COMMENTARY

Advances in Obesity Management: 2014

Fatima Cody Stanford, MD, MPH

Disclosures

December 11, 2014

In This Article

Focusing on Childhood Obesity

In an article published in the New England Journal of Medicine in January, Cunningham and colleagues[11] found that "incident obesity between the ages of 5 and 14 years was more likely to have occurred at younger ages, primarily among children who had entered kindergarten overweight."

The authors analyzed data from the Early Childhood Longitudinal Study, Kindergarten Class of 1998-1999, a nationally representative database with information on 7738 children who entered kindergarten in 1998 and were followed up through 2007.

When the children entered kindergarten at a mean age of 5.6 years, 12.4% were obese and 14.9% were overweight. The authors found that children who were overweight when entering kindergarten were four times as likely as their normal-weight classmates to become obese by age 14 years.

This study supports the notion that childhood obesity prevention must start well before a child enters kindergarten.

Other studies, including one by Bailey and colleagues[12] in JAMA Pediatrics, support the notion that early exposure to antibiotics may lead to obesity in childhood. Studies have shown that the gut microbiota plays a role in the regulation of energy homeostasis and fat storage through a variety of mechanisms.[13]

It is important to note that changes in the gut microbiota in children may happen in utero. In the International Journal of Obesity, Mueller and colleagues[14] found that prenatal exposure to antibiotics in the second and third trimester was associated with a higher offspring risk for obesity.

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