Programming of relative leptin concentrations by early diet may be one mechanism that links early nutrition with later obesity.

Childhood obesity is becoming a global epidemic. Twin studies suggest a heritability of fat mass, and disorders of energy balance that arise from genetic defects have been identified. In the past three years, five single gene disorders resulting in early onset obesity have been characterised. The discovery of these genetic defects has biological and clinical implications which are greater than the rarity of the individual diseases might suggest. (Arch Dis Child 2000;83:31-34)

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