BMI in Childhood and Its Association with Height Gain, Timing of Puberty, and Final Height

Abstract

No large population-based study has addressed the question of how overnutrition is related to subsequent height gain in childhood, timing of puberty, and final height. The present data represent a large Swedish population-based longitudinal growth study. Height gain in childhood, timing of reaching peak height velocity and height gain during adolescence, and final height were regarded as the short-term, interim, and long-term outcomes of childhood nutritional status, i.e. body mass index (BMI) change between 2 and 8 y. Midparental height was adjusted as the genetic influence on linear growth of the child. Childhood BMI gain was related to an increased height gain during the same period, i.e. an increase of 1 BMI unit was associated with an increase in height of 0.23 cm in boys and 0.29 cm in girls. A higher BMI gain in childhood was related to an earlier onset of puberty; the impact on the timing of puberty was 0.6 y in boys and 0.7 y in girls. Each increased unit of BMI gain in childhood also reduced the height gain in adolescence, 0.88 cm for boys and 0.51 cm for girls. No direct correlation was shown between childhood BMI gain and final height. We conclude that overnutrition between 2 and 8 y of age will not be beneficial from a final height point of view, as the temporary increase in height gain in childhood will be compensated by an earlier pubertal maturity and a subnormal height gain in adolescence. Abbreviations: BMI, body mass index PHV, peak height velocity ⌬B8 -2, BMI change between 2 and 8 y of age ⌬HCM8 -2, height gain between 2 and 8 y of age ⌬HCM18 -8, height gain between 8 and 18 y of age It is known that adequate nutrition is needed for normal growth during the pediatric years (1, 2). Some earlier studies of pediatric subjects also seem to support the hypothesis that overnutrition not only produces a normal growth but also accelerates linear growth (3, 4). Earlier studies were based on inpatient or outpatient series, and the number of subjects was relatively small. One study explored the association between obesity and height throughout childhood and adolescence (5); the obese subjects were seen to be taller than average in childhood, whereas during puberty they demonstrated a smaller growth spurt when compared with lean subjects. The series was taken from an obesity clinic, and the follow-up period was relatively short.The objective of this study is to investigate the association between BMI change in childhood, i.e. from 2 to 8 y of age, and gain in height during childhood, the timing of the puberty growth spurt, i.e. the age at PHV during puberty, and final height. The linear growth data were obtained from a population-representative longitudinal growth study of 3650 healthy children born at full-term between 1973 and 1975 in Göteborg, Sweden (6). METHODS Study population.The study subjects were selected from 5111 final grade-school children born in the early 1970s in Göteborg, Sweden, or the surrounding area of the city. The annual birth rate in Göteborg is around 4000 to 5500 newborns in t...

Pubertal height gain is inversely related to peak BMI in childhood

“…The growth study based on the GrowUp 1974 Gothenburgbirth cohort found somewhat similar results; a greater increase in BMI from 2−8 y of age was associated with a taller stature at 8 y (19). Our study also confirmed results from many studies tracking childhood obesity back to birth (20,21), with significant differences in birth-weight between children who went on to have higher BMIs during childhood compared with children with BMIs in the normal/underweight range.…”

“…However, most other non-American studies support our findings, with earlier onset of puberty in overweight/ obese boys; in the 1940s, under-nutrition was reported to delay onset of puberty and Mossberg found earlier puberty in obese Swedish boys. These findings were confirmed in the United Kingdom (18), and later in many European counties (19,25,30), and Japan (31). Correlation between BMI and mid-puberty was also seen for boys in a UK study, which found a linear correlation between BMI SDS in childhood and age at PHV (30).…”

Age of onset of a normally timed pubertal growth spurt affects the final height of children

“…Contemporary children are more obese, and the results of several studies have found that BMI exerts a negative effect on the height gain during puberty (11,12). We found no evidence of this relationship after analyzing our data, and we attribute this finding to the very small number of obese children in the study population: only five boys and four girls had a BMI above the 90th percentile.…”

Mexican anthropometric percentiles for ages 10–18

“…Although grouping adolescents by Tanner stage is interesting, determining the Tanner stage is difficult in large surveys. Additionally, overweight may affect sexual development, inducing acceleration in girls and delay in boys (He and Karlberg, 2001). Compared with Chilean 50th, 85th and 95th percentiles of BMI for age, Mexican boys and girls have higher BMI levels.…”