(11-11-05) Rapid weight gain in young children predicts coronary events in adulthood

NEW YORK (Reuters Health) - Children who are thin until the age of 2 and then gain weight rapidly are at increased risk for coronary events in adulthood, according to the findings of a study reported in October 27th issue of The New England Journal of Medicine.

Low birth weight has been linked to future heart disease, but the effect of postnatal growth on the risk of coronary events was unclear.
"The results, in a sense, were surprising in that they suggest people who go on to develop coronary heart disease do not thrive in the first 2 years after birth. But then, there is a sort of compensation and they start to put on weight rapidly," lead author Dr. David J. P. Barker, from Oregon Health and Science University in Portland, told Reuters Health.
"The people who will be in the ICUs in 50 years time are not the overweight children at 5 through 9 years of age, but rather the children who were thin but put on weight rapidly," he added.
The new study involved 8760 people who were born in Helsinki between 1934 and 1944 and followed for more than 50 years for coronary events. During follow-up, 357 men and 87 women were admitted to the hospital for coronary heart disease or experienced a fatal event.
As noted, at-risk subjects were thin from birth until 2 years of age. At this point, their BMIs began to increase relative to other children until finally reaching average values at about 11 years of age.
For boys, 1 standard deviation increase in BMI at 2 years decreased the risk of future coronary events by 24%, whereas at 11 years, this same increase raised the risk by 14%. The corresponding figures for girls were a decrease of 38% and an increase of 35%.
In addition to the link with coronary events, a low BMI at 2 years and rapid weight gain between 2 and 11 years were both associated with insulin resistance in adulthood.
In determining the future risk of heart disease and considering possible interventions, the message for pediatricians and parents is that instead of comparing a child's weight with that of his peers, they should be monitored in relationship to their own weight, Dr. Barker emphasized.

Source : N Engl J Med 2005;353:1802-1809.

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