Abstract
BackgroundRapid weight gain (RWG) in early-life is associated with increased risk of childhood obesity and is common among low-birth weight infants. Few studies have compared body mass index (BMI) trajectories of children experienced RWG to those who did not, across birth weight groups. We investigated the association between RWG in early-life and subsequent BMI trajectory and whether the association differs by birth weight.MethodsWe included term singletons from the UK Millennium Cohort Study (n = 10 637). RWG was defined as an increase in weight z-scores (derived using UK–WHO growth reference) between birth and 3 years >0.67. Mixed-effect fractional polynomial models were applied to examine the association between RWG and BMI trajectories (5–14 years). Models were further adjusted for confounders and stratified by birth weight-for-gestational-age group.ResultsMean BMI trajectories were higher in children who experienced RWG in early-life, compared with their non-RWG counterparts. RWG was associated with higher BMI at five years [by 0.76 kg/m2 (95% CI: 0.67–0.85) in boys and 0.87 kg/m2 (0.76–0.97) in girls]; the difference persisted into adolescence [1.37 kg/m2 (1.17–1.58) and 1.75 kg/m2 (1.52–1.99) at 14 years, respectively]. Differences remained after adjustment and were particularly greater for children born large-for-gestational-age than those born small- and appropriate-for-gestational-age. Mean BMI trajectories for large-for-gestational-age children with RWG exceeded international reference curves for overweight (for obesity at some ages in girls).ConclusionsRWG was associated with higher BMI trajectories throughout childhood and adolescence, especially in large-for-gestational-age children. Strategies for obesity prevention need to address factors during and before infancy and preventing excessive weight gain among infants who have already had adequate growth in utero.
Highlights
The obesity prevalence in children and adolescents has risen dramatically over the last four decades.[1]
A difference in mean body mass index (BMI) of 0.76 kg/m2 for boys and 0.87 kg/m2 (0.76–0.97) for girls was established at five years
Model 1: unadjusted; Model 2: adjusted for maternal BMI, maternal smoking, birth order, breastfeeding, early introduction to solid foods, ethnicity, family income and maternal education; Model 3: adjusted for birth weight. In this large contemporary cohort, we found that Rapid weight gain (RWG) in early-life was associated with higher BMI at five years and more rapid BMI gain subsequently from 5 to 14 years
Summary
The obesity prevalence in children and adolescents has risen dramatically over the last four decades.[1]. Few studies have compared body mass index (BMI) trajectories of children experienced RWG to those who did not, across birth weight groups. Conclusions: RWG was associated with higher BMI trajectories throughout childhood and adolescence, especially in large-forgestational-age children. We studied the contribution of general and abdominal obesity to metabolic cardiovascular risk among different ethnic groups. Results: Among ethnic minority men, age-adjusted prevalence rates of high metabolic risk ranged from 32 to 59% vs 33% among Dutch men. Age-adjusted prevalence rates of high metabolic risk ranged from 24 to 35% vs 12% among Dutch women. Conclusions: Obesity, especially abdominal obesity, contributes significantly to the prevalence of high metabolic cardiovascular risk Results suggest that this contribution varies substantially between ethnic groups, which helps explain ethnic differences in cardiovascular risk
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
