ACHIEVE AND MAINTAIN A HEAlTHY WEIGHT
21Guideline 1
• Childhood weight gain: There is convincing evidence that excess weight gain relative to height during
childhood is associated with increased risk of being overweight later in life (Grade A; Evidence Report,
Section 17.4).58,241,242
• Parental weight: There is convincing evidence that parental overweight or obesity is associated with
increased risk of child overweight or obesity. The risk is greater when both parents (rather than one) are
overweight or obese (Grade A; Evidence Report, Section 17.7).49-62
• Maternal smoking: There is evidence that babies born to mothers who smoke during pregnancy, as an
independent risk factor, probably have a higher risk of becoming overweight or obese in adolescence and
adulthood (Grade B; Evidence Report, Section 17.5).52,54,59-61,243
• Television: Recent evidence suggests that hours spent watching television by children is associated with
increased risk of overweight or obesity (Grade C; Evidence Report, Section 17.3).49,60,64-71,244-246 Media use,
including television viewing, may displace time children spend in physical activities246,247 and eating meals
and snacks in front of the television may also be associated with increased energy intake.^248
• Socioeconomic status: There is evidence from developed countries to suggest that a low family income
or socioeconomic status is associated with increased risk of overweight or obesity during childhood,
adolescence and young adulthood (Grade C; Evidence Report, Section 17.9).49,52,55,64,65,68,72-74 Similarly, the
evidence suggests that low socioeconomic status is associated with an increased risk of overweight or
obesity (Grade C; Evidence Report, Section 17.10).59,62,239,249-252
• Other factors: Although there were insufficient studies to make an evidence statement, other factors
associated with increased risk of overweight and obesity throughout life included:
- being overweight in adolescence^78
- consuming takeaway food and low quality snacks75-77
- childhood smoking78,83
- increased price of fruit and vegetables68,79
- low self-esteem and/or depression80-82
- low locus of control score84,85
- stressful family life86,87
- food insecurity65,81,253
- self-reported dieting,76,82,254 particularly in girls^255
- inadequate sleep60,244,256,257
- low rates of breakfast consumption.^258
The literature review to inform the revision of the uS dietary guidelines found strong and consistent evidence
that children and adults who eat fast food, particularly those eating at least one fast food meal per week, are at
increased risk of weight gain, overweight and obesity. There was not enough evidence to evaluate any association
between eating at other types of restaurants and risk of weight gain, overweight and obesity.^198 The uS review
also found moderate evidence suggesting that children who do not eat breakfast are at increased risk of
overweight and obesity, with the evidence being stronger for adolescents.^198
The uS review also found a limited body of evidence showing conflicting results about whether liquid and solid
foods differ in their effects on energy intake and body weight, except that soup at a meal may lead to decreased
energy intake and body weight.^198
Finally, an emerging body of evidence documents the impact of the obesogenic food environment on body weight
in children and adults. Current evidence indicates that the food environment is associated with dietary intake,
especially lower consumption of vegetables and fruits, and resulting in higher body weight.^198 This is discussed
further in Appendix A.