Increased height, birth weight early in life may reduce disease as adult

Previous studies have suggested that rapid weight gain during the first 2 years of life is associated with an increased risk for obesity and insulin resistance later in life. However, a new study with an emphasis on countries with low or middle income suggests that higher birth weight and early growth during the first 2 years of life led to improvements in height and levels of education.

“Our results challenge several programs in countries of low and middle income. … Traditional school feeding programs that increase BMI with little effect on height might be doing more harm than good in terms of future health,” researcher Linda S. Adair, PhD, of the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill, said in a press release.

The researchers collected data for 8,362 patients from five prospective birth cohort studies from Brazil, Guatemala, India, the Philippines and South Africa who had at least one adult outcome of interest.

They wrote that a higher birth weight was consistently related to an adult BMI of >25 kg/m2 (OR=1.28; 95% CI, 1.21-1.35) and a reduced tendency for short adult stature (OR=0.49; 95% CI, 0.44-0.54) and of not completing secondary school (OR=0.82; 95% CI, 0.78-0.87).

Additional data indicate that faster linear growth at age 2 years (OR=0.23; 95% CI, 0.20-0.52) and mid-childhood (OR=0.39; 95% CI, 0.36-0.43) was associated with a reduced risk for short adult stature and of not completing secondary school at age 2 years (OR=0.74; 95% CI, 0.67-0.78) and mid-childhood (OR=0.87; 95% CI, 0.83-0.92).

However, faster linear growth increased the likelihood for children being overweight at age 2 years (OR=1.24; 95% CI, 1.17-1.31) and mid-childhood (OR=1.12; 95% CI, 1.06-1.18), in addition to elevated BP at age 2 years (OR=1.12; 95% CI, 1.06-1.19) and mid-childhood (OR=1.07; 95% CI, 1.01-1.13), researchers wrote.

Moreover, faster relative weight gain was associated with an increased risk for adult overweight status at age 2 years (OR=1.51; 95% CI, 1.43-1.60) and mid-childhood (OR=1.76; 95% CI, 1.69-1.91), in addition to elevated BP at age 2 years (OR=1.07; 95% CI, 1.01-1.13) and mid-childhood (OR=1.22; 95% CI, 1.15-1.30), they wrote.

Linear growth and relative weight gain were not linked to dysglycemia. However, higher birth weight was related to a decreased risk for the disorder (OR=0.89; 95% CI, 0.81-0.98), according to data.

In an accompanying commentary, Zulfiqar A. Bhutta, MBBS, PhD, of the division of women and child health at Aga Khan University in Karachi, Pakistan, wrote that aside from study limitations, Adair and colleagues’ findings have clear implications.

“As shown by an analysis of evidence-based interventions, a focus on improvements in nutrition in pregnancy and linear growth in the first 2 years of life could lead to substantial reductions in stunting and improved survival,” Bhutta wrote.

According to Bhutta, there should be well-designed prospective studies with appropriate interventions and follow-up, including elements of child development, education, employment and earnings, as outcomes.

For more information:

Adair LS. Lancet. 2013;doi:10.1016/S0140-6736(13)60103-8.

Bhutta ZA. Lancet. 2013;doi:10.1016/S0140-6736(13)60716-3.

Disclosure: The researchers report no relevant financial disclosures.