Assessing risk factors for obesity between childhood and adolescence: I. Birth weight, childhood adiposity, parental obesity, insulin, and leptin.
OBJECTIVE
To assess the effects of body weight, body composition, parental obesity, and metabolic variables on the development of obesity in a large cohort of 5-year-old Native American children with a high propensity for obesity.


METHODS
During the summer months of 1992 to 1995 and again 5 years later, 138 (65 boys and 73 girls) 5-year-old Pima Indian children were studied. Height; weight; body composition; parental obesity; and fasting plasma insulin, glucose, and leptin concentrations were determined at baseline and follow-up. Linear regression models were used to assess the effect of the baseline variables on the development of obesity.


RESULTS
At both 5 and 10 years of age, Pima Indian children were heavier and fatter than an age- and gender-matched reference population. All anthropometric and metabolic variables tracked strongly from 5 to 10 years of age (r > or = 0.70). The most significant determinant of percentage of body fat at 10 years of age was percentage of body fat at 5 years of age (R(2) = 0.53). The combined effect of high maternal body mass index, elevated fasting plasma leptin concentrations, and low fasting plasma insulin concentrations at baseline explained an additional 4% of the total variance in adiposity at follow-up.


CONCLUSIONS
Although parental obesity and metabolic variables such as insulinemia and leptinemia at baseline account for a small percentage of the variance in adiposity at follow-up, early childhood obesity is the dominant predictor of obesity 5 years later. These results suggest that strategies to prevent childhood obesity must be initiated at a very early age.
Salbe
Arline D
AD
Clinical Diabetes and Nutrition Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA. arline_salbe@nih.gov
Weyer
Christian
C
Lindsay
Robert S
RS
Ravussin
Eric
E
Tataranni
P Antonio
PA
D000273:Adipose Tissue; D000293:Adolescent; D000886:Anthropometry; D001724:Birth Weight; D001786:Blood Glucose / Q000378:metabolism; D001823:Body Composition; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007198:Indians, North American; D007328:Insulin / Q000378:metabolism*; D020738:Leptin / Q000378:metabolism*; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D009765:Obesity / Q000453:epidemiology* / Q000208:ethnology / Q000235:genetics / Q000378:metabolism; D018570:Risk Assessment
D001786:Blood Glucose; D007328:Insulin; D020738:Leptin