Along with many other media outlets, MSNBC reports on a study in the American Journal of Health Promotion which found that that 32% of 7,500 babies studied were overweight or obese by the time they reached 9 months old, and that 34% were overweight or obese by age two. It’s a shocking finding on its face, and one that’s getting lots of attention, but I’m having some trouble parsing it. (I don’t have access to the actual study, so I’m drawing from various media reports).
For one thing, the study found that there was quite a bit of fluidity in weight among this young age group; some of the heaviest infants had lost their excess weight by age two, while some of the thinner babies had gained weight by toddlerhood.
The L.A. Times provides more detail:
- Boys were more at risk than girls (this contradicted earlier research).
- Latinos had the highest risk.
- Geographic location was not consistently associated with being obese or at risk.
- The family’s socioeconomic status didn’t seem to make a difference at 9 months of age. But by two years, the kids in the bottom economic 20% were most likely to be obese or at risk, while those in the top 20% were least likely to be obese or at risk.
Yet according to this site, the investigators concluded that:
the study shows no relationship between infant or childhood obesity and adult obesity. However, the relationship between higher percentile weights in babies seems to greatly increase the risk of childhood obesity.
That last quote is encouraging on its face, but how can it be true that there’s no relationship between childhood obesity and adult obesity?
Another question — since all of the infants studied were born in 2001 and part of a cohort that was followed through kindergarten, why didn’t the investigators look beyond age two, so we could see how many of these overweight or obese babies and toddlers carried their excess weight to age five or six? That would provide more proof that being overweight at age nine months or two is of real concern, as opposed to a developmental blip.
I’m not minimizing the very real problem of childhood obesity, and having a baby or toddler in the 95th percentile for weight (which the investigators used as the measure of obesity) is a red flag that shouldn’t be ignored by parents or pediatricians. But it seems like this study raises as many questions as it answers.
[Hat tip: Donna Gershenwald]
NotCinderell says
Also no comment about how maternal weight during pregnancy affected childhood obesity.
bettina elias siegel says
Not Cinderell: I’m pretty sure that they only had data for the kids in the cohort, not the maternal info. But I could be wrong. It would be interesting to know. But they did say somewhere that birth weight of the child had no correlation.
NotCinderell says
Birth weight of the kid might have no correlation, but I’ve read stuff that suggests that maternal obesity during pregnancy might be a correlation.
Bri says
I read this study, too, Bettina, and I also had some difficulty with it. First of all, there have been many other studies that have shown correlation between childhood obesity and adult obesity, so I am puzzled about the apparent lack of linkage that this one finds.
Secondly, you know how I feel about studies like this in general making big headlines. Should we be concerned about obesity among our children? Absolutely. But I am very worried about the attention drawn to the weight of babies — BABIES — by publicizing these studies too much. “Overweight” as a concept for a child who’s not even really eating a fully solid diet, nor moving his/her body to the extent that a toddler, older child, or adult can, is something I can barely wrap my brain around, to be honest. (Which is not to say that it cannot exist, but emphasis on it concerns me.) What I worry most about is that I see many parents already putting younger and younger children on unsafe, restrictive diets — offering skim milk to 1-year olds to keep their weight down, giving first graders Lean Cuisine to manage their caloric intake, restricting cheese, meat, nuts, and oils — without proper understanding of the long term health consequences that may have. Can you imagine if people start reading this kind of stuff and think “Oh, my 9-month-old has too many rolls on her thighs… I’d better cut back on her breastmilk/formula and restrict her to only a few tablespoons of strained peas and oatmeal at feedings?” It’s potentially disastrous, from a health perspective AND from the perspective of setting up positive long-term food relationships.
bettina elias siegel says
Bri: Yes! Thank you for making this point, which was buzzing in the back of my head, but I failed to articulate it in my post. There are clearly some parents out there making horrible food choices for their kids (soda in a baby bottle, etc.) But as soon as I saw mention of “portion control” in one of the media accounts, alarm bells went off. When left to their own devices (and free from invasive parental pressure, Ellyn Satter would want me to add), kids naturally follow their internal hunger cues. Babies stop nursing automatically when they’ve had enough. That’s why the “obesity” label at nine months is perplexing to me. I’m not saying it isn’t sometimes applicable, but I had the same worries that you did — that a parent would overzealously restrict food/fats out of a misguided fear of “infant obesity.” And, as another blogger noted, we’ve all seen how some babies get a little chubby, then lengthen out with the next growth spurt. So what does the random measurement at 9 months really show?
Bri says
Yep, yep, yep! And you’ve gotten me going, once again, so I’m just polishing off my own post on the subject (and giving you some bloggy love as always).
Renee says
In addition to babies gaining weight and then growing, older kids do that too –if a child is active and eating a healthy diet, they may still gain a bit of weight and look chubby right before a growth spurt. It doesn’t mean they need to diet.
I think this study on babies would be much more meaningful if it had included the types of foods the babies were being fed. If your 9-month old is existing mostly still on breast milk with some solid food supplementing it, then any weight gained is probably normal and necessary. If a 9-month old is being fed lots of juice (or soda, god forbid!) in a bottle, then maybe the weight gain is a signal of an inappropriate diet. In general, this study doesn’t seem all that useful.
bettina elias siegel says
Agreed!
bettina elias siegel says
YAY! I love when I inspire a RRG blog post!
P Reis says
I’ve already read articles in the recent past about people who have put their infants on DIETS because they were “overweight.” Not people who were told by their doctors that their babies were at an unhealthy weight, mind you, but people who were concerned by the pudge on their newborns. I just can’t even imagine. I definitely think that our notions of healthy weight in babies needs to be re-examined, since there’s such a wide variation in shapes and sizes. What a label to start a kid’s life out with. I also wondered if they differentiated between breast-fed and formula-fed babies in this study.
bettina elias siegel says
That’s so scary, P. Even though obesity (adult and child) is a real problem in our country today, fat-phobia can itself be a problem, apparently.
Karen says
Perhaps there’s no link btwn childhood obesity and adult obesity in this study because the population being studied is not yet 10 years old.
bettina elias siegel says
Maybe that’s what they meant. Hard to sort all this out without the actual study, but it appeared that you needed a subscription to the journal to access it. I’m a dedicated blogger, but not THAT dedicated! 🙂
jenna Food w/ Kid Appeal says
i hear the concerns about labeling little ones as “fat” but, should pedis not bring it up to spare kids and parents a complex?
given the amount of misinformation the public receives about nutrition (100M in food ads for unhealthy food every 4 days!) i think it’s time that the medical profession educate parents, including raising a flag if weight % or BMI comes in a potentially dangerous range. of course parents should be counseled that the kid could just be between growth spurts, or that weight may normalize when solid food and mobility come into play.
what is the harm in Drs asking parents what kids are eating on a daily basis, and informing them that added sugar, and low nutrient food with icky additives (processed food) is not only a risk factor for over-weight but also the WELLNESS of the child.
we only get one body, one set of organs, one immune system for our ENTIRE lives. nutrients for a child (and adults) is mission critical!
Bri says
Jenna, I agree 100%. The problem is, as we experienced with our preschooler, even a ped. who has been GREAT in every sense can fail to ask those “right” questions when it comes to a kid’s weight. We feed our kids well, I don’t mind saying, and yet the ped. never asked us what his diet is. She simply told us to cut out feeding him processed crap. Well…we don’t feed him processed food, but she never asked what he DOES eat. What I wonder about is whether all doctors are going to really do their good, investigative research with parents about what goes into the little ones’ mouths, or if they’re going to simplify the issue and distill it down so that it becomes more about a war against fat than a battle for health.
jenna Food w/ Kid Appeal says
agree. most pedis don’t spend enough time on nutrition in office visits. the instruction was appropriate “decrease processed food and sweet beverages” but didn’t address your particular issue, if there was one.
i hope pedis do start focusing on nutrition education with parents. but they may suggest the same low fat diet that most people associate with weight maintenance. even for kids over 2, low fat is not ideal. the brain needs good fat to develop and function. even in adulthood the body needs real fat.
Bri says
Boy, do we speak the same language! 🙂 I agree — I actually have found that for my husband and myself, in adulthood, the LESS we worry about traditional “adult” dietary issues like fat etc., and the more we focus on feeding ourselves the same kind of balanced diet with varied nutrients and good fats that we want our kids to eat, the healthier we’ve been and the less we’ve had to worry about weight.
Viki says
Gee Whiz bettina, I get busy for a week and you post THIS!
Both my girls would have been considered overweight at 9 months, both were over the 95th percentile. One is extremely skinny now (23 yrs old, size 1) and the other at 17 a nice curvy size 5. Both were breastfed.
My fear with this article and the way the Media runs with information like this is that people are going to start limiting good fats to these poor children. Lets face it, even some doctors don’t know what a good fat is…Good fats are needed for brain development. What is going to happen to these kids?
The information on what is best for kids to eat at what ages is conflicting. Everyone is on the lowfat bandwagon it seems. I work in a MDO/Preschool and there are mom’s sending in lowfat yogurt and 1% milk for their toddlers lunches. One of the mothers is a medical professional. Her child is NOT overweight, she is skinny.
bettina elias siegel says
Viki: I agree – this sort of info (whatever it means) in the hands of the media is not a good thing! “Babies Need to Diet!” and all that.
Re: low fat milk for toddlers — a question for you. Our pediatricians told us that after age two, it was time to switch from whole milk to, I think, 1% or 2%. (can’t recall now – it seems so long ago!) And my daughter soon showed a clear preference for skim, so we switched to that (it’s what I use in my coffee and cereal) and even now, at age 10, she’s still a big milk drinker but simply will not drink higher fat milk if offered to her. But at the same time, do we have to worry about low fat milk when there are so many other sources of fat in our children’s diets? E.g., my kids have butter on toast, I cook with olive oil and (don’t stint on it), they eat cheese, etc. And that’s not taking into account the less-than-healthy stuff they’re exposed to all the time outside my house (and sometimes inside it! 🙂 ) So is low-fat dairy a problem? Just wondering what your thinking is on this.
Viki says
my youngest is the same way, she says that whole milk tastes too thick…
I solve that by cooking with real butter, real cream, or whole milk.
We do not eat low fat yogurt at our house either, plain full fat yogurt. I use olive oil a lot and even(gasp) coconut oil for some things.
I don’t use other veg.oils.
We don’t eat much processed food. Although if I allow it in the house it will be gobbled up. (Stacey’s for instance, we have no will power for crispy carbs. but fries…we can do without)
The problem is at the preschool/MDO, the kids I work with are 1 yr old (this year…last year I worked with 3 yr olds) I worry about the lack of good quality fats in their diets because of brain development. When my kids were growing up I believe it was at a later age than 2 when we were told that we could go to 2%.
I was a big milk drinker as a child. As an adult I didn’t like milk very much, and didn’t drink a whole lot until a year or so ago when I found some local milk that wasn’t homogenized. It is Pasturized, but not ULTRA pasturized. So it can’t sit on the shelf of your fridge for Weeks. I have to shake it before I pour it. It tastes like I remember milk should taste.
In case you are wondering, I’ve lost 30 lbs in the last year eating butter and drinking whole milk and cream and full fat yogurt.
jenna Food w/ Kid Appeal says
me too. i’m the slimmest i’ve been since high school on a “full fat diet” meaning, full fat dairy only, no restrictions of healthy oils (coconut, olive), nuts, avocado. the only fat restrictions we make are fake fats (refined veg oils). instead of having “low fat” diet we try to eliminate it as much fake fat as possible at home (very little processed food), i make my own salad dressings from yogurt, sour cream, or olive oil. good fat is fuel for brain and body. sure, if i ate all that good real fat in addition to standard american diet, i would probably have issues with weight maintenance, but since i’m on a 90-95% “real” food diet, no weight issues no matter how much full fat dairy i eat.
as a young adult i could only drink skim milk, thought whole milk tasted too thick. now, i can drink tons of whole raw milk. raw milk is the best tasting milk i’ve ever had.
Viki says
jenna,
wish I could find raw milk! I’d love to try it. Guess I need to network more. 😉
I want my own chickens too DH isn’t too thrilled about that.
Viki says
actually that is 30lbs just since last May.
Chic Mummy says
My son had his own line on the weight chart, well above the 100% percentile, for his entire infancy and the majority of his toddlerhood, despite being breastfed and then eating (mostly) healthy solids. He is now four, and yes, his weight is still well above the line, but so is his height, and when they look at his BMI (adjusted for age) he is smack in the middle of the healthy range. I also query the fact that the study used the CDC growth charts (based on formula fed babies) when the majority of developed nations either have already or are in the process of switching to the WHO growth charts which are based on breastfed babies since WHO believes this is what “normal” growth patterns should be based on.