Abstract
BackgroundRapid infant weight gain (RIWG) is a very strong predictor of childhood overweight and obesity (COO). Socioeconomic position (SEP) is also related to the risk of COO and parents of different SEP may differ in their reaction to accelerated infant weight gain. Together this could lead to differences in how weight gain and COO risk relate across SEP. This study aimed to analyse possible interaction of SEP and RIWG on COO risk.MethodsA register-based longitudinal cohort study followed 19,894 healthy, term infants, born in Denmark between December 2011 and May 2015. Logistic regression models were used to estimate odds ratios (OR) of COO risk at 2 years (22–26 months) of age with 95% confidence intervals (95% CI) for categories of infancy weight gain based on changes in weight-for-age z-scores between 0 and 8–10 months of age (slow (<− 0.67), mean (− 0.67–0.67), rapid (> 0.67–1.34) and very rapid (> 1.34)). Possible multiplicative and additive interaction of SEP (based on household income and maternal education) on the relationship between infancy weight gain and COO were analysed.ResultsIn total, 19.1 and 15.1% experienced rapid or very rapid weight gain, respectively, and 1497 (7.5%) children were classified with COO at follow-up. These prevalences were higher in those with lower levels of SEP. Adjusted OR for COO were 3.09 (95% CI [2.66–3.59]) and 7.58 (95% CI [6.51–8.83]) for rapid and very rapid weight gain, respectively, when household income was included in the model. Results were similar in the model including maternal education. No signs of interactions were detected on a multiplicative scale. Weak signs of additive interaction were present, but these values did not reach significance.ConclusionBoth rapid and very rapid weight gain were associated with substantially higher risks of COO but these associations were not modified by SEP. This indicates that promotion of healthy weight gain should take place in all population groups irrespective of their SEP.
Highlights
Rapid infant weight gain (RIWG) is a very strong predictor of childhood overweight and obesity (COO)
Our comprehensive register-based cohort study confirms the results of the previous, smaller studies within this area [38, 39], and our findings suggest that activities involving prevention of RIWG and promotion of healthy infant weight gain as a part of an early-life COO prevention strategy can be relevant for all socioeconomic groups
We found that the association between infancy weight gain and COO more than doubled for both rapid and very rapid weight gain after adjusting for covariates, which suggests that other factors confounded this relationship
Summary
Rapid infant weight gain (RIWG) is a very strong predictor of childhood overweight and obesity (COO). Socioeconomic position (SEP) is related to the risk of COO and parents of different SEP may differ in their reaction to accelerated infant weight gain. Rapid infant weight gain (RIWG), generally defined as a change of more than 0.67 standard deviations in weightfor-age z-score between two time-points during infancy, is strongly and consistently related to overweight and obesity later in life [1,2,3,4]. The causal pathways are not clearly known, it has been proposed that infants with RIWG have a higher level of insulin resistance, central fat deposition and general fat accumulation that increase their risk of childhood overweight and obesity (COO) [4,5,6,7,8]. In a complex interplay together with individual, social and environmental factors, these macro-levelled factors are of significance for shaping healthy behaviour [15], for instance in relation to infant feeding [16]
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