Crossing Growth Percentiles in Infancy and Risk of Obesity in Childhood

Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA.
JAMA Pediatrics (Impact Factor: 5.73). 11/2011; 165(11):993-8. DOI: 10.1001/archpediatrics.2011.167
Source: PubMed


To examine the associations of upward crossing of major percentiles in weight-for-length in the first 24 months of life with the prevalence of obesity at ages 5 and 10 years.
Longitudinal study.
Multisite clinical practice.
We included 44 622 children aged from 1 month to less than 11 years with 122 214 length/height and weight measurements from January 1, 1980, through December 31, 2008.
The number of major weight-for-length percentiles crossed during each of four 6-month intervals, that is, 1 to 6 months, 6 to 12 months, 12 to 18 months, and 18 to 24 months.
Odds and observed prevalence of obesity (body mass index [calculated as weight in kilograms divided by height in meters squared] ≥95th percentile) at ages 5 and 10 years.
Crossing upwards 2 or more weight-for-length percentiles was common in the first 6 months of life (43%) and less common during later age intervals. Crossing upwards 2 or more weight-for-length percentiles in the first 24 months was associated with elevated odds of obesity at ages 5 years (odds ratio, 2.08; 95% CI, 1.84-2.34) and 10 years (1.75; 1.53-2.00) compared with crossing less than 2 major percentiles. Obesity prevalence at ages 5 and 10 was highest among children who crossed upwards 2 or more weight-for-length percentiles in the first 6 months of life.
Crossing upwards 2 or more major weight-for-length percentiles in the first 24 months of life is associated with later obesity. Upward crossing of 2 weight-for-length percentiles in the first 6 months is associated with the highest prevalence of obesity 5 and 10 years later. Efforts to curb excess weight gain in infancy may be useful in preventing later obesity.

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    • "One common feature of SGA babies and those exposed to the Dutch Winter Hunger early in gestation is that readily available food sources in the postnatal environment promote rapid ''catch-up growth''. Fast growth trajectories in early infancy are associated with increased prevalence of obesity, even in babies with normal birth weights (Stettler et al., 2003; Sachdev et al., 2005; Ong and Loos, 2006; Ekelund et al., 2007; Taveras et al., 2011). It has been proposed that preferential deposition of fat mass in neonates as compared to older infants underlies this observation (Veldhuis et al., 2006; Gillman, 2008). "
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    ABSTRACT: Suboptimal maternal nutrition exerts lasting impacts on obesity risk in offspring, but the direction of the effect is determined by the timing of exposure. While maternal undernutrition in early pregnancy is associated with increased body mass index, in later pregnancy it can be protective. The importance of the timing of maternal undernutrition is also observed in rodents, however, many of the processes that occur in the last trimester of human gestation are delayed to the postnatal period. Neonatal leptin administration exerts lasting impacts on susceptibility to obesity in rodents. Although leptin can influence the formation of hypothalamic circuits involved in homeostatic control of feeding during the postnatal period, these effects are too late to account for its ability to reverse adverse metabolic programming due to early gestational exposure to maternal undernutrition. This review presents an alternative framework for understanding the effects of neonatal leptin through influences on developing thermoregulatory circuits. Copyright © 2015. Published by Elsevier Inc.
    Frontiers in Neuroendocrinology 07/2015; DOI:10.1016/j.yfrne.2015.07.002 · 7.04 Impact Factor
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    • "The current data show that a rapid increase in the BMI during the first year of life, and especially between the ages of 6 and 9 months, significantly increases the risk of being overweight at 8 years of age (Table 3). Other authors have found similar results when studying weight gain in early childhood [13,14] and weight gain during adolescence [7,8,10]. "
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    ABSTRACT: Identifying important ages for the development of overweight is essential for optimizing preventive efforts. The purpose of the study was to explore early growth characteristics in children who become overweight or obese at the age of 8 years to identify important ages for the onset of overweight and obesity. Data from the Norwegian Child Growth Study in 2010 (N = 3172) were linked with repeated measurements from health records beginning at birth. Weight and height were used to derive the body mass index (BMI) in kg/m2. The BMI standard deviation score (SDS) for each participant was estimated at specific target ages, using a piecewise linear mixed effect model. At 8 years of age, 20.4% of the children were overweight or obese. Already at birth, overweight children had a significantly higher mean BMI SDS than normal weight 8-year-olds (p < .001) and this difference increased in consecutive age groups in infancy and childhood. A relatively large increase in BMI during the first 9 months was identified as important for being overweight at 8 years. BMI SDS at birth was associated with overweight at 8 years of age (OR, 1.8; 1.6-2.0), and with obesity (OR, 1.8; 1.4-2.3). The Odds Ratios for the BMI SDS and change in BMI SDS further increased up to 1 year of age became very high from 2 years of age onwards. A high birth weight and an increasing BMI SDS during the first 9 months and high BMI from 2 years of age proved important landmarks for the onset of being overweight at 8 years of age. The risks of being overweight at 8 years appear to start very early. Interventions to prevent children becoming overweight should not only start at a very early age but also include the prenatal stage.
    BMC Public Health 02/2014; 14(1):160. DOI:10.1186/1471-2458-14-160 · 2.26 Impact Factor
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    • "WLH provides the weight spectrum for a specific length segment (4,5).Therefore, the use of BMI as the key index for nutritional evaluation may not be as satisfactory in children under two years of age as it is in older children and adults (6). The age-adjusted references of several anthropometric measurements are currently used as either follow-up or screening criteria to monitor growth in children (7). "
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    ABSTRACT: Objective: To produce weight for length/height (WLH) percentiles to be used for the screening of growth and assessment of failure to thrive in infancy and early childhood. Methods: The data (2009-2010) of the Anthropometry of Turkish Children aged 0-6 years (ATCA-06) study were used. A cross-sectional study was designed to calculate the WLH references. Reference weight values for each 5-cm LH intervals were determined using the LMS Chart Maker Pro version 2.3 software program (The Institute of Child Health, London). Results: A total of 3123 children (1573 female, 1550 male) aged 0-6 years were included in the calculation of the 3rd, 5th, 10th, 25th, 50th, 75th, 85th, 90th, 95th, and 97th WLH percentiles. The difference between the 3rd and the 97th percentiles for males was 2.02 cm to 12.64 cm in the 50-54.99 cm and 125-130 cm LH ranges. In the girls, the differences between the 3rd-97th percentiles ranged from 2.02 cm to 12.64 cm in the 50-54.99 cm and 125-130 cm LH groups. The maximum difference between the 3rd and 97th percentiles was about half the variation of mean WLH throughout the first six years of life. The most rapid change in WLH was observed in the 0-2-year period. Turkish references for WLH were not different from the World Health Organization standards. Conclusions: This is the first study in Turkey presenting WLH references in 0-6 year old children. We suggest that the use of WLH in the first two years of life may be more useful than age-adjusted references in assessment of nutritional status and diagnosis of failure to thrive. Conflict of interest:None declared.
    Journal of Clinical Research in Pediatric Endocrinology 12/2013; 5(4):224-228. DOI:10.4274/Jcrpe.1139
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