Influence of growth trajectories on risk of overweight during early childhood among a population‐based longitudinal cohort in China

Abstract

To assess the nutritional status of preschool children aged under 5 in China and to examine the influence of early growth patterns on later adiposity and overweight risks (assessed using body mass index, BMI), we followed 131,215 children born during 2000–2005 in Zhejiang Province, south China. Z scores and prevalence of overweight were calculated using the 2006 WHO growth charts. The association was explored using linear and logistic models. From age 1 to 5, the prevalence (%) of overweight (BMI z‐score<2) decreased from 7.2, to 5.3, 3.1, 2.1, and 2.1, respectively. In the 21,711 participants with repeated anthropometric measures between birth and ages of 4–5, prevalence of overweight at ages 4–5 was 2.1%, while 11.8% had a BMI z‐score<1. Elevated risk for overweight at age 4–5 was associated with faster weight gain (100 g/month) during infancy (OR=2.41; 95% CI: 2.13–2.72) and 1‐3 years of life (OR=11.39 (9.10–14.26)) adjusted for covariates, while the risk was negatively associated with faster height growth (P<0.05). Other factors such as gender, urban/rural residence, birth weight, access to health care, maternal BMI and weight gain during pregnancy were also associated with overweight risk (P<0.05). In conclusion, prospective data from a large birth cohort in China show that rapid weight gain during early years of life and other pre‐ and postnatal factors predict increased risk for overweight at age 4‐5 years.