First 1,000 days are crucial in preventing childhood obesity, major European review finds

Efforts to prevent childhood obesity must begin even before conception, according to a major European review which found that both parents’ health and the social systems shaping family behaviours play a vital role in determining a child’s risk.

The report, published in Pediatric Obesity by researchers from the European EndObesity Consortium, brings together extensive evidence on the so-called “first 1,000 days” ,from preconception to two years of age and highlights how early-life interventions can influence long-term health outcomes.

The authors warn that many obesity prevention strategies start too late, focus narrowly on mothers, and fail to address wider social inequalities. They call for a coordinated approach that includes both parents before conception and is supported by systemic policy change.

Childhood obesity remains a global public health concern, driven by an imbalance between calorie intake and energy expenditure. It has been linked to a higher risk of adult obesity, cardiovascular disease and premature death. The World Obesity Atlas 2024 predicts that more than 750 million children aged between five and nineteen will be living with overweight or obesity by 2035, while over sixty per cent of affected children continue to live with obesity into adulthood.

The EndObesity review analysed data from twelve European studies and found that paternal factors such as diet and body mass index independently influence a child’s obesity risk. Yet only between 1.9 and 3.7 per cent of families met the criteria for an optimal “parental healthy lifestyle” during pregnancy, with healthier habits more common among those with higher socioeconomic status.

Most interventions, the report found, begin too late to be effective. A review of prenatal lifestyle trials involving over 11,000 women showed no significant impact on children’s weight or growth. By contrast, strategies focused on infant feeding, such as reducing early protein intake and limiting unmodified cow’s milk, produced the most consistent improvements in child weight outcomes.

The consortium concludes that tackling childhood obesity demands early, family-centred action and policy reforms that make healthy choices accessible for all. Without such systemic change, the intergenerational cycle of obesity is likely to persist.