Tool enables doctors to ID babies at risk of obesity, study says

March 4, 2016 by Suzanne Leigh
Tool enables doctors to ID babies at risk of obesity, study says

Newborns who are heavier than average and gain weight rapidly in the first six months of life face a heightened chance of obesity by the time they are old enough for kindergarten, according to a study published on March 4, 2016, in The Journal of Pediatrics.

This conclusion emerged from an obesity-risk algorithm developed by UCSF researchers, who evaluated demographic data, body measurements and nutrition patterns of Latino children in the San Francisco Bay Area. The researchers recruited and tracked pregnant Latina women and their offspring at UCSF Medical Center and Zuckerberg San Francisco General Hospital and Trauma Center. Of the 166 children followed, they found that 56—almost one third—were obese at age 5, based on the definition of the Centers for Disease Control and Prevention.

"Many recent studies have focused on single risk factors, such as maternal smoking or infant gain to predict the risk of obesity," said lead author Jacob Robson, MD, formerly of the UCSF Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition and currently assistant professor of pediatrics at the University of Utah, Primary Children's Hospital. "But targeting single risk factors may be inefficient and ineffective because the development of childhood obesity is a complex interaction of genetic, environmental and socioeconomic factors."

The researchers listed 10 known predictors of childhood obesity and used data from the children and their mothers to make a logistic regression model, a statistical analysis that predicts an outcome based on established factors.

Pre-Pregnancy Weight Also a Factor

The researchers discovered that the leading determinants of childhood obesity were higher-than-average birth weight and amount of weight gained at 6 months of age. Higher pre-pregnancy body mass index was the most important maternal predictor of obesity at age 5. Factors that had a modest impact on reducing the chance of obesity were breastfeeding and deferring solids until the infant was 6 months old, and older maternal age.

Using the algorithm, researchers found that among those infants whose risk score was ranked below the 25th percentile, 94 percent were in the normal weight range at age 5. In contrast, 61 percent of those whose risk score was categorized above the 75th percentile were obese by age 5. "The was 32 percent for this group of 5-year-olds," said Robson. "The algorithm has a high rate of accuracy in picking out which infants to worry about based on the presence and absence of certain factors."

While the study focused on the children of Latino women in San Francisco, the algorithm could be applied to other vulnerable populations, said senior author Janet Wojcicki, PhD, associate professor in the UCSF Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition. "Our recommendation would be to test our tool in other high-risk populations—African American, American Indian, Alaskan Native—that likely have the same risk factors for early obesity."

"Prognostic modeling, in which multiple risk factors are combined to estimate an individual's risk has been underutilized in childhood obesity prediction," said Robson. "A childhood obesity risk score like the one we developed derived from the presence or absence of known prenatal and postnatal risk factors could provide a simple filter for directing low-risk infants to routine weight monitoring, while reserving intensive prevention resources for those at high risk.

Pop-Up Message Could Alert Doctor to Patient's Risk

"Longitudinal data show that once a child becomes obese, it is likely to persist into adolescence and adulthood. Using the obesity-risk tool at the six-month visit would enable doctors to intervene early and most importantly prevent problems with weight and nutrition before they develop," said Wojcicki.

"As electronic records become standard practice, risk scoring has the potential for immediate and impactful applications,'' said Wojcicki. "Most electronic medical records can generate a risk score from risk factor data entered into the record. A pop-up message could alert providers to their patients' obesity risk score and whether intervention is indicated. This could serve as an important tool for busy providers who may fail to classify patients in the appropriate weight category, or may miss rapid infant growth if it is within the normal weight range."

Childhood obesity has more than doubled in children and quadrupled in adolescents in the past 30 years, according to 2011 figures from the CDC's National Center for Health Statistics. Obese children and adolescents are at higher risk for cardiovascular disease, diabetes, liver inflammation, bone and joint disorders, sleep apnea, and social and psychological problems.

Explore further: Review articles examine early-life risk factors, interventions for childhood obesity

More information: A Risk Score for Childhood Obesity in an Urban Latino Cohort. J Pediatr. (2016). DOI: 10.1016/j.jpeds.2016.01.055

Related Stories

Review articles examine early-life risk factors, interventions for childhood obesity

February 22, 2016
As the rate of obesity in the U.S. population has risen dramatically, more and more children are becoming overweight at younger and younger ages. Understanding the factors that contribute to childhood obesity and identifying ...

Cardiac and metabolic risk factors significantly more likely in severely obese teens

January 26, 2016
Compared to normal weight adolescents, severely obese teens had at least a 2-fold greater risk of having high total cholesterol, triglycerides, and fasting glucose levels, and a greater than 5-times increased risk of elevated ...

Maternal health linked to child's risk of obesity

February 11, 2016
Women's fat levels before and during pregnancy are linked to those of their infants in ways that can vary depending on a mother's ethnicity, a Singapore-based study shows, and highlights the need for nuanced health advice.

Obesity ups mortality risk in critically ill children

February 18, 2016
(HealthDay)—Being overweight or obese is linked to increased mortality in pediatric intensive care units (PICUs), according to research published online Feb. 16 in Pediatrics.

Weight and height during adolescence may impact future risk of developing Non-Hodgkin's lymphoma

February 22, 2016
A new analysis indicates that higher body weight and taller stature during adolescence increase the risk of developing Non-Hodgkin's Lymphoma (NHL), a type of cancer of the lymphatic system. The findings are published early ...

Study finds strong link between pre-pregnancy obesity and infant deaths

January 20, 2016
Pre-pregnancy obesity is strongly associated with infant mortality, and compliance with weight-gain guidelines during pregnancy has a limited impact on that mortality risk, a new study led by Boston University School of Public ...

Recommended for you

Study finds 90 percent of American men overfat

July 24, 2017
Does your waist measure more than half your height?

Are sugary drink interventions changing people's behaviour?

July 19, 2017
An evaluation of efforts designed to reduce how many sugary drinks we consume shows some success in changing younger people's habits but warns they cannot be the only way to cut consumption.

Young adult obesity: A neglected, yet essential focus to reverse the obesity epidemic

July 18, 2017
The overall burden of the U.S. obesity epidemic continues to require new thinking. Prevention of obesity in young adults, while largely ignored as a target for prevention and study, will be critical to reversing the epidemic, ...

Weight gain from early to middle adulthood may increase risk of major chronic diseases

July 18, 2017
Cumulative weight gain over the course of early and middle adulthood may increase health risks later in life, according to a new study led by researchers from Harvard T.H. Chan School of Public Health. They found that, compared ...

Study finds children carry implicit bias towards peers who are overweight

June 23, 2017
Even children as young as 9 years old can carry a prejudice against their peers who are overweight, according to a new study led by Duke Health researchers. They might not even realize they feel this way.

Mother's obesity boosts risk for major birth defects: study

June 15, 2017
Children of obese women are more likely to be afflicted by major birth defects, including malformations of the heart and genitals, according to a study published on Thursday.


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.