January 31, 2014
News Review From Harvard Medical School -- Chubby 5-Year-Olds Risk Early Obesity
In a new study, about half of the children who were obese by age 14 were already overweight in kindergarten. The risk of teen obesity for those overweight 5-year-olds was about 4 times as high as for children of normal weight. The study included more than 7,700 children in kindergarten from across the United States. Their average age was about 5½ when the study began. Researchers measured the children's weight and height 7 times between kindergarten and eighth grade (about age 14). When the study began, 12.4% were obese. Another 14.9% were overweight. Those figures rose to 20.8% obese and 17% overweight in eighth grade. About 5.4% of children became overweight during kindergarten and 1.7% each year from fifth through eighth grades. Researchers suggested that children who were at highest risk tended to become overweight and then obese early. The New England Journal of Medicine published the study. HealthDay News wrote about it January 29.
By Claire McCarthy, M.D.
Harvard Medical School
What Is the Doctor's Reaction?
If you want to prevent childhood obesity, you need to start early.
That's the message of a study just published in the New England Journal of Medicine. Researchers from Emory University in Atlanta looked at data from the Early Childhood Longitudinal Study. The 7,738 children were in kindergarten during 1998-1999. The group was chosen to represent a cross-section of U.S. children in that grade. Researchers studied them from kindergarten through eighth grade. During that period, they were weighed and measured 7 times.
The biggest and likely most important finding of the study: Children who were overweight in kindergarten were 4 times as likely to become obese. Among all the children who became obese between kindergarten and eighth grade, half were overweight in kindergarten. Three-quarters had a BMI (body mass index) greater than 70% of 5-year-olds.
Here are some other interesting findings of the study:
- Hispanic and black children were more likely to be obese than white children.
- The biggest increase in obesity rate was between first and third grades, when it jumped from 13% to 18%.
- The children from the wealthiest families were least likely to become obese.
- The children whose families were in the second-lowest income group were the most likely to become obese.
- Being large at birth (more than 4 kilograms grams, or 8 pounds, 13 ounces) increased the risk of becoming obese.
I've said this before in many other news reviews: Baby fat is bad. Having a little extra weight as an infant or young child may have been a good thing 100 years ago, when infant mortality was high. But for developed nations like the United States, it really isn't necessary now.
Being a little bit chubby as a baby or young child wasn't even such a big deal 50 or 20 years ago, when we had healthier diets and were far more active. But these days, with fast food, Super Size portions and hours of screen time daily, it's a big problem. Baby fat turns into preschooler fat, which turns into school-age and teenage fat. And then it turns into adult fat, with all the health consequences adult fat brings.
What Changes Can I Make Now?
Families can do a lot to help their children stay at a healthy weight early in childhood. Here are a few ideas:
- If you are pregnant, be careful not to gain too much weight. Pregnant women who gain a lot of weight are more likely to have big babies -- and obese children. Talk with your doctor about how much weight you should gain at each stage of pregnancy.
- Breastfeed. It can help babies stay at a healthy weight, and can help prevent obesity in childhood and later in life.
- Don't overfeed babies. When babies are fussy, it doesn't always mean that they are hungry. Talk to your doctor about how to figure out what different cries mean -- and how best to feed your baby.
- Be thoughtful about how you introduce solids. Babies shouldn't start solids before 4 months. Waiting until closer to 6 months may be a better idea. And when you do start, consider "baby-led weaning." This means that instead of spoon-feeding cereals and purees, families wait until babies can pick up foods (ones they can't choke on, of course!) and put them in their mouths.
- When kids are older, serve meals "family-style" and let children serve themselves. When they do, they are less likely to overeat -- and more likely to try new foods.
- Don't give your children juice, or any sweetened beverages. They don't need them, and sweetened beverages increase the risk of obesity.
- Shut off the TV (and limit other screen time). Having more screen time increases the risk of obesity, too.
- Serve fruits and vegetables at every meal.
- Check out www.choosemyplate.gov for information on healthy eating -- and lots of great recipes.
- Make exercise part of daily life starting at an early age. Do it as a family -- it's good for everyone.
What Can I Expect Looking to the Future?
If we don't make changes, what we can expect in the future is more obese children and obese adults. And we can expect more of the medical, emotional and financial consequences obesity brings.
This study gives us a very clear direction and directive: Start early. Let's pay attention, and take action.