Recent scientific evidence points to the origins of childhood obesity as an outcome of the dynamic interplay of genetic, behavioral, and environmental factors throughout early development, with a compelling body of evidence suggesting that both maternal and paternal nutritional and other exposures affect a child's risk of later obesity. The burgeoning field of epigenetics has led researchers to speculate that many of the observed associations between early developmental exposures and later risk of childhood obesity are mediated, at least in part, through epigenetic mechanisms.

To explore the body of evolving science that examines the nexus of biology, environment, and developmental stage on risk of childhood obesity, the Institute of Medicine and the National Research Council convened a workshop in February 2015. The workshop focused on the prenatal period, infancy, and early childhood and addressed evidence from both animal and human studies. Workshop objectives were to (1) identify epigenetic-mediated relationships between exposure to risk factors during sensitive periods of development (gestation through age 3) and subsequent obesity-related outcomes; (2) explore the science around periods of plasticity and potential reversibility of obesity risk in the context of early childhood development; and (3) examine the translation of epigenetic science to guide early childhood obesity prevention and intervention to reduce obesity risk. This report summarizes the information presented and discussed at the workshop.

Contents

• THE NATIONAL ACADEMIES
• PLANNING COMMITTEE ON UNDERSTANDING THE DYNAMIC RELATIONSHIP BETWEEN BIOLOGY, ENVIRONMENT, AND EARLY CHILDHOOD DEVELOPMENT ON RISK OF OBESITY
• Reviewers
• 1. Introduction
  • OPENING REMARKS
  • ORGANIZATION OF THE REPORT
• 2. Conceptual Overview of the Role of Epigenetics in Childhood Obesity
  • OVERVIEW
  • FUNDAMENTALS OF EPIGENETICS
  • CONCEPTUAL MODEL OF EPIGENETIC INFLUENCE ON OBESITY RISK
  • PANEL DISCUSSION WITH SPEAKERS
• 3. Etiology and Causal Inference
  • OVERVIEW
  • 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
  • OVERVIEW
  • 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 MICROBIOME AND OUR GENOME
  • THE EPIGENETICS OF THE MICROBIOME
  • TOXIC STRESS AND CHILDHOOD OBESITY
  • PANEL DISCUSSIONS WITH SPEAKERS
• 5. Real-World Application
  • OVERVIEW
  • PRENATAL EXPOSURE TO UNDER-NUTRITION AND OBESITY RISK IN ADULTHOOD
  • MESSAGES TO WOMEN ABOUT EPIGENETICS AND CHILDHOOD OBESITY
  • THEORY TO POLICY
  • THEORY TO CLINICAL PRACTICE
  • PANEL DISCUSSION WITH SPEAKERS
• 6. Data Gaps and Future Directions
  • OVERVIEW
  • FACILITATED DISCUSSION ON DATA GAPS AND FUTURE RESEARCH
  • FACILITATED DISCUSSION ON OPPORTUNITIES AND CHALLENGES IN EPIGENETICS RESEARCH
  • REFLECTIONS ON THE WORKSHOP DISCUSSION BY SHARI BARKIN
• References
• APPENDIXES
  • Appendix A Workshop Agenda
  • Appendix B Speaker Biographies

Rapporteur: Leslie A. Pray.

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.

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.

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.