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. Pediatrics 2010;125:686-695