Abstract
Objective:High birth weight and greater weight gain in infancy have been associated with increased risk of obesity as assessed using body mass index, but few studies have examined associations with direct measures of fat and lean mass. This study examined associations of birth weight and weight and height gain in infancy, childhood and adolescence with fat and lean mass in early old age.Subjects:A total of 746 men and 812 women in England, Scotland and Wales from the MRC National Survey of Health and Development whose heights and weights had been prospectively ascertained across childhood and adolescence and who had dual energy X-ray absorptiometry measures at age 60–64 years.Methods:Associations of birth weight and standardised weight and height (0–2 (weight only), 2–4, 4–7, 7–11, 11–15, 15–20 years) gain velocities with outcome measures were examined.Results:Higher birth weight was associated with higher lean mass and lower android/gynoid ratio at age 60–64 years. For example, the mean difference in lean mass per 1 standard deviation increase in birth weight was 1.54 kg in males (95% confidence interval=1.04, 2.03) and 0.78 kg in females (0.41, 1.14). Greater weight gain in infancy was associated with higher lean mass, whereas greater gains in weight in later childhood and adolescence were associated with higher fat and lean mass, and fat/lean and android/gynoid ratios. Across growth intervals greater height gain was associated with higher lean but not fat mass, and with lower fat/lean and android/gynoid ratios.Conclusion:Findings suggest that growth in early life may have lasting effects on fat and lean mass. Greater weight gain before birth and in infancy may be beneficial by leading to higher lean mass, whereas greater weight gain in later childhood and adolescence may be detrimental by leading to higher fat/lean and android/gynoid ratios.
Highlights
Fat and lean mass influence health and physical functioning
Greater weight gains in infancy and early childhood and in late adolescence were associated with higher lean mass, whereas greater gains in later childhood and adolescence were associated with higher fat mass, and higher fat/lean mass and android/gynoid ratios
Greater height gain was associated with higher lean mass and lower fat/lean and android/gynoid ratios; these associations were mainly working through final adult height
Summary
Fat and lean mass influence health and physical functioning. High fat mass is associated with a range of adverse health outcomes, including type 2 diabetes, hypertension, stroke, impaired physical functioning and higher rates of mortality.[1] Low lean mass, an indicator of low skeletal muscle mass, is associated with lower physical performance levels,[2,3] adverse glucose metabolism[4] and low bone mineral content.[5] Low muscle mass is an essential component of the most widely used definitions of sarcopenia,[6,7] a condition of increasing public health concern.[6]. In addition to evidence that contemporaneous factors such as physical activity and diet influence adult fat and lean mass,[8,9] there is growing evidence that factors such as growth during gestation, infancy, childhood and adolescence may have a role. High birth weight[10] and rapid weight gain in infancy[11,12] have been consistently shown to be associated with increased risk of obesity in adulthood, measured by body mass index (BMI)
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