Size at birth, weight gain in infancy and childhood, and adult blood pressure in 5 low- and middle-income-country cohorts: when does weight gain matter?

University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
American Journal of Clinical Nutrition (Impact Factor: 6.5). 04/2009; 89(5):1383-92. DOI: 10.3945/ajcn.2008.27139
Source: PubMed

ABSTRACT Promoting catch-up growth in malnourished children has health benefits, but recent evidence suggests that accelerated child weight gain increases adult chronic disease risk.
We aimed to determine how birth weight (BW) and weight gain to midchildhood relate to blood pressure (BP) in young adults.
We pooled data from birth cohorts in Brazil, Guatemala, India, the Philippines, and South Africa. We used conditional weight (CW), a residual of current weight regressed on prior weights, to represent deviations from expected weight gain from 0 to 12, 12 to 24, 24 to 48 mo, and 48 mo to adulthood. Adult BP and risk of prehypertension or hypertension (P/HTN) were modeled before and after adjustment for adult body mass index (BMI) and height. Interactions of CWs with small size-for-gestational age (SGA) at birth were tested.
Higher CWs were associated with increased BP and odds of P/HTN, with coefficients proportional to the contribution of each CW to adult BMI. Adjusted for adult height and BMI, no child CW was associated with adult BP, but 1 SD of BW was related to a 0.5-mm Hg lower systolic BP and a 9% lower odds of P/HTN. BW and CW associations with systolic BP and P/HTN were not different between adults born SGA and those with normal BW, but higher CW at 48 mo was associated with higher diastolic BP in those born SGA.
Greater weight gain at any age relates to elevated adult BP, but faster weight gains in infancy and young childhood do not pose a higher risk than do gains at other ages.

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    Pediatrics 10/2014; 134(5). DOI:10.1542/peds.2014-1045 · 5.30 Impact Factor
  • Journal of Nutrition 12/2014; 144(12):2092-3. DOI:10.3945/jn.114.200543 · 4.23 Impact Factor
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    ABSTRACT: Objectives To investigate the association between birth weight and blood pressure (BP) and to determine the effect of body size change from birth to adulthood on BP. Design A cross-sectional design to collect retrospective data. Participants 1253 female nurses aged 35–65 years in Hong Kong. Main outcome measures Birth weight, height, weight, BP, waist circumference, demographics and lifestyle factors were collected by a self-administered questionnaire through mail survey. These self-reported variables have been validated in a pilot study. The conditional relative weight (CRW), which was calculated as a residual of current weight regressed on birth weight, was used to express higher or lower relative weight gain from birth to adulthood. Results No significant linear association between overall range of birth weight and BP was found. The curve estimation showed a significant quadratic curvilinear association (‘J’ shape). In the piecewise-linear analysis, a significant inverse association between birth weight z-scores and BP was observed in the birth weight ≤3.1 kg group (systolic BP (SBP): coefficient B=−1.73, 95% CI −3.17 to −0.30; diastolic BP (DBP): B=−1.12, 95% CI −2.19 to −0.06). A positive but non-significant association occurred in the birth weight >3.1 kg group. Participants who belonged to the lowest 10% birth weight category but at the current top 10% BMI group had higher BP than participants in other BMI groups. The CRW z-score was positively associated with BP (coefficient B: 4.18 for SBP and 2.87 for DBP). Conclusions Unlike most previous studies, we found a ‘J’ shape association rather than a linear association between birth weight and BP. Women with large percentile crossing of body size from birth to adulthood were more likely to have elevated BP. A higher weight gain from birth to adulthood than expected led to higher BP.
    BMJ Open 09/2014; 4(9):e005115. DOI:10.1136/bmjopen-2014-005115 · 2.06 Impact Factor

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