Revisiting the EarlyBird Diabetes Study

child's play

The EarlyBird Diabetes Study has been going on for 12 years, keeping an eye on the same cohort of healthy kids, and it intends to continue until they are 16 years old. They are looking mainly at the causes and effects of insulin resistance. The website says:

Insulin resistance, largely the result of obesity, is believed to underpin the high prevalence of diabetes and cardiovascular disease that characterizes modern society. EarlyBird is distinctive in combining objective measures of physical activity and body composition from the age of 5y with annual fasting blood samples, which reach beyond simple body composition (BMI and body fat) to metabolic health (glucose control, insulin sensitivity, blood fats, cholesterol, blood pressure).

In the big picture of childhood obesity knowledge, these scientists believe there is a large amount of theory supported by slender evidence. If they were Texans, they might say, “All hat and no cattle.” But they are not Texans, because this research is taking place in the United Kingdom. There, as elsewhere, individuals and companies and well-intentioned government bodies are implementing programs and urging the adoption of even more programs, without much science to justify their enthusiasm.

The EarlyBird Study wants to help society allocate scarce resources to where they will do the most good. The website says:

Diabetes and heart disease are related to obesity, and everyone knows what causes obesity — or at least we think we do. But until we measure it, what we think we know is inevitably hunch, assumption or, worst of all, prejudice… We must be receptive to what sometimes seems counterintuitive if we are to get to the bottom of childhood obesity… The outcomes of adding fruit to the lunch-box or of prescribing two hours of PE a week, while intuitively good, are in reality unknown… Understanding the problem has to be a key issue.

Even though the overall study will not be summarized for several years, information is always being extracted along the way. It’s not only the general population that is sometimes misinformed. The scientific community also has its popular beliefs, and some of the EarlyBird results have been contrary to them. All the work is peer-reviewed and characterized as “statistically robust.”

What are these surprising results? Some have to do with physical activity, which is almost universally accepted as a key element in maintaining a healthy weight. However, EarlyBird evidence shows that obesity leads to inactivity, not vice versa. Fat comes first, then immobility. Potatoes come first, before couch-potatohood.

These scientists believe that calorie reduction is way more important than exercise. Though it seems like, according to their own standard of open-mindedness, they might specify “calorie reduction — or some other factor.”

But while exercise doesn’t seem to prevent kids from gaining weight, it does keep them metabolically healthier. As Childhood Obesity News has noted before, this can have many beneficial effects, any one of which might nudge a child off the path of potential obesity, and indirectly provide an opportunity to escape obesity and/or diabetes.

Another surprise brings disappointment to many neighborhood activists and school reformers. Apparently, sports centers and parks don’t really seem to inspire kids to rise above their accustomed levels of activity. That doesn’t mean we should neglect the necessity of rec halls and green spaces, which are important for many reasons. We just need to get over the expectation that they will reduce childhood obesity. The researchers say:

Like most things biological, a child’s activity level seems to be ‘set’ by the brain, and therefore strongly defended against change.

School PE programs don’t seem to make a difference, either, or walking or biking to school. If kids are made to run around at school or hike back and forth, it looks like they compensate for that inconvenience by being less active on their own time.

Your responses and feedback are welcome!

Source: “Key Findings from EarlyBird,”
Source: “The EarlyBird Study,”
Image by Christina Spicuzza.

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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