Pediatric interventions at 1 to 3 age may have the greatest impact at preventing childhood obesity

Columbia researchers have uncovered a critical age when many inner city children become overweight or obese: between the ages of 1 and 3 years old.

In a chart review of 1,713 children ages 1-5 years living in inner-city neighborhoods of New York City, they found that the risk of being overweight or obese significantly increased with each successive year of age, with the biggest increases in prevalence between the ages of 1 and 3 years.

By age 5, half of the children were overweight or obese. Boys were slightly more likely to be obese than girls.

Of the children sampled, 52 percent were boys, 78 percent were Latino, 17 percent were African-American, and 85 percent were Medicaid recipients.

“These findings indicate that pediatric interventions aimed at this critical age may have the greatest impact at preventing childhood obesity,” said Melissa Glassman, M.D., pediatrician at Columbia University Medical Center, and one of the lead authors of the study. “Addressing weight issues before the age of 3 may be vital to reducing the overall prevalence of obesity among inner city adolescents and adults.”

Additional research is needed about the events that occur during the critical age period in order to develop effective interventions aimed at reducing obesity. While the causes of this dramatic, early rise in obesity prevalence remain unknown, the Columbia researchers speculate that feeding behaviors may play a crucial role.

“The critical age period encompasses a major transition period for children, when they develop and establish food preferences and eating behaviors,” said Dr. Glassman.

She advises that pediatricians should screen early for obesity and offer advice to parents about the important role they play as their children move from a primarily milk-based diet of infancy to one consisting of a variety of solid foods. In order to help their children establish healthy eating patterns, parents need to think about the types of foods that they themselves eat and keep in the home, and how they approach mealtimes and the feeding (or overfeeding) of their children.

“It's important for parents to know that children model their eating preferences and behaviors on what their parents eat, that it can take multiple attempts of offering new foods before children like them, and that even very young children will stop eating on their own when they are full,” Dr. Glassman added.

Findings are being presented at the 2007 Pediatric Academic Societies annual meeting, May 3-8, in Toronto. Dr. Glassman's presentation will be held on Tuesday, May 8 at 3:30 pm in Room 701B, Toronto Convention Center.

Dr. Glassman is available for comment on these findings, pediatric interventions that can address obesity and what parents can do to reduce the risk of their children becoming overweight or obese at these very young ages.

http://www.cumc.columbia.edu