C-Reactive Protein Concentration Predicts Change in Body Mass Index during Childhood

Abstract

ObjectiveInflammation may constitute an underlying mechanism for increased risk of developing chronic diseases in later years, but few prospective studies have assessed the influence of low-grade inflammation on body weight gain, particularly among children in low- to middle-income settings with lower prevalence of overweight and obesity. We aimed to investigate whether C-reactive protein (CRP), as a biomarker of low-grade inflammation, predicts changes in body mass index-for-age z scores (BAZ) during childhood.MethodsA population-based longitudinal study was conducted in the Brazilian Amazon among children aged ≤10 years in 2007, with follow-up visits in 2009 and 2012. Outcome was annual change in BAZ. As the main exposure of interest, CRP concentrations were divided into four categories, with values <1 mg/L divided in tertiles plus a fourth category with values ranging from 1 to 10 mg/L. Children were simultaneously screened for iron and vitamin A deficiencies, diarrhea, and wheezing. We used mixed-effect linear regression models to measure the effect of CRP concentrations on annual BAZ change and linear regression models to explore CRP predictors at baseline.ResultsAt baseline, 1007 children had CRP and anthropometric data [mean (SD) age: 5.3 (2.9) years; 50.9% male, 84.5% mulatto/mixed-race, 14.0% at risk for overweight or obesity, 4.8% stunted]; 737 were successfully followed up. Morbidities and nutritional deficiencies were widespread. Among participants aged >5 years, children in the highest tertile of CRP <1 mg/L at baseline, regarded as an indicator of low-grade inflammation, had a 0.04 z/y higher gain in BAZ (95% CI: 0.01, 0.09 z/y) during follow-up. CRP was positively associated with household poverty and worse nutritional indicators.ConclusionsWe found evidence of a role for low-grade inflammation in predicting annual BAZ gain among children aged >5 years.

Intergenerational associations of dietary inflammatory index with birth outcomes and weight status at age 5 and 9: Results from the Lifeways cross‐generation cohort study

“…Lifestyle factors are associated with subclinical inflammation, and dietary habits may play a central role in the regulation of chronic inflammation, at least in non‐pregnant adults . Regular physical activity and replacement of sedentary behaviour with moderate to vigorous physical activity have been associated with more favourable inflammatory profiles in adults .…”

“…Lifestyle factors are associated with subclinical inflammation, 37 and dietary habits may play a central role in the regulation of chronic inflammation, at least in non-pregnant adults. 7,8 Regular physical activity and replacement of sedentary behaviour with moderate to vigorous physical activity have been associated with more favourable inflammatory profiles in adults. 38 On the other hand, adverse lifestyle habits such as smoking and alcohol consumption have been linked with elevated inflammatory status 4,5 and more pro-inflammatory diets, 13,39 in line with our findings.…”

“…Obesity is characterized by a state of chronic low‐grade inflammation, and a bidirectional association between inflammation and obesity has been hypothesized . Several studies have assessed the prospective association between elevated concentrations of inflammatory markers, such as C‐reactive protein (CRP), fibrinogen, interleukin‐6 (IL‐6), and weight change . Inflammatory status was associated with weight gain in middle‐aged adults and additionally with weight loss in older adults .…”

“…Inflammatory status was associated with weight gain in middle‐aged adults and additionally with weight loss in older adults . In children, CRP concentrations predicted annual BMI‐for‐age z score gain during childhood . There is also evidence that prenatal factors, including maternal weight and nutrition, can modify placental and fetal growth and, therefore, predispose children to developing chronic diseases, such as obesity, in later life …”

Heterogeneous effects of market integration on sub-adult body size and nutritional status among the Shuar of Amazonian Ecuador

“…Diverse in nature and degree, this collective phenomenon of market integration (MI) – increasing production for and consumption from a market-based economy – has become a primary focus of Amazonian anthropological and human ecological research (Godoy et al, 2005; Hern, 1991; Lu, 2007; Santos et al, 1998; Valdivia, 2005). At the centre of this body of work has been investigation of the impact of markets on the biology and health of indigenous peoples, with particular interest in understanding the nature of relationships between MI and patterns of increasing adult overweight/obesity and chronic disease (Benefice et al, 2007; Brabec et al, 2007; Byron, 2003; Dangour, 2003; Godoy et al, 2006b; Gugelmin and Santos, 2001; Gurven et al, 2013; Liebert et al, 2013; Lindgärde et al, 2004; Lourenço et al, 2014; Santos and Coimbra, 1996; Silva and Eckhardt, 1994; Tavares et al, 2003; Welch et al, 2009; Zeng et al, 2013). …”