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HAMILTON, CANADA – Researchers at McMaster University have pinpointed six crucial, modifiable factors during a child’s first three years that significantly influence the trajectory of obesity, particularly among South Asian children. The findings, published on April 10, 2025, in JAMA Network Open, offer valuable guidance for parents, healthcare professionals, and policymakers aiming to combat childhood obesity within this specific population.
South Asian children are known to be at a higher risk for developing increased levels of abdominal fat and subsequent cardiometabolic issues, including a greater predisposition to diabetes, often despite having a lower overall birth weight. This phenomenon is sometimes referred to as the ‘thin-fat’ phenotype.
“We know that current measures of childhood obesity such as the body mass index (BMI) don’t work well for South Asians because of the so-called ‘thin-fat’ phenotype,” explained Sandi Azab, the study’s first author and an assistant professor in McMaster’s Department of Medicine. She noted that South Asian newborns often have lower birth weight but proportionally higher body fat compared to White Europeans, a pattern that persists even in later generations after migration. Azab highlighted the need for research focusing on diverse ethnic groups and tracking obesity development over time, rather than relying on single-point measurements often based on White European families.
The comprehensive study analyzed data from over 900 children initially, identifying six key modifiable factors linked to adiposity (excess body fat). These include three maternal factors:
- Maternal obesity before pregnancy
- Weight gain levels during pregnancy
- A health-conscious maternal diet during and around pregnancy (including poultry, eggs, fruits, vegetables, seafood, and certain refined grains like puri, idli, and dosa)
Additionally, three factors related directly to the infant or child’s early life were associated with a lower trajectory of adiposity:
- Breastfeeding for 12 months or longer
- Increased daily physical activity
- Reduced screen time
The researchers found a direct correlation between the number of these risk and protective factors a child is exposed to and their level of childhood adiposity. This relationship was confirmed across three cohorts totalling 3,171 children in Canada and the United Kingdom, encompassing both South Asian and White European children.
Based on these findings, the study proposes developing a combined score based on these factors for use in clinical and public health settings. This score could help identify children at higher risk early on and allow for targeted interventions.
“The protective factors identified in our research are modifiable,” stated Dr. Sonia Anand, the study’s corresponding author and a professor in McMaster’s Department of Medicine. She emphasized factors like reduced screen time, increased physical activity in the first three years, and breastfeeding for at least the first year as achievable goals.
Dr. Anand, who also serves as McMaster’s Associate Vice-President, Global Health, stressed the importance of translating this research into action. “We need to disseminate the knowledge generated… to parents, and to shift our efforts towards developing and testing interventions… and towards shaping actionable recommendations and policies to support healthy life trajectories,” she urged, suggesting potential interventions like subsidized maternal nutrition programs and improved access to breast pumping equipment.
The research received support from numerous organizations, including the Canadian Institutes of Health Research, the Heart and Stroke Foundation, and the Wellcome Trust, among others.
Disclaimer: This news article is based on information provided regarding a study published in JAMA Network Open. It is intended for informational purposes only and does not constitute medical advice. Consult with healthcare professionals for any health concerns or before making any decisions related to health or treatment.
