DR. BURKE, section editor for Journal Club, is chairman of the department of pediatrics at Saint Agnes Hospital, Baltimore. He is a contributing editor for <italic>Contemporary Pediatrics</italic>. He has nothing to disclose in regard to affiliations with
Maternal obesity surgery results in fewer obese offspring
Investigators compared the prevalence of obesity in two groups of children whose mothers had a history of obesity that resulted in malabsorptive surgery. Forty-five of the children in the study were born before their mothers had biliopancreatic bypass surgery, when mean maternal body mass index (BMI) was 48. The other 172 children were born after their mothers had malabsorptive surgery, when the mean maternal BMI was 31. Data for the study, which followed the offspring from the ages of 2 to 18 years, was collected from a tertiary referral center as well as maternal telephone interviews.
About 57% of children born to mothers after they had surgery were of normal weight, compared with 36% of children born to mothers before they had surgery. Similarly, birth after maternal surgery decreased the prevalence of obesity in the offspring by 52%, and severe obesity by 45.1%. In children from 6 to 18 years of age born after maternal surgery, the prevalence of overweight was at population levels (Kral JG et al: Pediatrics 2006;118:e1644).
So, obesity is not all in the genes. Among other factors, the intrauterine nutritional environment seems to have some role in determining which babies will end up overweight. We still have a lot to learn about the interactions between genetics and environment in development of obesity.