Obesity can be predicted from infancy, CWRU researchers find

photo of baby crawlingInfants as young as 2 months old already exhibit growth patterns that can predict the child’s weight by age five, according to researchers at Case Western Reserve University’s Frances Payne Bolton School of Nursing and Tennessee State University.

“Almost from birth, we quickly saw this growth pattern emerge in our curves and growth charts for weight over height,” said Susan Ludington, the study’s lead investigator and the Carl W. and Margaret David Walter Professor of Pediatric Nursing at Case Western Reserve.

Analyzing well-child records, normal weight babies with a body mass index (BMI) in the 17th percentile were found to have plateaued at about two months and rarely deviated over the next five years, she said. Overweight or obese babies crossed the 17th percentile many months later (about age 14 months) and continued an upward climb when BMI growth patterns were monitored.

Ludington collaborated with Lisaann Gittner, assistant professor of public service at Tennessee State University, and Harold Haller, director of Case Western Reserve’s Center for Statistical Consulting. Their findings were reported in Clinical Pediatrics.

The researchers found that, by age 5, normal weight children developed differently from birth than those considered overweight, obese or severely obese.

For this study, 221 children were selected from 4,000 records of healthy children under the care of a health maintenance organization. Each had weight, height and medical records from nine 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, or were on medications that might skew results. No other study of early weight changes has used a sample of only healthy infants and children.

“We didn’t want anything to interfere with regular eating,” Ludington said.

She said the study also differed from others because researchers had access to maternal health records, with information about 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.

Tracking obesity to the first months of life came after Haller took a new statistical approach to infant growth. He plotted on a graph a baby’s weight divided by height instead of using BMI scores as a guideline. By graphing, a pattern emerged that found both girls and boys known to be obese at age 5 begin to show significantly higher weight over height than normal weight babies as early as 2 to 4 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, Ludington said.

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 2.

Ludington said the next step is to find a good intervention that takes into consideration whether a baby is fed on demand or a schedule, the amount of milk a baby receives, whether the baby should have breast milk or formula, and sleep/awake activity patterns of each infant.

Because this study offers a good control group of healthy children, Ludington said, a broader study with thousands of children will determine if those growth patterns hold up for all children, as well as healthy ones.

2 Comments

  1. Elizabeth Pierce

    06/13/2013

    While all of this is all well and good, it bothers me that researchers seem to think that obesity is an all or nothing that occurs at birth. I am a prime example of how nothing is as it seems. I was born at just under 5 lbs. I was the smallest member of my class until puberty. At puberty, I gained to 135 lbs at 5′ tall. Over the years of junior high and high school, I lost to 128 lbs and grew another 5 inches. At no point in time during my childhood was I EVER obese. However, after getting pregnant at 19, I did start gaining and eventually ended up super-morbidly obese at 361 lbs. The trouble I ran into was that I was unable to get help with losing weight because I had no co-morbidities. My knees had to be completely destroyed and mobility almost non-existant before I was able to finally get help in the form of gastric sleeve surgery. Now, 145 lbs later, I feel better, but my knees are still destroyed and will eventually need to be replaced. We TALK about wanting to do something but the fact of the matter is that they only way to take care of obesity is to spend a whole lot of money and to do it basically on your own. Why are we not allowed to have nutritional support (in the form of weekly dietician visits) unless we have heart disease or diabetes? For 20+ years, I asked for help and was denied because I was healthy. I should not have gotten to the brink of having to use a wheelchair in order to get help!

    Reply
    • Shanaz Rahim

      06/13/2013

      Elizabeth, I am glad you got help, but disappointed that it had to come at a price. It seems like the only way to get anything done is to actually need it. There are no prevention guidelines set and implemented properly, from what I’ve seen and heard.

      For my younger siblings, a doctor visit comes back the same: underweight and not getting enough of a balance of vitamins and minerals. Yet they take supplements everyday (sometimes even they remind us!) and they exercise when the weather permits them to jump around playing hopscotch or ride their bikes. I am the oldest and not America-born yet they are. But what’s ‘normal’ for us is not ‘normal’ for American pediatricians.

      And when you try to ask them about culture and genetic differences, we (as the family) are suddenly stupid and did not go to medical school. The article is vague and the study can’t simply choose similar children to study.

      Reply

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