Obesity, it appears, has something in common with smoking: once the pattern is established, it’s difficult to change. A new study shows that children who are overweight or obese as 5 year olds are more likely to be obese as adolescents. Other studies have shown that obese adolescents tend to become obese adults. Thus, it appears that, if a child is obese at age 5, chances are high that child will become an obese adult.
However, the new study of obesity does offers reason for hope. If a child can avoid obesity by at age 5, he or she has a good chance to avoid a lifetime of obesity and all of the health problems associated with it.
The study was conducted by Solveig Cunningham and her colleagues at Emory University in Atlanta. With financial support from the NICHD, the Emory researchers analyzed data from the Early Childhood Longitudinal Study, Kindergarten Class of 1998-1999, a data set compiled by the U.S. Department of Education (with support from a number of federal partners, including NICHD). The researchers analyzed data on height and weight collected from more than 7700 children throughout the United States, as the children progressed from kindergarten through eighth grade.
The researchers found that 12 percent were obese when they entered kindergarten, and another 15 percent were overweight. By the eighth grade, almost 21 percent were obese and another 17 percent were overweight. Not all obese or overweight children retained their extra weight and not all normal weight children remained that way. However, the trends were clear. Overweight 5-year-olds were four times more likely than normal-weight 5-year olds to become obese by eighth grade (incidence of 32%% vs. 8%).
No one can say just why one person becomes obese and another remains trim. The overwhelming consensus among researchers is that obesity results from a combination of genetic and environmental factors. Some people may simply have more of a tendency to gain weight than do others. However, environment also plays a role. For example, children in certain neighborhoods may not have as many opportunities for getting out and moving around as children from other areas. Similarly, some families, for reasons of tradition, cultural heritage, economics, or even lack of knowledge about good nutrition, may select more caloric foods, and be in the habit of serving larger portion sizes.
According to the U.S. Centers for Disease Control and Prevention (CDC), 12 percent of preschoolers are obese. Even in childhood, obesity carries the risk for such physical and mental health problems as high cholesterol, high blood sugar, and asthma. More than one-third of adults are obese. For adults, obesity is one of the leading causes of preventable death, such as heart disease, stroke, type 2 diabetes, and many kinds of cancer.
Fortunately, we’ve learned a few things about how to prevent obesity and to help those who may already have gained weight. The American Academy of Pediatrics (AAP) has reviewed the research supported by NICHD and others to formulate recommendations for preventing and treating overweight and obesity in children. I’ve cited them here, along with additional information on nutrition and maintaining a healthy weight.
I encourage all parents and caregivers to take advantage of the federal government’s information resources to help their children maintain a healthy weight. First Lady Michelle Obama’s Let’s Move! Initiative is dedicated to solving the challenge of childhood obesity within a generation. The Let’s Move! Website provides helpful information on diet and exercise for parents, school systems, and community leaders. Here at NIH, NHLBI’s We Can! (Ways to Enhance Children's Activity & Nutrition) national education program provides parents and caregivers with tools and activities, so they can encourage their children to eat healthy, increase physical activity, and reduce screen time.
And finally, NICHD’s “Media Smart Youth” program is an interactive after-school program that teaches young people how media influence their health, nutrition, and physical activity. The program helps students build skills to make informed decisions about being physically active and eating nutritious food in daily life. The goal is to establish healthy habits that will last into adulthood.
Especially with the data from this recent study, it appears best to start when children are young and establish healthy habits before weight becomes a problem. And, although it may be difficult to change things for families in which unhealthy habits have taken hold, nothing is set in stone, and change is still possible. What may be most important is to start now.
Originally posted: February 26, 2014