Abstract

We analyzed the nationwide longitudinal data to explore body mass index (BMI) growth trajectories and the time of adiposity rebound (AR). Personal data of 84,005 subjects born between 2008 and 2012 were obtained from infant health check-ups which were performed at 5, 11, 21, 33, 45, 57, and 69 months. BMI trajectories of each subject were made according to sex and the timing of AR, which was defined as the lowest BMI occurred. Subjects were divided according to birth weight and AR timing as follows: very low birth weight (VLBW), 0.5 kg ≤ Bwt ≤ 1.5 kg; low birth weight (LBW), 1.5 kg < Bwt ≤ 2.5 kg; non-LBW, 2.5 kg < Bwt ≤ 5.0 kg; very early AR, before 45 months; early AR, at 57 months; and moderate-to-late AR, not until 69 months. Median time point of minimum BMI was 45 months, and the prevalence rates of very early, early, and moderate-to-late AR were 63.0%, 16.6%, and 20.4%, respectively. BMI at the age of 57 months showed a strong correlation with AR timing after controlling for birth weight (P < 0.001). Sugar-sweetened beverage intake at 21 months (P = 0.02) and no-exercise habit at 57 months (P < 0.001) showed correlations with early AR. When VLBW and LBW subjects were analyzed, BMI at 57 months and breastfeeding at 11 months were correlated with rapid weight gain during the first 5 months (both P < 0.001). Based on this first longitudinal study, the majority of children showed AR before 57 months and the degree of obesity at the age of 57 months had a close correlation with early AR or rapid weight gain during infancy.

Highlights

  • The trajectory of an individual’s body mass index (BMI) during life is quite variable

  • When very low birth weight (VLBW) and low birth weight (LBW) subjects were analyzed, BMI at 57 months and breastfeeding at 11 months were correlated with rapid weight gain during the first 5 months

  • Based on this first longitudinal study, the majority of children showed adiposity rebound (AR) before 57 months and the degree of obesity at the age of 57 months had a close correlation with early AR or rapid weight gain during infancy

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Summary

Introduction

The trajectory of an individual’s body mass index (BMI) during life is quite variable. The BMI rapidly increases during the first year, subsequently decreases and reaches a nadir around 4–8 years of age [1]. Thereafter, BMI increases again and this second rise following the last minimum BMI is referred to as the adiposity rebound (AR) [2]. The timing of AR is wellknown to have a close relationship with obesity in later childhood, adolescence, and adulthood [3,4,5,6,7]. The definition of early AR varies according to studies, children who had early AR showed later obesity, insulin resistance, dyslipidemia, and hypertension [3, 5, 8]. Early AR is considered as a potent marker for obesity and metabolic syndrome

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