Chubby Babies at Risk
for Staying That Way
Excerpt By Eric Sabo, Reuters Health

Fat babies may be happy babies, but infants who put on pounds too quickly are more likely to be overweight as adults, according to a new study.

Research published in the American Journal of Clinical Nutrition suggests that newborns who have bulked up by 4 months of age are twice as likely to tip the scales 20 years later when compared to babies who gain weight more slowly.

Dr. Nicolas Stettler, the lead author of the report, cautions that it is too early to tell if a chubby infancy represents the start of a growing problem. But given the clear-cut advantages of preventing obesity rather than fighting it later, Stettler explained to Reuters Health that good habits are best instilled early on.

"This could be a critical time in the development of obesity," said Stettler, a nutrition specialist at the Children's Hospital of Philadelphia. "Gaining weight rapidly at such a young age is associated with permanent changes that may make it harder to regulate appetite and energy balance."

Stettler's team followed several hundred African American children who were born in Philadelphia around 1960. Obesity rates continue to soar for every age group and race, but the risks of heart disease and other obesity-related problems are particularly hard felt by minorities, especially African Americans.

Researchers collected weight-related information on the children at birth, 4 months, 1 year, and 7 years of age. Nearly two decades later, Stettler and his colleague took a fresh set of measurements and then compared them to what the study participants weighed in the past.

The now grown-up participants were considered obese if they had a body mass index of 30 or greater, plus a substantial amount of body fat. Body mass index is a measure of weight that takes height into consideration.

Infants who gained more than eight to 10 pounds in the first four months of life doubled their chance for being obese by the time they turned 20 years of age. After controlling for other possible causes, such as a heavy birth weight or a mother who weighed more than normal during pregnancy, the researchers estimate that one third of adult obesity was directly related to the rapid weight gain of early childhood.

In an editorial that accompanied the paper, Dr. Jack Yanovski, a growth and obesity expert at the National Institutes of Health, argues that the small study size makes it hard to draw firm conclusions. When Stettler's team included stout 7 year olds in their analysis, for example, infant weight gain did not appear to be a significant cause of adult obesity.

But the results "may ultimately help us to identify children at unusual risk of adult obesity," Yanovski concluded.

Stettler suggests there could be a solution already. The participants in his study mostly grew up on baby formula, which has been linked to faster weight gain compared with infants who are breast fed.

"If you breast feed the child will stop when it's had enough, while a mother may overfeed with formula," said Stettler. "This may override the internal cue that causes individuals to overeat later in life."

Stettler does not discount the fact that many other important factors can lead to obesity, such as a sedentary lifestyle and too many visits to fast food restaurants. But mothers who breast feed their children for the first six months, a practice that has been endorsed by pediatrician groups, might prevent their kids from eventually leaving the house severely overweight.

"Breast feeding can help teach a child how to regulate food intake," said Stettler.

SOURCE: American Journal of Clinical Nutrition 2003;77:1350-1351,1374-1378.

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