The March issue of Pediatrics has two articles about the littlest children – those under 2. The first one says that nothing we are saying to try makes much of a difference in preventing obesity and the other says that they are not getting fatter at this age anyway. (1,2)
The first study was conducted in New Zealand. They’re just like us in many ways. They tried diet, activity, breast feeding and sleep advice over numerous sessions to a group of new mothers and compared that to a control group that did not get pushed to do these things that the usual punditry says should make babies not so fat. They found that by 2 years there was no effect of these interventions. In a secondary analysis they did find that the sleep advice group had less obesity but it was not related to how much those babies slept or any sleep problems and it was only significant by comparison to the other 3 interventions, diet, activity and breast feeding but not to the control group. So that is probably a fluke of data dredging. (1)
The second study used the National Health and Nutrition Examination Survey (NHANES) data going all the way back to 1976, early in the obesity epidemic and up to 2014 the latest data. They found there was no trend in the weights and shapes of babies up to 2 years of age. Babies have not been getting bigger and there was no trend in the numbers of undersized babies either. (2)
The seeds of the obesity epidemic may be sown in these smallest of people but the usual advice does not help and they are not the ones who are too fat as a group. It is true that very fat babies are more likely to be fat adults. It is true that fat 5 years olds are even more likely to be fat adults. Obese teenagers have an even greater propensity than babies and 5 year olds to be obese adults and the strongest link of all is between obese 25 year olds and obese 50 year olds. Also the rates of obesity increase with age. So a lot of skinny kids are also getting obese. There must be an important clue in this observation. I don’t know what it is. But in waging the war on obesity maybe we should leave the littlest children out of it.
John DiTraglia M.D. is a Pediatrician in Portsmouth. He can be reached by e-mail- firstname.lastname@example.org or phone-354-6605.