Body Mass Index Growth Curves Research Articles

Cumulative burden and trajectories of body mass index and blood pressure from childhood and carotid intima-media thickness in young adulthood

There are significant gaps in understanding of the association between levels and rate of change of body mass index (BMI) and blood pressure (BP) at different ages during childhood and carotid intima-media thickness (CIMT) in adulthood. We investigated the association between trajectories of BMI and BP from childhood to adulthood and adult CIMT among Iranian participants in the Tehran Lipid and Glucose Study (TLGS) cohort. A total of 1334 participants (692 men), from the TLGS cohort (1999–2018) with repeated measurements of BMI and BP (2–6 times) from childhood (3–18 years) to young adulthood (20–40 years) were selected. Trajectory parameters included levels and linear slopes of BMI and BP growth curve models, and cumulative burden defined as the area under those curves (AUC). After adjusting for confounders, AUC of BMI and diastolic blood pressure (DBP) were significantly associated with high CIMT in adulthood, with the standardized odds ratios (OR) and 95% confidence interval (95% CI) of 1.35 (1.12–1.62) and 1.27 (1.01–1.60), respectively. Associations between level-independent slopes of BMI and adult CIMT were significantly positive (ORs: 1.27 to 1.26) during childhood ages (3–18 years). Further, levels of BMI (ORs: 1.23 to 1.29) and DBP (ORs: 1.25 to 1.33) during the ages of 13–18 and 11–17 years, respectively, were significantly associated with CIMT in adulthood (all P < 0.05). The cumulative burden of BMI and DBP was associated with CIMT in adulthood. Adolescence is a crucial period for high CIMT, which has implications for early prevention of atherosclerosis.

Body Mass Index Growth Curves for Birth to 24 Months Children in Ankara with RefCurv Software

It is important to monitor the development of infants and children during their growth period. Various anthropometric parameters of children are measured at regular intervals after birth, and their general health and nutrition and physiological needs are assessed based on these measurements. To construct the current body mass index (BMI) percentiles and compare them with the literature reports and World health organisation (WHO) data. Cross-sectional design. This study is a cross-sectional research on 1,345 boys and 1,364 girls of age ranging from 0 to 24 months; their BMIs were measured at the Başkent University Hospital from January 2018-December 2021. The BMI growth curves for either gender were constructed according to the LMS method by using RefCurv 0.4.2. software. The "gamlss" package was employed for the selection of model parameters in fitting the BMI growth curves, and the model performance was evaluated with reference to the generalized Akaike information criterion (GAIC). According to gender, smoothed BMI growth curves were constructed in the 3rd-97th percentiles. The model adequacy of the fitted growth curves was evaluated with the worm plot. The fit of the BMI model to the data was found to be sufficient, with 95% of the BMI values occurring between two elliptic curves. We examined the current BMI percentiles and growth curves of children aged 0-2 years living in Ankara and noted a slight increase in the BMI percentile values obtained by gender when compared to the WHO standards.

Influence of neck circumference, waist circumference and body mass index among children with overweight and normal weight

OBJECTIVE: To compare the measurements of neck circumference, waist circumference, and body mass index (BMI) between obese and eutrophic children. METHODS: Cross-sectional research, using primary and case control data, with a comparative approach of anthropometric variables, carried out with 218 students, 119 girls and 99 boys, from a municipal elementary school in São Paulo. Data collected were sex, age, body weight, height, neck circumference (NC), and waist circumference (WC). The BMI was calculated and classified using the BMI growth curve, according to age, in percentiles. For data analysis, non-parametric tests were applied. RESULTS: According to the BMI, 36.2% of the children were overweight when the agreement test was performed between all physical circumference measurements. However, there was a weaker agreement between BMI and NC and between BMI and WC measures. The correlation between the measures was greater between BMI and WC (62%), compared to between BMI and WC and between NC and WC. CONCLUSION: The use of the NC measure, as an additional measure for anthropometric assessment in pediatric patients, is suggested, due to its practicality and as a complement for screening and monitoring childhood obesity.

Long-term growth patterns in children born with cleft lip and/or palate. A systematic review.

Introduction: in children with cleft lip and/or palate nutritional status and growth may be impaired due to early life feeding difficulties. Objective: to review the existing literature on the nutritional prognosis during childhood of patients undergoing surgery for cleft lip and/or palate (CLP), their body composition and growth patterns from 2 to 10 years of age, and the possible effects of their early nutritional status on the long-term onset of overweight. Methods: a systematic search of growth and body composition parameters in 2-10 year-old CLP children, including cross-sectional and longitudinal studies, and using the Pubmed and Scopus databases. From the 2,983 retrieved articles, 6 were finally included. Results: two studies out of 6 were longitudinal and the other 4 were cross-sectional, including very heterogeneous samples. Weight and height were used as growth parameters in 2 studies; 2 studies used body mass index (BMI); and the remaining 2 used indexes of nutritional status derived from anthropometric measures. The studies showed discrepancies among results: 3 of them found growth differences between children with CLP and their counterparts, whereas the other 3 did not. The two longitudinal studies did not show any significant differences between the mean BMI z-scores or growth curves of cleft patients and their counterparts. When differences existed, the most affected group was that under 5 years, syndromic children, and adopted children with CL/P. Conclusions: the literature is scarce comparing growth patterns between children with CLP and controls, and results cannot confirm that children with CLP aged 2-10 years, excluding those with syndromes or belonging to vulnerable populations, have different growth patterns or a worse nutritional status than their counterparts.

Early growth and carotid intima-media thickness at midlife: Northern Finland 1966 Birth Cohort study

Abstract Background Carotid intima-media thickness (CIMT) reflects atherogenesis and is a strong predictor of cardiovascular diseases. Although cardiovascular diseases have been shown to originate in foetal life and childhood, the information on the contribution of early growth to CIMT in adulthood remains limited. Purpose To assess the influence of early growth patterns on CIMT in midlife. Methods A subpopulation of the Northern Finland Birth Cohort 1966 took part in follow-up, including CIMT evaluation by ultrasound (n=1155) at the age of 46 years. Maternal pre-pregnancy body mass index (BMI) was self-reported and birth weight and gestational age were measured after delivery. BMI growth curves were modelled based on frequent anthropometric measurements in infancy and childhood. Peak weight and height velocity in infancy (0–2 years of age, n=637) as well as age and BMI at adiposity peak (AP, mean age 9 months, n=461) and at adiposity rebound (AR, mean age 5.8 years, n=562) were established. Results are reported as unstandardized beta (β) with 95% confidence intervals for one standard deviation increase in early growth variable. Associations were adjusted for sex, birth weight, maternal pre-pregnancy BMI as well as adult weight, height, systolic blood pressure, low-density lipoprotein cholesterol, physical activity, diabetes, heart diseases and antihypertensive medication. Results Infant peak weight velocity (β=0.018 (0.011, 0.025), p&amp;lt;0.001) was associated with a higher CIMT in midlife, independently of adjustments for sex, early life factors and adult cardiometabolic factors (β=0.011 (0.003, 0.019), p=0.010). Infant peak height velocity was also associated with adult CIMT, but only in females (β=0.012 (0.004, 0.021), p=0.004) and the association was attenuated after adjustments (β=0.010 (0.0, 0.021), p=0.055). Birth weight and gestational age were not associated with adult CIMT. BMI at AP (β=0.011 (0.003, 0.019), p=0.007) and BMI at AR (β=0.010 (0.003, 0.018), p=0.005) were directly associated with CIMT in midlife in univariate analysis, but not independently of adult cardiometabolic factors. Timing of AP and AR were not related to adult CIMT. Finally, maternal pre-pregnancy BMI (β=0.005 (0.0, 0.011), p=0.066) also tended to be associated with a higher CIMT in midlife. Conclusions Rapid growth in infancy was the most important early growth-related factor associating with CIMT in midlife, and this relationship was not fully mediated by adult anthropometrics, cardiometabolic risk factors and morbidity. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Yrjö Jahnsson Foundation, Aarne Koskelo Foundation

Long-term burden of higher body mass index from childhood on adult cardiometabolic biomarkers: A 30-year cohort study

Background and aimsData are limited regarding the association between long-term burden of higher body mass index (BMI) from childhood and cardiometabolic biomarkers. Methods and resultsA total of 1553 individuals aged 6–15 years, who were examined 4 or more times for BMI since childhood and followed for 30 years were included in our analysis. Total area under the curve (AUCt) and incremental AUC (AUCi) were calculated as the long-term burden and trends of BMI. Cardiometabolic biomarkers including serum uric acid (SUA), fasting blood-glucose (FBG), and triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C) were obtained from venous blood samples. The results showed a positive association of BMI AUCt and AUCi with cardiometabolic biomarkers. After adjusting for demographic variables, the AUCt and AUCi of BMI were significantly associated with a higher level of SUA (β = 3.71; 2.87), FBG (β = 0.09; 0.09), and TG/HDL-C (β = 0.14; 0.11). We performed further studies after dividing subjects into four groups according to AUCt and AUCi of BMI by quartiles. Compared with the lowest quartile group, the highest quartile group had significantly increased risk ratios of hyperuricemia (RR = 2.01; 1.74), type 2 diabetes mellitus (RR = 8.18; 3.96), and high-risk TG/HDL-C (RR = 4.05; 3.26). ConclusionOur study identifies all subjects’ BMI growth curve from childhood and indicates that the long-term burden of higher BMI significantly increases the cardiometabolic risk, and the impact of excessive body weight on cardiometabolic health originates in early life. We emphasize the importance of weight control from childhood for cardiometabolic health.

Anthropometric heritability and child growth in a Caribbean village: A quantitative genetic analysis of longitudinal height, weight, and body mass index in Bwa Mawego, Dominica.

Body size and composition vary widely among individuals and populations, and long-term research in diverse contexts informs our understanding of genetic, cultural, and environmental impacts on this variation. We analyze longitudinal measures of height, weight, and body mass index (BMI) from a Caribbean village, estimating the extent to which these anthropometrics are shaped by genetic variance in a small-scale population of mixed ancestry. Longitudinal data from a traditionally horticultural village in Dominica document height and weight in a non-Western population that is transitioning to increasingly Westernized lifestyles, and an 11-generation pedigree enables us to estimate the proportions of phenotypic variation in height, weight, and BMI attributed to genetic variation. We assess within-individual variation across growth curves as well as heritabilities of these traits for 260 individuals using Bayesian variance component estimation. Age, sex, and secular trends account for the majority of anthropometric variation in these longitudinal data. Independent of age, sex, and secular trends, our analyses show high repeatabilities for the remaining variation in height, weight, and BMI growth curves (>0.75), and moderate heritabilities (h2height = 0.68, h2weight = 0.64, h2BMI = 0.49) reveal clear genetic signals that account for large proportions of the variation in body size observed between families. Secular trends show increases of 6.5% in height and 16.0% in weight from 1997 to 2017. This horticultural Caribbean population has transitioned to include more Westernized foods and technologies over the decades captured in this analysis. BMI varies widely between individuals and is significantly shaped by genetic variation, warranting future exploration with other physiological correlates and associated genetic variants.

Rate of change in body mass index at different ages during childhood and adult obesity risk.

Childhood body mass index (BMI) predicts adult obesity. How growth trajectories during childhood relate to adult obesity risk is not well defined. We aimed to characterize BMI growth trajectories from childhood to midlife and to examine the associations between BMI growth rates at childhood age points and adult obesity risk. The longitudinal study included 2732 participants with repeated BMI measurements from childhood (4-19y) to adulthood (20-51y). A random-effects model was used to construct BMI growth curves by race and sex. Model-estimated levels and linear growth rates of BMI were linked to adult obesity in separate multivariable logistic regression models at individual childhood age points. BMI followed cubic growth curves. Childhood BMI linear slope estimates were higher in adults with obesity than in adults without obesity (P<0.001). The association between childhood BMI growth rate and adult obesity was significantly higher in puberty and postpuberty (12-19y) than in early childhood (4-11y) with a peak at age 14 (odds ratio=3.1 and 95% confidence interval, 2.7-3.5). Rates of change in BMI at different childhood ages are differentially associated with adult obesity. Puberty and postpuberty are crucial periods for the development of obesity in later life.

Long-term childhood body mass index and adult bone mass are linked through concurrent body mass index and body composition.

Body mass plays a crucial role in the bone growth and development, but few studies have examined the association of long-term cumulative impact and trajectory patterns of childhood body mass index (BMI) with adult bone mass, and the mediation effect of adult BMI and body composition on these associations. A total of 397 Chinese adults (54.4%) who had been examined for BMI 4-8 times during childhood (6-19 years) and bone mass in adulthood (29-37 years), were included for analysis. Adult bone mineral content (BMC), areal bone mineral density (aBMD) and body composition were assessed via dual-energy x-ray absorptiometry. Childhood BMI growth curves were constructed using a random-effects mixed model. The area under the curve (AUC) was calculated to represent the long-term impact of childhood BMI. At baseline, 24.4%, 66.2%, 7.6% and 1.8% of the participants were underweight, normal weight, overweight and obese, respectively. Quadratic curve parameters of childhood BMI differed significantly between groups of adult whole body (WB) BMC, lumbar spine (LS) aBMD and femoral neck (FN) aBMD, with low BMC/aBMD groups having lower childhood BMI than the normal groups. AUC of childhood BMI was significantly and positively related to adult WB BMC and aBMD at each site, irrespective of sex. Significant mediation effects of adult BMI were shown on the association of childhood BMI AUC with adult WB BMC in males (52.0%) and FN aBMD in both sexes (males: 65.4%; females: 64.3%). Additionally, mediation effect of fat mass index was only noted on the association of childhood BMI AUC with adult WB BMC (41.3%), with a positive total indirect effect estimated at 0.118. The adult lean mass index, by contrast, mediated the childhood BMI-adult BMC/aBMD association positively at all sites in males (71.5%~89.2%) and at WB BMC in females (45.0%). These findings suggest that the impact of body weight on adult bones originates from childhood, which is mediated by concurrent BMI and body composition.

At what age do normal weight Canadian children become overweight adults? Differences according to sex and metric

Background: The prevalence of overweight and obesity doubles between adolescence and young adulthood; however, the exact age, and appropriate metric to use to identify when overweight develops is still debated.Aim: To examine the age of onset of overweight by sex and four metrics: body mass index (BMI), fat mass (%FM), waist circumference (WC) and waist-to-height ratio (WHtR).Subjects and methods: Between 1991 and 2017, serial measures of body composition were taken on 237 (108 males) individuals (aged 8–40 years of age). Hierarchical random effects models were used to develop growth curves. Curves were compared to BMI, %FM and WC overweight age- and sex-specific cut-points.Results: In males, the BMI growth curve crossed the cut-point at 22.0 years, compared to 23.5 and 26.5 years for WHtR and %FM, respectively; WC cut-off was not reached until 36 years. In females, the BMI growth curve crossed the overweight cut-point at 21.5 years, compared to 14.2 years for %FM and 21.9 and 27.5 years for WC and WHtR, respectively.Conclusion: In summary, overweight onset occurs during young adulthood with the exception of WC in males. BMI in males and %FM in females were the metrics identifying overweight the earliest.

Abstract 003: Growth Trajectories of Body Mass Index During Childhood and Adult Hypertension

Background: Childhood body mass index (BMI) predicts adult hypertension. However, information is lacking regarding the relationship between BMI growth trajectories during childhood and adult hypertension risk. We aimed to test the hypothesis that BMI growth rates at different childhood ages have differential influences on adult hypertension risk, independent of BMI levels. Methods: The study included 1,772 Whites and 960 Blacks with repeated BMI and blood pressure measurements from childhood (4-19 years) to adulthood (20-51 years). A random-effects mixed model was used to construct BMI growth curves by race and sex. Model-estimated linear growth rates of BMI at different childhood ages were linked to adult hypertension (defined by measured blood pressure or antihypertensive medication) in multivariable logistic regression models. Results: Hypertensive adults had higher BMI across childhood than normotensive adults. Overall, linear slope and cubic parameters of BMI were higher in hypertensive adults than in normotensive adults in all four race-sex groups (p ≤ 0.023). Odds ratio of adult hypertension for each kg/m 2 /year increase in BMI linear slope was 1.22 (95% CI =1.11-1.34) at age 4, was non-significant between ages 5-9, and gradually increased thereafter and plateaued beginning at age 15 (odds ratio = 1.41 and 95% CI = 1.28-1.56) (Figure). Conclusions: Rapid increase in BMI during and after puberty is associated with elevated risk of hypertension in adult life, which has implications for early prevention.

Infant BMI peak as a predictor of overweight and obesity at age 2 years in a Chinese community-based cohort

ObjectivesInfant body mass index (BMI) peak has proven to be a useful indicator for predicting childhood obesity risk in American and European populations. However, it has not been assessed in...

Body mass index growth trajectories associated with the different parameters of the metabolic syndrome at adulthood.

Growth trajectories have shown to be related to obesity and metabolic risks in later life, however body mass index (BMI) trajectories according to the presence or absence of metabolic syndrome (MS) and its parameters in adulthood are scarce in literature. To investigate BMI trajectories during childhood in relation to MS and its parameters in adult age. A total of 1919 subjects (43.4% male, 20-60 y) participated in this retrospective cohort study. Height, weight, waist circumference (WC), blood glucose, high-density lipoprotein cholesterol, triglycerides and blood pressure were measured at adulthood. Childhood weight and height were collected retrospectively from health booklets. Differences between BMI growth curves of subjects with and without MS were assessed using mixed models for correlated data. BMI trajectories differed according to the presence or not of MS at adulthood, from the age of 4 years forward (all P<0.05), to the presence or not of hypertriglyceridemia from 1.5 years forward (all P<0.05), and to WC>94 cm (men) / 80 cm (women) compared to lower WC, at all ages (all P<0.05). BMI growth curves differ according to the presence or not of MS at adulthood, but differences only appeared after the age of 4 years. Changes vary according to the MS parameters considered. Deviation of the MS-associated BMI curve from normal pattern could correspond to alteration in body composition. These differences in BMI trajectories during childhood support the theory of an early origin of the MS, justifying early prevention.

Weight, Length, and Body Mass Index Growth of Children Under 2 Years of Age With Cleft Lip and Palate.

To study the growth of length-for-age (L/A), weight-for-age (W/A), and body mass index (BMI) of children with cleft lip and palate receiving a normal diet; to establish specific growth curves for children with cleft palate with or without cleft lip (CLP/ICP) who had not undergone palatoplasty and for children with isolated cleft lip (ICL); and to assess if CLP/ICP growth differed from ICL growth and if CLP/ICP and ICL growth differed from growth for typical children. Prospective and cross-sectional study. Hospital for Rehabilitation of Craniofacial Anomalies, Bauru, São Paulo, Brazil. Weight and length of 381 children with cleft lip and palate and who were younger than 2 years were recorded and used to calculate W/A, L/A, and BMI growth curves. The 2006 World Health Organization growth charts were used as a reference for typical children. All children received a normal diet for age. Children with CLP/ICP had median W/A and BMI growth curves below growth curves for typical children but showed spontaneous recovery starting at approximately 5 months of age, even with nonoperated cleft palate. Children with ICL had growth similar to that of typical children. Children with CLP/ICP, who initially had W/A and BMI values less than those of the ICL group, had W/A and BMI equal to or higher than the ICL group after 9 months of age. Children with CLP/ICP had impaired W/A and BMI growth with spontaneous recovery starting early in childhood. This study established specific W/A, BMI, and L/A growth curves for children with cleft lip and palate.

Early Life Factors and Inter-Country Heterogeneity in BMI Growth Trajectories of European Children: The IDEFICS Study.

BackgroundStarting from birth, this explorative study aimed to investigate between-country differences in body mass index (BMI) trajectories and whether early life factors explain these differences.MethodsThe sample included 7,644 children from seven European countries (Belgium, Cyprus, Germany, Hungary, Italy, Spain, Sweden) participating in the multi-centre IDEFICS study. Information on early life factors and in total 53,409 repeated measurements of height and weight from 0 to <12 years of age were collected during the baseline (2007/2008) and follow-up examination (2009/2010) supplemented by records of routine child health visits. Country-specific BMI growth curves were estimated using fractional polynomial mixed effects models. Several covariates focussing on early life factors were added to the models to investigate their role in the between-countries differences.ResultsLarge between-country differences were observed with Italian children showing significantly higher mean BMI values at all ages ≥ 3 years compared to the other countries. For instance, at age 11 years mean BMI values in Italian boys and girls were 22.3 [21.9;22.8; 99% confidence interval] and 22.0 [21.5;22.4], respectively, compared to a range of 18.4 [18.1;18.8] to 20.3 [19.8;20.7] in boys and 18.2 [17.8;18.6] to 20.3 [19.8;20.7] in girls in the other countries. After adjustment for early life factors, differences between country-specific BMI curves became smaller. Maternal BMI was the factor being most strongly associated with BMI growth (p<0.01 in all countries) with associations increasing during childhood. Gestational weight gain (GWG) was weakly associated with BMI at birth in all countries. In some countries, positive associations between BMI growth and children not being breastfed, mothers’ smoking during pregnancy and low educational level of parents were found.ConclusionEarly life factors seem to explain only some of the inter-country variation in growth. Maternal BMI showed the strongest association with children’s BMI growth.

Assessing Resting Metabolic Rate in Overweight and Obese Adolescents With a Portable Indirect Calorimeter

Indirect calorimetry measured via the traditional indirect calorimeter is considered the "gold standard" for determining resting metabolic rate (RMR). Portable devices for assessing RMR are a less expensive option for measuring RMR in the clinical setting. This pilot study tested the reliability and validity of a portable device for measuring RMR, specifically in overweight and obese adolescents. Participants aged 17-19 years (n = 19) and ≥85th percentile on the Centers for Disease Control and Prevention body mass index growth curves for age and sex were recruited from a university campus. Participants completed testing on a traditional indirect calorimeter and a portable indirect calorimeter in a randomized order on 2 separate testing days. A paired samples t test comparing the means of the portable device and the traditional indirect calorimeter found no significant difference (P = .22). The test-retest intraclass correlation coefficient for assessing RMR was 0.91, indicating reliability of the portable indirect calorimeter. Compared with measured RMR, the Mifflin-St Jeor equation demonstrated 37% accuracy, and the Molnar equation demonstrated 57% accuracy. This pilot study found portable indirect calorimetry to be reliable and valid for assessing RMR in an overweight and obese adolescent population. In addition, this study indicates that portable indirect calorimetry may be an acceptable option for assessing RMR in this population compared with the traditional indirect calorimeter or predictive equations.

Greener neighbourhoods, slimmer children? Evidence from 4423 participants aged 6 to 13 years in the Longitudinal Study of Australian children.

There is a growing belief that green space (for example, parks) help prevent obesity. There is evidence of an inverse association between green space and childhood body mass index (BMI); however, the majority of these studies are cross-sectional. Longitudinal studies that track change in BMI across childhood in relation to levels of green space proximity would improve the quality of evidence available for decision making. Objectively measured BMI was obtained every 2 years between 2006 and 2012 for 4423 participants initially aged 6-7 years in the Longitudinal Study of Australian Children (LSAC). The LSAC is a nationally representative study on a range of health and socio-demographic measures. Using Australian Bureau of Statistics mesh block data, which classify small scale land areas based on the main usage, each participant was assigned an objective measure of green space availability within their Statistical Area (level 2) of residence. Gender-stratified multilevel linear regression was used to estimate BMI growth curves across childhood in relation to green space availability. Family income, Australian Indigenous status, mothers' education and language spoken were used to adjust for socio-economic confounding. Age was found to be an effect modifier of associations between green space and BMI for boys (P=0.005) and girls (P=0.048). As children grew older, an inverse patterning of BMI by green space availability emerged. These findings held after adjustment for socio-economic circumstances for boys (P=0.009), though were less robust for girls after this adjustment (P=0.056). A beneficial effect of green space on BMI emerges as children grow older. However, there was little additional benefit after a modest amount of green space was met. Further research is needed to understand whether the drivers of this effect are from age-specific mechanisms, or whether the benefit of living in a greener neighbourhood is accumulated through childhood.

Exclusive Breastfeeding Protective for Growth Trajectory to 5 Years in a WIC Cohort

OBJECTIVEThe impact of exclusive breastfeeding (EBF) on child body mass index (BMI) from birth through 60 months of age was investigated.METHODS60,190 mothers and children attending Women, Infant and Children (WIC) clinics in the central coast counties of California provided data on breastfeeding duration, maternal pre‐pregnancy BMI, and child weight‐for‐length (WL) were measured at 3 month intervals until 5 years of age. Missing time points were interpolated in determining child BMI/WL z‐score trajectories plotted on the Center of Disease Control infant and child growth curves. Multivariate analysis of variance was used to contrast the impact of not EBF, EBF from 0‐3 months, and EBF from 0‐6 months in Hispanic (n=43,360) versus Other (n=16,830) children, controlling for maternal pre‐pregnancy BMI.RESULTSDuration of EBF from 0‐3 and 0‐6 months of age was protective against child BMI z‐scores being above the average growth trajectory (P=0.0001). A significant inverse association between EBF and overall BMI/WL z‐scores for both males and females (P&lt;0.0001) was found. Impact of EBF on child growth trajectory began to weaken at 15 months for females and 18 months for males. Children who were not EBF had higher mean BMI/WL z‐scores at every time point than those who were EBF. Those who were EBF for 0‐3 months had a lower BMI; those who were EBF for 0‐6 months had even lower BMI z‐scores by 5 years of age. Hispanic children had a higher BMI growth curve than non‐Hispanic children even after adjusting for EBF and pre‐pregnancy BMI. Mothers with a higher pre‐pregnancy BMI tended to have children with higher BMI/WL z‐scores (P&lt;0.0001).CONCLUSIONThe study supports public health efforts to encourage EBF for at least 3 months and optimally for 6 months.

Weight Status and DSM-5 Diagnoses of Eating Disorders in Adolescents From the Community

To estimate jointly the point prevalence of weight and eating disorders in a community sample of adolescents; to investigate psychosocial correlates of thinness, overweight, and obesity, and of full- and subthreshold eating disorders (EDs); and to examine the relationships between weight status and prevalence of EDs. A total of 3,043 Canadian adolescents (1,254 males and 1,789 females; mean age = 14.19 years, SD = 1.61 years) completed self-report questionnaires, including the Eating Disorder Diagnostic Scale, and measures of psychosocial functioning. Objective weight and height were collected, and weight status was defined according to the International Obesity Task Force body mass index growth curve centiles. In all, 29.5% (95% CI = 26.7, 32.5) of males and 22.8% (95% CI = 20.5, 25.2) of females were overweight or obese. A total of 2.2% (95% CI = 1.5, 3.2) of males and 4.5% (95% CI = 4.4, 4.5) of females met DSM-5 criteria for an ED; in addition, 1.1% (95% CI = 0.7, 1.9) of males and 5.1% (95% CI = 4.0, 6.5) of females were identified with a subthreshold ED. Both full- and subthreshold EDs were significantly associated with markedly impaired psychosocial functioning. There was a significant relationship between prevalence of EDs and weight status, with an increased risk for a bulimic disorder in obese relative to normal-weight males (odds ratio [OR] = 7.86) and females (OR = 3.27). This study provides estimates for the prevalence of DSM-5 EDs in adolescents, further support for their impact on mental health, and new evidence for an association between bulimic disorders and obesity. Results call for an integrated approach in research and prevention regarding the whole spectrum of eating- and weight-related disorders.

Infant BMI peak, breastfeeding, and body composition at age 3 y

With the increasing focus on obesity, growth patterns in infancy and early childhood have gained much attention. Although the adiposity rebound has been in focus because of a shown association with adult obesity, not much has been published about the infant peak in body mass index (BMI). This study links age and BMI at infant peak to duration of breastfeeding and body composition at 3 y of age. Frequent weight and height measurements for 311 Danish children in the SKOT (Complementary and Young Child Feeding - Impact on Short and Long Term Development and Health; in Danish) cohort were used to estimate BMI growth curves for the age span from 14 d to 19 mo by using a nonlinear mixed-effects model. BMI growth velocity before peak and age and BMI at peak were derived from the subject-specific models. Information about pregnancy and breastfeeding was assessed from background questionnaires. Assessment of body composition at age 3 y was made based on bioelectrical impedance, weight, and height. A longer duration of exclusive breastfeeding was associated with an earlier peak in infant BMI (P = 0.0003) and a lower prepeak velocity (P < 0.0001). BMI level at peak and prepeak velocity was positively associated with fat and fat-free mass at age 3 y (all P < 0.0001), whereas a later age at peak was associated with a lower fat mass, fat mass index, and fat-free mass index at age 3 y (all P < 0.001). BMI peak characteristics are strongly associated with both duration of exclusive breastfeeding and body composition at 3 y of age. Thus, a better knowledge of characteristics and determinants of the early BMI peak is likely to improve our understanding of early development of obesity.