Abstract
ObjectiveTo systematically examine infant size and growth, according to the 2006 WHO infant growth standards, as risk factors for overweight status in young adulthood in a historical cohort. Specifically, to assess: Whether accounting for length (weight-for-length) provides a different picture of risk than weight-for-age, intervals of rapid growth in both weight-for-age and weight-for-length metrics, and what particular target ages for infant size and intervals of rapid growth associate most strongly with overweight as a young adult.Patients/MethodsData analysis of 422 appropriate for gestational age white singleton infants enrolled in the Fels Longitudinal Study. Odds ratios (OR) for overweight and obesity in young adulthood (age 20–29) were calculated using logistic regression models for the metrics at each target age (0, 1, 3, 6, 9, 12, 18, 24 months) comparing ≥85th v. <85th percentile, as well as rapid growth (Δ≥0.67 Z-score) through target age intervals. Models accounted for both maternal and paternal BMI.ResultsInfants ≥85th percentile of weight-for-age at each target age (except 3 months) had a greater odds of being overweight as a young adult. After accounting for length (weight-for-length) this association was limited to 12, and 18 months. Rapid weight-for-age growth was infrequently associated with overweight as a young adult. Rapid weight-for-length growth from 0 to 24 months, 1 to 6, 9, 12, 18, and 24 months and from 3 to 9, 12, 18, and 24 months was strongly associated with overweight status as a young adult.ConclusionsThe WHO weight-for-length metric associates differently with risk of being overweight as a young adult compared to weight-for-age. Intervals of rapid weight-for-length growth ranging from months (0–24), (1–12, 18, and 24) and (3–9, and 12) displayed the largest OR for being overweight as a young adult.
Highlights
Extensive research has demonstrated overweight and obese adults experience a greater risk for a spectrum of health outcomes.[1]
Rapid weight-for-age growth was infrequently associated with overweight as a young adult
Rapid weight-forlength growth from 0 to 24 months, 1 to 6, 9, 12, 18, and 24 months and from 3 to 9, 12, 18, and 24 months was strongly associated with overweight status as a young adult
Summary
Extensive research has demonstrated overweight and obese adults experience a greater risk for a spectrum of health outcomes.[1]. A number of studies have examined size and growth during different periods of infancy with later obesity, and systematic reviews have concluded larger infant size and rapid growth are associated with later obesity in childhood and adulthood.[4,5,6] Despite the consistency of these findings, the majority of the studies have used child or adolescent obesity as the outcome rather than adulthood, used internal or descriptive growth charts as a reference rather than the currently recommended 2006 World Health Organization growth standards, reported data at limited time points during infancy (e.g. birth, 4, 12, or 24 months), and did not have both maternal and paternal BMI for comparison and adjustment.[4,5,6,7] the preponderance of studies used weight-for-age as a metric,[8] which provides information on energy balance, but does not completely inform on the nature of infant growth
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