New paper on childhood growth and obesity

Kevin D Hall, Nancy F Butte, Boyd A Swinburn, Carson C Chow. Dynamics of childhood growth and obesity: development and validation of a quantitative mathematical model. Lancet Diabetes and Endocrinology 2013 .

You can read the press release here.

In order to curb childhood obesity, we need a good measure of how much food kids should eat. Although people like Claire Wang have proposed quantitative models in the past that are plausible, Kevin Hall and I have insisted that this is a hard problem because we don’t fully understand childhood growth. Unlike adults, who are more or less in steady state, growing children are a moving target. After a few fits and starts we finally came up with a satisfactory model that modifies our two compartment adult body composition model to incorporate growth. That previous model partitioned excess energy intake into fat and lean compartments according to the Forbes rule, which basically says that the ratio of added fat to lean is proportional to how much fat you have so the more fat you have the more excess Calories go to fat. The odd consequence of that model is that the steady state body weight is not unique but falls on a one dimensional curve. Thus there is a whole continuum of possible body weights for a fixed diet and lifestyle. I actually don’t believe this and have a modification to fix it but that is a future story.

What puzzled me about childhood growth was how do we know how much more to eat as we grow? After some thought, I realized that what we could do is to eat enough to maintain the fraction of body fat at some level, using leptin as a signal perhaps, and then tap off the energy stored in fat when we needed to grow. So just like we know how much gasoline (petrol) to add by simply filling the tank when it’s empty, we simply eat to keep our fat reserves at some level. In terms of the model, this is a symmetry breaking term that transfers energy from the fat compartment to the lean compartment. In my original model, I made this term a constant and had food intake increase to maintain the fat to lean ratio and showed using singular perturbation theory that his would yield growth that was qualitatively similar to the real thing. This then sat languishing until Kevin had the brilliant idea to make the growth term time dependent and fit it to actual data that Nancy Butte and Boyd Swinburn had taken. We could then fit the model to normal weight and obese kids to quantify how much more obese kids eat, which is more than previously believed. Another nice thing is that when the child stops growing the model is automatically the adult model!