Influence of post-partum BMI change on childhood obesity and energy intake

Autoři: Martha M. Téllez-Rojo aff001;  Belem Trejo-Valdivia aff001;  Elizabeth Roberts aff002;  Teresa Verenice Muñoz-Rocha aff001;  Luis F. Bautista-Arredondo aff001;  Karen E. Peterson aff003;  Alejandra Cantoral aff004
Působiště autorů: Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico aff001;  Anthropology Department, University of Michigan, Ann Arbor, Michigan, United States of America aff002;  Nutritional Sciences Department, School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America aff003;  CONACYT, Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico aff004
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224830



Association between parent’s Body Mass Index (BMI) and their children, has been widely documented. Individual, familiar and structural factors play a role in this relation. We analyzed the association between maternal BMI change during the first year post-partum and their offspring’s growth-trajectories and energy intake in their first five years of life.


Compare growth-trajectories and children’s caloric intake according to post-partum mother´s BMI classification.


The anthropometric assessment was taken in 935 mother-child pairs along the study period. Mothers were classified into four groups according to their BMI-trajectories in the post-partum. Children’s weight for height z-scores (WHZ) was compared among groups using random-effects regression models. A longitudinal comparison of children’s caloric intake by the maternal group was carried out.


At 42 months of age, infants from mothers that remained overweight during the first year post-partum had, on average, 0.61 SD higher WHZ than those from mothers who remained in a recommended BMI group (R-BMI) in the same period. At 60 months of age, children´s prevalence of obesity was almost twice in the maternal overweight group vs R-BMI group (14.2% and 7.3% respectively). Chances for a child of having an over caloric intake were 36.5% (95% IC: 6.6%, 74.8%) and significantly higher among children from overweight mothers than those from R-BMI mothers. The difference in children’s WHZ trajectory remained significant after adjusting for caloric intake, suggesting that contextual factors play a role in shaping children’s obesity. A concurrent ethnographic study with the study subjects provides suggestions as to what these factors might be, including changes in the food landscape.


Children from overweight mothers tended to have a more caloric diet yielding a higher propensity to obesity. Contextual factors such as food landscape might contribute to childhood obesity beyond having an overweight mother. Pregnancy and post-partum is a window of opportunity for interventions to decrease the incidence of children’s overweight.

Klíčová slova:

Anthropometry – Body Mass Index – Diet – Food – Childhood obesity – Children – Mothers – Obesity


1. Swinburn BA, Sacks G, Hall KD, McPherson K, Finegood DT, Moodie ML, et al. The global obesity pandemic: Shaped by global drivers and local environments. Lancet. 2011;378: 804–814. doi: 10.1016/S0140-6736(11)60813-1 21872749

2. Rivera JÁ, de Cossío TG, Pedraza LS, Aburto TC, Sánchez TG, Martorell R. Childhood and adolescent overweight and obesity in Latin America: a systematic review. Lancet Diabetes Endocrinol. 2014;2: 321–332. doi: 10.1016/S2213-8587(13)70173-6 24703050

3. Hernández-Cordero S, Cuevas-Nasu L, Morales-Ruán M del C, Méndez-Gómez Humarán I, Ávila-Arcos MA, Rivera-Dommarco JA. Overweight and obesity in Mexican children and adolescents during the last 25 years. Nutr Diabetes. 2017;7: e247–e247. doi: 10.1038/nutd.2016.52 28287630

4. Hernández-Ávila M, Rivera-Dommarco J, Shamah-Levy T, Cuevas-Nasu L, Gómez-Acosta LM, Gaona-Pineda EB, et al. Encuesta Nacional de Salud y Nutrición de Medio Camino 2016. (ENSANUT MC 2016) [Internet]. Cuernavaca, México; 2016. Available:

5. Barquera S, Campos I, Rivera JÁ. Mexico attempts to tackle obesity: the process, results, push backs and future challenges. Obes Rev. 2013;14: 69–78. doi: 10.1111/obr.12096 24103026

6. S Franco. Obesity and the Economics of Prevention—Fit not Fat [Internet]. Oecd. 2010. doi: 10.1002/yd.370

7. Strauss RS, Knight J. Influence of the Home Environment on the Development of Obesity in Children. Pediatrics. 1999;103: e85–e85. doi: 10.1542/peds.103.6.e85 10353982

8. Leah L, Law C, Lo Conte R, Power C. Intergenerational influences on childhood BMI: the effect of parental BMI trajectories. Am J Clin Nutr. 2009;89. doi: 10.3945/ajcn.2008.26759 19106237

9. Silventoinen K, Rokholm B, Kaprio J, Sorensen TIA. The genetic and environmental influences on childhood obesity: A systematic review of twin and adoption studies. Int J Obes. 2010;34: 29–40. ijo2009177 [pii]\r doi: 10.1038/ijo.2009.177

10. Classen TJ, Thompson O. Genes and the intergenerational transmission of BMI and obesity. Econ Hum Biol. 2016;23: 121–133. doi: 10.1016/j.ehb.2016.08.001 27599025

11. Jablonka E, Lamb MJ, Zeligowski A. Evolution in four dimensions: genetic, epigenetic, behavioral, and symbolic variation in the history of life [Internet]. MIT Press. 2005. doi: 10.1172/JCI27017.Book

12. Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, De Onis M, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013; doi: 10.1016/S0140-6736(13)60937-X

13. Gauthier KI, Krajicek MJ. Obesogenic environment: A concept analysis and pediatric perspective. J Spec Pediatr Nurs. 2013;18: 202–210. doi: 10.1111/jspn.12027 23822844

14. Whitaker RC, Deeks CM, Baughcum a E, Specker BL. The relationship of childhood adiposity to parent body mass index and eating behavior. Obes Res. 2000;8: 234–40. doi: 10.1038/oby.2000.27 10832766

15. Danielzik S, Langnäse K, Mast M, Spethmann C, Müller MJ. Impact of parental BMI on the manifestation of overweight 5–7 year old children. Eur J Nutr. 2002;41: 132–138. doi: 10.1007/s00394-002-0367-1 12111051

16. Næss M, Holmen TL, Langaas M, Bjørngaard JH, Kvaløy K. Intergenerational transmission of overweight and obesity from parents to their adolescent offspring—The HUNT study. PLoS One. 2016;11: 1–14. doi: 10.1371/journal.pone.0166585 27851798

17. Grant JF, Chittleborough CR, Taylor AW. Parental midlife body shape and association with multiple adult offspring obesity measures: North West adelaide health study. PLoS One. 2015;10: 1–15. doi: 10.1371/journal.pone.0137534 26355742

18. Zalbahar N, Najman J, McIntrye HD, Mamun A. Parental pre-pregnancy BMI influences on offspring BMI and waist circumference at 21 years. Aust N Z J Public Health. 2016;40: 572–578. doi: 10.1111/1753-6405.12574 27624991

19. Johnson PCD, Logue J, McConnachie A, Abu-Rmeileh NME, Hart C, Upton MN, et al. Intergenerational change and familial aggregation of body mass index. Eur J Epidemiol. 2012;27: 53–61. doi: 10.1007/s10654-011-9639-5 22187263

20. Davey Smith G, Steer C, Leary S, Ness A. Is there an intrauterine influence on obesity? Evidence from parent child associations in the Avon Longitudinal Study of Parents and Children (ALSPAC). Arch Dis Child. 2007;92: 876–880. doi: 10.1136/adc.2006.104869 17595200

21. Jääskeläinen A, Pussinen J, Nuutinen O, Schwab U, Pirkola J, Kolehmainen M, et al. Intergenerational transmission of overweight among Finnish adolescents and their parents: A 16-year follow-up study. Int J Obes. 2011;35: 1289–1294. doi: 10.1038/ijo.2011.150 21829157

22. Patel R, Martin RM, Kramer MS, Oken E, Bogdanovich N, Matush L, et al. Familial associations of adiposity: Findings from a cross-sectional study of 12,181 parental-offspring trios from Belarus. PLoS One. 2011;6. doi: 10.1371/journal.pone.0014607 21298034

23. Fleten C, Nystad W, Stigum H, Skjaerven R, Lawlor DA, Davey Smith G, et al. Parent-Offspring Body Mass Index Associations in the Norwegian Mother and Child Cohort Study: A Family-based Approach to Studying the Role of the Intrauterine Environment in Childhood Adiposity. Am J Epidemiol. 2012;176: 83–92. doi: 10.1093/aje/kws134 22771730

24. Corsi DJ, Subramanian S V, Ackerson LK, Davey Smith G. Is there a greater maternal than paternal influence on offspring adiposity in India? Arch Dis Child. 2015;100: 973–979. doi: 10.1136/archdischild-2014-307690 26044138

25. Lawlor DA, Smith GD, O’Callaghan M, Alati R, Mamun A, Williams GM, et al. Epidemiologic evidence for the fetal overnutrition hypothesis: Findings from the Mater-University study of pregnancy and its outcomes. Am J Epidemiol. 2007;165: 418–424. doi: 10.1093/aje/kwk030 17158475

26. Lawlor DA, Timpson NJ, Harbord RM, Leary S, Ness A, McCarthy MI, et al. Exploring the developmental overnutrition hypothesis using parental-offspring associations and FTO as an instrumental variable. PLoS Med. 2008;5: 0484–0493. doi: 10.1371/journal.pmed.0050033 18336062

27. Whitaker KL, Jarvis MJ, Beeken RJ, Boniface D, Wardle J. Comparing maternal and paternal intergenerational transmission of obesity risk in a large population-based sample. Am J Clin Nutr. 2010;91: 1560–7. doi: 10.3945/ajcn.2009.28838 20375189

28. Linabery AM, Nahhas RW, Johnson W, Choh AC, Towne B, Odegaard AO, et al. Stronger influence of maternal than paternal obesity on infant and early childhood body mass index: The Fels Longitudinal Study. Pediatr Obes. 2013;8: 159–169. doi: 10.1111/j.2047-6310.2012.00100.x 23042783

29. Heude B, Kettaneh A, Rakotovao R, Bresson JL, Borys JM, Ducimetière P, et al. Anthropometric relationships between parents and children throughout childhood: The Fleurbaix-Laventie Ville Santé Study. Int J Obes. 2005;29: 1222–1229. doi: 10.1038/sj.ijo.0802920 15795752

30. Hughes SO, Anderson CB, Power TG, Micheli N, Jaramillo S, Nicklas TA. Measuring feeding in low-income African–American and Hispanic parents. Appetite. 2006;46: 215–223. doi: 10.1016/j.appet.2006.01.002 16504340

31. Matheson DM, Robinson TN, Varady A, Killen JD. Do Mexican-American Mothers’ Food-Related Parenting Practices Influence Their Children’s Weight and Dietary Intake? J Am Diet Assoc. 2006;106: 1861–1865. doi: 10.1016/j.jada.2006.08.004 17081838

32. Perng W, Tamayo-Ortiz M, Tang L, Sanchez BN, Cantoral A, Meeker JD, et al. Cohort Profile Paper: The Early Life Exposure in Mexico to Environmental Toxicants (ELEMENT) Project. BMJ Open. 2019; 1–49. doi: 10.1136/bmjopen-2019-030833

33. Hernández-Avila M, González-Cossío T, Hernández-Avila JE, Romieu I, Peterson KE, Aro A, et al. Dietary calcium supplements to lower blood lead levels in lactating women: A randomized placebo-controlled trial. Epidemiology. 2003;14: 206–212. doi: 10.1097/01.EDE.0000038520.66094.34 12606887

34. Téllez-Rojo MM, Hernández-Avila M, González-Cossío T, Romieu I, Aro A, Palazuelos E, et al. Impact of breastfeeding on the mobilization of lead from bone. Am J Epidemiol. 2002;155: 420–428. doi: 10.1093/aje/155.5.420 11867353

35. Ettinger AS, Lamadrid-Figueroa H, Téllez-Rojo MM, Mercado-García A, Peterson KE, Schwartz J, et al. Effect of calcium supplementation on blood lead levels in pregnancy: A randomized placebo-controlled trial. Environ Health Perspect. 2009;117: 26–31. doi: 10.1289/ehp.11868 19165383

36. Téllez-Rojo MM, Hernández-Avila M, Lamadrid-Figueroa H, Smith D, Hernández-Cadena L, Mercado-García A, et al. Impact of bone lead and bone resorption on plasma and whole blood lead levels during pregnancy. Am J Epidemiol. 2004;160: 668–678. doi: 10.1093/aje/kwh271 15383411

37. Afeiche M, Peterson KE, Sánchez BN, Cantonwine D, Lamadrid-Figueroa H, Schnaas L, et al. Prenatal lead exposure and weight of 0- to 5-year-old children in Mexico city. Environ Health Perspect. 2011;119: 1436–1441. doi: 10.1289/ehp.1003184 21715242

38. Braun JM, Hoffman E, Schwartz J, Sanchez B, Schnaas L, Mercado-García A, et al. Assessing windows of susceptibility to lead-induced cognitive deficits in Mexican children. Neurotoxicology. 2012;33: 1040–1047. doi: 10.1016/j.neuro.2012.04.022 22579785

39. Martinez SM, Rhee K, Blanco E, Boutelle K. Maternal Attitudes and Behaviors Regarding Feeding Practices in Elementary School−Aged Latino Children: A Pilot Qualitative Study on the Impact of the Cultural Role of Mothers in the US−Mexican Border Region of San Diego, California. J Acad Nutr Diet. 2014;114: 230–237. doi: 10.1016/j.jand.2013.09.028 24315129

40. Chaidez V, Townsend M, Kaiser LL. Toddler-feeding practices among Mexican American mothers. A qualitative study. Appetite. 2011;56: 629–632. doi: 10.1016/j.appet.2011.02.015 21354235

41. WHO. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 1997;894: 1–253. doi: 10.1016/S0140-6736(57)91352-1

42. Gibson RS. Principles of nutritional assessment. Oxford University Press; 1990.

43. WHO, De Onis M, Onyango A, Borghi E, Siyam A, Pinol A. WHO child growth standards. Length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age. Methods and development [Internet]. Pediatric Croatica Supplement. 2006. doi: 10.4067/S0370-41062009000400012

44. Hernández-Avila M, Romieu I, Parra S, Hernández-Avila JE, Madrigal H, Willett W. Validity and reproducibility of a food frequency questionnaire to assess dietary intake of women living in Mexico City. Salud Publica Mex. 1998;40: 133–140. doi: 10.1590/s0036-36341998000200005 9617194

45. National Institute of Public Health. The compiled México-INSP Food Composition Data Bank. México DF; 2002.

46. Flores M, Macías N, Rivera M, Barquera S, Hernández L, García-Guerra A, et al. Energy and nutrient intake among Mexican school-aged children, Mexican National Health and Nutrition Survey 2006. Salud Publica Mex. 2009;51 Suppl 4: S540–50. doi: 10.1590/S0036-36342009001000009 20464230

47. Greene GW, Smiciklas-Wright H, Scholl TO, Karp RJ. Postpartum weight change: how much of the weight gained in pregnancy will be lost after delivery? Obstet Gynecol. 1988;71: 701–7. Available: 3357658

48. Ohlin A, Rössner S. Maternal body weight development after pregnancy. Int J Obes. 1990;14: 159–73. Available:

49. Luke B, Hediger ML, Scholl TO. Point of diminishing returns: When does gestational weight gain cease benefiting birthweight and begin adding to maternal obesity? J Matern Fetal Med. 1996;5: 168–173. doi: 10.1002/(SICI)1520-6661(199607/08)5:4<168::AID-MFM2>3.0.CO;2-I 8796789

50. Scholl TO, Hediger ML, Schall JI, Ances IG, Smith WK. Gestational weight gain, pregnancy outcome, and postpartum weight retention. Obstet Gynecol. 1995;86: 423–7. Available: doi: 10.1016/0029-7844(95)00190-3 7651655

51. Gunderson EP, Abrams B. Epidemiology of Gestational Weight Gain and Body Weight Changes After Pregnancy. Epidemiol Rev. 1999;21: 261–275. doi: 10.1093/oxfordjournals.epirev.a018001 10682262

52. McLachlan G, Peel D. Finite Mixture Models [Internet]. Wiley Series in Probability and Statistics. New York: Wiley. 2000. p. 419. doi: 10.1198/tech.2002.s651

53. Diggle P, Heagerty P, Liang K-Y, Zeger Scott. Analysis of longitudinal data. [Internet]. Oxford University Press; 2004. Available:

54. Küpers LK, L’Abée C, Bocca G, Stolk RP, Sauer PJJ, Corpeleijn E. Determinants of weight gain during the first two years of life-the GECKO drenthe birth cohort. PLoS One. 2015;10. doi: 10.1371/journal.pone.0133326 26192417

55. Fielding-Singh P. A Taste of Inequality: Food’s Symbolic Value across the Socioeconomic Spectrum. Sociol Sci. 2017;4: 424–448. doi: 10.15195/v4.a17

56. Warin M, Moore V, Davies M, Ulijaszek S. Epigenetics and Obesity: The Reproduction of Habitus through Intracellular and Social Environments. Body Soc. 2016;22: 53–78. doi: 10.1177/1357034X15590485

57. Doi L, Williams AJ, Frank J. How has child growth around adiposity rebound altered in Scotland since 1990 and what are the risk factors for weight gain using the Growing Up in Scotland birth cohort 1? BMC Public Health. 2016;16: 1081. doi: 10.1186/s12889-016-3752-z 27737667

58. Robinson S, Marriott L, Poole J, Crozier S, Borland S, Lawrence W, et al. Dietary patterns in infancy: the importance of maternal and family influences on feeding practice. Br J Nutr. 2017; doi: 10.1017/S0007114507750936 17532867

59. Rosas LG, Guendelman S, Harley K, Fernald LCH, Neufeld L, Mejia F, et al. Factors associated with overweight and obesity among children of Mexican descent: Results of a binational study. J Immigr Minor Heal. 2011;13: 169–180. doi: 10.1007/s10903-010-9332-x 20217234

60. Safer D, Agras W, Bryson S, Hammer L. Early body mass index and other anthropometric relationships between parents and children. Int J Obes. 2001;25: 1532–1536. doi: 10.1038/sj.ijo.0801786 11673777

61. Abu-Rmeileh NME, Hart CL, McConnachie A, Upton MN, Lean MEJ, Watt GCM. Contribution of midparental BMI and other determinants of obesity in adult offspring. Obesity. 2008;16: 1388–1393. doi: 10.1038/oby.2008.211 18421278

62. Cooper R, Hyppönen E, Berry D, Power C. Associations between parental and offspring adiposity up to midlife: The contribution of adult lifestyle factors in the 1958 british birth cohort study. Am J Clin Nutr. 2010;92: 946–953. doi: 10.3945/ajcn.2010.29477 20702606

63. Gutiérrez J, Rivera-Dommarco J, Shamah-Levy T, Villalpando-Hernández S, Franco A, Cuevas-Nasu L, et al. Encuesta Nacional de Salud y Nutrición 2012. Resultados Nacionales [Internet]. Cuernavaca, México; 2012. Available:

64. Jáuregui A, Medina C, Salvo D, Barquera S, Rivera-Dommarco JA. Active Commuting to School in Mexican Adolescents: Evidence From the Mexican National Nutrition and Health Survey. J Phys Act Heal. 2015;12: 1088–1095. doi: 10.1123/jpah.2014-0103 25247894

65. Cade J, Thompson R, Burley V, Warm D. Development, validation and utilisation of food-frequency questionnaires–a review. Public Health Nutr. 2002;5: 567–587. doi: 10.1079/PHN2001318 12186666

66. Kipnis V, Midthune D, Freedman L, Bingham S, Day NE, Riboli E, et al. Bias in dietary-report instruments and its implications for nutritional epidemiology. Public Health Nutr. 2002;5: 915–923. doi: 10.1079/PHN2002383 12633516

67. Andersen LF, Lande B, Arsky GH, Trygg K. Validation of a semi-quantitative food-frequency questionnaire used among 12-month-old Norwegian infants. Eur J Clin Nutr. 2003;57: 881–888. doi: 10.1038/sj.ejcn.1601621 12879081

68. Bourges R. H, Casanueva E, Rosado JL. Recomendaciones de ingestión de nutrimentos para la poblacioón mexicana. Editorial Medica panamericana; 2005.

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