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Health in Alaska

Obesity research shows three crucial weight
periods during childhood

By Emma Ross
AP Medical Writer

ATHENS, Greece - Evidence is growing that people's weight at three periods of childhood may be critical in setting them up to be fat in adulthood, scientists said.

Being born either too big or too small, the early appearance of puppy fat, and tubbiness in teenagehood seem to be emerging as important factors influencing how much of a struggle with weight people have as adults, according to experts gathered in early June at Europe's annual conference on obesity research.

Identifying these critical periods, they say, could help public health experts determine where best to intervene.

Many scientists believe that what happens around the time of birth is a particularly important time and that the evidence for this is especially robust.

Studies have shown that babies who are born large are more likely to end up fat as adults. However, being born very small also seems to increase the risk of obesity in adulthood, especially if such infants are then fed intensively to allow rapid growth so that they catch up with their peers.

"There are data from several different countries, including Israel, America, Europe and Southeast Asia showing a U-shaped curve," said Tim Lobstein, a childhood obesity specialist at the International Obesity Task Force.

"The lower end of it seems to be a thrifty situation where if you have a malnourished mother, the fetus will trigger the genes that conserve as much as possible. It will ... be triggering a laying down of any surplus energy as fat rapidly," Lobstein said.

"Babies that weigh less than 2.5 kilograms, or 5.5 pounds, would be considered small," he said. "The optimum is to try and have a baby around the 6 pounds or 7 pounds mark."

While the small baby problem is mostly one of the developing world, the major issue in wealthier countries is babies being born too big, experts say.

But convincing many parents, and even nurses, to move away from aiming for a big baby is likely to be a challenge, experts predict.

"They like to see them get high up on those (growth) curves, particularly in those early days. It's pretty ingrained in the maternal and child health nursing system to have a big baby, and it's probably not a smart idea," said Dr. Boyd Swinburn, an obesity expert from Deakin University in Melbourne, Australia. "And this underrecognition by parents is huge. It's going to be a major stumbling block."

The next stage that may be important is the preschool period, research suggests. Several studies indicate that children who gain weight before gaining height between toddlerhood and school-age seem to have a higher chance of being fat adults.

Rapid weight gain due to overfeeding in the first year of life may be particularly risky for later obesity, experts say.

Major studies over the last few years indicate that about one in three children who are fat in early childhood end up as fat adults. Children that get fat before the age of 8 tend to become more severely obese as adults than those who gain their weight afterward.

But being fat in the teenage years seems to be even more predictive of later risk of obesity, research indicates. About 70 percent of fat adolescents end up with obesity later in life.

The problem with obesity in adolescence seems to be that the male sex hormone testosterone pushes fat to the belly - a high risk location, while in girls, the problem is that they tend to gain significant weight during their teens.

The three stages of childhood considered critical for obesity development outlined at the conference are scheduled to be discussed at an upcoming World Health Organization expert meeting in Japan later this month.

Vascular health issues need more attention

By Lauran Neergaard
AP Medical Writer

WASHINGTON - Promising cancer research needs to be translated more quickly into practical methods of diagnosis and treatment, a presidential commission says.

Barriers exist at every step between the laboratory and a patient's bed, according to the report released June 13. Unless those barriers are eased, "the national investment in cancer research will be tragically squandered, for discoveries that do not lead to improved patient outcomes are tantamount to no discovery at all," the President's Cancer Panel said.

This year, some 1.37 million new cases of cancer will be diagnosed and about 570,000 Americans will die from cancer, according to the American Cancer Society.

Because the risk of cancer increases with age, cases are expected to rise as the number of older people increases. Yet the past two decades have produced "a biological revolution" bringing new insights into how cancer forms, said one member of the commission, Margaret Kripke of the M.D. Anderson Cancer Center in Texas.

The challenge is to speed the translation of more of those insights into something doctors and patients can use. Aside from scientific challenges, one problem is that advances can take too long to reach patient care, said the panel's chairman, Dr. LaSalle Leffall Jr. of Howard University in Washington.

"If we don't get the information out, of what value is it to patients?" he asked.

Among the panel's recommendations:

  • The National Cancer Institute should require that hospitals it designates as comprehensive cancer centers disseminate research findings to local oncologists and other cancer organizations.

  • The institute should redouble efforts to increase community-level clinical trials. About 20 percent of cancer patients are medically eligible for those studies, but just 3 percent enroll. One reason is that trials are offered mainly in academic medical centers, while at least 80 percent of cancer patients are treated by community oncologists.

  • Lack of trust is an additional reason for the low study enrollment. To improve that, cancer researchers must do a better job sharing the results of clinical trials with subjects and participating communities.

  • Medicare officials should consider collecting information about the stages of cancer of patients treated under the program. This data could be used to improve treatment decisions and see how quickly research findings are translated into practice.

    Federal cancer officials had no immediate comment on the recommendations. The three-member commission, which also included cycling champion and cancer survivor Lance Armstrong, provides periodic reports to the president on issues surrounding cancer research, incidence and care.

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