Objective: Different body mass index (BMI) trajectories that result in obesity may have diverse health consequences, yet this heterogeneity is poorly understood. We aimed to identify distinct classes of individuals who share similar BMI trajectories and examine associations with cardiometabolic health. Approach and Results: Using data on 3549 participants in ALSPAC (Avon Longitudinal Study of Parents and Children), a growth mixture model was developed to capture heterogeneity in BMI trajectories between 7.5 and 24.5 years. Differences between identified classes in height growth curves, body composition trajectories, early-life characteristics, and a panel of cardiometabolic health measures at 24.5 years were investigated. The best mixture model had 6 classes. There were 2 normal-weight classes: normal weight (nonlinear; 35% of sample) and normal weight (linear; 21%). Two classes resulted in young-adulthood overweight: normal weight increasing to overweight (18%) and normal weight or overweight (16%). Two classes resulted in young-adulthood obesity: normal weight increasing to obesity (6%) and overweight or obesity (4%). The normal-weight-increasing-to-overweight class had more unfavorable levels of trunk fat, blood pressure, insulin, HDL (high-density lipoprotein) cholesterol, left ventricular mass, and E/e′ ratio compared with the always-normal-weight-or-overweight class, despite the average BMI trajectories for both classes converging at ≈26 kg/m 2 at 24.5 years. Similarly, the normal-weight-increasing-to-obesity class had a worse cardiometabolic profile than the always-overweight-or-obese class. Conclusions: Individuals with high and stable BMI across childhood may have lower cardiometabolic disease risk than individuals who do not become overweight or obese until late adolescence.

Whereas Abderhalden and Bloch illustrate rapid height catch-up in children from intact social background, Goldstein's observations in orphans and children from poor social background parallel the growth patterns observed in children of modern middle and low-income countries. The historic observations question the current concept of stunting as prima facie evidence of malnutrition and chronic infection, and support the view that "the child's longitudinal growth is largely independent of the extent and nature of the diet".

Objective:To investigate changes in socio-economic inequalities in growth in height, weight, BMI and grip strength in children born during 1955–1993 in Guatemala, a period of marked socio-economic-political change.Design:We modelled longitudinal data on height, weight, BMI and hand grip strength using Super-Imposition by Translation and Rotation (SITAR). Internal Z-scores summarising growth size, timing and intensity (peak growth velocity, e.g. cm/year) were created to investigate inequalities by socio-economic position (SEP; measured by school attended). Interactions of SEP with date of birth were investigated to capture secular changes in inequalities.Setting:Urban and peri-urban schools in the region of Guatemala City, Guatemala.Participants:Participants were 40 484 children and adolescents aged 3–19 years of Ladino and Maya ancestry (nobservations 157 067).Results:The difference in height (SITAR size) between lowest and highest SEP decreased from −2·0 (95 % CI −2·2, −1·9) sd to −1·4 (95 % CI −1·5, −1·3) sd in males, and from −2·0 (95 % CI −2·1, −1·9) sd to −1·2 (95 % CI −1·3, −1·2) sd in females over the study period. Inequalities also reduced for weight, BMI and grip strength, due to greater secular increases in lowest-SEP groups. The puberty period was earlier and shorter in higher-SEP individuals (earlier SITAR timing and higher SITAR intensity). All SEP groups showed increases in BMI intensity over time.Conclusions:Inequality narrowed between the 1960s and 1990s. The lowest-SEP groups were still >1 sd shorter than the highest. Risks remain for reduced human capital and poorer population health for urban Guatemalans.

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