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Acceleration of BMI in Early Childhood and Risk of Sustained Obesity
abstract
This abstract is available on the publisher's site.
Access this abstract nowBACKGROUND
The dynamics of body-mass index (BMI) in children from birth to adolescence are unclear, and whether susceptibility for the development of sustained obesity occurs at a specific age in children is important to determine.
METHODS
To assess the age at onset of obesity, we performed prospective and retrospective analyses of the course of BMI over time in a population-based sample of 51,505 children for whom sequential anthropometric data were available during childhood (0 to 14 years of age) and adolescence (15 to 18 years of age). In addition, we assessed the dynamics of annual BMI increments, defined as the change in BMI standard-deviation score per year, during childhood in 34,196 children.
RESULTS
In retrospective analyses, we found that most of the adolescents with normal weight had always had a normal weight throughout childhood. Approximately half (53%) of the obese adolescents had been overweight or obese from 5 years of age onward, and the BMI standard-deviation score further increased with age. In prospective analyses, we found that almost 90% of the children who were obese at 3 years of age were overweight or obese in adolescence. Among the adolescents who were obese, the greatest acceleration in annual BMI increments had occurred between 2 and 6 years of age, with a further rise in BMI percentile thereafter. High acceleration in annual BMI increments during the preschool years (but not during the school years) was associated with a risk of overweight or obesity in adolescence that was 1.4 times as high as the risk among children who had had stable BMI. The rate of overweight or obesity in adolescence was higher among children who had been large for gestational age at birth (43.7%) than among those who had been at an appropriate weight for gestational age (28.4%) or small for gestational age (27.2%), which corresponded to a risk of adolescent obesity that was 1.55 times as high among those who had been large for gestational age as among the other groups.
CONCLUSIONS
Among obese adolescents, the most rapid weight gain had occurred between 2 and 6 years of age; most children who were obese at that age were obese in adolescence.
Additional Info
Disclosure statements are available on the authors' profiles:
Acceleration of BMI in Early Childhood and Risk of Sustained Obesity
N. Engl. J. Med 2018 Oct 04;379(14)1303-1312, M Geserick, M Vogel, R Gausche, T Lipek, U Spielau, E Keller, R Pfäffle, W Kiess, A KörnerFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
This observational study demonstrates that prenatal and early interventions are key to mitigate the rising obesity rates in the US and around the world. Unfortunately, the medical community has been slow to address excess weight in parents prior to conception and often lag behind in addressing obesity in the pediatric population. More efforts should be made to properly educate physicians on how to treat obesity in the pediatric and adult populations to begin to make headway in addressing the most prevalent chronic disease of humankind—obesity.