Pay particular attention to the last paragraph!


Excerpts from another article from e-OB-GYN,

Volume 41 <http://www.obgynnews.com/issues?Vol=41>, Issue
21<http://www.obgynnews.com/issues/contents?issue_key=TOC@@JOURNALS@QO@0041@0021>,
Page 24 (01 November 2006)


Combating Obesity Needs to Start in the Womb

DIANA MAHONEY<http://www.obgynnews.com/article/PIIS0029743706723710/fulltext#>(New
England Bureau)

 <Efforts to prevent childhood obesity should begin in the womb and infancy
to turn the tide on the startling increase in the number of overweight and
obese children in this country, according to Dr. Matthew W. Gillman.

In a study of more than 120,000 children enrolled in a Massachusetts health
maintenance organization, Dr. Gillman and his colleagues at Harvard Medical
School in Boston showed that the prevalence of overweight and obesity among
healthy middle-class children younger than 6 years increased by 59% between
1980 and 2001. The increase in the number of overweight infants younger than
6 months during the same time period was 74% (Obesity 2006;14:1107–12).

Results of another study found that children who were overweight very young
were not likely to outgrow that "baby fat" when they were older.

In fact, the very definition of "overweight" is coming into question with
the introduction of new growth standards by the World Health Organization
(WHO), which differ fundamentally from the Centers for Disease Control and
Prevention (CDC) standards and classify more American infants and young
children as overweight. . . . . . .

Efforts to mitigate the risk of overweight in babies should include
interventions targeted at parents that focus on avoiding excessive weight
gain during pregnancy, preventing gestational diabetes, and promoting
breast-feeding, which tends to be associated with leaner babies, according
to Dr. Gillman. . . . . .The growth charts themselves have been the subject
of some controversy in recent years. . . . . . . .

New growth standards introduced by WHO in April of this year were designed
to fit this bill, said Dr. Garza, who chaired the WHO Multicentre Growth
Reference Study from which the new standards were generated. The goal of the
study was to develop standards based on the growth and development of
healthy infants and children up to 5 years old from around the world. . . .
. The children were selected based on predefined criteria for feeding
practices, nutrition, and health care that have been previously associated
with good health outcomes. . . . . . . For the purposes of the study,
breast-feeding—including exclusive/predominant breast-feeding for at least
the first 4–6 months of life and continued complementary breast-feeding for
at least 1 year—was considered the normative behavior for infant feeding.

The study showed that, despite individual differences among the children,
the average growth across the board was similar, indicating the important
influence of healthy growth conditions in early life, Dr. Garza said. . . .
. . .  It is unclear whether the U.S. pediatric community will adopt or
adapt these new growth charts.

With the WHO curves, more babies and young children in the United States in
particular fall into an overweight category, compared with the CDC growth
chart, possibly because a smaller percentage of U.S. babies are breast-fed,
and breast-fed babies tend to be leaner than formula-fed babies.

This does not diminish the relevance of the growth curves in the United
States, according to Dr. Garza. Rather, "it highlights the fact that
breast-feeding is an important early risk reduction factor and should be
promoted as such."

It has yet to be determined whether the United States will adopt the new WHO
standard or adapt existing standards to include some of the important
changes, but the possibility was put on the table in late June at a meeting
of the CDC, the National Institutes of Health, and the American Academy of
Pediatrics, according to Dr. Frank R. Greer, chairman of the AAP Committee
on Nutrition.>

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