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. 

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AngelaDaum
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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.

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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.

stevets
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@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.

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.

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.