Body Mass Index (BMI) Trajectories in Infancy Differ by Population Ancestry and May Presage Disparities in Early Childhood Obesity

Roy, Sani M.; Chesi, Alessandra; Mentch, Frank; Xiao, Rui; Chiavacci, Rosetta M.; Mitchell, Jonathan A.; Kelly, Andrea; Hákonarson, Hákon; Grant, Struan F.A.; Zemel, Babette S.; McCormack, Shana E.

doi:10.1210/jc.2014-4028

Cited by 48 publications

(66 citation statements)

References 28 publications

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“…Our study contributes to the relatively thin knowledge on the extent to which BMI growth among very young children varies by racial and ethnic group, along with identifying significant predictors [22]. The incidence of overweight/obesity status is already quite high by 4 years of age: approximately one-third for both females and males.…”

Section: Discussionmentioning

confidence: 74%

Racial and Ethnic Disparities in Early Childhood Obesity: Growth Trajectories in Body Mass Index

Guerrero

Mao

Fuller

et al. 2015

J. Racial and Ethnic Health Disparities

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Objective The aims of this study are to describe growth trajectories in the body mass index (BMI) among the major racial and ethnic groups of US children and to identify predictors of children's BMI trajectories. Methods The Early Childhood Longitudinal Study-Birth Cohort (ECLS-B) was used to identify predictors of BMI growth trajectories, including child characteristics, maternal attributes, home practices related to diet and social behaviors, and family sociodemographic factors. Growth models, spanning 48 to 72 months of age, were estimated with hierarchical linear modeling via STATA/Xtmixed methods. Results Approximately one-third of 4-year-old females and males were overweight and/or obese. African-American and Latino children displayed higher predicted mean BMI scores and differing mean BMI trajectories, compared with White children, adjusting for time-independent and time-dependent predictors. Several factors were significantly associated with lower mean BMI trajectories, including very low birth weight, higher maternal education level, residing in a two-parent household, and breastfeeding during infancy. Greater consumption of soda and fast food was associated with higher mean BMI growth. Soda consumption was a particularly strong predictor of mean BMI growth trajectory for young Black children. Neither the child's inactivity linked to television viewing nor fruit nor vegetable consumption was predictive of BMI growth for any racial/ethnic group. Conclusion Significant racial and ethnic differences are discernible in BMI trajectories among young children. Raising parents’ and health practitioners’ awareness of how fast food and sweetened-beverage consumption contributes to early obesity and growth in BMI—especially for Blacks and Latinos—could improve the health status of young children.

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Section: Discussionmentioning

confidence: 74%

Racial and Ethnic Disparities in Early Childhood Obesity: Growth Trajectories in Body Mass Index

Guerrero

Mao

Fuller

et al. 2015

J. Racial and Ethnic Health Disparities

View full text Add to dashboard Cite

show abstract

“…14 The CDC has not published BMI growth charts for children aged <2 years, 15 and an expert panel on WHO growth standards did not comment on the clinical use of the BMI charts before age 2 years, calling for additional research on the health implications of BMI in this age group. 10 The present study provides evidence that the clinical use of BMI or WFL percentiles for evaluating infants and toddlers aged <2 years can effectively differentiate infants at higher risk vs lower risk for severe obesity.…”

Section: Discussionmentioning

confidence: 99%

High Body Mass Index in Infancy May Predict Severe Obesity in Early Childhood

Smego

Woo

Klein

et al. 2017

The Journal of Pediatrics

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Objective To characterize growth trajectories of children who develop severe obesity by age 6 years and identify clinical thresholds for detection of high-risk children before the onset of obesity. Study design Two lean (body mass index [BMI] 5th to ≤75th percentile) and 2 severely obese (BMI ≥99th percentile) groups were selected from populations treated at pediatric referral and primary care clinics. A population-based cohort was used to validate the utility of identified risk thresholds. Repeated-measures mixed modeling and logistic regression were used for analysis. Results A total of 783 participants of normal weight and 480 participants with severe obesity were included in the initial study. BMI differed significantly between the severely obese and normal-weight cohorts by age 4 months (P < .001), at 1 year before the median age at onset of obesity. A cutoff of the World Health Organization (WHO) 85th percentile for BMI at 6, 12, and 18 months was a strong predictor of severe obesity by age 6 years (sensitivity, 51%−95%; specificity, 95%). This BMI threshold was validated in a second independent cohort (n = 2649), with a sensitivity of 33%−77% and a specificity of 74%−87%. A BMI ≥85th percentile in infancy increases the risk of severe obesity by age 6 years by 2.5-fold and the risk of clinical obesity by age 6 years by 3-fold. Conclusions BMI trajectories in children who develop severe obesity by age 6 years differ from those in children who remain at normal weight by age 4–6 months, before the onset of obesity. Infants with a WHO BMI ≥85th percentile are at increased risk for developing severe obesity by age 6 years.

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“…Analyses were performed separately by gender given the distinct growth trajectories of male and female infants. 11 …”

Section: Methodsmentioning

confidence: 99%

“…10 Recent studies have suggested that BMI may be a useful index of adiposity in infancy that also provides information about future obesity risk. 11–17 To our knowledge, no studies have evaluated the relative performance of BMI versus WFL with respect to estimating future obesity risk in full-term infants. It is unknown whether these metrics agree with each other in identifying risk for excess adiposity in infancy.…”

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confidence: 99%

Infant BMI or Weight-for-Length and Obesity Risk in Early Childhood

et al. 2016

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BACKGROUND Weight-for-length (WFL) is currently used to assess adiposity under 2 years. We assessed WFL- versus BMI-based estimates of adiposity in healthy infants in determining risk for early obesity. METHODS Anthropometrics were extracted from electronic medical records for well-child visits for 733949 full-term infants from a large pediatric network. World Health Organization WFL and BMI z scores (WFL-z and BMI-z, respectively) were calculated up to age 24 months. Correlation analyses assessed the agreement between WFL-z and BMI-z and within-subject tracking over time. Logistic regression determined odds of obesity at 2 years on the basis of adiposity classification at 2 months. RESULTS Agreement between WFL-z and BMI-z increased from birth to 6 months and remained high thereafter. BMI-z at 2 months was more consistent with measurements at older ages than WFL-z at 2 months. Infants with high BMI (≥85th percentile) and reference WFL (5th–85th percentiles) at 2 months had greater odds of obesity at 2 years than those with high WFL (≥85th percentile) and reference BMI (5th–85th percentiles; odds ratio, 5.49 vs 1.40; P < .001). At 2 months, BMI had a higher positive predictive value than WFL for obesity at 2 years using cut-points of either the 85th percentile (31% vs 23%) or 97.7th percentile (47% vs 29%). CONCLUSIONS High BMI in early infancy is more strongly associated with early childhood obesity than high WFL. Forty-seven percent of infants with BMI ≥97.7th percentile at 2 months (versus 29% of infants with WFL ≥97.7th percentile at 2 months) were obese at 2 years. Epidemiologic studies focused on assessing childhood obesity risk should consider using BMI in early infancy.

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Body Mass Index (BMI) Trajectories in Infancy Differ by Population Ancestry and May Presage Disparities in Early Childhood Obesity

Abstract: We demonstrate sex- and ancestry-specific differences in infancy BMI and an association of infancy peak BMI with childhood BMI. These findings support the potential utility of infancy BMI to identify children younger than age 2 years with increased risk for later obesity.

Cited by 48 publications

References 28 publications

Racial and Ethnic Disparities in Early Childhood Obesity: Growth Trajectories in Body Mass Index

Racial and Ethnic Disparities in Early Childhood Obesity: Growth Trajectories in Body Mass Index

High Body Mass Index in Infancy May Predict Severe Obesity in Early Childhood

Infant BMI or Weight-for-Length and Obesity Risk in Early Childhood

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