Request for Information (RFI) on Improved Understanding of Risk and Mechanisms for Developing Obesity in Infants and Young Children

Notice Number: NOT-DK-20-004

Key Dates
Release Date: January 16, 2020
Response Date: February 28, 2020

Related Announcements

Issued by
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
National Heart, Lung, and Blood Institute (NHLBI)
Office of Behavioral and Social Sciences Research (OBSSR)
Office of Disease Prevention (ODP)


The purpose of this Request for Information (RFI) is to solicit innovative ideas to better characterize risk factors and understand the underlying mechanisms through which these factors contribute to the development of obesity during early childhood. The goal is to develop innovative, targeted and more effective strategies for childhood obesity prevention.


Obesity in children and adolescents has increased dramatically over the past three decades and continues to be a major public health problem (1). Obesity prevention and treatment approaches for children are limited and most behavioral interventions show, on average, only modestly favorable changes in Body Mass Index (BMI) which are not sustained (2,3). Substantial inter-individual differences also exist in response to interventions, and we cannot predict consistently who will or will not respond to a given intervention strategy.

The trajectory of BMI during childhood is predictive of obesity in later years. A meta-analysis of 15 prospective cohort studies found that about 55% of children with obesity continue to have obesity during adolescence and 80% of adolescents with obesity continue to have obesity in young adulthood (4). For children and adolescents with obesity, compared to those of normal weight, there is a 5 times greater risk of having obesity in young adulthood.

Studies also have shown that accelerated growth patterns during infancy and childhood are associated with a higher risk of overweight or obesity in adolescence and/or adulthood. A meta-analysis of 14 cohort studies found that rapid weight gain during the first 2 years of life was associated with approximately a 4-fold greater risk for developing overweight or obesity from childhood to adulthood (5). Research also suggests that high-risk growth trajectories or patterns emerge during infancy and early childhood, and tend to persist, suggesting critical periods in the development of overweight and obesity (5,6,7).

Significant progress has been made in identifying behavioral, biological, psychosocial, and environmental factors that place children at a higher or lower risk of developing obesity. Yet, the complex mechanisms that underlie how these factors contribute to excess weight gain or adiposity are not well understood. Characterizing highly predictive metabolic and biobehavioral phenotypes that emerge during infancy and early childhood and uncovering mechanisms that underlieindividual susceptibility to developing childhood obesity will help to develop more targeted and effective prevention strategies beginning at an early age.

Information Requested

This RFI seeks input from stakeholders throughout the scientific research community and the public regarding any of the following topics, as well as any additional ideas not included below:

  • Research to better characterize molecular profiles (including the genome, epigenome, transcriptome, proteome, metabolome, lipodome, and microbiome) and metabolic and biobehavioral phenotypes that predict or determine the development of obesity during early childhood.
  • Use of a systems biology approach (including the study and integration of the genome, epigenome, transcriptome, proteome, metabolome, lipodome, and microbiome) to determine underlying biological and behavioral mechanisms for the development of obesity during early childhood and their interactions.
  • Use of technological advances to characterize individual variability in neurocognitive function/traits, sleep, activity/exercise, ingestive behaviors, and nutrition and the composition of diet (including composition of human milk, if applicable) and to better understand how they impact growth, body composition, and the development of obesity during early childhood.
  • Use of methods [including Global Positioning System (GPS) and others]to better understand how differences in social and environmental context may differentially influence phenotypic expression.
  • Research approaches that will improve understanding of the mechanisms by which children are at higher or lower risk for accelerated growth trajectories and the development of obesity in the early years, including types of study designs, study sample characteristics, and assessment methodologies.
  • Specific populations for whom research on risk and underlying mechanisms should be prioritized (and a rationale for the proposed priorities). This could include, but is not limited to, developmental stage (e.g., intrauterine environment, first 6 months of life, puberty, etc.); families with a strong family history of obesity or with siblings discordant for obesity;children with severe obesity;or at-risk populations, such as racial and ethnic minority populations or children/families of low socioeconomic status.
  • Characterization of particular challenges, acceptability, and feasibility of obtaining biospecimens/tissue samples, imaging, and other relevant metabolic, biobehavioral, and environmental measures in real-time and at sensitive time periods from mothers, infants, young children, and families as well as strategies to address/overcome them.
  • Resources (e.g., biorepositories, registries, and electronic health records) that could be leveraged or used to advance mechanistic studies in humans.

How to Submit a Response

All responses to this RFI must be submitted electronically to the following email at by 11:59 PM, EST, on February 28, 2020.

Responses to this RFI are voluntary. Do not include any proprietary, classified, confidential, or sensitive information in your response. The NIH will use the information submitted in response to this RFI at its discretion and will not provide comments to any respondent's submission. The collected information will be reviewed by federal staff, may appear in reports, and may be shared publicly on any federal website.

The Government reserves the right to use any non-proprietary technical information in summaries of the state of the science, and any resultant solicitation(s). The NIH may use the information gathered by this RFI to inform the development of future funding opportunity announcements.

This RFI is for information and planning purposes only and should not be construed as a solicitation or as an obligation on the part of the Federal Government, the National Institutes of Health (NIH), or individual NIH Institutes and Centers. No basis for claims against the U.S. Government shall arise as a result of a response to this request for information or from the Government’s use of such information.


  1. Hales CM, Fryar CD, Carroll MD, Freedman DS, Ogden CL. Trends in Obesity and Severe Obesity Prevalence in US Youth and Adults by Sex and Age, 2007-2008 to 2015-2016. JAMA. 2018 Apr 24;319(16):1723-1725.
  1. Brown T, Moore TH, Hooper L, Gao Y, Zayegh A, Ijaz S, Elwenspoek M, Foxen SC, Magee L, O'Malley C, Waters E, Summerbell CD. Interventions for preventing obesity in children. Cochrane Database Syst Rev. 2019 Jul 23;7:CD001871.
  1. Brown TJ, Mead E, Ells LJ. Behavior-Changing Interventions for Treating Overweight or Obesity in Children Aged 6 to 11 Years. JAMA Pediatr. 2019 Apr 1;173(4):385-386.
  1. Simmonds M, Llewellyn A, Owen CG, Woolacott N. Predicting adult obesity from childhood obesity: a systematic review and meta-analysis. Obes Rev. 2016 Feb;17(2):95-107.
  1. Zheng M, Lamb KE, Grimes C, Laws R, Bolton K, Ong KK, Campbell K. Rapid weight gain during infancy and subsequent adiposity: a systematic review and meta-analysis of evidence. Obes Rev. 2018 Mar;19(3):321-332.
  1. Stuart B, Panico L. Early-childhood BMI trajectories: evidence from a prospective, nationally representative British cohort study. Nutr Diabetes. 2016 Mar 7;6:e198.
  1. Geserick M, Vogel M, Gausche R, Lipek T, Spielau U, Keller E, Pfäffle R, Kiess W, Körner A. Acceleration of BMI in Early Childhood and Risk of Sustained Obesity. N Engl J Med. 2018 Oct 4;379(14):1303-1312.


Please direct all inquiries to:

Voula Osganian, MD, ScD, MPH
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Phone: (301) 827-6939