Predicting Obesity At Birth

Researchers say they have a formula for divining which newborns are at highest risk of becoming obese during childhood.

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Researchers say they have a formula for divining which newborns are at highest risk of becoming obese during childhood.

With childhood obesity rates tripling over the last 30 years in the U.S., there is an urgent need to find better ways of curbing weight gain, and the earlier these efforts start, the better. So an international group of scientists have developed a model for predicting a child’s risk of developing obesity, which they hope will encourage parents to take early action to improve their children’s health.

(MORE: Study: Obese Kids Have Less Sensitive Taste Buds)

“Many believe the critical time for the development of obesity is between ages zero and five—before kids go to school,” says lead study author Philippe Froguel, from the School of Public Health at Imperial College London. “Each year after age five is too late, and we wanted to find a way to predict the likelihood at birth. There are many non-genetic factors that are easy to analyze and are costless.”

To develop their formula, called the obesity risk calculator, the researchers analyzed data from the 1986 Northern Finland Birth Cohort that tracks a population of over 4,000 participants who were born in 1986. The scientists looked at five risk factors for obesity, including birth weight, body mass index (BMI) of the parents, the number of people in the newborn’s household, mother’s professional status and the mother’s smoking status during pregnancy. Each of these has been linked to obesity, either by promoting weight gain in a physiological or behavioral way; working mothers, for example, tend to make fewer meals at home, and their children are more likely to eat higher-calorie meals prepared at restaurants or in processed packages, while heavier parents may pass on obesity-related genes to their children.

(MORE: Can Laws Against Junk Food in Schools Rein In Child Obesity?)

The obesity risk calculator accurately predicted obesity rates among kids in the Finnish cohort, as well as two additional cohorts in Italy and the United States. About 20% of those kids predicted to have the highest risk for obesity accounted for 80% of all the childhood obesity cases. “Nobody has tried to make an equation to predict this before and I don’t know why,” says Froguel.

The researchers believe that having a simple tool to predict childhood obesity risk beginning at birth not only alerts physicians to children who are particularly vulnerable to weight gain, but provides an opportunity to motivate parents to keep their child’s health in check. The authors write:

Parents of newborns are particularly sensitive to information given about their child’s health. Once informed of their baby’s increased risk for obesity, they might be more receptive to routine advice provided from birth during the first two years of life within population-wide prevention: breast-feeding, feeding on demand, weaning no earlier than the sixth month with recommended meal patterns and food portions, avoiding of television and sugar-sweetened beverages.

“From my work in hospitals, I’ve been shocked by the lack of knowledge about nutrition, especially from young mothers. Even how to take care of the child if it’s crying,” says Froguel. “There is not enough education. New parents may think giving food to the child is the only way to get them to stop crying, but if you continue to do that the child could be overweight.”

(MORE: Q&A with the White House Chef on Healthy Eating)

Froguel envisions that the model may be used more as a teaching tool for health care experts than as a scare tactic for new parents. “If you scare the mom, it’s not useful, but for social workers and healthcare providers, it is a valuable education tool for high risk groups like new mothers, low income families and children with obese siblings,” he says.

He stresses that although the equation was successful in large populations in Finland, Italy and the U.S., it may need to be adjusted to more accurately reflect populations in different countries. “People don’t eat the same in every country, they don’t have the same culture. In some countries like Japan, the mothers are less likely to work or the people do not smoke. The equation works everywhere, but it cannot be the same equation for each country. We have to create predictions using different elements of an environment,” says Foguel.

Clinically, the equation could help caretakers to make weight maintenance a priority, but Dr. Stephen Pont, chair of the American Academy of Pediatrics Provisional Section on Obesity and a pediatrician at Dell Children’s Medical Center of Central Texas, says there is a critical need to take action now. “I think this can be helpful, however any child born today in America, the odds are that they will be challenged by their weight in the future. To some degree, the cards are already stacked against them,” says Pont. Having such a calculator in place for future generations, however, may ultimately contribute to earlier interventions and hopefully lower rates of obesity among children. “I do think these tools will be helpful to raise awareness. We see more and more research coming out showing the earliest impact we can have the better. Even having a mom who is a good weight before she is even pregnant can help.”

The study is published online in the journal PLOS ONE.

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FormulaFeeder
FormulaFeeder

Wait, I'm confused: the criteria they used to predict obesity had fudge-all to do with infant feeding- and yet they are stressing the mode of feeding/timing of solids as the take-home message? In the hopes that parents, once alerted to their high risk, might adhere to guidelines which supposedly reduce the risk of obesity - even though according to this "calculator", those very guidelines had nothing to do with overall obesity risk? 

It seems that even when it isn't about bottle versus breast, it somehow is. I may be confused, but I am not surprised.

joeberman334
joeberman334

Obese parents may pass along "genes" to the kids? No, the fat parents will pass along poor eating habits, a refrigerator filled with Dr. Pepper, and cabinets filled with twinkies to their kids.  BEING FAT IS A CHOICE.  Not genetic.  I don't care what anyone says, the law of conservation of mass says that matter cannot be created or destroyed.  Therefore, if you take in fewer calories than you expend you will lose weight.  Basic physics.  If being fat was genetic then why don't I see any fat Somalians?  Are you saying the people over there don't have the genes?

thewholetruth
thewholetruth

The food was changed in the USA, UK and Australia 30 years ago when dangerous food chemicals from the USA was allowed into European. The food today causes  insulin resistance If you are insulin resistance you hold fat and have a hard time losing weight. You can eat very little and the weight still does not come off. Insulin resistance will hold fat and diets won't work.

When researchers used a specialized diabetes diet on overweight people all lost weight even those who did not have diabetes.People must wake up to the fact that Fake Foods make you fat and cause inflammation  this includes diet soda which was proven by researchers that it makes you fatter. 

This was revealed by Danish researchers in Europe  Click here  http://spirithappy.org/wp/2011/06/29/i-have-tried-every-diet-new-study-agrees-with-spirit-happy-diet-soda-causes-weight-gain/

AngelaDaum
AngelaDaum

With both of my pregnancies I was active, at healthier than I ever did in my life, never smoked or drank or did drugs.  I got plenty of sleep and didn't want any fast food whatsoever. Sooooooo - 1st child I had completely normal growth and weight.  2nd child I had has weight issues.  She has a recessive gene deficiency called MC4R - the Melanocortin-4 Receptor has mutations that cause  morbid obesity, increased height and/or possible diabetes.  She goes to an endocrinologist, dietician as well as a lipid and hypertension specialst.  In short, the receptor does not communicate properly therefore some patients do not receive the mental message they are full.  There is no "quick fix" so teaching proper diet and exercise is the best that can be done for now.  Did your brilliant study include this as an option for obese children?  This is not a widely known condition - even Michelle Obama in her wonderful war on obesity has not taken genetics into account.  Quit blaming the mother (or father or family environment) - there are other factors to consider. 

BreeKozak
BreeKozak

As a future dietitian, I think this would be a great and easy formula to use in my future practice when counseling new moms, specifically those in the WIC program who may have limited knowledge about nutrition and the various risk factors that can contribute to obesity.  It could be eye opening to them that factors like their own smoking habits and work schedule can put their kids at risk for obesity.   It also sounds like the formula accurately predicted obesity in 80% of the participants, so I'd say this simple formula could be very useful.

CheckRaiseAllIn
CheckRaiseAllIn

Imagine this exchange:

Doctor: "Mother, based on your work schedule, your lifestyle habits, and your current obesity, your child is at high risk for obesity."

Mother: "Why the !#$% should I care?  What's wrong with being fluffy?  Are you calling me fat?  It's my God-given right to be fat if I want to!  And it's my God-given right to make my kids fat if I want to!  They can diet when I'm dead, but I ain't gonna stop eating my McDonald's!"

lorileeky
lorileeky

Little babies are suppose to be fat and cuddly. 

JoeyBaloney
JoeyBaloney

More pseudo science by a bunch of morons eager to applystatistical methods at any price (as opposed to putting in the real workto combat obesity).  And what does this sentence mean to you?: "About20% of those kids predicted to have the highest risk for obesityaccounted for 80% of all the childhood obesity cases."   What happenedto the other 80%?  I guess that they didn't turn out obese.  So that's afalse positive rate of  4 out of 5 !!!  Why that's even worse thanmammograms and PSA testing which other idiots are recommending weabolish.  Forget all these idiots.

Gromby
Gromby

Way back , before the proliferation of manufactured powdered infant formula , if a mother couldn't produce enough to sate her child , it was common practice to just enhance cow's milk with Karo syrup to fill in the gaps. And it worked. But overall , no study is really needed , it lies with the majority in the genetics , as several have already stated. Common sense.

KellyValceanu
KellyValceanu

No mention of artificial infant food--formula vs breastfeeding as an indicator? Read the label on artificial food for infants. Feed the infant high fructose corn syrup made from Monsanto corn straight out of the chute and what do you expect the infants metabolism to progress to? The answer is right there. No other indicators needed. The new sugars developed for this artificial food are creating the obesity epidemic.

DrBillToth
DrBillToth

Rocket science - mom is fat, family is fat = baby fat...at least in Finland.  And “If you scare the mom, it’s not useful,....".  Really?  Now it's up to doctors laboring under managed care to stop the epidemic of obesity?  When does a child even see a doctor?  For a well baby check up every few months?  and then maybe once per year?...and at those times only for a few minutes.  Who teaches a child to eat, to lift the fork or spoon from table to mouth.....a muscular activity completely under conscious control?  Who teaches a child to eat in front of TV or to go outside and play, move, exercise?  Who puts all those fast food ads on TV or in video games?  Evil children or adults that should know better.  Live With Intention, DrBillTothCom/blog

stevets
stevets

@joeberman334 Genetics does play a huge part in many cases, but when looking at obesity as a whole, culture and people's bad choices are why we have a wide spread epidemic. People are always surprised when I turn down junk food. Political correctness is one of the reasons why culture is making this happen. It is ok to stand up for causes that fight medical conditions such as cancer, but when someone suddenly wants to fight obesity they are labelled disrespectful to people of size. It is too difficult to deliver the message to them that obesity is wrong and that diet and exercise are important without insulting everyone. What is more important than the message of obesity being wrong is the message that people can do what they set their minds to. Being that I used to be much heavier, if you would have asked me two years ago about running long distance races and triathlons, I would have thought "no way".

JoeyBaloney
JoeyBaloney

@BreeKozak This "formula" based on data presented in this ridiculous article has a false positive rate of 80%!  It obviously casts too large a net.  Here is a simple numerical example that perhaps you can grasp.  Assume a population of 1000 of which 150 would later become obese (that's about right).  The formula is applied to the population of 1,000 and on this basis 600 are identified as high risk!  Of this 600, 20%, or 120, are correctly identified as high risk as they ultimately do become obese (and make up 80% of the 150).  But what of the remaining 480 (600 minus 120)?  These individuals do not become obese and were thus incorrectly identified as high risk by the formula.  Yea, any formula can capture the high risk group if it casts it net wide enough but of what value are such formulas if the wrongly identify 80% of a population?  Answer: of no value.  Get it now?

BreeKozak
BreeKozak

@JoeyBaloney  Sounds like you don't understand statistics.  Here, I'll help you out.  Out of all of the infants in the study, only 20% qualified for the high-risk for obesity category based on the criteria set by the researchers.   Years later, they found that 80% of those who ended up obese were accurately put into that high-risk category as infants.  Meaning the researchers accurately predicted obesity in 80% of the cases, missing only 20% with this simple formula.

Xieno
Xieno

@AMom Simple answer: The mom controls what food the baby intakes before birth. The father/dad is not eating for the child. So if the mom chooses to drink more caffeine, or eat more food than is healthy for a pregnancy, there's not much the guy can do. There is a more complex answer, but I figured I should keep it simple for now.

edesalvo
edesalvo

@DrBillToth It goes a little further than all that, Dr. Bill. Sure, fat people breed fat people due to food intake and lifestyle choices. Look at "Here comes Honey Boo Boo." But there can also be one fat person in a family of otherwise healthy people. You're in Finland?  I'm sure you are aware of the United States lack of healthcare and information, despite many arguing it is "one of the best." Unless you're super wealthy, you have very limited access to health care. Women do not get paid maternity leave or guaranteed leave. That means a LOT of money lost! In fact, many women end up working right until they can't any more and then go back to work too soon. I was one of them. Most do not breastfeed- they simply can't afford to! Time away at work, need to pump, employers who view it as a hindrance on productivity- it doesn't matter if it's a legally protected right. I'm in NY- an employer can fire you for ANY reason. Women are forced to pass up promotions, better hours or even their job. I know from first hand experience and relentless discrimination despite my skills and track record. But lets say a mom is fortunate to have a job to go to- hopefully it's one that pays enough to live off of, but chances are likely it's not. This creates the NEED for pre-processed foods and quick meals. Even with a college education, I have not found a job above $16.50 an hour after having a kid and lost my job because I became pregnant and the location eventually ceased to exist. Now, if I have to pay for child care, which is AT MINIMUM $10/hour (if I don't want that great of care for my child in NY), I am now making below minimum wage to depend on for everything. If there is another income, maybe that helps, but what that really boils down to is I cannot AFFORD TIME to cook, shop, prepare foods, care for the child and still fulfill all other responsibilities if we want to pay our bills- especially if I am to take care of myself! And I'm not talking about cable, internet or treats. We have NONE of that in our house, nor do we even drink soda and can't even afford candy (I guess being poor enough helps you not gain too much). Let's say I NEED to try to work from home because I cannot leave the house due to child care costing way too much. Now, you're talking about needing to entertain a child with some TV or video games, assuming you have those luxuries to be able to get work done. You ever try making phone calls or doing ANY work with a screaming toddler for hours on end? You don't have time to go to a park and, where I live, there are no parks for 5 miles, plus we only have one car my husband needs to use to WORK. Plus, people in our situation don't have days off, relaxation, or any help if there is no family able or willing. 24 hours of non stop working, like a slave and no freedom. So by the end of the day, I'm too exhausted, mentally and physically in addition to not sleeping because of a baby, to even exercise or entertain the idea of cooking or more cleaning.Resources are scarce and the poorer people do not have the help they need to pull themselves out of it. If working every minute trying to not be homeless, many HAVE to rely on cheap fast food. Forget healthy menu options- those cost double! If you are poor enough to be on medicaid, you aren't getting information or help you need. If you are well off enough that you aren't on medicaid, you are struggling terribly to put food on the table and have no time to think about anything else. If you're wealthy and can afford fresh food and the time to prepare it or hire someone to, good for you. But MOST of us aren't that. 

"I can live with intention " all I want and teach my child about fruits and vegetables and how to live in a healthy way, but it comes down to being stuck with what I'm stuck with. 

JoeyBaloney
JoeyBaloney

@BreeKozak @JoeyBaloney Boy are you intellectually challenged or what?  See they applied their wonderful formula to a population and of that population came up with a group "predicted to have the highest risk for obsity."  Then of that high risk group identified by application of their formula, 20% actually became obese (in addition to others that were not identified by this formula).  So, again, what about the other 80% of the high risk group?  These obviously didn't become obese.  So of the original sample, this formula wrongly selected 4 out of 5 -- a horrifically bad false positive rate.  But ah, you aspire to be a dietician so I guess you understand this material better that this M.D. or maybe not.

LainiT
LainiT

That was not the point. They stated in the article that if the mom works then the child (not while in eutero) is less likely to get home cooked meals and more likely to get fast food or processed foods. If the DAD stayed home (or chose not to) this factor would be influenced. As always, it is expected that the mother take on all the responsibility of taking care of the child and staying home from work and doing all the cooking. This is not a "flaw" in the study, it is just a missing component and completely sexist point of view.

beebee
beebee

@edesalvo @DrBillToth  

Maybe you should have postponed having a child until you had the time and money to care for one properly?

JoeyBaloney
JoeyBaloney

@BreeKozak @beebee @JoeyBaloney You are a dope.  See my numerical example above.  Re-consider your career aspirations.  Dieticians ain't the brightest but you'd be an outlier on the dummy side of the curve.

JoeyBaloney
JoeyBaloney

@beebee @JoeyBaloney That's not what it says here, is it? It does not directly disclose how many were identified as high risk.  It simply states that of those identified as high risk 20% of these individuals became obese (by virtue of the disclosure that these 20% accounted for the majority of the obese group).  See my numerical example for further clarification.

BreeKozak
BreeKozak

@beebee @JoeyBaloney Huh? You are really struggling with this sentence...It says the 20% of those predicted to be at the highest risk for obesity accounted for 80% of all the obesity cases.  You're right.  80% were NOT high risk, and of those 80%, only 20% went on to become obese.  That high risk category contained 80% of all of the obesity cases.

BreeKozak
BreeKozak

@JoeyBaloney @BreeKozak Oh wait, and I forgot, you're an MD.  You don't believe in simple and quick ways to give some preventive care.   You believe in getting em good and fat so you can prescribe meds up the hooha and perform multiple high-cost surgeries.  That's where the real money is, I hear.

ReneeKiscadenCrabill
ReneeKiscadenCrabill

@LainiT I agree completely.  It's as if we, as working mothers, are being punished if our children are obese.  The days of one salary household are gone, unless you are independently wealthy.  It's difficult for many mothers to stay home.  We do the best we can, but it seems that no matter what we do, it is not good enough.

kinkaid
kinkaid

@beebee

In the time it too her to write all of those rants she could have prepared her kid a nice healthy meal.

edesalvo
edesalvo

@beebee @edesalvo @DrBillToth Oh really? And when do you think that is, sociologist BeeBee? And who is to say I didn't have money to raise a child "properly" at one point before having them? And had $5,000 just saved for said child to cover expenses while maintaining a job AND paying the bills? We were paying ALL our bills and saving money in the bank. I was even married before getting pregnant, if that redeems me in front of your holier-than-thou eyes. We were pretty happy for a long time before we had our child and pretty secure. I was fully employed immediately after graduation making good money (for my lifestyle. Sure, I couldn't afford lobster and new iPhones every week) until something called "life" happened- a medical emergency that drained the finances. Only in America do we fear medical bills more than dying. Employers, I have found, don't want to give you benefits til you've been with them a year. And even then, they have ways to make you "temporary" first and go through 2 years before getting anything with them. I graduated a few months before and maintained 2 full time jobs to support myself through university and maintaining a 3.9 GPA to give myself a future. Wasn't sitting idle! I had to spend thousands to save a family member's life and hospitalization of myself in the same one month period due to an accident and emergency I was in. I went from being top at my position and making a nice comfortable amount to that company having issues during the economy and losing my position due to complications related to pregnancy, being in an accident and having everything do a 180. All at once. Silly me, I decided to "work through it" with my husband and not take welfare. Maybe you would think it would be better on the economy if I should just have died and allowed our family member to as well? Then, my husband's business had to close because of economy-related issues and a partner that screwed him over for almost $100,000. Entire streets and complexes closed. Landlords couldn't rent a single store on some streets. Wasn't just a couple people out of business. I'm so sorry I wasn't born into a family with money and I've had to work my way up from literally nothing but still survive. So happy that you had life handed to you and are qualified to judge.