Chubby Kids: Overweight for Life?

Double chins, dimply thighs, and pudgy tummies are signs of a happy healthy baby, right?

Wrong!

That sweet and chubby cherub may be cute to look at, but the reality is that such a baby may be headed for a lifetime of obesity and the health problems connected to being overweight, especially if those excess folds of fat stick around until the age of five. And that’s not so cute after all.

If you want to help your young children avoid a life of dieting and weight-related health risks, there's a new study published in the New England Journal of Medicine you may find useful. It raises some interesting questions about what it is in a child’s early years — perhaps even before birth — that sets the stage for obesity.

If you think your chubby toddler or preschooler will naturally outgrow being overweight, think again.

Some bleak realities came to light as a result of the nine-year study. If you think your chubby toddler or preschooler will naturally outgrow being overweight, think again. The study found childhood obesity is largely established by the time a child enters kindergarten.

The researchers, from Emory’s Rollins School of Public Health, looked at data for about 8,000 kindergarteners, following them through the eighth grade. Kindergarteners who were overweight were almost three times as likely (21%) as children of normal weight to become obese by the time they reached the eighth grade. Only 8 percent of normal-weight kindergarteners were obese in the eighth grade.

If a child was obese at the start of kindergarten, their fate was largely sealed.

Children were weighed seven times over the course of the study and classified as overweight or obese based on the Centers for Disease Control and Prevention Growth Charts and their body mass index. Children were considered overweight when their weight put them in the 85th percentile for their age and height (only 15% of kids their age and size weigh less); those in the 95th percentile or above were considered obese.

If a child was obese at the start of kindergarten, their fate was largely sealed. Most of the kids who were overweight or obese in kindergarten were obese when seen again as fifth graders and eighth graders. The largest increase in the prevalence of obesity was seen between first and third grade. Obesity during adolescence usually continues into adulthood.

Socioeconomic factors like family income, race, and ethnicity impact the rate of obesity in preschoolers, but by the time they reached kindergarten they no longer made a difference. If a child was already overweight or obese, those extra pounds were the major factor determining a child's weight going forward.

The risk of obesity appears to begin at birth for some children. Previous studies have identified a relationship between excessive weight gain in the first six months of life and a higher risk of obesity. While these researchers had no records of the children’s weights prior to kindergarten, they did have their recorded birth weights, and they found that 23 percent of babies who weighed more than 8.8 pounds at birth were obese by kindergarten.

Infants who weighed a lot at birth (8.8 pounds or more) and were overweight by kindergarten had the highest risk (31 percent) of becoming obese before they reached the age of 14.

Solveig A. Cunningham, Ph.D., the lead researcher, said in a press release, “Our findings uncovered several important points by examining incidence (of obesity) over time. We have evidence that certain factors established before birth and during the first five years are important. Obesity-prevention efforts focused on children who are overweight by five-years-old may be a way to target children susceptible to becoming obese later in life.”

Just because the facts indicate that a child who is fat at five is far more likely to be overweight when they're older doesn't mean that nothing can be done. In an editorial accompanying the study, researchers at the Harvard School of Public Health and Massachusetts General Hospital stressed the importance of risk reduction strategies aimed at improving nutrition and physical activity. They believe these are key to reducing early childhood weight gain and the subsequent risk of childhood obesity.

Actively play with your children. Encourage a physically active lifestyle. Model healthy behaviors. Make wellness a part of your family values.

When does the pathway to obesity begin, and what causes the pendulum to swing one way or another? Family lifestyle, diet, and levels of physical activity are established influences, but so may be a mother’s weight and eating habits during pregnancy. When mothers are obese, they are more likely to have children who are overweight and likelier to die early. Fathers' diets and eating habits may make also a difference.

This study shows just how long-term an effect allowing a young child to become overweight can often have. There may be as-yet-unknown factors in the early home and preschool environments that lead to early weight gain and obesity, and further research will hopefully provide an even clearer picture.

This study makes it clear that having a chubby child can often lead to a lifetime of overweight. So here’s some advice to parents (and other caregivers) from a dietitian, mother, and grandmother:

• Know you play an important role in preventing your child from becoming obese. Pregnant moms, take care of yourselves. Eat right, and strongly consider breastfeeding your baby.
• It’s never too early to start teaching children healthy habits. Pay attention to what you feed your baby. Introduce them to healthy foods early in life. Don’t even let them taste junk food until they have learned to like healthy foods like fresh fruit and vegetables. Then limit the junk food you feed your child, including processed foods and fast foods. Make it an occasional treat, not a favorite lunch or dinner.
• Play more and more actively. Limit screen time — all kinds of screens. Fifty years ago, playing outside is what kids did. Now there are television shows and game consoles and computers to tempt them to sit still. But playing outside is still fun. Provide your children with outdoor toys like balls and jump ropes, bicycles and skates. Actively play with your children. Encourage a physically active lifestyle. Model healthy behaviors. Make wellness a part of your family values.

These are the best weapons in the fight against childhood obesity.