Early increase in body mass index and cardiometabolic risk in adolescence

Abstract

Early increase in body mass index and cardiometabolic risk in adolescence To the Editor: In an assessment of the influence of the weight gain trajectory from birth to 14 years old, Barraclough et al found that an early increase in body mass index (BMI) above the 90th percentile before 3 years of age resulted in an unfavorable cardiometabolic risk profile in adolescence, compared with children with a late increase in BMI. 1 This finding is important because early identification of children with likely future cardiometabolic risks is essential for promoting cardiovascular health in early childhood. 2 We would like to add our view on the relationship between the early BMI pattern and cardiometabolic risk. Early excess BMI before 3 years of age is important in relation to future cardiometabolic risk, but it is not necessary for the child to be overweight or obese at the start of the BMI rise. 1,3 We have found that a BMI increase from age 1.5 to 3.0 years, even if BMI is in the normal range just before the increase, is related to a greater increase in Homeostatic Model Assessment of Insulin Resistance per BMI increase at age 12 years compared with a stable or decreased BMI from 1.5 to 3.0 years of age. 4-6 These data were obtained from 1.5-and 3.0-year-old checkups, including weight and height measurements, as defined by the Ministry of Health, Labour and Welfare in Japan. This finding suggests that children with a BMI increase before age 3 years, a period normally characterized by decreased BMI, are more prone to developing insulin resistance in adolescence. Furthermore, another analysis of longitudinal growth data indicated that BMI rebound (adiposity rebound) earlier than approximately 3 years of age with lower pre-rebound BMI leads to greater risk of childhood obesity. 7 These results suggest that an early increase in BMI before age 3 years is important, even if the absolute BMI is low, because this BMI pattern is closely related to cardiometabolic risk in adolescence.

Childhood obesity: rapid weight gain in early childhood and subsequent cardiometabolic risk

“…AR may represent a critical window of development or may simply be an epiphenomenon of early rebound of BMI occurring in children who were already in higher BMI percentiles ( 32 , 33 , 34 ). Previous studies have looked at the BMI pattern of the percentile curves constructed cross-sectionally, whereas studies using longitudinal data have shown that many children with early AR had a normal or even low BMI at or before the AR, independent of BMI at AR age, followed by an increased BMI after AR ( 29 , 34 , 35 , 36 ).…”