Double chins, dimply thighs, and pudgy tummies are signs of a happy, healthy baby, right? Wrong!
That chubby cherub may be cute, but the reality is that such a baby may be headed for a lifetime of obesity and the health problems connected to being overweight, especially if those excess folds of fat stick around until the age of 5. A new study published in the New England Journal of Medicine raises some interesting questions about what happens in a child's early years -- perhaps even before birth -- that sets the stage for obesity. The study also found childhood obesity is largely established by the time a child enters kindergarten.
The researchers, from Emory University's Rollins School of Public Health in Atlanta, looked at data for about 8,000 kindergarteners, following them through the eighth grade. Kindergarteners who were overweight were almost three times as likely as children of normal weight to become obese by the time they reached the eighth grade. Only 8 percent of normal-weight kindergarteners were obese in the eighth grade.
Children were weighed seven times over the course of the study and classified as overweight or obese based on the Centers for Disease Control and Prevention Growth Charts and their body mass index. Children were considered overweight when their weight put them in the 85th percentile for their age and height (only 15 percent of kids their age and size weigh more); those in the 95th percentile or above were considered obese.
Most of the kids who were overweight or obese in kindergarten were obese when seen again as fifth graders and eighth graders. The largest increase in the prevalence of obesity was seen between first and third grade. Obesity during adolescence usually continues into adulthood.
Socioeconomic factors like family income, race, and ethnicity impact the rate of obesity in preschoolers, but by the time they reached kindergarten they no longer made a difference. If a child was already overweight or obese, those extra pounds were the major factor determining a child's weight going forward.
The risk of obesity appears to begin at birth for some children. Previous studies have identified a relationship between excessive weight gain in the first six months of life and a higher risk of obesity. While these researchers had no records of the children's weight prior to kindergarten, they did have their recorded birth weight, and they found that 23 percent of babies who weighed more than 8.8 pounds at birth were obese by kindergarten.
Infants who weighed 8.8 pounds or more at birth and were overweight by kindergarten had the highest risk (31 percent) of becoming obese before they reached the age of 14.
Solveig A. Cunningham, Ph.D., the lead researcher, said, "Our findings uncovered several important points by examining incidence of obesity over time. We have evidence that certain factors established before birth and during the first five years are important. Obesity-prevention efforts focused on children who are overweight by 5 years old may be a way to target children susceptible to becoming obese later in life."
In an editorial accompanying the study, researchers at the Harvard School of Public Health and Massachusetts General Hospital stressed the importance of risk reduction strategies aimed at improving nutrition and physical activity. They believe these are key to reducing early childhood weight gain and the subsequent risk of childhood obesity.
When does the pathway to obesity begin, and what causes the pendulum to swing one way or another? Family lifestyle, diet, and levels of physical activity are established influences, but so may be a mother's weight and eating habits during pregnancy. When mothers are obese, they are more likely to have children who are overweight and likelier to die early. Fathers' diets and eating habits may make also a difference.
This study shows just how long-term an effect allowing a young child to become overweight can often have. There may be unknown factors in the early home and preschool environments that lead to early weight gain and obesity, and further research will hopefully provide an even clearer picture.
This article originally appeared on The Doctor Will See You Now
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