Objectives. To systematically review the evidence from prospective and retrospective cohort studies on the association between gestational weight gain (GWG) and offspring’s body weight.Methods. Electronic databases PubMed, Web of Science, CINAHL, and Academic Search Premiere were searched from inception through March 18, 2013. Included studies (n=23) were English articles that examined the independent associations of GWG with body mass index (BMI) and/or overweight status in the offspring aged 2 to 18.9 years. Two authors independently extracted the data and assessed methodological quality of the included studies.Results. Evidence from cohort studies supports that total GWG and exceeding the Institute of Medicine maternal weight gain recommendation were associated with higher BMIz-score and elevated risk of overweight or obesity in offspring. The evidence of high rate of GWG during early- and mid-pregnancy is suggestive. Additionally, the evidence on inadequate GWG and net GWG in relation to body weight outcomes in offspring is insufficient to draw conclusions.Conclusions. These findings suggest that GWG is a potential risk factor for childhood obesity. However, findings should be interpreted with caution due to measurement issues of GWG and potential confounding effects of shared familial characteristics (i.e., genetics and maternal and child’s lifestyle factors).

Background: The aim of this study was to examine the differences in diet, physical activity, and weight status among children living in rural and urban America and to study the roles of obesity-related behaviors in residence-based differences in childhood obesity. Methods: We performed cross-sectional analysis of the 1999–2006 National Health and Nutrition Examination Survey data, restricted to 14,332 children aged 2–19 years old (2771 rural, 13,766 urban). Residence was measured at the census tract level using Rural-Urban Commuting Areas. Age-specific questions were used to assess physical activity, and the 24-hour diet recall was used to measure dietary intake. Results: Among 2- to 11-year-olds, rural children consumed 90 more kcal/day on average than urban children ( p < 0.05) and were more likely to consume the recommended two to three cups of dairy per day ( p < 0.05). More 2- to 11-year-old rural children also reported participating in exercise five or more times per week than urban children of the same age (79.7% vs. 73.8%). Among 12- to 19-year-olds, rural children were less likely to consume any fruit or meet the recommendation of two cups of fruit. Using measured height and weight data, proportionately more rural than urban children were overweight/obese (35.4% v. 29.3%) and obese (18.6% v. 15.1%). Rural children had 30% higher odds of being overweight and/or obese even after adjustment for sociodemographics, health, diet, and exercise behaviors. Conclusions: The persistently higher odds of overweight and obesity among rural children even after adjustment suggest that rural environments may be “obesogenic” in ways that a person-level analysis cannot discern. Future research should examine disparities in the accessibility and affordability of healthy food and beverage choices and safe physical activity locales in rural areas.

Objective. Little is known about how acculturation may influence participation in leisure-time physical activity and obesity among adolescents. The objective of this study was to examine these associations among Hispanic adolescents. Design. Data were drawn from the 2003 National Survey of Children's Health, restricted to Hispanic adolescents aged 10–17 (n=4704). Acculturation was assessed by proxy measures (generation status and language spoken at home). Adolescents who were not reported to engage in physical activity lasting at least 20 minutes, that was vigorous enough to cause sweating and hard breathing, for at least three days per week were defined as failing to meet physical activity requirements. Obesity was defined as gender and age-specific body mass index values at or above the 95th percentile of the reference population. Multiple logistic regressions were performed to adjust for confounders. Results. Of the Hispanic adolescents studied, 25.2%, 43.8%, and 31.1% were first, second, and third generation or more, respectively. English was the primary language in the home for 42.8% of these adolescents. Compared with adolescents in the third generation, adolescents from immigrant families had higher odds for not obtaining recommended physical activity (first generation: adjusted odds ratio [AOR] = 1.50, 95% conference intervals [CI]: 1.09, 2.05; second generation: AOR = 1.29, 95% CI: 0.99, 1.69). Living in homes where English was not the primary language, vs. English-speaking homes, was also associated with not obtaining recommended physical activity (AOR = 1.36, 95% CI: 1.06, 1.75). The unadjusted prevalence of obesity was higher in homes where English was not the primary language (22.5% vs. 16.1%; p<0.01), but this difference disappeared after adjusting for family socioeconomic status. Generational status was not a significant correlate of obesity. Conclusions. Findings suggest that future public health interventions that aim to increasing physical activity among Hispanic adolescents should be tailored based on generational status and English-language use.

Mexican American children are disproportionately affected by obesity. Data on how the acculturation process influences diet and body weight among ado