Prenatal Measures to Prevent Childhood Obesity

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In advanced cases of overweight, up to and including morbid obesity, in teenagers and adults, the answer becomes clear. Many, many people are addicted to food in the same way an alcoholic or cocaine addict is hooked. They can only help themselves through interventions that adhere closely to the classical 12-step program, especially effective in a residential setting.

But that’s treatment. On the prevention end, the childhood obesity epidemic is a tangled ball of twine, with many frayed ends sticking out. Everyone is asking, “What actually works, to inoculate our children against this plague, to protect them from the dismal prospect of lifelong illness connected with obesity?” It often seems as if we will never know which bits of string to grab, so the puzzle can be unraveled. Following the leads suggested by current research could have a positive impact on the future.

So onward, to the expectant mothers. Remember when we used to believe that a baby in the womb was as impermeable as a walnut in its shell? Hardly. Next thing we knew, there were fetal alcohol syndrome babies and crack babies, and now we have this:

The study of 300 children has shown for the first time that what a woman eats and drinks during her pregnancy can alter her child’s DNA… It revealed that change in DNA — called epigenetic change — could result in a child storing more fat, increasing the risk of obesity, diabetes or heart disease as an adult.

New Zealand Herald reporter Vaimoana Tapaleao is talking about discoveries made by Sir Peter Gluckman, who teaches at the Liggins Institute in Auckland. The professor always suspected that maternal nutrition influences a child’s degree of risk for obesity and other undesirable health conditions. He characterizes this as a major breakthrough, the most important result of his investigations ever, and the vindication of 15 years’ work. Of course, every study of this kind requires a team, and this one included personnel from both New Zealand and Singapore, under the auspices of the University of Southhampton.

It was apparent that 25% of the subjects “showed signs of a change in their DNA make-up caused by their mother’s diet during pregnancy.” It became obvious that there is some essential element needed in a mother’s diet, especially during the first trimester. Unfortunately, a lot more work remains to be done before the answer becomes clear.

Some things are known. Neither the mother’s nor the baby’s weight makes a difference, as far as the child’s risk of later obesity. A skinny mom could have a slender baby, but if she didn’t eat enough carbohydrates while the baby was developing, the result could very well be an obese teenager. But low carbohydrate intake alone is not the whole story. Gluckman calls it a key factor but not the only factor, and is anxious to continue his research. A writer for ThirdAge, known as “ninasen,” adds some details:

The study used tissue from umbilical cords to measure the rate of epigenetic change in a child. Epigenetic change occurs when non-genetic factors cause DNA changes. Researchers saw that changes in a mothers diet can cause the epigenetic rate to fluctuate and may prompt the fetus to develop a metabolism that carries more fat.

Any time you see a headline that begins, “Pregnant Women Given Drugs…” there is an instinctive fight-or-flight reaction. Medicating the gravid has frequently led to unintended consequences, to say the least. Writer Amelia Thomson-DeVeaux brought that awareness to her coverage of this chapter on childhood obesity:

A new study is being conducted in Britain, where obese pregnant women at the Liverpool Women’s Hospital will be given a drug to reduce the food supply to their unborn babies. It will not help the women themselves lose weight, but researchers hypothesize that the drug may prevent the birth of oversized babies, reducing, among other effects, the need for cesarean sections.

The drug is called Metformin, and it is already used to reduce blood sugar levels in pregnant women who suffer from diabetes. Now, it will be used to not only in an attempt to produce smaller, more easily deliverable babies, but to prevent preeclampsia, a serious complication that affects many overweight pregnant women. Defenders of the medication say that a woman can’t be expected to suddenly change the habits of a lifetime, eating a better diet and getting more exercise just because she became pregnant. So a pill is necessary to get the job done.

As a representative of the other side, the journalist quotes Alison Wetton (who happens to run a weight loss corporation) in favor of healthy weight loss achieved through nutrition and exercise:

This would be far preferable to popping a pill that may help pregnancy outcomes. It is unlikely to break the cycle of an unhealthy lifestyle leading to overweight children and the continuing rise of obesity and diabetes in the general population.

The article attracted a large number of comments, almost universally against the idea of prescribing this drug to pregnant women. It is obviously a hot-button topic, and really, just on general principle, let’s hope there is a better way.

Your responses and feedback are welcome!

Source: “Mum’s diet key to baby health,” New Zealand Herald, 04/09/11
Source: “Obesity in Children Linked to Pregnant Moms Diet,” ThirdAge, 04/13/11
Source: “Pregnant Women Given Drugs To Prevent Childhood Obesity,”, 05/14/11
Image by viralbus (Thomas Widmann), used under its Creative Commons license.

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OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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