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High weight in infancy fails to indicate obesity in childhood
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Increased weight in infancy does not predict childhood obesity, and more than half of infants with overweight had a normal BMI by age 8 years, according to an analysis of three longitudinal growth studies published in Pediatric Obesity.
“This [study] suggests that, while overweight may be an enduring characteristic, more extreme BMIs in infancy tend not to persist,” Charlotte M. Wright, MSc, MD, professor of community child health at the University of Glasgow, United Kingdom, and colleagues wrote. “Thus, a high weight in infancy has a moderate positive predictive value for becoming overweight in mid-childhood, but not for becoming obese, and its sensitivity is very low.”
To examine whether high weight in infancy is an indicator of obesity in childhood, researchers used data from cohorts of three previously published studies: Newcastle Growth and Development study of 1987, Gateshead Millennium study of 1999 and the Tampere study of 2003. These provided a total of 2,122 participants. Researchers converted weights to age- and sex-adjusted z scores and identified the measurements closest to the target ages of 3, 6, 9 and 12 months and 5 and 8 years. Overweight BMI was defined as having a z score between 1 and 2 standard deviations, whereas obese BMI was defined as having a z score of 2 standard deviations or greater.
Using binary variables of raised or normal weight or BMI at each time marker, researchers then examined the movement between weight status (normal weight to overweight to obesity) from 3 months (which was used as the baseline to assess infant-child transitions) to 8 years.
Researchers found that, at 12 months, 5% of the infants had high weight (standard deviation [SD] 2) and 26% had raised or high weight (SD 1). At age 5 years, 4% had BMI of at least 2 SD and 21% had BMI of at least 1 SD, and at 8 years 6% had BMI of at least 2 SD and 23% had BMI at least 1 SD.
The majority of infants with high weight at birth tended to regress to normal weight by 3 months and to remain in this category until 12 months.
The 29% of children who had raised weight at 3 and/or 12 months were 5.4 (95% CI, 3.6-8.3) times more likely to have high BMI ( 2 SD) in childhood and 3.77 (95% CI, 3.1-4.58) times more likely to have BMI with SD at least 1 than those who did not have raised weight.
Researchers also found that nearly 66% of the infants with raised weight did not have BMI with at least 1 SD at 8 years and less than 25% of those with high weight in infancy had BMI with at least 2 SD at 8 years.
Finally, it was determined that 64% of infants with raised weight in infancy had normal BMI at age 8 years.
Researchers concluded that high weight in infancy is not an important risk factor for obesity in childhood.
“As children begin to interact more with the obesogenic environment, those with infancy weight above the normal range will be at some increased risk of later obesity, but most children with high BMI in childhood will emerge from the much larger group of infants with normal weight,” the researchers wrote. “Thus, a watch-and-wait approach seems most sensible in infancy while continuing universal interventions, such as those promoting exclusive breastfeeding, supporting healthy complementary feeding and encouraging physical activity.” – by Melissa J. Webb
Disclosures: The authors report no relevant financial disclosures.
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