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Obesity Research Shows 3 Crucial Periods
Evidence is growing that people's weight at three
periods of childhood may be critical in setting
them up to be fat in adulthood, scientists said.
Being born either too big or too small and the
early appearance of puppy fat and tubbiness in teenagehood
seem to be emerging as important factors influencing
how much of a struggle with weight people have as
adults, according to experts gathered this week
at Europe's annual conference on obesity research.
Identifying these critical periods, they say, could
help public health experts determine where best
to intervene.
Many scientists believe that what happens around
the time of birth is a particularly important time
and that the evidence for this is especially robust.
Studies have shown that babies who are born large
are more likely to end up fat as adults. However,
being born very small also seems to increase the
risk of obesity in adulthood, especially if such
infants are then fed intensively to allow rapid
growth so that they catch up with their peers.
"There are data from several different countries,
including Israel, America, Europe and Southeast
Asia showing a U-shaped curve," said Tim Lobstein,
a childhood obesity specialist at the International
Obesity Task Force.
"The lower end of it seems to be a thrifty situation
where if you have a malnourished mother, the fetus
will trigger the genes that conserve as much as
possible. It will ... be triggering a laying down
of any surplus energy as fat rapidly," Lobstein
said.
"Babies that weigh less than 2.5 kilograms, or
5.5 lbs, would be considered small," he said. "The
optimum is to try and have a baby around the 6 lbs
or 7 lbs mark."
While the small baby problem is mostly one of the
developing world, the major issue in wealthier countries
is babies being born too big, experts say.
But convincing many parents, and even nurses, to
move away from aiming for a big baby is likely to
be a challenge, experts predict.
"They like to see them get high up on those (growth)
curves, particularly in those early days. It's pretty
ingrained in the maternal and child health nursing
system to have a big baby, and it's probably not
a smart idea," said Dr. Boyd Swinburn, an obesity
expert from Deakin University in Melbourne, Australia.
"And this underrecognition by parents is huge. It's
going to be a major stumbling block."
The next stage that may be important is the preschool
period, research suggests. Several studies indicate
that children who gain weight before gaining height
between toddlerhood and school-age seem to have
a higher chance of being fat adults.
Rapid weight gain due to overfeeding in the first
year of life may be particularly risky for later
obesity, experts say.
Major studies over the last few years indicate
that about one in three children who are fat in
early childhood end up as fat adults. Children that
get fat before the age of 8 tend to end more severely
obese as adults than those who gain their weight
afterward.
But being fat in the teenage years seems to be
even more predictive of later risk of obesity, research
indicates. About 70 percent of fat adolescents end
up with obesity later in life.
The problem with obesity in adolescence seems to
be that the male sex hormone testosterone pushes
fat to the belly a high risk location, while
in girls, the problem is that they tend to gain
alot of weight during their teens.
"We know that fatness in adolescence predicts later
obesity, but the link between adult obesity and
becoming fat in adolescence is less clear," said
Dr. William H. Dietz, director of nutrition and
physical activity at the U.S. Centers for
Disease Control and Prevention.
The three stages of childhood considered critical
for obesity development outlined at the conference
are scheduled to be discussed at an upcoming
World Health Organization expert meeting
in Japan later this month.