Adriëtte Oostvogels

8 Chapter 1 Over the past decades there has been a worldwide increase in the prevalence of overweight and obesity in children. 1 In the Netherlands, nearly one fifth of children is overweight or obese. 2 Overweight children have a more adverse cardiometabolic profile compared to normal weight children and are at increased risk of adult overweight, diabetes, and cardiovascular disease. 3-7 An important predictor of childhood overweight and cardiometabolic profile is maternal (prepregnancy) body mass index (BMI). 8-13 Children of mothers with overweight or obesity have a higher birth weight, are at increased risk of childhood overweight, and a more adverse cardiometabolic profile in childhood. 8-13 Also in adulthood, offspring of mothers with overweight or obesity are more often overweight, have a more adverse cardiometabolic profile, and an increased risk for cardiometabolic diseases, cardiovascular events and all-cause mortality. 12-15 Understanding the mechanisms underlying the association between maternal overweight and offspring’s cardiometabolic profile will provide clues for developing interventions and public health strategies to prevent overweight and the associated risks of cardiometabolic diseases throughout the life course and in future generations. Therefore, this thesis will study the association between maternal prepregnancy BMI (pBMI) and offspring’s cardiometabolic profile and its possible underlying mechanisms in pre- and postnatal life, as described in Figure 1. More specifically, the influence of maternal early pregnancy lipid profile on maternal blood pressure and offspring’s cardiometabolic profile in childhood will be studied, as well as the influence of maternal and paternal family history of diabetes on body composition and the metabolic profile in childhood. Subsequently, the influence of maternal pBMI on offspring’s postnatal growth and of early postnatal growth on offspring’s cardiometabolic profile in childhood will be investigated. Furthermore, ethnic and socioeconomic inequalities in growth to overweight in childhood will be examined. Additionally, possible differences in these associations between boys and girls will be studied in this thesis. This chapter will give a literature overview on these subjects, identify the knowledge gaps in the literature, and postulate the hypothesis and outline of this thesis.