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Updated: Aug 15, 2026
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Metabolic risk in early childhood: the EarlyBird Study
T J Wilkin1, L D Voss, B S Metcalf
1The EarlyBird Research Centre, Peninsula Medical School, Plymouth, UK. T.Wilkin@pms.ac.uk
Insights
Insulin resistance in children is linked to current weight, not birth weight. Physical activity varies by child, and gender influences insulin resistance, challenging simple explanations like overnutrition.
Area of Science:
- Pediatric Endocrinology
- Metabolic Health
- Childhood Obesity
Background:
- Historically, low birth weight was linked to later insulin resistance.
- Rising birth weights and insulin resistance necessitate alternative explanations.
- The EarlyBird study investigates childhood insulin resistance and metabolic disturbances.
Purpose of the Study:
- To identify factors contributing to insulin resistance in children.
- To examine the relationship between early childhood metabolic markers and insulin resistance.
- To explore the influence of physical activity, body composition, and genetics on insulin resistance.
Main Methods:
- Prospective cohort study of 307 healthy children.
- Serial measurements of anthropometrics, body composition, and metabolic markers (e.g., HOMA-IR).
- Assessment of diet, physical activity, and parental metabolic health.
Main Results:
- Insulin resistance correlates with current weight at age 5, not birth weight.
- Females exhibit higher intrinsic insulin resistance than males.
- Physical activity variation is child-specific; fatness and insulin resistance are dissociated in young children.
Conclusions:
- Current notions of overnutrition and underactivity are insufficient to explain childhood insulin resistance.
- Further research is needed to understand the complex development of obesity and insulin resistance in children.
Objective:
For a decade or more, poor nutrition during gestation, expressed as low weight at birth, was held to be the factor responsible for insulin resistance later in life. Birth weights, however, are rising and insulin-resistant states, such as diabetes, faster still. Alternative explanations are needed for insulin resistance in contemporary society. This review cites data from the EarlyBird study on the relationships of insulin resistance and metabolic disturbance in early childhood.
Design:
EarlyBird is a nonintervention prospective cohort study that asks the question 'Which children develop insulin resistance, and why?' It is unique in taking serial blood samples from a young age with which to monitor the behaviour of insulin resistance and its metabolic correlates, and in its comprehensive assessment of factors known or thought to influence insulin resistance
Subjects:
In all, 307 randomly selected healthy school children at school entry (mean age 4.9 y) and at 12 and 24 months later.
Measurements:
In the children: Birth weight and, at each time point height, weight, body mass index (BMI, kg/m(2)), skinfolds at five sites, circumferences, resting energy expenditure, physical activity, body composition, heart rate variability, diet, HOMA-IR and HOMA-ISC, blood pressure, full blood count, haemoglobin and haematocrit, HbA1C, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, uric acid, IGF-1, gonadotrophins and SHBG. In their parents: At baseline height, weight, BMI, waist circumference, HOMA-IR and HOMA-ISC, full blood count, haematocrit, HbA1C, total cholesterol, HDL cholesterol, calculated LDL cholesterol, triglycerides, uric acid, gonadotrophins and SHBG.
Results:
Four observations are reported here: (1) There are clear correlations in contemporary children between insulin resistance and weight at 5 y, but none with birth weight. (2) Females throughout life are intrinsically more insulin resistant than males. (3) The substantial variation of physical activity among young children is attributable to the child, and not to his environment. (4) There is dissociation in young children between fatness and insulin resistance.
Conclusion:
There is much yet to be learned about the development of obesity and insulin resistance in children. The notions of overnutrition and underactivity alone are too simplistic.
