Childhood body mass index trajectories and risk of overweight and obesity in young adulthood: a population-based prospective cohort study
摘要
Childhood body mass index (BMI) change is associated with obesity in adulthood but is often investigated in isolated age windows. This study aimed to identify age windows of BMI changes that are associated with overweight, including obesity, in young adulthood. This study was embedded in a population-based, prospective cohort study among 3528 participants born in Rotterdam, the Netherlands, between 2002 and 2006. Data on gestational-age-adjusted birth weight and sex- and age-adjusted BMI (BMI-SDS) was repeatedly collected between 2 and 20 years in a dedicated research center. Associations between childhood BMI-SDS and young adult (from 17 to 21 years of age) BMI-SDS and overweight/obesity were analyzed. Of children with overweight, including obesity, at 2, 6, 10, and 14 years, 32.6%, 54.0%, 57.4%, and 70.3%, respectively, had overweight around 18 years of age. Positive deviations from the expected BMI at any age were positively associated with odds of overweight at 18, with the strongest effect estimate at 6 years (p-values < 0.05). Of children in the highest BMI tertile between 2 and 10 years, only those with BMI growth deceleration, defined as a decrease comparable to crossing a major percentile line on a growth chart, between 2 and 6 years did not have increased risk of overweight at 18 years, whereas all other children in the highest BMI tertile did.
Conclusion: Optimizing healthy and reversing unhealthy BMI trajectories in early childhood, especially before 6 years, may be a great opportunity for the prevention of overweight and obesity.