Published online September 1, 2006
PEDIATRICS Vol. 118 No. 3 September 2006, pp. 1118-1123 (doi:10.1542/peds.2006-0740)
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ARTICLE

Little Evidence for Early Programming of Weight and Insulin Resistance for Contemporary Children: EarlyBird Diabetes Study Report 19

Alison N. Jeffery, MSca, Brad S. Metcalf, BSca, Joanne Hosking, PhDa, Michael J. Murphy, FRCPb, Linda D. Voss, PhDa and Terence J. Wilkin, MDa

a Department of Endocrinology and Metabolism, Peninsula Medical School, Plymouth, United Kingdom
b Department of Biochemical Medicine, Ninewells Hospital, Dundee, United Kingdom

OBJECTIVE. The aim of this study was to evaluate whether adaptive responses made to the uterine or very early infant environment are affecting the current metabolic health of young children in the United Kingdom.

METHODS. Participants were 300 healthy children and their parents from the EarlyBird Diabetes Study cohort. Children were recruited from randomly selected schools at 5 years of age. Retrospective measures were maternal prepregnancy weight (n = 230), maternal fasting glucose levels at 28 weeks of pregnancy (n = 27), birth weight, and infant weight at ages 3 and 6 weeks. Prospective measures were insulin resistance, height, weight, and percentage of body fat (sum of 5 skinfold measurements) at ages 5, 6, 7, and 8 years.

RESULTS. Maternal third-trimester fasting glucose levels were associated positively with birth weight but were not associated with either weight or insulin resistance for the same children at 8 years. Birth weight was unrelated to insulin resistance at 8 years. There were no relationships between weight change in the first weeks of life and weight, percentage of fat, or insulin resistance at 8 years. Longer breastfeeding correlated inversely, although weakly, with percentage of body fat for boys only. Current weight was correlated with insulin resistance at 8 years.

CONCLUSIONS. For these contemporary children, neither the gestational environment nor early postnatal growth predicted insulin resistance, which was best predicted by current weight. There was no evidence that predictive adaptive responses made by the fetus or infant affected the child's weight or insulin resistance later in childhood.

Key Words: birth weight • body composition • body mass index • breastfeeding • children • fetal programming • insulin resistance • metabolic syndrome • obesity • weight

Abbreviations: HOMA-IR—homeostasis model assessment-insulin resistance

Accepted Apr 28, 2006.