The Endocrine Society's 98th Annual Meeting & Expo:

Predicting Infant Risk for Childhood Obesity

A babies hand on an adult handPediatric obesity is a major health problem in the United States in approximately 17%, or 12.7 million children and adolescents aged 2 through 19 years.1 Early childhood obesity often persists into adulthood and increases lifelong risks for serious health issues such as high blood pressure, heart disease, and metabolic disease.2 A means to predict an infant’s risk of becoming obese in childhood was the topic presented by Allison R. Smego, MD. Dr. Smego is a clinical fellow at Cincinnati Children’s Hospital.

“Pediatricians do not have much to guide identifying at-risk children prior to the age of two. There is little known about how growth patterns differ between children who develop severe obesity and those who stay lean,” stated Dr. Smego. The objectives of the study were two-fold:

  1. Determine when children with severe obesity gain weight more rapidly compared with children who stay lean.
  2. Determine a weight-related marker to help identify children who are at-risk of becoming severely obese before they develop obesity


Electronic health records were utilized to identify four study populations. “The children were selected based on a BMI [body mass index] between the ages of two and six or early childhood. We had two severely obese groups with a BMI ≥ the 99th percentile [n=480], and two lean groups with a BMI between the 5th and 75th percentile [n=783]. We collected height and weight data on these patients from the electronic medical record,” Dr. Smego explained.

Weight evaluation over time determined BMI divergence between the two groups starting around 4 to 6 months of age—the obese groups were separated from the lean children. Dr. Smego stated the study provided the following results: “At 6, 12, or 18 months of age, a BMI greater than or equal to the World Health Organization [WHO] BMI growth charts led to a greater than a 50% chance of being overweight or obese by age 6 years. And having a BMI exceeding the 85th percentile during infancy led to a 3- to 9-fold increased risk of developing severe obesity by age 6.”

Conclusions

  • BMI in children who become severely obese deviates from normal weight children as early as 6 months of age.
  • BMI exceeding the 85th percentile in infancy can identify at-risk children.
  • Dr. Smego recommended pediatricians measure and evaluate BMI in children as young as 6 months of age.
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