Early childhood weight gain: Latent patterns and body composition outcomes

Abstract

Background Despite early childhood weight gain being a key indicator of obesity risk, we do not have a good understanding of the different patterns that exist. Objectives To identify and characterise distinct groups of children displaying similar early‐life weight trajectories. Methods A growth mixture model captured heterogeneity in weight trajectories between 0 and 60 months in 1390 children in the Avon Longitudinal Study of Parents and Children. Differences between the classes in characteristics and body size/composition at 9 years were investigated. Results The best model had five classes. The “Normal” (45%) and “Normal after initial catch‐down” (24%) classes were close to the 50th centile of a growth standard between 24 and 60 months. The “High‐decreasing” (21%) and “Stable‐high” (7%) classes peaked at the ~91st centile at 12‐18 months, but while the former declined to the ~75th centile and comprised constitutionally big children, the latter did not. The “Rapidly increasing” (3%) class gained weight from below the 50th centile at 4 months to above the 91st centile at 60 months. By 9 years, their mean body mass index (BMI) placed them at the 98th centile. This class was characterised by the highest maternal BMI; highest parity; highest levels of gestational hypertension and diabetes; and the lowest socio‐economic position. At 9 years, the “Rapidly increasing” class was estimated to have 68.2% (95% confidence interval [CI] 48.3, 88.1) more fat mass than the “Normal” class, but only 14.0% (95% CI 9.1, 18.9) more lean mass. Conclusions Criteria used in growth monitoring practice are unlikely to consistently distinguish between the different patterns of weight gain reported here.

The associations of maternal and paternal obesity with latent patterns of offspring BMI development between 7 and 17 years of age: pooled analyses of cohorts born in 1958 and 2001 in the United Kingdom

“…For example, a one-unit higher maternal BMI might be related to a 0.05 kg/m 2 /year steeper offspring BMI trajectory on average, but growth mixture modelling might provide additional information that higher maternal BMI is associated with greater odds of their child belonging to a small adolescent-onset of underweight group. A recent paper by Dos Santos et al found that maternal obesity was related to membership of unhealthy latent BMI trajectory classes (e.g., always obese) in the 2001 cohort [ 22 ], and similar findings have been reported in other studies [ 7 , 8 , 10 , 23 , 24 ]. The majority of this literature, however, does not consider paternal BMI and inadvertently contributes to the “imbalance of DOHaD [development origins of health and disease] research towards the study of maternal pregnancy exposures” [ 25 , 26 ].…”

Early life programming of health and disease: The long‐term consequences of obesity in pregnancy

“…Clues with respect to the mechanism of programming by maternal obesity may be gained from studies of GDM because the long‐term health of offspring exposed to GDM is largely the same as that observed with maternal obesity, although obesity can occur without GDM and vice versa. As early as 2 years of age, GDM offspring exhibit markedly greater risk of obesity 113 and this persists into childhood 114–116 . Dabelea et al 117 .…”

“…As early as 2 years of age, GDM offspring exhibit markedly greater risk of obesity 113 and this persists into childhood. [114][115][116] Dabelea et al 117 followed up sibling pairs where one of the pair had been exposed to GDM and the other had not. Among people in their early 20s, those who had experienced GDM in foetal life had a BMI on average 2.6 kg m -2 greater than unexposed siblings.…”

Conceptualizing and Measuring Appetite Self-Regulation Phenotypes and Trajectories in Childhood: A Review of Person-Centered Strategies

“…A common example of phenotypes defined in terms of trajectories of ASR-related constructs with a single variable is trajectories for weight gain or BMI. Norris et al ( 72 ), for instance, examined weight trajectories from 0 to 60 months of age using GMM to identify five groups of individuals with different average trajectories. The subgroups included “average,” “high-decreasing,” and “stable-high” BMI trajectories.…”