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Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Quantification of the energy gap in young overweight children. The PIAMA birth cohort study
Saskia W van den Berg1, Jolanda M A Boer, Salome Scholtens
1National Institute for Public Health and the Environment, Bilthoven, the Netherlands. saskia.van.den.berg@rivm.nl
Insights
A small daily energy gap, approximately 289-320 kJ, contributes to overweight in young children. Addressing this energy imbalance through minor behavior changes can prevent excess weight gain, but significant effort is needed for weight loss.
Area of Science:
- Pediatric Endocrinology
- Nutritional Science
- Public Health
Background:
- Overweight in children is a gradual process stemming from a sustained positive energy balance.
- Understanding the specific energy surplus contributing to excess weight is crucial for intervention.
Purpose of the Study:
- To quantify the "energy gap" responsible for excess body weight gain in young children.
- To determine the daily energy surplus leading to overweight in children aged 5-7 years.
Main Methods:
- Utilized weight and height data from 2190 children in the PIAMA birth cohort study (ages 2 to 5-7).
- Estimated accumulated body energy based on weight gain and calculated the energy gap assuming 50% energy efficiency.
Main Results:
- Ten percent of children were overweight by age 5-7.
- Overweight children exhibited a median weight gain of 13.3 kg compared to 8.5 kg in normal-weight children over 4 years.
- A daily energy gap of 289-320 kJ (69-77 kcal) was identified as the primary driver for excess weight gain in most overweight children.
Conclusions:
- A persistent daily energy gap of 289-320 kJ can lead to overweight in young children.
- Small behavioral modifications can help close the energy gap and prevent further weight gain.
- Reversing existing excess weight in overweight children requires substantial and sustained effort.
Background:
Overweight develops gradually as a result of a long term surplus on the balance between energy intake and energy expenditure. Aim of this study was to quantify the positive energy balance responsible for excess body weight gain (energy gap) in young overweight children.
Methods:
Reported data on weight and height were used of 2190 Dutch children participating in the PIAMA birth cohort study. Accumulated body energy was estimated from the weight gain observed between age 2 and age 5-7. Energy gap was calculated as the difference in positive energy balance between children with and without overweight assuming an energy efficiency of 50%.
Results:
Ten percent of the children were overweight at the age of 5-7 years. For these children, median weight gain during 4-years follow-up was 13.3 kg, as compared to 8.5 kg in the group of children who had a normal weight at the end of the study. A daily energy gap of 289-320 kJ (69-77 kcal) was responsible for the excess weight gain or weight maintenance in the majority of the children who were overweight at the age of 5-7 years. The increase in daily energy requirement to maintain the 4.8 kilograms excess weight gain among overweight children at the end of the study was approximately 1371 kJ.
Conclusions:
An energy gap of about 289-320 kJ per day over a number of years can make the difference between normal weight and overweight in young children. Closing the energy gap in overweight children can be achieved by relatively small behavior changes. However, much more effort is required to lose the excess weight gained.
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