Early Childhood Obesity: Multifactorial Influences with a Prominent Familial Contribution

Abstract

Objective: Early childhood obesity is an increasing public health problem with long-term consequences. Identifying risk factors is essential for effective preventative strategies. To evaluate prenatal, perinatal, and postnatal influences including: breastfeeding and nutritional practices; lifestyle and daily habits; household, sociocultural, and economic conditions; and parental anthropometric characteristics to better elucidate the determinants of obesity in early childhood. Methods: This cross-sectional study included children aged 12-60 months, divided into children with obesity and non-obese controls. Standardized anthropometric assessments were performed in all participants. Parents completed a structured questionnaire capturing perinatal characteristics, infant feeding practices, dietary intake, medical history, lifestyle behaviors, and household-level factors. Results: A total of 210 children (113 girls; 53.8%) were included, comprising 106 obese and 104 non-obese individuals, with comparable age between groups (3.4 +/- 1.3 vs. 3.3 +/- 1.3 years). Both maternal and paternal body mass index (BMI) values were significantly higher in the obese group, and maternal employment (27.4% vs. 5.8%) and maternal obesity (42.5% vs. 21.2%) were more prevalent. Maternal smoking during pregnancy (23.6% vs. 7.7%) and gestational diabetes (22.6% vs. 9.6%) were also more frequent. Feeding practices and current dietary patterns did not differ significantly between groups. In multivariable analysis, maternal employment (aOR3.74), sibling obesity (aOR2.21), and extended family obesity burden (aOR 1.19) independently predicted childhood obesity. Conclusion: Familial obesity burden, including parents, siblings and extended family members, showed the strongest associations with obesity, highlighting the need for early identification of high-risk children. The implementation of family-centered and family-encompassing preventive strategies targeting physical activity, diet, and daily routines should be considered in these high-risk children.