Childhood Weight Changes Predict Sugar Problem

Findings from a new study suggest that children destined to develop impaired glucose tolerance, a problem that can lead to diabetes, do not start out life being overweight. Rather, these kids start out being thinner than normal only to experience a rapid increase in their body weight later in childhood and adolescence.

Findings from a new study suggest that children destined to develop impaired glucose tolerance, a problem that can lead to diabetes, do not start out life being overweight. Rather, these kids start out being thinner than normal only to experience a rapid increase in their body weight later in childhood and adolescence. Previous reports have suggested that the risk of type 2 diabetes is elevated in people with low birth weights who become obese later as adults. However, it was unclear if their obesity actually begins during childhood and at what age. “Understanding the origin of obesity may be especially important in developing countries, where type 2 diabetes is rapidly increasing yet public health messages still focus on reducing childhood ‘undernutrition,'” study author Dr. Harshpal Singh Sachdev, from Maulana Azad Medical College in New Delhi, India, and colleagues note. To investigate, the researchers assessed glucose tolerance in 1492 young adults from India who had height and weight measurements taken at regular intervals throughout childhood and adolescence. These measurements were used to calculate the body mass index (BMI). A BMI of 26 or higher is typically considered overweight. The findings are reported in this week’s New England Journal of Medicine. Nearly 11 percent of subjects had impaired glucose tolerance and 4.4 percent had diabetes, the researchers note. Subjects destined for such problems typically had a low BMI between birth and 2 years, an increase in BMI that began at a young age (called early rebound), and an accelerated increase in BMI until adulthood. Although subjects who developed glucose impairments had an increase in BMI between 2 and 12 years, none were obese at 12 years, the authors point out. During this early period, a rise in the BMI by 1 degree from the norm was associated with a 36 percent increase in the risk of impaired glucose tolerance or diabetes in adulthood. “The association of adult obesity and its complications with birth weight, rebound of the BMI, and overweight during adolescence suggests that these periods may prove critical for the prevention of early overweight and its effects on adult disease,” Dr. William H. Dietz, from the Centers for Disease Control and Prevention in Atlanta, notes in a related editorial. (SOURCE: The New England Journal of Medicine, Reuters Health, Feb, 2004.)