Fat babies at risk?

They report that big babies and those who gain the most weight during the first two years of life appear to have an increased risk for being overweight later in childhood and beyond.

The researchers based this conclusion on a review of 24 studies that examined the relationship between early weight gain and later obesity.

The review is reported in the October 13 edition of the British Medical Journal.

"There are a whole range of factors that influence infant growth," says researcher Janis Baird, MD, PhD. "Our finding suggests that these factors are also important in influencing the risk of later obesity."

While weight gain among infants and toddlers may be linked to weight issues later on, paediatric obesity experts who spoke to WebMD say the association is far from proven.

The review did not consider birth weight or weight gain among babies of low birth weight. Studies that have examined these factors as predictors of weight later in life have been conflicting.

"I think we still have a lot to learn about how early weight gain affects later weight," University of Colorado professor of paediatrics Nancy Krebs, MD, says.

Paediatric cardiologist Reginald Washington, MD, is Krebs’ co-chairman on the American Academy of Paediatrics’ Task Force on Obesity.

Even if heavier babies are at greater risk for becoming heavy adults, Washington says that does not mean that a skinny baby will become a skinny adult or a fat baby will become a fat adult.

"Interventions may turn out to be important, but we may be talking about things as simple as breast-feeding instead of bottle feeding or making sensible recommendations to parents about how they feed their young children," Baird says.

Krebs says the biggest predictor of whether a chubby baby will become an overweight child is his parents’ weight.

"As a physician, if I see an infant or toddler becoming overweight I judge how worried I need to be by looking at the parent," she says.

Washington says genetic predisposition and environmental factors have converged to create "a perfect storm" for obesity during childhood and beyond.

The easy availability of calorie-dense foods and increasingly sedentary lifestyles top his list of environmental influences contributing to what he calls a "global obesity epidemic."

"People have their favourite issues," he says. "They may blame fast food, or television, or vending machines in school for this problem. All of these things are important, but it isn’t likely that any single one of them is responsible."

So what can parents do to help ensure that their young children maintain a healthy weight? Plenty, the experts say.

"It is especially important for parents who have struggled with their own weight to make the right choices for their babies," Krebs says.

That means following the AAP’s recommendations to breast-feed exclusively for at least your baby’s first six months of life and being responsive to feeding cues so that you don’t overfeed later on, she says.

Healthy foods such as fruits and vegetables should be offered instead of fat- and sugar-dense foods that have little nutritional value.

"That doesn’t mean french fries, which are the most commonly consumed vegetable among children under two," Krebs says. Encouraging physical activity is important for babies and toddlers, just as it is for adults, Washington adds.

"You can’t put them in a stroller for six hours a day," Washington says. "They need to move."

Washington also warns against using unhealthy foods to reward small children. Offering a child a sugary treat for finishing all of her vegetables sends not one, but three, bad messages.

"You are telling the child that vegetables are something they need to be rewarded for eating, that they need to eat everything regardless of whether or not they are still hungry, and that sugary desserts are good," he says.