REVIEW article
Front. Nutr.
Sec. Nutrition and Metabolism
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1597746
This article is part of the Research TopicMaternal and Infant Nutrition: Impact on Breast Milk, Infant Gut Microbiota and Health DevelopmentView all 14 articles
Offspring's Exposome: a narrative review on the influence of early life factors on childhood obesity risk
Provisionally accepted
Beatrice Maccarini1
Federica Loperfido1,2*
Irene Bianco1Francesca Sottotetti1Dana El Masri1Chiara Ferrara1Federica Verme1Erika Cangelosi1
Niccolò Meriggi3
Carlotta De Filippo3
Hellas Cena1,4
Rachele De Giuseppe1- 1Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Lombardy, Italy
- 2University of Pavia, Pavia, Italy
- 3Institute of Agricultural Biology and Biotechnology (IBBA), National Research Council (CNR), 56124, Pisa, Italy
- 4Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, 27100, Pavia, Italy
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Childhood obesity has emerged as a global health challenge, with significant long-term health consequences, including an increased risk of non-communicable diseases. The "first 1000 days" of life is a critical window for shaping long-term health outcomes. This narrative review aims to explore the role of environmental exposures, categorized within the exposome framework, in developing childhood obesity. The exposome encompasses three domains: general external exposures (e.g., air pollution, urbanization), specific external exposures (e.g., nutrition, physical activity, socioeconomic status), and internal exposures (e.g., metabolic responses, oxidative stress). Evidence identifies risk factors such as maternal smoking during pregnancy, early-life exposure to endocrine-disrupting chemicals, and air pollution, which contribute to obesogenic processes. In contrast, protective factors include access to green and blue spaces, exclusive breastfeeding, adequate complementary feeding, regular physical activity, limited screen time, and sufficient sleep, which support healthy growth trajectories. Findings regarding socioeconomic status, PFAS exposure, and human breast milk macronutrients composition remain heterogeneous and context-dependent. The findings highlight the need to integrate public health strategies addressing modifiable environmental and lifestyle factors. Identifying a 'healthy exposome' that protects against obesity risk, can steer the development of personalized prevention strategies, ultimately reducing the burden of obesity and associated diseases.
Keywords: Childhood Obesity, infant nutrition, Exposome, Gut Microbiota, Maternal lifestyle, Human breast milk
Received: 31 Mar 2025; Accepted: 15 Sep 2025.
Copyright: © 2025 Maccarini, Loperfido, Bianco, Sottotetti, El Masri, Ferrara, Verme, Cangelosi, Meriggi, De Filippo, Cena and De Giuseppe. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Federica Loperfido, federica.loperfido@unipv.it
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