Trajectories of Growth among Children Who Have Coronary Events as Adults

Barker, D. J. P.; Osmond, Clive; Forsén, Tom; Kajantie, Eero; Eriksson, Johan G.

doi:10.1056/nejmoa044160

Cited by 1,311 publications

(1,166 citation statements)

References 20 publications

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“…31 This BMI trajectory during childhood is associated with insulin resistance and coronary vascular diseases in later life. [32][33][34] Similar secular trends are reported in other countries.…”

Section: Secular Trends In Growth Patternssupporting

confidence: 84%

“…The BMI trajectory of subjects who were thin in infancy and thereafter put on weight rapidly (Figure 2b) is associated with insulin resistance and coronary heart diseases. [32][33][34] In a study conducted in India, 33 despite an increase in BMI between the ages of 2 and 12 years, none of the subjects with impaired glucose tolerance or diabetes were obese at the age of 12 years. The mechanisms by which body fat is acquired seem to be at least as important as the consequences of excess fat per se in the pathogenesis of diabetes, hypertension and cardiovascular diseases.…”

Section: Assessment Of the Age At Adiposity Reboundmentioning

confidence: 99%

“…The decline in energy intake in infants and children over the last decades is very likely the consequence of the low-energy protein-rich diet they currently consumed. 50 Undernutrition at any time in early life (during fetal life as reflected by low birth weight 1 or before an early adiposity rebound [32][33][34] ) may predispose to later risks. A relative energy deficit 66 may programme 'thrifty metabolism' and mechanisms of adaptative thermogenesis.…”

Section: Factors Associated With An Early Ar and Increased Fatnessmentioning

confidence: 99%

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Early adiposity rebound: causes and consequences for obesity in children and adults

et al. 2006

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Childhood obesity is an important public health problem, with a rapidly increasing frequency worldwide. Identification of critical periods for the development of childhood and adolescent obesity could be very useful for targeting prevention measures. Weight status in early childhood is a poor predictor of adult adiposity status, and most obese adults were not obese as children. We first proposed to use the body mass index (BMI) charts to monitor individual BMI development. The adiposity rebound (AR) corresponds to the second rise in BMI curve that occurs between ages 5 and 7 years. It is not as direct a measure as BMI at any age, but because it involves the examination of several points during growth, and because it is identified at a time when adiposity level clearly change directions, this method provides information that can help us understand individual changes and the development of health risks. An early AR is associated with an increased risk of overweight. It is inversely associated with bone age, and reflects accelerated growth. The early AR recorded in most obese subjects and the striking difference in the mean age at AR between obese subjects (3 years) and non-obese subjects (6 years) suggest that factors have operated very early in life. The typical pattern associated with an early AR is a low BMI followed by increased BMI level after the rebound. This pattern is recorded in children of recent generations as compared to those of previous generations. This is owing to the trend of a steeper increase of height as compared to weight in the first years of life. This typical BMI pattern (low, followed by high body fatness level) is associated with metabolic diseases such as diabetes and coronary heart diseases. Low body fatness before the AR suggests that an energy deficit had occurred at an early stage of growth. It can be attributable to the high-protein, low-fat diet fed to infants at a time of high energy needs, the former triggering height velocity and the latter decreasing the energy density of the diet and then reducing energy intake. The high-fat, low-protein content of human milk may contribute to its beneficial effects on growth processes. Early (pre-and postnatal) life is a critical period during which environmental factors may programme adaptive mechanisms that will persist in adulthood. Under-nutrition in fetal life or during the first years after birth may programme a thrifty metabolism that will exert adverse effects later in life, especially if the growing child is exposed to overnutrition. These observations stress the importance of an adequate nutritional status in childhood and the necessity to provide nutritional intakes adapted to nutritional needs at various stages of growth. Because the AR reflects particular BMI patterns, it is a useful tool for the paediatrician to monitor the child's adiposity development and for researchers to investigate the different developmental patterns leading to overweight. It contributes to the understanding of chronic disease programming and suggests ne...

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Section: Secular Trends In Growth Patternssupporting

confidence: 84%

Section: Assessment Of the Age At Adiposity Reboundmentioning

confidence: 99%

Section: Factors Associated With An Early Ar and Increased Fatnessmentioning

confidence: 99%

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Early adiposity rebound: causes and consequences for obesity in children and adults

et al. 2006

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“…Similar growth patterns seen in infants without CHD are associated with obesity and a greater risk of adult cardiovascular disease 27, 28. In addition, although most children have normal nutritional requirements after surgical palliation, medical providers and parents may continue to stress weight gain as a goal 29.…”

Section: Discussionmentioning

confidence: 96%

Metabolic Syndrome in Adults With Congenital Heart Disease

Deen

Krieger

Slee

et al. 2016

JAHA

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BackgroundMetabolic syndrome increases risk for atherosclerotic coronary artery disease, and its prevalence increases with increasing age and body mass index. Adults with congenital heart disease (ACHD) are now living longer and accruing coronary artery disease risk factors. However, the prevalence of metabolic syndrome in ACHD patients is unknown.Methods and ResultsWe conducted a retrospective cohort study of ACHD patients at our center to quantify the prevalence of metabolic syndrome in an ACHD population. Using case‐control matching, we constructed a comparable control group from a population‐based sample of 150 104 adults. International Diabetes Federation criteria were used to define metabolic syndrome. We used logistic regression to compare the risk of metabolic syndrome across the resulting cohorts, which were composed of 448 ACHD patients and 448 controls matched by age and sex. Mean age of both groups was 32.4±11.3 years, and 51.3% were female. Obesity was present in 16.1% of the ACHD patients and 16.7% of the controls. Metabolic syndrome was more common in ACHD patients than in controls (15.0% versus 7.4%; odds ratio 1.82, 95% CI 1.25–2.65).ConclusionsOur data suggest that metabolic syndrome is more common among adults with congenital heart disease than in the general population. Thus, patients with congenital heart disease should be screened for metabolic syndrome and risk factors mitigated where possible to prevent atherosclerotic coronary artery disease. Preventive cardiology should be included during routine ACHD care.

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“…Besides newborn weight and length, the cohort contains information on placental weight and diameters, marital status, parity, time of last menstrual period, maternal age, height and weight (at the end of gestation), as well as father's occupation, as a proxy for socioeconomic status. Details of the birth records have been described previously 10. Maternal BMI was calculated as kg/m 2 .…”

Section: Methodsmentioning

confidence: 99%

Early Life Risk Factors for Incident Atrial Fibrillation in the Helsinki Birth Cohort Study

Johnson

Salonen

Kajantie

et al. 2017

JAHA

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BackgroundEarly life risk factors are associated with cardiometabolic disease, but have not been fully studied in atrial fibrillation (AF). There are discordant results from existing studies of birth weight and AF, and the impact of maternal body size, gestational age, placental size, and birth length is unknown.Methods and ResultsThe Helsinki Birth Cohort Study includes 13 345 people born as singletons in Helsinki in the years 1934–1944. Follow‐up was through national registries, and ended on December 31, 2013, with 907 incident cases. Cox regression analyses stratified on year of birth were constructed for perinatal variables and incident AF, adjusting for offspring sex, gestational age, and socioeconomic status at birth. There was a significant U‐shaped association between birth weight and AF (P for quadratic term=0.01). The lowest risk of AF was found among those with a birth weight of 3.4 kg (3.8 kg for women [85th percentile] and 3.0 kg for men [17th percentile]). High maternal body mass index (≥30 kg/m2) predicted offspring AF; hazard ratio 1.36 (95% CI 1.07–1.74, P=0.01) compared with normal body mass index (<25 kg/m2). Maternal height was associated with early‐onset AF (<65.3 years), hazard ratio 1.47 (95% CI 1.24–1.74, P<0.0001), but not with later onset AF. Results were independent of incident coronary artery disease, hypertension, or diabetes mellitus.ConclusionsHigh maternal body mass index during pregnancy and maternal height are previously undescribed predictors of offspring AF. Efforts to prevent maternal obesity might reduce later AF in offspring. Birth weight has a U‐shaped relation to incident AF independent of other perinatal variables.

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Trajectories of Growth among Children Who Have Coronary Events as Adults

Cited by 1,311 publications

References 20 publications

Early adiposity rebound: causes and consequences for obesity in children and adults

Early adiposity rebound: causes and consequences for obesity in children and adults

Metabolic Syndrome in Adults With Congenital Heart Disease

Early Life Risk Factors for Incident Atrial Fibrillation in the Helsinki Birth Cohort Study

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