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Childhood weight changes predict sugar problem
NEW YORK (Reuters Health) - 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, February 26, 2004.
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