Adolescent blood pressure, body mass index and skin folds: Sorting out the effects of early weight and length gains

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Journal of epidemiology and community health (Impact Factor: 3.5). 02/2011; 66(2):149-54. DOI: 10.1136/jech.2010.124842
Source: PubMed


Although there is longstanding evidence of the short-term benefits of promoting rapid growth for young children in low-income settings, more recent studies suggest that early weight gain can also increase the risk of chronic diseases in adults. This paper attempts to separate the effects of early life weight and length/height gains on blood pressure, body mass index (BMI), sum of skin folds and subscapular/triceps skin fold ratio at 14-15 years of age.
The sample comprised 833 members of a prospective population-based birth cohort from Brazil. Conditional size (weight or height) analyses were used to express the difference between observed size at a given age and expected size based on a regression, including all previous measures of the same anthropometric index. A positive conditional weight or height indicates growing faster than expected given prior size.
Conditional weights at all age ranges were positively associated with most outcomes; each z-score of conditional weight at 4 years was associated with an increase of 6.1 mm in the sum of skin folds (95% CI 4.5 to 7.6) in adolescence after adjustment for conditional length/height. Associations of the outcomes with conditional length/height were mostly negative or non-significant-each z-score was associated with a reduction of 2.4 mm (95% CI -3.8 to -1.1) in the sum of skin folds after adjustment for conditional weight. No associations were found with the skin fold ratio.
The promotion of rapid length/height gain without excessive weight gain seems to be beneficial for long-term outcomes, but this requires confirmation from other studies.

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Available from: Pedro Hallal, Oct 01, 2015
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    • "The association of weight gain with MetS risk is consistent with findings from a study addressing the same question, in a Scandinavian country [19]. Infancy weight gain has previously been associated with later obesity in childhood and adulthood [15] [18] [25] [26]. "
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    Free Radical Research 03/2012; 46(3):253-64. DOI:10.3109/10715762.2011.651467 · 2.98 Impact Factor
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    ABSTRACT: Purpose Early growth patterns have been associated with subsequent obesity risk. However, findings from middle-income populations suggest that early infant growth may benefit lean mass and height rather than adiposity. We tested the hypothesis that rapid weight or length gain in different growth periods would be associated with size and body composition in adolescence, in a prospective birth cohort from southern Brazil. Methods Body composition was assessed in 425 adolescents (52.2% male) at 14 years. Exposures were birth weight z-score and conditional growth in weight or length for the periods 0–6, 6–12 and 12–48 months. Differences in anthropometric and body composition outcomes between tertiles of growth in each period were tested by one-way analysis of variance. Results Size at birth and conditional weight and length at 6 months were associated with later height. The effect of infant weight gain on lean mass was greater for males than females, and effect on fat mass greater for females than males. By early childhood, rapid weight gain generated relatively similar effects on both tissue masses in both sexes. Rapid length gain had stronger effects on outcomes in males than females at each time point, and benefited lean mass more than adiposity. All effects were substantially attenuated after adjusting for current height. Early weight gain was more important than length gain at influencing body composition outcomes in adolescence. Conclusions Rapid infant weight and length gains were primarily associated with larger size in adolescence rather than increased adiposity. From one year onwards, associations between rapid weight gain and fat and lean masses remained after adjustment for height.
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