Contribution of Early Weight Gain to Childhood Overweight and Metabolic Health: A Longitudinal Study (EarlyBird 36)

Abstract

Most excess weight before puberty is gained before 5 years of age. Weight at 5 years of age bears little relation to birth weight but closely predicts weight at 9 years of age. Single measures of current weight are predictive of metabolic health, whereas weight gain within a specific period adds little. A single measure of weight at 5 years of age provides a pointer to future health for the individual. If metabolic status at 9 years of age means future risk, diabetes/cardiovascular prevention strategies might better focus on preschool-aged children, because the die seems to be largely cast by 5 years of age, and a healthy weight early in childhood may be maintained at least into puberty.

Assortative weight gain in mother–daughter and father–son pairs: an emerging source of childhood obesity. Longitudinal study of trios (EarlyBird 43)

“…The wide divergence in offspring BMI-SDS according to category of parental BMI already present at 5 years, but lack of difference at birth, suggests an early post-natal (but not gestational) influence, and we have documented elsewhere that over 90% of the weight centiles crossed before puberty by contemporary girls (470% in boys) are crossed before the age of 5 years. 22 Others have suggested that the first few months of life may be crucial. 23 The implications may be important, where so much emphasis is placed on school physical education, school dinners, school transport and so on.…”

Adipose tissue dysregulation and metabolic consequences in childhood and adolescent obesity: potential impact of dietary fat quality

“…The short-and long-term health consequences of elevated BMI in childhood and adolescence remain unclear. While some prospective studies suggest that excess weight gain during these developing years is directly associated with adverse future health outcomes, including incidence of type 2 diabetes (T2D) (4,5) , CVD (6,7) and some cancers (8,9) , others disagree (10)(11)(12) . Studies that fail to show a relationship between childhood weight and disease outcome in adulthood have suggested that significant relationships dissipate when adjusted for adult BMI (12) .…”

A Life Course Perspective on Health Trajectories and Transitions

“…One British study that generated an enormous amount of media interest was analysis of the EarlyBird cohort by Gardner et al (2009). This study examined weight gain (defined as an increase in weight z-score [z-scores are age-and sexstandardised measurements, so an increase in weight z-score means an increase in weight given what would be expected from a child's age and sex]) between birth, five years, and nine years in a cohort of 233 children from the south-west of England.…”

“…They also suggest that potential risk factors in school-aged children should be de-emphasised, stating "given the pattern of weight gain reported here, the contribution to childhood obesity by computers, school meals, (lack of) sports clubs, (absence of) school playing fields, and the 'school-run' (all of which are vilified regularly by the media) might be questioned". This analysis of the EarlyBird study, however, included only 233 children with weight as the only measure of adiposity, and measurements at just three ages -birth, five and nine years (Gardner et al 2009). …”

“…In this cohort, repeated measurements of weight and height were available from birth to age 15 years for 625 children. The authors conducted similar analyses to Gardner et al (2009), but made use of z-scores for both body mass index (BMI) and weight, rather than relying only on weight as in the EarlyBird publication. In contrast to the findings of Gardner et al, Hughes et al reported that mean weight and BMI z-scores increased steadily as the children got older, with the changes being most marked after school entry age (age five years).…”