Abstract
SummaryObjectivesTo investigate whether high weight in infancy predicts obesity in childhood.MethodData from two UK cohorts (Newcastle Growth and Development N = 795, Gateshead Millennium N = 393) and one Finnish (Tampere N = 1262) were combined. Z scores of weight at 3 and 12 months and body mass index (BMI) at 5 and 8 years were categorized as raised/overweight (1 to <2 SD) or high/obese (≥2 SD).ResultsThe majority of infants with raised or high weight at birth tended to revert to normal by 3 months and to track in the same category from 3 to 12 months. Although infants with high weight were five times more likely to have BMI ≥ 2 SD at 8 years (p < 0.001), only 22% went on to have BMI ≥ 2 SD, while 64% of infants with raised weight had normal BMI at 8 years. Of children with BMI ≥ 2 SD aged 8 years, only 22% had raised weight in infancy and half had BMI ≥ 2 SD for the first time at that age.ConclusionsInfants with raised weight in infancy tend to remain so, but most children who go on to have BMI ≥ 2 SD were not unusually heavy infants and the majority of infants with high weight reverted to overweight or normal weight in childhood.
Highlights
While increasing levels of overweight and obesity throughout the life course are concerning, worries about overweight and obesity in childhood cause particular anxiety, due to concern that this will fuel even larger rises in rates of obesity in later life [1]
Many studies have described an association between overweight and rapid weight gain in infancy with overweight in later childhood [2,3,4,5]. This has led to the proposal that obesity has its origins in early childhood and that infancy, or even pregnancy, could be a prime period in which to prevent obesity, as it precedes the onset of obesity for most children and the child’s diet is largely under parental control [6,7]
A German study found that while weight change over the first 2 years of life was the best predictor of a body mass index (BMI) in the obese range at school entry, still only one in five children with rapid weight gain went on to have obesity [4] and we made a similar observation in a UK cohort [10]
Summary
While increasing levels of overweight and obesity throughout the life course are concerning, worries about overweight and obesity in childhood cause particular anxiety, due to concern that this will fuel even larger rises in rates of obesity in later life [1]. Evidence from early life preventative interventions has generally been disappointing [8] and some have suggested that this approach is not realistic, both because of the difficulty of changing early risk factors for obesity and the relative lack of tracking from infancy to childhood [9]. This apparent paradox reflects the fact that, while there undoubtedly is an association between infant weight and later overweight, it is not clear how important that association really is. A German study found that while weight change over the first 2 years of life was the best predictor of a body mass index (BMI) in the obese range at school entry, still only one in five children with rapid weight gain went on to have obesity [4] and we made a similar observation in a UK cohort [10]
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