Full Tummy, Happy Heart?

Pediatricians invest significant effort in the promotion of faster weight gain in children under 2 who are not growing as they should. They press the issue because there’s a great deal of evidence that suggests that growth delays during this stage of life negatively impact future cognitive development as well as rates of morbidity and mortality; however, recent studies also suggest that rapid weight gain during the first two years of life is associated with an increased risk of obesity and insulin resistance in adulthood.

In the past few years, we’ve learned a lot about how certain aspects of health and wellbeing in early childhood—particularly during the first 1,000 days of life, beginning in the womb—have long-term effects on people’s health. In March of this year, the prestigious medical journal The Lancet published an article that sheds light on this topic.

The article in question is interesting because it uses data from five low- and middle-income countries: Brazil, the Philippines, Guatemala, India and South Africa. Similarities in the findings suggest that they may be valid for other countries with comparable characteristics. The research focuses on three key periods: birth, age 2, and childhood (defined as the period between ages 4 and 8). The study evaluates how birthweight, growth in height, and weight gain relative to growth in height are related to body mass index (BMI) and stature, cardiometabolic risk factors, and some human development outcomes such as level of schooling in adulthood.

The findings of this study are encouraging:

• Birth: It was found that higher birthweight is associated with an increased likelihood of adult overweight but also with a lower risk of other negative health conditions.
• The first two years of life: Higher relative weight at age 2 is associated with an increased risk of being overweight at adulthood and greater risk for high blood pressure. In contrast, it does not appear to be related to adult stature, educational attainment or diabetes risk. Greater relative height at age 2 was related to lower risk of short stature and poor educational attainment.
• Childhood (between ages 4 and 8): By contrast, higher relative weight in childhood was associated with a higher likelihood of adult overweight and high blood pressure but was unrelated to educational attainment. Greater relative height in childhood was related to lower risk of short stature and poor educational attainment.

It’s worth noting that higher birthweight and higher relative weight at age 2 seemed to be positively associated with higher BMI but greater lean mass in adulthood. Conversely, higher relative weight in childhood was more strongly correlated with higher body fat in adulthood.

Evidence from this research supports targeted interventions that increase birthweight and growth during the first 2 years of life, as they are likely to have effects on schooling and height in adulthood, but also for their potential to protect against chronic diseases. In other words, these findings support the importance of the first 1,000 days of life as a window of opportunity for nutritional interventions. In addition, this research illustrates that beyond the age of 2, nutritional interventions are critical to preventing overweight and obesity. With an eye toward public policy, this research seems to give us clear indications of how important it is for nutritional initiatives to reach children with the right messages at the right time.