Patterns of early life body mass index and childhood overweight and obesity status at eight years of age

Abstract

Background: Excess weight gain in infancy and childhood is associated with increased risk of subsequent obesity. Identifying patterns of infancy and childhood weight gain associated with subsequent obesity or overweight status could help identify children at highest risk. Thus, we examined patterns of infancy and early childhood BMI in relation to mid-childhood overweight and obesity status.

Methods: In a prospective cohort of 215 children from Cincinnati, OH (born: 2003-2006), we measured weight and length or height at ages 4 weeks and 1, 2, 3, 4, 5, and 8 years. We calculated BMI z-scores using World Health Organization references. Using linear fixed effect models, we estimated mean BMI at each age and rates of change in BMI between ages 4 weeks and 5 years by children's overweight and obesity status at age 8 years, assessed with BMI z-scores or bioelectric impedance analysis (BIA).

Results: Children who became overweight (BMI, n = 51 and BIA, n = 37) or obese (BMI, n = 22 and BIA, n = 29) at age 8 years had greater BMI at all ages compared to normal weightchildren. Children who were overweight had similar rates of change in BMI as children who were lean. Children who were obese had greater gains in BMI between age 4 weeks and 5 years, with the most rapid gains in the first 2 years.

Conclusions: Results from this study of modest sample size, suggest that adiposity patterns in the first 5 years of life are related to subsequent childhood overweight and obesity risk.

Keywords: Adiposity; And rapid growth; Children; Epidemiology; Obesity.

Conflict of interest statement

Ethics approval and consent to participate

The institutional review boards of Cincinnati Children’s Hospital Medical Center and the cooperating delivery hospitals approved this study. The research was conducted in accordance with the Declaration of Helsinki. All parents or caregivers provided informed consent for their child to participate in the study.

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1

Adjusted Mean BMI Z-scores from Ages 4 Weeks to 5 Years According to WHO BMI-Derived Child Overweight/Obesity Status at Age 8 Years: The HOME Study a,b,c,d aAdjusted for maternal race, education, marital status, age at delivery, household income, and breastfeeding duration bOverweight and obesity status at age 8 years was defined as having age- and sex-specific BMI z-scores >1 and >2 according to WHO references, respectively c142, 51, and 22 children were lean, overweight, or obese at age 8 years, respectively, and they contributed 732, 235, and 103 repeated BMI z-scores dShading represents the 95% confidence interval

Fig. 2

Adjusted Mean BMI Z-scores from Ages 4 Weeks to 5 Years According to Bioelectric Impedance-Derived Child Overweight/Obesity Status at Age 8 Years: The HOME Study a,b,c,d aAdjusted for maternal race, education, marital status, age at delivery, household income, and breastfeeding duration bOverweight and obesity status at age 8 years was defined as having age- and sex-specific body fat percent standard deviation scores >1 and >2, respectively [21] c149, 37, and 29 children were lean, overweight, or obese at age 8 years, respectively, and they contributed 761, 177, and 132 repeated BMI z-scores dShading represents the 95% confidence interval