Health TSU — 23 June 2013
TSU Study Shows Obesity Can be Predicted in Infants as Young as Two Months

NASHVILLE (TSU News Service) – According to the Centers for Disease Control and Prevention, childhood obesity has more than doubled in children and tripled in adolescents in the past 30 years. It is an alarming trend that is raising serious concerns about obese children and their ability to live through childhood without a myriad of mental and physical illness.

Now a recent study concludes that a child’s risk of obesity can be predicted as early as two months into infancy by looking at growth patterns, which are helpful in predicting a child’s weight by age five.

By analyzing well-child records, researchers at Tennessee State University and Case Western Reserve University, found that normal-weight babies with a body-mass index (BMI) in the 17 percentile were found to have plateaued at about two months and rarely deviated over the next five years, while overweight or obese babies crossed the 17 percentile many months later (about age 14 months) and continued an upward climb when BMI growth patterns were monitored.

Dr. Lisaann Gittner, assistant professor of Public Service at TSU and coauthor of the study, said the results shows that obesity rates grow differently in early life, and the findings could potentially change the age at which obesity is typically diagnosed, which is now at or after age two.

“We found that, by age five, normal-weight children developed differently from birth than those considered overweight, obese or severely obese,” said Gittner, who has been studying childhood obesity since 2006. “The trajectories show that with a 75-85 percent confidence rate what a child will weigh by the time they are school age and whether that will be normal or obese.”

For this study, 221 children were selected from 40,000 records of healthy children under the care of a health maintenance organization. Each had weight, height and medical records from eight to 12 well check-ups over the first five years of their lives. None had a hospital or emergency room visit, medical procedure or other special medical condition, not classified as underweight or on medications that might skew results.

According to Gittner, they wanted to be sure to use only healthy children with normal growth for the study.

“No other study of early weight changes has used this type of sample of only healthy infants and children, which was a significant part of the research,” said Gittner. “This was different because everyone else had used children who could have been injured or ill, while we only looked at children who were healthy to determine what various growth trajectories looked like in healthy children.”

Along with the child’s health, researchers also looked at the health of the mother, excluding those with pre-pregnancy or gestational diabetes. They also looked at the mothers’ pre-pregnancy weights and whether they smoked—a factor that could influence the baby’s weight.

The researchers suspect, based on prior research findings by others, how a mother ate during pregnancy might have contributed to a baby’s hormones and the ability to satisfy a baby’s hunger.

According to Gittner, researchers plotted on a graph a baby’s weight divided by height instead of using standard BMI scores as a guideline. By graphing, a pattern emerged that found both girls and boys known to be obese at age five begin to show significantly higher weight over height than normal weight babies as early as two to four months of age.

Because such patterns emerge before children generally start eating solid food, early life growth patterns may provide important information about a person’s future health issues.

The researchers also questioned using the BMI index as a guide to growth, which is based on European babies primarily breast-fed in the first year. In the United States, many babies have only formula feedings.

These findings could potentially change the age at which obesity is typically diagnosed, which is now at or after age two.

“This is a significant finding because now we can monitor growth patterns in the first year of life and predict a pattern that may indicate early development of obesity,” said Gittner. “Two months might be the time to start counseling to minimize future risk of or continuing obesity. With early recognition, we can help with intervention programs that will help curb obesity rates.”

The findings were reported in Clinical Pediatrics. Gittner collaborated with Dr. Susan Ludington, the study’s lead investigator and the Carl W. and Margaret David Walter Professor of Pediatric Nursing at Case Western Reserve, and Dr. Harold Haller, director of Case Western Reserve’s Center for Statistical Consulting.

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