), more likely to introduce solid foods before 4 months of age (OR: 1.91 for black, 2.04 for Hispanic), and higher rates of maternal restrictive feeding practices (OR: 2.59 for black, 3.35 for Hispanic); and after 2 years old, more televisions in their bedrooms (OR: 7.65 for black, 7.99 for Hispanic), higher intake of sugar-sweetened beverages (OR: 4.11 for black, 2.48 for Hispanic), and higher intake of fast food (OR: 1.65 for black, 3.14 for Hispanic). Black and Hispanic children also had lower rates of exclusive breastfeeding and were less likely to sleep at least 12 hours/day in infancy.


CONCLUSIONS
Racial/ethnic differences in risk factors for obesity exist prenatally and in early childhood. Racial/ethnic disparities in childhood obesity may be determined by factors that operate at the earliest stages of life.
Taveras
Elsie M
EM
Obesity Prevention Program, Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, 133 Brookline Ave, 6th floor, Boston, MA 02215, USA. elsie_taveras@harvardpilgrim.org
Gillman
Matthew W
MW
Kleinman
Ken
K
Rich-Edwards
Janet W
JW
Rifas-Shiman
Sheryl L
SL
D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005006:Ethnicity / Q000208:ethnology*; D057140:Fast Foods / Q000009:adverse effects; D005260:Female; D015438:Health Behavior / Q000208:ethnology; D054624:Health Status Disparities; D006801:Humans; D008019:Life Style / Q000208:ethnology; D008297:Male; D008425:Maternal Behavior / Q000208:ethnology; D009765:Obesity / Q000208:ethnology* / Q000209:etiology; D011247:Pregnancy; D011446:Prospective Studies; D044469:Racial Groups / Q000208:ethnology*; D012307:Risk Factors; D012959:Socioeconomic Factors; D055815:Young Adult