Objective. To determine whether a rapid rate of weight gain in early infancy is associated with overweight status in childhood.
Design. Prospective, cohort study from birth to age 7 years.
Setting. Twelve sites across the United States.
Participants. Twenty-seven thousand, eight hundred ninety-nine (27 899) eligible participants born at full term between 1959 and 1965.
Main Outcome Measure. Overweight status at age 7 years, defined by a body mass index above the 95th percentile of the Centers for Disease Control and Prevention reference data.
Results. In the 19 397 participants with complete data (69.6%), the prevalence of overweight status at age 7 years was 5.4%. The rate of weight gain during the first 4 months of life (as 100 g/month) was associated with being overweight at age 7 years, after adjustment for several confounding factors: odds ratio: 1.38; 95% confidence interval: 1.32–1.44. This association was present in each birth weight quintile, and remained significant after adjustment for the weight attained at age 1 year (odds ratio: 1.17; 95% confidence interval: 1.11–1.24).
Conclusions. A pattern of rapid weight gain during the first 4 months of life was associated with an increased risk of overweight status at age 7 years, independent of birth weight and weight attained at age 1 year. These findings may lead to new hypotheses regarding the cause of childhood obesity, which may contribute to our understanding of this increasing public health problem in the United States.
Comments
Rapid weight gain in the formula-fed infant is indicator of future obesity
I read this article and want to call attention to the fact that the exclusively breastfed infant will gain weight at a rapid rate in the first 4-6 months of life; in the second half of the first year, the breastfed baby's rate of weight gain slows. Whitehead and others have documented this phenomenon.
However, the artificially-fed baby is at risk for future obesity when the rate of weight gain is rapid. Mothers will feed formula ad lib if the baby is fussy, or to finish everything in the bottle because formula is expensive. Taveras and others have documented that breastfeeding sustains the baby's self-regulation of intake, which may be one reason that breastfeeding is protective against obesity.
The clinician, when faced with an infant whose rate of weight gain is rapid, needs to determine which method of feeding is being used to provide accurate counseling.
Conflict of Interest:
None declared