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Could your earliest moments of life - from your mother's prenatal care to the way you were delivered - make you fat?
Those in-utero experiences may matter, according to new research from the University of Utah and Utah State University that explores the fetal origins of adolescent obesity.
The research found a teen is more likely to be overweight, for example, if his or her mother smoked during pregnancy or gave birth via a cesarean section. But the prenatal factor that appears to have the biggest impact on adolescent weight is a mother's pre-pregnancy weight.
A child born to a woman who is overweight or obese is almost two to four times more likely to be overweight as a teen as a child born to a woman with normal weight.
Researcher Rebecca Utz, assistant U. sociology professor, can't say whether the mother's weight plays such a large role because of nature or nurture. Is the mother passing on poor genes? Poor diet and exercise habits?
Or, "is there something about the actual gestation. . . . Is she teaching her child in utero different types of metabolic processes? We cannot really determine that," Utz said.
Ditto for the other risk factors. Regardless, she hopes her study will spur health officials to emphasize to women the importance of prenatal care and maintaining a healthy weight before they get pregnant.
"I don't think there's much counseling about trying to get a woman healthier, more fit, perhaps leaner, before she ever tries to conceive," Utz said.
In a novel approach, Utz and her partners analyzed the birth certificates and subsequent driver's licenses of 200,000 Utahns born between 1983 and 1990. They calculated the teens' body mass index using their self-reported weight and height and then drew connections between their BMI and their birth environment.
In the future she will use public records to analyze those same 200,000 teens' family, neighborhood and school settings. The children are anonymous, but researchers can get information about their neighborhood's demographics and their schools' nutrition and P.E. policies, for example.
"Should we be focusing more on prenatal environments [or] creating different school environments?" Utz wonders. "What is going to be the sort of best salve for the wound for talking about this obesity epidemic in America?"
Analyzing the fetal origins of health isn't new, but connecting the womb environment to childhood obesity is relatively unusual.
"Utz's study does provide the first data I've seen, especially Utah-specific data, that makes that correlation," said Lois Bloebaum, manager of the Utah Department of Health's Reproductive Health Program.
The next hurdle is ensuring women are healthy before and during pregnancy. Some road blocks are starting to fall, according to Bloebaum.
For example, while Medicaid covers seven hours of nutritional counseling for some low-income pregnant women, the state's reimbursement rate to dieticians was so low few provided the services. The state recently increased reimbursement from $21.50 an hour to $51.74.
Federal guidelines that encourage obese women to gain at least 15 pounds during pregnancy are being reviewed, Bloebaum said.
"During pregnancy we don't talk about any weight loss," said Jennifer Avalos, a registered dietician for a Salt Lake City Women, Infants and Children office, a federal program that provides food and education to low-income families. But "they really can have a healthy pregnancy and lose weight if the reason they lose weight is because they're adopting healthy practices."
Doctors might discuss the risks of weight gain on the mother's health, but they rarely link it to their children's. That needs to happen, said Michael Varner, a Salt Lake City ob-gyn.
"What mother eats, what sort of environmental exposures she encounters, her own metabolic milieu if she's diabetic or has hypertension or things like that all have very substantial impacts on how that baby is going to do down the line," he said.
Nicole Mihalopoulous, a doctor at the U.'s Adolescent Medicine Clinic, hopes the message gets through. Most of her teen patients come to her with weight problems. Just like the problem starts with the family, so does the solution, she said.
"The entire family has to make changes."
What predicts teen obesity?
New Utah research shows a teen is more likely to be overweight if his or her mother:
-- smoked
-- didn't get a high school diploma
-- gained too much weight during the pregnancy
-- was single at the time of the birth
-- started prenatal care in the second trimester or didn't seek care at all
A teen also is more likely to be overweight if he or she:
-- weighed more than 7 pounds 7 ounces at birth
-- was delivered through a cesarean section
-- at one minute after birth had a low APGAR score, which measures a newborn's physical condition
Women's health fair
The University of Utah is holding a free Women's Health Fair Thursday from 5:30 p.m. to 8 p.m. It will take place at the Madsen Health Center, 555 S. Foothill Blvd. The fair - staffed by doctors, nutritionists and nurses - will cover bone, heart, mental and reproductive health, along with headaches, physical activity, nutrition and contraception. There will also be health screenings.
For more information, call 585-9971.