Weight Gain in Infancy and Vascular Risk Factors in Later Childhood

Michael R. Skilton, PhD^a,^b, 

Guy B. Marks, PhD^c, 

Julian G. Ayer, PhD^b,

Frances L. Garden, MBiostat^b,^c,^d, 

Sarah P. Garnett, PhD^b,^e,^f,

Jason A. Harmer, MBBS^b, 

Stephen R. Leeder, PhD^b,^d,^g, 

Brett G. Toelle, PhD^c, 

Karen Webb, PhD^h, 

Louise A. Baur, PhD^b,^d,^e, and

David S. Celermajer, PhD^b

PEDIATRICS Vol. 131 No. 6 June 1, 2013 pp. e1821 -e1828

(doi: 10.1542/peds.2012-2789)

1. ^aBoden Institute of Obesity, Nutrition, Exercise, and Eating Disorders,
2. ^bSydney Medical School;
3. ^dSydney School of Public Health;
4. ^eThe Children's Hospital at Westmead Clinical School; and
5. ^gMenzies Centre for Health Policy, University of Sydney, Sydney, Australia;
6. ^cWoolcock Institute of Medical Research, Glebe, Australia;
7. ^fInstitute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, Australia; and
8. ^hAtkins 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.