Weight Loss by Overweight Girls May Lower Risk for Diabetes in Adulthood
By Laurie Barclay, MD
Medscape Medical News
June 10, 2010 — Weight loss by overweight girls may lower their risk for diabetes in adulthood, according to the results of an analysis from the Nurses' Health Study II reported in the June issue of Diabetes Care.
"These findings suggest that ensuring that overweight kids reverse their weight gain is critical to limiting their future risk of diabetes as adults," said lead author Edwina Yeung, PhD, from the Eunice Kennedy Shriver National Institute of Child Health and Human Development in Bethesda, Maryland, in a news release.
The goal of this analysis was to evaluate the association of childhood overweight, along with other life course weight characteristics, with the development of type 2 diabetes in adulthood.
In the Nurses' Health Study II, a total of 109,172 women reported on their recalled level of body fatness at ages 5, 10, and 20 years using 9-level pictorial diagrams (somatotypes) reflecting extreme thinness (category "1") to obesity (category "9"). Body mass index (BMI) was calculated from recalled weight at age 18 years and in adulthood. Those participants who reported having type 2 diabetes completed a supplementary questionnaire.
Somatotypes at ages 5 and 10 years were positively associated with the risk for diabetes in adulthood (P for trends < .0001). Women with somatotypes of at least "6" vs "2" at age 5 years had adjusted relative risks (RR) for adult diabetes of 2.19 (95% confidence interval [CI], 1.79 - 2.67). At age 10 years, the RR for somatotypes of at least "6" vs "2" was 2.57 (95% CI, 2.20 - 3.01). The risk was increased for increases in size by somatotype or by weight gain since age 18 years.
Compared with women who had never been overweight, women who were overweight as an adult (BMI > 25 kg/m2) but not before adulthood had an adjusted RR of 8.23 (95% CI, 7.41 - 9.15). For women who were also overweight at age 10 years (somatotype ? "5") and at age 18 years (BMI > 25 kg/m2), the adjusted RR was 15.10 (95% CI, 13.21 - 17.26). Women who had increased childhood size but who did not continue to be overweight in adulthood did not have an increased risk for adult diabetes.
"Increased body size starting from childhood is associated with a greater risk of diabetes in adulthood," the study authors write. "However, women who become lean in adulthood do not have an increased risk."
Limitations of this study include observational design, use of recalled somatotype instead of BMI for measurement of childhood size, generalizability limited to Caucasian women, and possible residual confounding.
"Our findings demonstrate that the importance of childhood overweight stems largely from adult overweight," the study authors conclude. "It remains important then to promote lifestyle changes from youth so that the adverse trajectory could be avoided. Multiple interventions that childhood overweight can be addressed have been suggested, but these remain to be fully tested."
The National Institute of Child Health and Human Development, the National Cancer Institute, and the National Institute of Diabetes and Digestive and Kidney Diseases provided funding for this analysis. The study authors have disclosed no relevant financial relationships.
