In retrospect, the summer of 2006 might someday be known as “The Summer When Obesity Dominated the Medical News.” Between Memorial Day and Labor Day, no less than 3 major reports documenting the health risks that may be associated with being overweight have appeared. These studies include (but are in no way the only reports published):A report in the American Journal of Clinical Nutrition questioning the validity of the Body/Mass Index in the elderly as a predictor of future cardiovascular events. The summary of that study can be read at this Associated Content link. (Index Medicus Citation: Am J Clin Nutr. 2006; 118: 669-682).
The publication of a significant change in the American Heart Association (AHA) guidelines to emphasize the importance of both diet and a “healthy” lifestyle. This recommendation can be read in the online edition of the AHA’s journal Circulation. (Index Medicus Citation: Circulation; 2006; 114:82-96).
The most recent and, in many aspects, the most alarming report comes from the September issue of the respected journal Pediatrics. In a report entitled “Identifying Risk for Obesity in Early Childhood,” Philip R. Nader, MD of the Department of Community Pediatrics at the University of California at San Diego and associates from across the United States and the United Kingdom reported that being overweight (defined as > 85 %ile of Body Mass Index (BMI) for the participant’s age as found in previously published studies) during childhood strongly correlated with obesity at the age of 12.
The longitudinal study (a study in which a given group is examined at intervals in order to determine which factors point to a specified outcome at the conclusion of the study) initially involved 1400 healthy infants examined at 10 sites around the United States. The height and weight of these children were recorded at 2, 3, 4.5, 7, 9, 11, and 12 years of age. At the end-point of the study (when the child was 12 years old), 1042 children remained in the sample, of whom 555 had been weighed and measured at all seven points in time. After analysis of the data collected, the researchers found that:
1) Children who were overweight during their preschool years were five times more likely to be overweight at age 12.
2) Children who were overweight at all three assessments during their elementary school years (at 7, 9, and 11 years of age) demonstrated a 374-fold increased risk of being heavy at age 12.
3) 60% of children who ever overweight during preschool years and 80% of those overweight during elementary school were found to be overweight at the end of the study.
The authors point out that while the data seems to strongly suggest a correlation between a child’s weight during the preschool and elementary school years and the occurrence of obesity in the high school and young adult years, the study population may not be a true cross-section of the total at risk population and that other factors such as ethnic background were not considered during the study.
Noting the above mentioned possible weaknesses of the reported study, the authors did recommend that health care providers treating those in this age group should be more vigilant for signs of childhood obesity.
Writing in the “discussion” section of their report, the authors stated that “On the basis of the growth data reported here, it would seem that pediatricians can be confident in counseling parents to begin to address the at-risk child’s eating and activity patterns,rather than delaying in hopes that overweight and the patterns that support it will resolve themselves in due course. Identifying children at risk for adolescent obesity provides physicians with an opportunity for earlier intervention with the goal of limiting the progression of abnormal weight gain that resultsin the development of obesity-related morbidity.”
The Index Medicus citation for this report is Pediatrics; Vol. 118 No. 3 September 2006, pp. e594-e601.
Gding SS, et al. Dietary recommendations for children and adolescents: a guide for practitioners: consensus statement from the American Heart Association. Circulation; 2005; 112:2061-2075 [Full Text].
Nader PR, et al. Identifying Risk for Obesity in Early Childhood.Pediatrics; Vol. 118 No. 3 September 2006, pp. e594-e601 (prepublication early release) [Full Text].