Rapid weight gain during infancy and subsequent adiposity: a systematic review and meta-analysis of evidence.
ABSTRACT: The contribution of rapid weight gain (RWG) during infancy to later adiposity has received considerable investigation. The present systematic review and meta-analysis aimed to update the literature on association between RWG and subsequent adiposity outcomes. Electronic searches were undertaken in EMBASE, MEDLINE, psycINFO, PubMed and ScienceDirect. Studies that examined the associations between RWG (a change in weight z-scores > 0.67) during infancy (from birth to age 2 years) and subsequent adiposity outcomes were included. Random effects meta-analysis was conducted to obtain the weighted-pooled estimates of the odds of overweight/obesity for those with RWG. Seventeen studies were eligible for inclusion with the majority of studies (15/17) being of high/acceptable quality and reporting positive associations between RWG during infancy and later adiposity outcomes. RWG in infancy was associated with overweight/obesity from childhood to adulthood (pooled odds ratio = 3.66, 95% confidence interval: 2.59-5.17, I2 > 75%). Subgroup analyses revealed that RWG during infancy was associated with higher odds of overweight/obesity in childhood than in adulthood, and RWG from birth to 1 year was associated with higher odds of overweight/obesity than RWG from birth to 2 years. The present study supports that RWG during infancy is a significant predictor of adiposity in later life.
Project description:Rapid weight gain in infancy has been established as a risk factor for the development of later obesity.We aimed to investigate the role of changes in infant body composition (assessed via total body electrical conductivity) on the development of overweight/obesity in mid-childhood.Fifty-three term infants were evaluated at birth, three times during infancy and in mid-childhood. Logistic regression was used to determine associations between rates of total weight gain, fat mass gain and lean mass gain during infancy and later overweight/obesity (defined as body mass index [BMI] ?85th percentile), adjusted for birth weight and parent education.At follow-up (age 9.0?±?1.8 years), 30% were overweight/obese. More rapid total weight gain from 0 to 4 months was associated with twofold odds (odds ratio [OR] 1.98, 95% confidence interval [CI] 1.05-3.74, P?=?0.04) of overweight/obesity in mid-childhood. From 0 to 8 months, more rapid weight gain was associated with nearly fivefold odds (OR 4.76, 95% CI 1.05-21.5, P?=?0.04), and more rapid fat mass gain was associated with eightfold odds (OR 8.03, 95% CI 1.11-58.2, P?=?0.04) of later overweight/obesity.This exploratory study suggests that rapid weight gain, especially fat mass gain, in earlier infancy predisposes to mid-childhood overweight/obesity.
Project description:BACKGROUND:Rapid weight gain (RWG) in early-life is associated with increased risk of childhood obesity and is common among low-birth weight infants. Few studies have compared body mass index (BMI) trajectories of children experienced RWG to those who did not, across birth weight groups. We investigated the association between RWG in early-life and subsequent BMI trajectory and whether the association differs by birth weight. METHODS:We included term singletons from the UK Millennium Cohort Study (n = 10 637). RWG was defined as an increase in weight z-scores (derived using UK-WHO growth reference) between birth and 3 years >0.67. Mixed-effect fractional polynomial models were applied to examine the association between RWG and BMI trajectories (5-14 years). Models were further adjusted for confounders and stratified by birth weight-for-gestational-age group. RESULTS:Mean BMI trajectories were higher in children who experienced RWG in early-life, compared with their non-RWG counterparts. RWG was associated with higher BMI at five years [by 0.76 kg/m2 (95% CI: 0.67-0.85) in boys and 0.87 kg/m2 (0.76-0.97) in girls]; the difference persisted into adolescence [1.37 kg/m2 (1.17-1.58) and 1.75 kg/m2 (1.52-1.99) at 14 years, respectively]. Differences remained after adjustment and were particularly greater for children born large-for-gestational-age than those born small- and appropriate-for-gestational-age. Mean BMI trajectories for large-for-gestational-age children with RWG exceeded international reference curves for overweight (for obesity at some ages in girls). CONCLUSIONS:RWG was associated with higher BMI trajectories throughout childhood and adolescence, especially in large-for-gestational-age children. Strategies for obesity prevention need to address factors during and before infancy and preventing excessive weight gain among infants who have already had adequate growth in utero.
Project description:BACKGROUND:Rapid weight gain (RWG) has been recognized as an important determinant of childhood obesity. This study aims to explore the RWG distribution among children at six-month intervals from birth to two years old and to examine the association of RWG in each interval with overweight or obesity development in preschool- and school-aged children. METHODS:Data were obtained from the Taiwan Birth Cohort Study, which is a nationally representative sample of 24,200 children who participated in a face-to-face survey. A total of 17,002 children had complete data both for weight and height at each of the five measurement time periods. Multivariable logistic regression models quantified the relationship between RWG and childhood overweight or obesity. RESULTS:A total of 17.5% of children experienced rapid weight gain in the first six months of age, compared to only 1.8% of children from 18-24 months. RWG was significantly associated with an increased risk of developing overweight or obesity at 36?months (RWG birth-6?months: OR?=?2.6, 95% CI: 2.3-2.8; RWG 18-24?months: OR?=?3.7, 95% CI: 2.9-4.6), 66?months (RWG birth-6?months: OR?=?2.2, 95% CI: 2.0-2.4; RWG 18-24?months: OR?=?2.3, 95% CI: 1.8-2.8), and 8?years of age (RWG birth-6?months: OR?=?1.7, 95% CI: 1.6-1.9; RWG 18-24?months: OR?=?2.4, 95% CI: 2.0-3.0). CONCLUSIONS:Childhood RWG increased the risk of subsequent overweight or obesity, regardless of the specific time interval at which RWG occurred before the age of two years. The results reinforce the importance of monitoring childhood RWG continuously and show the risks of childhood RWG with respect to the development of overweight or obesity at preschool and school ages.
Project description:Small size at birth and greater BMI in childhood are associated with greater brachial blood pressure (BP) in later life. Aortic (central) BP differs from brachial BP and is more predictive of organ damage and cardiovascular events; the relationship between BMI in childhood and central BP is not known.Using data from 3154 people from the Avon Longitudinal Study of Parents and Children, we assessed associations between repeated measures of BMI from birth to age 10 with central and brachial BP at age 17.Lower BMI at birth (thinness) was associated with greater central and brachial BP. No associations were seen between BMI in early childhood (<7 years) and later BP, but greater BMI from 7 to 10 years was associated with higher BP. Associations were similar for central and brachial SBP and for DBP, and were stronger in males compared with females. The highest BP was seen in participants who were low-birth-weight and overweight or obese at both the end of infancy (age 2) and at the time of BP assessment (age 17); mean central SBP was 104.2? mmHg (SD?=?11.0) compared with 100.7 (SD?=?10.5) in participants who were normal-birth-weight and overweight or obese at 2 and 17 years.Small size at birth followed by rapid adiposity gain in infancy and continued overweight/obesity are associated with greater BP in young adulthood. These findings emphasize the importance of maintenance of normal weight in childhood for the prevention of high BP.
Project description:BACKGROUND:Rapid weight gain (RWG) during infancy increases the risk of excess weight later in life. Nutrition- and feeding practices associated with RWG need to be further examined. The present study aimed to examine nutrition- and feeding practice-related risk factors for RWG during the first year of life. METHODS:A population-based longitudinal birth cohort study of 1780 infants, classified as having RWG or non-RWG during 0-3-4, 0-6 and 6-12?months. RWG was defined as a change >?0.67 in weight standard deviation scores. Associations between nutrition- and feeding practice-related factors and RWG were examined with logistic regression models. RESULTS:Of the participating infants, 47% had RWG during 0-3-4?months, 46% during 0-6?months and 8% during 6-12?months. In the fully adjusted models, bottle-feeding at birth and at 3-4?months and nighttime meals containing formula milk were positively associated with RWG during 0-3-4?months (p?<?0.05 for all). Breastfeeding at 3-4?months and nighttime meals containing breast milk were negatively associated with RWG during this period (p?<?0.001). Bottle-feeding at birth, 3-4 and 6?months and nighttime meals containing formula milk at 3-4?months were positively associated with RWG during 0-6?months (p?<?0.01 for all). Breastfeeding at 3-4 and 6?months was negatively associated with RWG (p?<?0.01). During 6-12?months, only bottle-feeding at 3-4?months was positively associated with RWG (p?<?0.05). CONCLUSIONS:RWG was more common during the first 6?months of life and bottle-feeding and formula milk given at night were risk factors for RWG during this period.
Project description:This study, performed as part of the international EarlyNutrition research project (http://www.project-earlynutrition.eu), provides a systematic review of systematic reviews on the effects of nutritional interventions or exposures in children (up to 3?years of age) on the subsequent risk of obesity, overweight and adiposity. Electronic databases (including MEDLINE, Embase and Cochrane Library) were searched up until September 2015. Forty systematic reviews were included. A consistent association of breastfeeding with a modest reduction in the risk of later overweight and obesity in childhood and adulthood was found (the odds decreased by 13% based on high-quality studies), but residual confounding cannot be excluded. Lowering the protein content of infant formula is a promising intervention to reduce the risk of later overweight and obesity in children. There is no consistent evidence of an association of the age of introducing complementary foods, sugar-sweetened beverage or energy intake in early childhood with later overweight/obesity, but there are some indications of an association of protein intake during the complementary feeding period with later overweight/obesity. There was inadequate evidence to determine the effects of other nutritional interventions or exposures, including modifications of infant formula composition, fat intake or consumption of different food groups.
Project description:Because of the lack of relevant data, we investigated the association between rapid weight gain (RWG) during early childhood and cardiovascular risk factors in Japanese adolescents.The source population comprised 2285 adolescents aged 13 to 14 years enrolled in any public school in Fukuroi City, Japan during 2008, 2009, or 2010. Since there are no private schools in this city, almost all adolescents who lived in the city went to 1 of these schools. We obtained data on blood pressure (BP), serum lipids, and anthropometry during adolescence, as well as anthropometry at birth, age 1.5 years, and age 3 years, from the Maternal and Child Health Handbook for 1624 children. RWG was defined as a change in body-weight standard deviation score greater than 0.67 from age 0 to 1.5 years or from age 1.5 to 3 years.After adjusting for confounding factors, adolescents who had RWG from 0 to age 1.5 years or from age 1.5 to 3 years were more likely to be overweight. Adolescents who had RWG during both periods were more likely to be overweight (odds ratio [OR], 6.37; 95% CI, 3.06-13.24), have unfavorable lipid concentrations (OR, 2.03; 95% CI, 1.15-3.58), and have high BP (OR: 2.36, 95% CI: 1.34-4.13). The associations with unfavorable lipid concentrations and high BP disappeared after further adjusting for current body mass index.RWG during early childhood predicts unfavorable lipid concentrations and high BP in Japanese adolescents, and this relationship is mediated by body mass index in later life.
Project description:BACKGROUND:Studies of body mass index and semen quality have reported mixed results, but almost all were cross-sectional and many were conducted in selected populations. Longitudinal studies in population-based cohorts are necessary to identify how timing and duration of excess adiposity may affect semen quality. METHODS:In 193 members of the Child Health and Development Studies birth cohort, we examined associations of birth weight and adiposity at six time points spanning early childhood and adulthood with sperm concentration, motility, and morphology at mean age 44 years, as well as with corresponding 2010 World Health Organization (WHO) subfertility reference levels. RESULTS:Birth weight for gestational age percentile was positively associated with square-root sperm concentration (regression coefficient B [95% confidence interval] = 0.02?×?103 sperm/ml [0.004, 0.04]). Overweight/obesity in men's 20s was associated with lower percent progressive motility (B =-5.2 [-9.9, -0.63]), higher odds of low motility (odds ratio (OR) = 2.4 [1.3, 4.4]), and higher odds of poor morphology (OR = 1.9 [0.94, 3.8]). Those who were overweight/obese in their 20s were also more likely to meet two or three WHO subfertility criteria (OR = 3.9 [1.6, 9.4]) compared with normal-weight men. Each additional adult decade in which a participant was overweight/obese was associated with higher odds of low motility (OR = 1.3 [0.96, 1.6]) and higher odds of meeting two or three WHO subfertility criteria (OR = 1.5 [1.0, 2.2]). CONCLUSIONS:In our data, associations among adiposity and sperm concentration, motility, and morphology varied according to timing and duration of exposure, potentially reflecting different biological mechanisms that influence these semen parameters.
Project description:Maternal smoking during pregnancy is associated with reduced offspring birth length and has been postulated as a risk factor for obesity. Causality for obesity is not established. Causality is well-supported for birth length, but evidence on persistence of height deficits is inconsistent.We examined the association between maternal smoking during pregnancy and trajectories of offspring height (0-10 years, N?=?9424), ponderal index (PI) (0-2 years, N?=?9321) and body mass index (BMI) (2-10 years, N?=?8887) in the Avon Longitudinal Study of Parents and Children. To strengthen inference, measured confounders were controlled for, maternal and partner smoking associations were compared, dose-response and associations with post-natal smoking were examined.Maternal smoking during pregnancy was associated with shorter birth length, faster height growth in infancy and slower growth in later childhood. By 10 years, daughters of women who smoke during pregnancy are on average 1.11?cm (SE?=?0.27) shorter after adjustment for confounders and partner smoking; the difference is 0.22 cm (SE?=?0.22) for partner's smoking. Maternal smoking was associated with lower PI at birth, faster PI increase in infancy, but not with BMI changes 2-10 years. Associations were stronger for maternal than partner smoking for PI at birth and PI changes in infancy, but not for BMI changes after 2 years. A similar dose-response in both maternal and partner smoking was seen for BMI change 2-10 years.Maternal smoking during pregnancy has an intrauterine effect on birth length, and possibly on adiposity at birth and changes in height and adiposity in infancy. We do not find evidence of a specific intrauterine effect on height or adiposity changes after the age of 2 years.
Project description:Infant-feeding patterns may influence lifelong health. This study tested the hypothesis that longer duration of breastfeeding and later introduction of complementary foods in infancy are associated with reduced adult cardiovascular risk.Data were pooled from 10?912 subjects in the age range of 15-41?years from five prospective birth-cohort studies in low-/middle-income countries (Brazil, Guatemala, India, Philippines and South Africa). Associations were examined between infant feeding (duration of breastfeeding and age at introduction of complementary foods) and adult blood pressure (BP), plasma glucose concentration and adiposity (skinfolds, waist circumference, percentage body fat and overweight/obesity). Analyses were adjusted for maternal socio-economic status, education, age, smoking, race and urban/rural residence and infant birth weight.There were no differences in outcomes between adults who were ever breastfed compared with those who were never breastfed. Duration of breastfeeding was not associated with adult diabetes prevalence or adiposity. There were U-shaped associations between duration of breastfeeding and systolic BP and hypertension; however, these were weak and inconsistent among the cohorts. Later introduction of complementary foods was associated with lower adult adiposity. Body mass index changed by -0.19?kg/m(2) [95% confidence interval (CI) -0.37 to -0.01] and waist circumference by -0.45?cm (95% CI -0.88 to -0.02) per 3-month increase in age at introduction of complementary foods.There was no evidence that longer duration of breastfeeding is protective against adult hypertension, diabetes or overweight/adiposity in these low-/middle-income populations. Further research is required to determine whether 'exclusive' breastfeeding may be protective. Delaying complementary foods until 6 months, as recommended by the World Health Organization, may reduce the risk of adult overweight/adiposity, but the effect is likely to be small.