title: Early life predictors of preschool overweight and obesity: a case-control study in Sri Lanka.
abstract: BACKGROUND
  Childhood obesity increases the risk of obesity in adulthood and is associated with cardiovascular disease risk factors. Our aim was to assess the early life risk factors associated with overweight and obesity among preschool children.
  
  
  METHODS
  In this case-control study, from the 1087 preschool children measured, age, sex and ethnicity matched 71 cases and 71 controls were recruited. Cases and controls were defined according to the WHO 2006 growth standards. The birth and growth characteristics were extracted from the child health development records. Infant feeding practices and maternal factors were obtained from the mother. Rapid weight gain was defined as an increase in weight-for-age Z score (WHO standards) above 0.67 SD from birth to 2 years. The magnitude and significant difference in mean values of the variables associated with overweight and obesity were evaluated using logistic regressions and paired t-test, respectively.
  
  
  RESULTS
  Cases had significantly shorter duration (months) of breastfeeding (19.4, 24.6, p = 0.003), and smaller duration (months) of exclusive breastfeeding (3.7, 5.1, p = 0.001) compared to controls. Rapid weight gain (OR = 6.3, 95% CI = 2.04-19.49), first born status (OR = 3.6, 95% CI = 1.17-10.91) and pre-pregnancy obesity (OR = 4.0, 95% CI = 1.46-10.76) were positively associated with overweight and obesity. Breastfeeding more than 2 years (OR = 0.2, 95% CI = 0.06-0.57) was negatively associated with overweight and obesity.
  
  
  CONCLUSIONS
  Rapid weight gain within first two years, first-born status and pre-pregnancy obesity of the mother contributed for preschool obesity. Our results suggest that intervention may be indicated earlier in infancy and during the toddler and preschool years to tackle the increasing prevalence of obesity.
authors.affiliation: Department of Applied Nutrition, Faculty of Livestock, Fisheries and Nutrition, Wayamba University of Sri Lanka, Makandura 60170, Sri Lanka. rldk_rathnayake@yahoo.com.
authors.forename: Kumari M
authors.initials: KM
authors.lastname: Rathnayake
authors.forename: Aberna
authors.initials: A
authors.lastname: Satchithananthan
authors.forename: Senarath
authors.initials: S
authors.lastname: Mahamithawa
authors.forename: Ranil
authors.initials: R
authors.lastname: Jayawardena
mesh_terms: D001835:Body Weight; D001942:Breast Feeding / Q000706:statistics & numerical data; D016022:Case-Control Studies; D002657:Child Development; D002675:Child, Preschool; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D009035:Mothers; D009765:Obesity / Q000453:epidemiology; D050177:Overweight / Q000453:epidemiology*; D063766:Pediatric Obesity / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D012574:Schools; D013188:Sri Lanka / Q000453:epidemiology; D015430:Weight Gain