Childhood obesity: Early years a ‘critical window’

At Shining Stars Family Child Care in San Francisco, toddlers and preschoolers celebrate birthdays with quinoa cakes sweetened only with sweet potatoes.

There’s no juice at snack time. Instead, the children sip water flavored with berries or cucumbers.

And they do work up a thirst, salsa dancing and running around the center’s backyard.

The children may not know they are engaged in an obesity prevention program backed by research. They just know “they love it,” Shining Stars owner Zonia Torres says.

Researchers say an early embrace of healthy habits is a key ingredient in tackling an urgent problem: excess weight gain in very young children.

Researchers have long known that heavy children often grow up to become heavy teens and adults. The latest research, a study that followed 50,000 German children, found an especially strong risk when children gain weight too rapidly from ages 2 to 6.

An early weight surge “is the most powerful predictor of subsequent obesity in adolescence,” says Michael Freemark, a professor of pediatrics at Duke University School of Medicine.

The longer a child stays heavy, the more likely the pounds are to stick, says Freemark, who wrote an editorial accompanying the study, published this month in the New England Journal of Medicine.

Many obese adults were never obese children, he says, but obese children and teens are at very high risk for becoming obese adults.

Researchers do not know how much of the extra risk is genetic and how much is driven by unhealthy habits and exposure to fast foods, comfy sofas and alluring screens. It’s possible, Freemark says, that an early weight surge changes the body in ways that make it harder to control weight later.

For the next nine months, USA TODAY plans to explore the health challenges that confront people in all 50 states. This story is second in that series. The first was on Alzheimer’s.

Nearly 40 percent of adults are obese, according to the federal Centers for Disease Control and Prevention. Hopes for a decline in young children were dashed by a study by the American Academy of Pediatrics that found 15 percent of children ages 2 to 5 were obese in 2015-16, up from 11 percent in 2013-14.

A more encouraging survey, from the federal Special Supplemental Nutrition Program for Women, Infants and Children (WIC), found that the obesity rate among low-income children ages 2 to 4 enrolled in that program fell to 14.5 percent in 2014, down from 15.9 percent in 2010. The next round of WIC data, from 2016, has not been released.

Whatever the exact numbers, Freemark wrote in his editorial, it’s clear that “we are now witness to an evolving epidemic of childhood obesity” that’s putting youngsters at risk for eventual complications ranging from type 2 diabetes to fatty liver disease.

The early years are a critical window, he says, and perhaps the best time to prevent harm.