Abstract
Background: The late occurrence of adiposity peak (AP) and the early occurrence of adiposity rebound (AR) are considered the earliest indicators for obesity and its related health conditions later in life. However, there is still limited information for their upstream factors. Therefore, in this study, we aimed to identify the parental and child factors associated with the timing of AP and AR in the early stage of life.Methods: This is a population-based longitudinal study conducted in Shanghai, China. The BMI data of children born between September 2010 and October 2013 were followed from birth to 80 months. Subject-specific body mass index trajectories were fitted by non-linear mixed-effect models with natural cubic spline functions, and the individual's age at AP and AR was estimated. The generalized linear regression models were applied to identify the upstream factors of late occurrence of AP and early occurrence AR.Results: For 7,292 children with estimated AP, boys were less likely to have a late AP [adjusted risk ratio (RR) = 0.83, 95% confidence interval (CI): 0.77–0.90, p < 0.001], but preterm born children had a higher risk of a late AP (adjusted RR = 1.25, 95% CI: 1.07–1.47, p < 0.01). For 10,985 children with estimated AR, children with breastfeeding longer than 4 months were less likely to have an early AR (adjusted RR = 0.80, 95% CI: 0.73–0.87, p < 0.001), but children who were born to advanced-age mothers and who were born small for gestational age had a higher risk of having an early AR (adjusted RR = 1.21, 95% CI: 1.07–1.36, p < 0.01; adjusted RR = 1.20, 95% CI: 1.04–1.39, p = 0.01).Conclusions: Modifiable pre-birth or early-life factors associated with the timing of AP or AR were found. Our findings may help develop prevention and intervention strategies at the earliest stage of life to control later obesity and the health conditions and diseases linked to it.
Highlights
Over the past half-century, the prevalence of overweight or obesity in China has rapidly increased, alongside with fast economic growth, globalization, and urbanization [1]
The current literature has shown that a later adiposity peak (AP) or an earlier adiposity rebound (AR) is associated with the occurrence of overweight or obesity [6,7,8,9] and the associated adverse health outcomes in childhood, adolescence, or adulthood [6, 7, 9,10,11,12]
The upstream factors related to a late AP occurrence and selected into the multivariable model were parental education levels, gestational anemia, gestational diabetes mellitus (GDM), multiparous, sex, preterm birth, cesarean delivery, multiple gestations, low birth weight, macrosomia, Small for gestational age (SGA), breastfeeding duration longer than 4 and 6 months, sleep duration shorter than 14 h/day during birth and 3 months of age, and longer than 17 h/day during birth and 3 months of age
Summary
Over the past half-century, the prevalence of overweight or obesity in China has rapidly increased, alongside with fast economic growth, globalization, and urbanization [1]. As a screening tool for overweight and obesity [4], a higher BMI can be an indicator of a greater risk of health problems due to the weight in an individual. The BMI value rapidly increases during the first year of life and decreases and reaches a nadir between 4 and 6 years of age. After that, it increases again gradually through adolescence and most of adulthood. The late occurrence of adiposity peak (AP) and the early occurrence of adiposity rebound (AR) are considered the earliest indicators for obesity and its related health conditions later in life. In this study, we aimed to identify the parental and child factors associated with the timing of AP and AR in the early stage of life
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