Insulin resistance is now the commonest cause of premature death in the western world, underlying diabetes, heart disease, hypertension, high cholesterol, stroke, infertility and many cancers. Insulin resistance results largely from lifestyle, and is most obviously associated with obesity – upper body (intra-abdominal) obesity in particular. If insulin resistance is the fuse, then the fuse burns slowly in some, faster in others. Crucially, we need to know what lights it in the first place. Left unchecked, one in five children born today will develop diabetes in their lifetime.
Professor Terence Wilkin, Professor of Endocrinology and Metabolism at the Peninsula Medical School in Plymouth, led the ‘EarlyBird Study’ between 2000 and 2013 to find which factors in childhood lead to diabetes in later life. The EarlyBird Study was distinctive in combining objective measures of physical activity and body composition with annual fasting blood samples in some 300 healthy school children since they were just 5y. (Click to EarlyBirds – The Volunteers) These measures reach beyond simple body composition (BMI and body fat) to metabolic health (glucose control, insulin sensitivity, blood fats, cholesterol, blood pressure).
Professor Wilkin first approached Dr Chai Patel, whom he taught as a medical student, for assistance with funding the research programme in 2006. The Bright Future Trust and the Patel family had contributed close to £1m by the time the study was completed September 2013.
The results of the EarlyBird research were published in April 2015 and indicated that obesity in children has quite different causes at different ages. This finding could have far-reaching implications for attempts to reduce the global epidemic of childhood obesity, as it indicates that very different approaches may be needed at various stages of development.
The EarlyBird study showed that the rise in obesity among very young children has been largely restricted to the minority with obese parents. Toddlers as a whole have not changed.
By contrast, obesity among adolescents has not been restricted to those with obese parents, but has occurred across the entire age group.
The data suggest that parenting is the fundamental influence on weight gain in the early years, whereas more general (peer-group) influences take over later on. Public health strategies may need to be tailored accordingly. Professor Wilkin said: “ We now need further studies to explore this in more depth, as it could have significant implications for healthcare.”
The EarlyBird Study was funded The Bright Future Trust, Peninsula Foundation, BUPA Foundation and the EarlyBird Diabetes Trust.