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Most obesity interventions are aimed at school-age children and teenagers, but the obesity epidemic also affects infants and toddlers; 10% of children younger than 2 years are overweight, and the percentage of obese children aged 2 to 5 years more than doubled from 5% in 1980 to 12% in 2006. The New York Times reports that many researchers are starting to believe that the obesity trajectory starts before a child is born and prevention efforts need to start earlier.
Researchers are concerned that epigenetic changes resulting from the interaction of inherited genes and environmental conditions in the womb and in early development might predispose children to obesity. For instance, women who smoke during pregnancy tend to have smaller babies at birth, but these same babies are at risk for obesity. Such epigenetic changes might help explain why children born to mothers with type 2 diabetes have a higher body-mass index and risk for developing diabetes: These children often are overfed in utero, which might reset their satiety point and cause them to eat more after birth.
Rabin RC. Baby fat may not be so cute after all. New York Times. Mar 23, 2010. (http://bit.ly/pa201004211)
Comment
As the author of the NewYork Times article notes, targeting pregnant women and young children with diet restrictions will be difficult because of social taboos about labeling these populations as overweight. However, certain children are entering the world more “hard-wired” to develop obesity. Pediatricians should begin counseling families about obesity prevention at their first interaction and challenge the notion that the chubbier baby is the healthier baby.