Wednesday, July 9, 2008

Wanted ! Fat Baby, Thin Kid - Part 1

I took our 15mo. old to the doctor this week for her standard wellness check up. Our usual doctor was not available and we got one of the senior members in the office. His verdict...she is exceptionally tall and a bit fat.

Now, what I want to know is how can body mass index be a good predictor of infant (under 2 years old) obesity? Would not lean body mass be a much better assessment of health. Body mass does not distinguish between over fat babies and muscular babies. Whereas lean body mass measures how much fat vs. muscle a person has. Plus, do not genetics, exercise and nutrition play a part in obesity?

One web site, CBC News , reviewed three articles in the June (2008) issue of the American Journal of Clinical Nutrition. The articles draw attention to weight gain during critical periods of growth and later adult obesity.

France - Two Critical Periods Influence Obesity
1st Report: "researchers from the health research organization Institut National de la Sante et de la Recherche Medicale in France followed children from birth to age 5, identifying two critical periods in which early-life weight gain appeared to influence later obesity risk. The first critical period occurred in the first few months of life and the second occurred after age 2. Between these periods, growth seemed to be preferentially directed towards height and not weight," researcher Marie-Aline Charles tells WebMD.

London - Critical Period in First 6 months
3rd Report: "Rapid weight gain during the first six months of life was found to increase obesity risk later in childhood. Researchers from London's Institute of Child Health investigated the associations between weight gain during different periods in infancy and later body composition in 105 boys and 129 girls living in the U.K."

- Critical Period After Age Two
2nd Report: "Researchers found little evidence of an obesity link associated with rapid weight gain before the age of 2. But rapid weight gain after the second birthday was found to be a risk factor for obesity later in life. The study included 885 Finnish men and 1,032 women between the ages of 56 and 70, whose childhood weights and heights were known from medical records."

"Rapid weight gain before age 2 was associated with increases in lean mass while rapid gains later in childhood predicted higher body fat in adulthood."

Harvard University:
"Obesity prevention researcher Matthew W. Gillman, MD, of Harvard Medical School tells WebMD that rapid weight gain after age 2 or 3 is now generally recognized as a risk factor for later obesity. He adds that there is "mounting evidence" that the same is true for rapid weight gain in the first few months or even weeks of life, but the link has not been proven."

My conclusion after reading this article is that if my baby rapidly gains weight (faster then height gain) during the first few months and even more critically after two years old that her obesity chances in adulthood are increased. But if she is a fast grower in general before 2 years then she is more likely to be a leaner person.

Dr. Sears has a few more things to say about child obesity. Including if your parents are lean (or were when they were younger) then you have a lesser chance of being obese. Body type, metabolism, temperament and eating habits all influence ones chances of becoming obese. He also includes fat intake, parent's habits and TV watching.

He also states, "Lean parents have only a seven percent chance of having an obese adolescent. If one parent is obese, there is a forty percent chance their child will be obese. If both parents are obese, the probability of the child's being obese may be as high as eighty percent. Genes may actually be a more powerful determinant of obesity than diet. Studies on adopted children show that these children's body weight tends to be more like their biological parents than their adopting ones."

Other important info: "One study showed that nine out of ten obese infants became lean by the time they were seven. Yet, obese infants are still three times more likely to be fat at age seven than infants who have been lean from the start. Studies have also shown that forty percent of obese seven-year-olds are likely to become obese adults, seventy percent of obese preteens are likely to become obese adults, and around eighty percent of obese adolescents are obese as adults. The fatter children are in the first few years of life and the longer they keep their excess fat, the greater the likelihood they will remain fat into adolescence and adulthood. "

Now this doctor I saw with my baby made me rather terrified by the time I walked out of the office. He at one point asked if I saw all the news reports about children getting shots for their diabetes. He mentioned a pharma chemical that she would end up having to take because she was fat. While he spoke I was trying to understand how my child, who comes from a family that has rather plump babies and thin kids & teens, suddenly be the first obese kid or teen in our family? How could a vegetarian baby who's parents take her to the park 7 days a week for running, climbing, lifting and pushing become an obese child & teen?

I gave it some thought...a few times a week she gets gelato from the baker/gelato shop. And 1-2 times a week gets a carrot muffin from the cafe. We can cut those portions in half.

The second thought was this new doctor never did a history other then asking what does she eat and can she walk. I said she can dribble a soccer ball across the play ground. But he doesn't know our family has plump babies & stick thin kids/teens. He doesn't know her paternal side does have a few people with high body mass but a very high number (meaning very lean) lean body mass. He doesn't know that we rarely watch TV, and love walking and sports.

I think what happened was he walked in. Didn't realize how much she weight by looking at her. Saw the weight number in the book and panicked. I am now even more concerned that he was referencing news paper articles and not research papers when speaking with me.

Yes, I believe due to research currently being done that the children who watch too much TV, don't exercise and drink too much soda/ juice have a high tendency to be over weight and obese. But I don't think due to research papers I am reading that a child under 2 years old should be put on a diet or the parent scared into believing that they caused their one year old to a life time of obesity & diabetes.

I will take my baby to a nutritionist to check her lean body mass just to have a record to compare to. I will also tract her food & exercise over the next 3 months until her 18 month check up. I have to admit I feel like I am on a mission to prove I am right. But I will have collect observed data & more research papers to prove my point.

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