Body Mass Index (BMI) Trajectories from Birth to 11.5 Years: Relation to Early Life Food Intake

Abstract

Recent research has shown that the pattern of change over time, or trajectory, of body mass index (BMI) varies among children. However, the factors that underlie the heterogeneity in these trajectories remain largely unexplored. Our aim was to use a growth mixture model to empirically identify classes of BMI trajectories (from birth to 11.5 years) and examine the effects of breastfeeding, introduction of solids, as well as food and nutrient intake at 18 months on these BMI trajectories. We identified three BMI growth trajectories between birth and age 11.5 years, separately in boys and girls. Breastfeeding duration less than six months and the early introduction of solids did not adversely influence BMI trajectories in our sample but high intakes of meat, particularly high fat varieties, and high intakes of carbohydrate at age around 18 months were associated with a high BMI trajectory in boys. It is not clear whether these dietary factors confer a direct risk of higher BMI in childhood or are markers for other dietary patterns that are present early and/or develop through childhood and contribute to higher BMI.

Developmental trajectories of adiposity from birth until early adulthood and association with cardiometabolic risk factors

“…Developmental trajectories in children and adolescents were described in different settings but study comparisons are inappropriate due to differences in statistical solutions, growth modelling 20,21 versus growth mixture modelling (a group-based approach); 22-27 great heterogeneity in age ranges and differences in the outcome modelled, mostly using BMI [25][26][27] or BMI z-score. 20,[22][23][24] Adiposity differences between trajectories appeared in the first years of life and there was a low probability (about 10%) of changing trajectory from adolescence onwards (data not shown).…”

Health Care Utilization by Body Mass Index in a Pediatric Population

“…Multiple studies indicate that BMI percentiles increase gradually over time in children. 42, 43 However, baseline BMI is a strong risk factor for eventual development of obesity, and children that become obese by age 3 to 5 years are likely to remain obese. 43-46 Therefore, the misclassification that is likely to result from our use of baseline BMI category as opposed to changes in BMI over time should be minimal.…”

Growth trajectories in early childhood, their relationship with antenatal and postnatal factors, and development of obesity by age 9 years: results from an Australian birth cohort study

“…Our finding of four groups agrees with the results reported by Carter et al, 11 based on five z-BMI measurements between ages 4 and 10, and those of Mustillo et al, 13 drawn from annual weight and height measurements between ages 9 and 16 years. While other authors have reported three distinct trajectory groups, [8][9][10] these studies were limited by maternal reported heights and weights 10 or did not analyse standardised BMI. [8][9] Our results also demonstrate that the broad groupings of growth that we identified had clearly detectable effects on body size at age 9 years, with the group of children in the high growth group in early childhood showing a fourfold increase in odds of overweight or obesity at age 9 years.…”

“…While other authors have reported three distinct trajectory groups, [8][9][10] these studies were limited by maternal reported heights and weights 10 or did not analyse standardised BMI. [8][9] Our results also demonstrate that the broad groupings of growth that we identified had clearly detectable effects on body size at age 9 years, with the group of children in the high growth group in early childhood showing a fourfold increase in odds of overweight or obesity at age 9 years. Those children in the accelerated growth trajectory group in early childhood had a 15-fold increase in odds of overweight or obesity at age 9 years.…”

“…6 It also allows investigation of common determinants that may include maternal characteristics, behaviours and pregnancy complications. 5,7 Recent studies that consider growth across childhood and adolescence suggest a small number of distinct growth trajectories, with three [8][9][10] or four [11][12][13] trajectories commonly reported, broadly corresponding to groups of children characterised as never overweight, chronically overweight, accelerating, or declining. Haga et al 14 derived trajectories from 11 repeated measurements of BMI between birth and age 12 years, and reported a five-group model for boys, and a six-group model for girls.…”