Gestational Diabetes and Childhood Obesity

Guest Author: Ashley Rasmussen

Childhood obesity has become a growing problem in today’s overfed, underactive societies. Numerous recommendations to curb this obesity epidemic have been proposed, many of which involve reactive, rather than proactive, measures. Unfortunately, many parents don’t take the right steps to ensure their child is eating healthfully until it is too late and they are met with a diagnosis of overweight or obesity and the many health problems that result.

What if parents had a way of knowing at birth whether or not their child was at risk of becoming overweight? This would give them plenty of time to take action to prevent weight problems from developing. Although this sounds like something out of the distant future, the reality may be closer than we think for some parents and children. In the June issue of The Journal of Pediatrics, Tessa Crume and colleagues delve into a link between maternal diabetes and childhood body mass index, a discovery that could have positive implications for winning the war on obesity.

Body mass index, or BMI, is essentially a calculation of weight related to height, and a key determinant of overweight status. Higher BMIs are normally associated with unhealthy weights and an increased risk of health complications such as heart disease and diabetes. Children with high BMIs, therefore, are likely to be considered overweight or obese and are more prone to developing weight-related complications later in life.

While it would be impossible to predict a newborn’s BMI at every stage of their life, there are some clues that can determine whether a child is at risk of trending toward a high BMI as they mature. The key clue Crume and colleagues picked up on in their research was maternal diabetes status: children whose mothers developed gestational diabetes at some point during their pregnancy were more likely than children of non-diabetic mothers to have high BMIs, and a faster rate of BMI growth, as they progressed through childhood, with the greatest risk of having a high BMI seen during the pre-pubertal period of ages 10-13.
While children of diabetic mothers that participated in the study were likely to have normal BMIs during early childhood, their weight-to-height ratio appeared to significantly shift upward as they approached puberty, putting many in the overweight range. Additionally, the diabetic mothers were more likely to be overweight than those with out diabetes, suggesting a possible familial component to children’s future weight problems.

The results of this study can be used to fight the war on childhood obesity by targeting those children who may be more susceptible to developing weight problems before these problems actually begin. Children whose mothers developed diabetes while pregnant can be counseled on healthy eating habits from an early age and carefully monitored to ensure that their weight is not creeping out of the normal range. Childhood is the best time to instill healthy eating habits and take corrective actions should poor habits or outcomes occur; by targeting at-risk children early, we can help prevent the looming problems of overweight and obesity from becoming a reality.

Source:
Crume, Tessa L., Lorraine Ogden, Stephen Daniels, Richard F. Hamman, Jill M. Norris, and Dana Dabelea. “The Impact of In Utero Exposure to Diabetes on Childhood Body Mass Index Growth Trajectories: The EPOCH Study.” The Journal of Pediatrics. Volume 158, Number 6, June 2011: 941-6.