Abstract
ABSTRACTOBJECTIVE:To analyze the effects of early determinants on adolescent fat-free mass.METHODS:A cohort study with 579 adolescents evaluated at birth and adolescence in a birth cohort in São Luís, Maranhão. In the proposed model, estimated by structural equation modeling, socioeconomic status (SES) at birth, maternal age, pregestational body mass index (BMI), gestational smoking, gestational weight gain, type of delivery, gestational age, sex of the newborn, length and weight at birth, adolescent socioeconomic status, “neither study/nor work” generation, adolescent physical activity level and alcohol consumption were tested as early determinants of adolescent fat-free mass (FFM).RESULTS:A higher pregestational BMI resulted in higher FFM in adolescence (Standardized Coefficient, SC = 0.152; p < 0.001). Being female implied a lower FFM in adolescence (SC = −0.633; p < 0.001). The negative effect of gender on FFM was direct (SC = −0.523; p < 0.001), but there was an indirect negative effect via physical activity level (SC = −0.085; p < 0.001). Women were less active (p < 0.001). An increase of 0.5 kg (1 Standard Deviation, SD) in birth weight led to a gain of 0.25 kg/m2 (0.106 SD) in adolescent FFM index (p = 0.034). Not studying or working had a negative effect on the adolescent's FFM (SC = −0.106; p = 0.015). Elevation of 1 SD in the adolescent's physical activity level represented an increase of 0.5 kg/m2 (0.207 SD) in FFM index (p < 0.001).CONCLUSIONS:The early determinants with the greatest effects on adolescent FFM are gender, adolescent physical activity level, pregestational BMI, birth weight and belonging to the “neither-nor” generation.
Highlights
According to the developmental origin of health and disease theory, events occurring during early developmental phases starting from fetal life may be related to determined lifelong health and disease patterns[1]
Many studies have focused on early determinants as predictors of future body fat, but few have verified the effect of these determinants on fat-free mass (FFM) during different stages of life[3]
Contemporary aspects related to lifestyle such as physical activity and eating habits have been well established as factors influencing the FFM of an individual[8,9,10]
Summary
According to the developmental origin of health and disease theory, events occurring during early developmental phases starting from fetal life may be related to determined lifelong health and disease patterns[1]. Fat-free mass is a clinical indicator of health and a determinant of functional capacity, being associated with a longer survival of patients with heart disease and cancer, among others[4,5,6]. Contemporary aspects related to lifestyle such as physical activity and eating habits have been well established as factors influencing the FFM of an individual[8,9,10]. Earlier aspects such as growth during gestation, childhood and adolescence have been investigated, the available scientific literature is scarce and controversial[3,11]
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