Rapid Infancy Weight Gain and 7- to 9-year Childhood Obesity Risk

Abstract

Obesity is increasing in developing countries. This study aimed to identify the association between rapid infancy weight gain and obesity risk among early school-age children.A total of 581 singletons (349 boys, 232 girls) whose mothers participated in an antenatal multiple micronutrient supplement trial in rural western China were followed from birth to between 7 and 9 years of age. Height and weight were measured at birth, 1.5 years, and between 7 and 9 years. At the 7- to 9-year time point, body composition was determined using bioelectrical impedance analysis. Multilevel mixed analysis was used to test the associations between rapid weight gain in infancy (from birth to age 1.5 years) and body size and composition or overweight/obesity among early school-age children.Overall, 31.2% (181 of 581) of the infants showed a weight-for-age Z score gain greater than 0.67 between birth and 1.5 years, indicating rapid weight gain. Approximately 5.7% (33 of 579) of the subjects were overweight (BMI-for-age Z scores [BAZ] >1 and ≤2) or obese (BAZ >2). Rapid infancy weight gain was associated with a higher BAZ (P < 0.001), mid-upper arm circumferences (P < 0.001), percentage body fat (P < 0.001), and fat mass index (P < 0.001) at 7 to 9 years of age after adjusting for biological and social economic factors, genetic factors, and perinatal and postnatal factors. These associations appeared to be independent of gender, economic status at early school age, and maternal nutritional status at enrollment. Rapid growers may have approximately 3 times the risk of being overweight/obese during the early school-age years (odds ratio = 2.94, 95% CI: 1.17–7.43, P = 0.022).Rapid infancy weight gain is a risk factor for being overweight/obesity among early school-age children in rural western China. We propose that social and biological determinants, such as economic status, physical activity, and feeding practice, should be targeted to prevent obesity.

Rapid weight gain during infancy and subsequent adiposity: a systematic review and meta‐analysis of evidence

“…Infant rapid weight gain and later adiposity M. Zheng et al 323 obesity reviews countries from five continents: Europe (24,25,30,31), USA (32-34), Asia (26,(35)(36)(37)(38)(39), Australia (28,40), Brazil (29) and South Africa (27) with sample size ranging from 142 to 18,296 participants ( Table 1). Of the 12 prospective cohort studies, most studies included healthy term or appropriate-for-gestational age (AGA) children with no restrictions on birth weight status, and the subsequent adiposity outcomes were measured at ages 2 to 46.5 years.…”

“…The case-control study included overweight/obese (cases) and normal weight (control) 3-to 5-year-old children born >37 weeks of gestation (37). The duration of RWG examined varied across studies, from birth to 3-4 months (26,35), birth to 6 months (29,40), birth to 1 year (27,28,31), birth to 18 months (36,38,39), and birth to 2 years (30,32,37). Two studies examined multiple periods of RWG from birth (33,34).…”

“…Prevalence of overweight/obesity varied substantially among studies ranging from 5.7% to 48.5%. Other adiposity outcomes measured included BMI z-score or BMI (25,27,29,30), WC (29,32,40), skin-folds (27,30), percentage body fat/fat mass (27,30,32,39), fat-free mass (27,32), waist-to-hip ratio (40) and mid-upper arm circumference (27,30,39). Apart from the aforementioned adiposity outcomes, one study also evaluated abdominal and visceral adipose tissue depots (32).…”

“…Most studies used multivariable linear and logistic regression models for continuous and categorical outcomes, respectively (Table 1 ). Other methods utilized were multilevel mixed effect models to adjust for hierarchical nature of the data or test effect of RWG on longitudinal growth trajectories (30,39), Pearson chi-squared test (28) and analysis of variance (27). With respect to adjustment for covariates, large variations were observed between studies.…”

A scoping review of epidemiologic risk factors for pediatric obesity: Implications for future childhood obesity and dental caries prevention research

“…Increased birth weight was associated with childhood obesity (38,44,54,58,103,109,113,145,195,196,200), particularly birthweights >85th and >90th percentiles (56,144) and birthweights 2.5 kg (104), 3 kg (77), 3.5 kg (107,143,201,202), 4 kg (73,92,183,194,206), and >4.5 kg (159). In addition, studies identified rapid weight gain in the first year of life (109,158,168,187,188,199) as well as high infant weight (147,151,155,156,179) as risk factors.…”