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ORIGINAL RESEARCH COMMUNICATION |
1 From the Division of Gastroenterology and Nutrition, The Children’s Hospital of Philadelphia (NS, BSZ, and VAS), the Center for Clinical Epidemiology and Biostatistics (NS and SKK), and the WM Krogman Center for Research in Child Growth and Development (SHK), University of Pennsylvania School of Medicine, Philadelphia.
Background: Obesity is increasing in the United States. Evidence-based prevention is a public health priority and should target well-defined risk factors and critical periods.
Objective: We tested the hypothesis that rapid weight gain during early infancy is associated with obesity in African American young adults, a group at increased risk of obesity.
Design: A cohort of 300 African Americans born at full term was followed from birth to 20 y of age. A pattern of rapid weight gain was defined as an increase in weight-for-age ≥ 1 SD between birth and 4 mo.
Results: About 29% of subjects had a pattern of rapid weight gain during infancy; 8% were obese [body mass index (in kg/m2) ≥ 30] at age 20 y. One-third of the obesity at age 20 y could be attributed to rapid weight gain in the first 4 mo of life. After adjustment for confounding factors, subjects with rapid weight gain during early infancy were more likely to become obese at age 20 y (odds ratio = 5.22; 95% CI: 1.55, 17.6; P = 0.008). The results were confirmed by using a combination of body mass index and skinfold thickness (odds ratio = 6.72; 95% CI: 1.93, 23.4; P = 0.003).
Conclusions: The results of the present study provide evidence that a pattern of rapid weight gain during early infancy is associated with obesity not only in childhood but also in young adulthood. We propose that early infancy constitutes a critical period for the development of obesity. Mechanisms of action and prevention strategies require further investigation.
Key Words: Birth order • birth weight • African Americans • children • cohort studies • growth • infants • obesity • skinfold thickness • weight gain
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