Skinny Kids Who Get Heavy Risk Diabetes

Children Who Cross From Low to High Weight Face Health Troubles

From the WebMD Archives

Feb. 25, 2004 -- Thin infants face serious health problems if they gain a lot of weight after the age of 2 years.

Several studies have linked a low birth weight to a particularly high risk of diabetes and heart disease in adulthood. Now a report in the Feb. 26 issue of The New England Journal of Medicine suggests that the problem begins in childhood.

A research team followed some 1,400 men and women in Delhi, India, from birth until they were 26 to 32 years old. The main finding: Being thinner than average in early childhood and becoming fatter than average after the age of 2 years tended to increase the risk of developing glucose intolerance and/or diabetes.

"This is a continuing process after the age of 2 years," study co-author Harshpal Singh Sachdev, MD, a professor at Maulana Azad Medical College in New Delhi, India, tells WebMD. "However, most of the association [is seen in those who cross from low- to high-weight categories] between 2 to 12 years of age. Thus, category crossing at any age after 2 years is associated with development of disease. The earlier one detects it, the better it would be for initiating interventions."

Childhood Obesity, Adult Health Trouble

Sachdev says it's the same story all over the world. Kids don't get enough exercise -- and they eat too much "energy-dense" food. Translation: too much TV, too many computer games, too much fast food, too many sugary drinks, and too little physical activity.

His advice to kids -- and adults -- is short if not sweet.

"Avoid getting fatter relative to yourself, particularly if you were thin as an infant," Sachdev says. "Possibilities for this include optimal physical activity and nutrition."

Chubby children used to be thought of as healthy, notes Matthew W. Gillman, MD, an associate professor at Harvard Pilgrim Health Care and Harvard Medical School in Boston.

"I think that we are slowly coming to a consensus that overfeeding during infancy and early childhood -- which may have been seen as healthy decades ago -- can't be seen that way any more," Gillman tells WebMD. "It may be predicting the kinds of health outcomes that are the scourge of the modern world."


Gillman says it's now well known that lower birth weight is linked to risk of obesity, diabetes, and even heart disease and stroke. The Indian study, he says, adds to this body of knowledge.

"What is underlying these associations between lower birth weight and poor health outcomes? Where this particular article helps is it shows us that accelerated weight gain during childhood seems to be one of the culprits," he says.

Unfortunately, there is no quick fix. Sachdev and Gillman agree that ways must be found to encourage children to exercise more and to eat more nutritious foods. Public awareness is a necessary first step.

"Maybe years ago a fat child was a healthy child," Gillman says. "But today, in the developed world, that is not as big an issue as what will happen to these children in the future."

WebMD Health News


SOURCES: Bhargava, S.K. The New England Journal of Medicine, Feb. 26, 2004; vol 350: pp 865-875. Dietz, W.H. The New England Journal of Medicine, Feb. 26, 2004; vol 350: pp 855-857. Harshpal Singh Sachdev, MD, professor, Maulana Azad Medical College, New Delhi, India. Matthew W. Gillman, MD, associate professor, Harvard Pilgrim Health Care and Harvard Medical School, Boston.
© 2004 WebMD, Inc. All rights Reserved.


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