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We thank Dr Arisaka et al for raising the question as to whether adiposity rebound may mediate the association we find between low birth weight and the risk of coronary heart disease (CHD). They note that a low birth weight has been identified as a factor that accelerates the timing of AR.1Cissé A.H. Lioret S. de Lauzon-Guillain B. et al.Association between perinatal factors, genetic susceptibility to obesity and age at adiposity rebound in children of the EDEN mother-child cohort.International journal of obesity (2005). 2021; 45: 1802-1810Crossref PubMed Scopus (11) Google Scholar This is interesting observation has been reported previously, but not consistently.2Eriksson J.G. Forsen T. Tuomilehto J. Osmond C. Barker D.J. Early adiposity rebound in childhood and risk of Type 2 diabetes in adult life.Diabetologia. 2003; 46: 190-194Crossref PubMed Scopus (354) Google Scholar, 3Rolland-Cachera M.F. Deheeger M. Maillot M. Bellisle F. Early adiposity rebound: causes and consequences for obesity in children and adults.Int J Obesity. 2006; 30: S11Crossref PubMed Scopus (346) Google Scholar, 4Baldassarre M.E. Di Mauro A. Caroli M. et al.Premature Birth is an Independent Risk Factor for Early Adiposity Rebound: Longitudinal Analysis of BMI Data from Birth to 7 Years.Nutrients. 2020; 12Crossref Scopus (8) Google Scholar In agreement with this potential role of AR as a mediator, previous studies using the Helsinki birth cohorts showed that a low ponderal index at birth was associated earlier AR.2Eriksson J.G. Forsen T. Tuomilehto J. Osmond C. Barker D.J. Early adiposity rebound in childhood and risk of Type 2 diabetes in adult life.Diabetologia. 2003; 46: 190-194Crossref PubMed Scopus (354) Google Scholar Further, using these cohorts, AR was examined in relation to the development of type 2 diabetes (T2D), but not CHD. Individuals who later developed T2D had low birthweight and low ponderal index at birth, low weight at one year, an early AR and thereafter above average weight and BMI.2Eriksson J.G. Forsen T. Tuomilehto J. Osmond C. Barker D.J. Early adiposity rebound in childhood and risk of Type 2 diabetes in adult life.Diabetologia. 2003; 46: 190-194Crossref PubMed Scopus (354) Google Scholar Although these results suggest that an early AR potentially plays a role in the association between low birth weight and T2D, we did not comment on AR in our manuscript as a potential mediator because it has not been studied in relation to CHD risk. Furthermore, although we reported on the association between birth weight and CHD, our study should not be considered an examination of low birth weight as a cause of CHD. In studies that do examine low birth weight as a cause of CHD, we agree that it could be interesting to examine the AR as a mediator. Low birth weight, weight gain trajectory in infancy, adiposity rebound, and risk of adult coronary heart diseaseThe Journal of PediatricsPreviewBlond et al reported the associations between weight gain trajectories from birth to 12 months and risk of adult coronary heart disease (CHD) in Danish persons born between 1959 and 1961, in relation to birth weight influenced by prenatal exposures affecting fetal growth.1 The authors concluded that the future risk of CHD is determined by having a low birth weight, regardless of rapid weight gain patterns during infancy. CHD was more strongly related to low birth weight and lost its significant correlation with the rate of weight gain in the first year of life. Full-Text PDF