Weight Gain in Infancy and Vascular Risk Factors in Later Childhood

Author:

Skilton Michael R.12,Marks Guy B.3,Ayer Julian G.2,Garden Frances L.234,Garnett Sarah P.256,Harmer Jason A.2,Leeder Stephen R.247,Toelle Brett G.3,Webb Karen8,Baur Louise A.245,Celermajer David S.2

Affiliation:

1. Boden Institute of Obesity, Nutrition, Exercise, and Eating Disorders,

2. Sydney Medical School;

3. Woolcock Institute of Medical Research, Glebe, Australia;

4. Sydney School of Public Health;

5. The Children's Hospital at Westmead Clinical School; and

6. Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, Australia; and

7. Menzies Centre for Health Policy, University of Sydney, Sydney, Australia;

8. Atkins Center for Weight and Health, Department of Nutritional Sciences and Toxicology and School of Public Health, University of California, Berkeley, California

Abstract

OBJECTIVE: We hypothesized that early weight gain would be associated with incident obesity, higher blood pressure, systemic inflammation, and arterial wall thickening in later childhood. METHODS: A longitudinal birth cohort was recruited antenatally from 2 maternity hospitals in Sydney, Australia, between September 1997 and December 1999. Three hundred ninety-five nondiabetic children who were followed to age 8 years had complete data for early weight gain and arterial wall thickness. RESULTS: Independent predictors of excess early weight gain (age 0–18 months; adjusted for height gain) included male gender (0.411 kg [SE: 0.103], P < .001), fewer weeks’ gestation (−0.121 kg [SE: 0.044] per week, P = .006), birth length (0.156 kg [SE: 0.024] per cm, P < .001), and failure to breastfeed to 6 months of age (0.498 kg [SE: 0.108], P < .001). Early height-adjusted weight gain was significantly associated with later childhood overweight (odds ratio [OR]: 1.67 [95% confidence interval (CI): 1.26 to 2.20] per kg) and obesity (OR: 2.07 [95% CI: 1.53 to 2.79] per kg), excess central adiposity (OR: 1.54 [95% CI: 1.20 to 1.98] per kg), higher systolic blood pressure (1.24 mm Hg [SE: 0.33] per kg, P < .001), higher C-reactive protein (0.17 mg/dL [SE: 0.06] per 100% increase in weight gain, P = .006), and greater carotid intima-media thickness (0.012 mm [SE: 0.004] per kg, P = .002). CONCLUSIONS: Early postnatal weight gain from birth to age 18 months is significantly associated with later childhood overweight and obesity, excess central adiposity, and greater arterial wall thickness.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology, and Child Health

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