Franks et al. highlight the importance of childhood obesity in premature death in adulthood, and their findings provide support for the need for primary prevention of obesity as early as possible. Numerous studies have shown that childhood obesity is often preceded by a high birth weight. Maternal hyperglycemia during pregnancy is probably the most important cause of macrosomia and excess body fat at birth. Remarkably, a study involving the same population as that studied by Franks et al. showed that exposure to maternal diabetes in utero increased the risk of childhood obesity.
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