Growth patterns in childhood and adolescence and adult body composition: a pooled analysis of birth cohort studies from five low and middle-income countries (COHORTS collaboration)

BMJ Open · 19 authors, 9 centres

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TL;DR

Higher birth weight and earlier linear growth in infancy were also positively but more weakly associated with adult body composition outcomes.

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This pooled secondary analysis of six prospective birth cohort studies from five low- and middle-income countries examined associations of serial measures of linear growth and relative weight from birth through adolescence with adult body composition. In pooled analyses, higher birth weight and relative weight gains in infancy, childhood, and adolescence were positively associated with all adult outcomes (BMI, FMI, FFMI, FM/FFM ratio, and waist circumference). Relative weight gains in childhood and adolescence were the strongest predictors of adult body composition, with effect sizes approximately twice the magnitude of infancy estimates. Higher conditional height in infancy was a significant but weak predictor of higher FMI in adult men and women. Linear growth in childhood was weakly and positively associated with women's adiposity measures. Site-specific and sex-stratified analyses showed consistency in direction of estimates, though magnitudes varied.

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cohort

SPECIALTY

epidemiology

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ORIGINAL PAPER

PMC10030655

Growth patterns in childhood and adolescence and adult body composition: a pooled analysis of birth cohort studies from five low and middle-income countries (COHORTS collaboration)

BMJ Open

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ABSTRACT

Abstract Objective We examined associations among serial measures of linear growth and relative weight with adult body composition. Design Secondary data analysis of prospective birth cohort studies. Settings Six birth cohorts from Brazil, Guatemala, India, the Philippines and South Africa. Participants 4173 individuals followed from birth to ages 22–46 years with complete and valid weight and height at birth, infancy, childhood and adolescence, and body composition in adult life. Exposures Birth weight and conditional size (standardised residuals of height representing linear growth and of relative weight representing weight increments independent of linear size) in infancy, childhood and adolescence. Primary outcome measures Body mass index, fat mass index (FMI), fat-free mass index (FFMI), fat mass/fat-free mass ratio (FM/FFM), and waist circumference in young and mid-adulthood. Results In pooled analyses, a higher birth weight and relative weight gains in infancy, childhood and adolescence were positively associated with all adult outcomes. Relative weight gains in childhood and adolescence were the strongest predictors of adult body composition (β (95% CI) among men: FMI (childhood: 0.41 (0.26 to 0.55); adolescence: 0.39 (0.27 to 0.50)), FFMI (childhood: 0.50 (0.34 to 0.66); adolescence: 0.43 (0.32 to 0.55)), FM/FFM (childhood: 0.31 (0.16 to 0.47); adolescence: 0.31 (0.19 to 0.43))). Among women, similar patterns were observed, but, effect sizes in adolescence were slightly stronger than in childhood. Conditional height in infancy was positively associated with FMI (men: 0.08 (0.03 to 0.14); women: 0.11 (0.07 to 0.16)). Conditional height in childhood was positively but weakly associated with women’s adiposity. Site-specific and sex-stratified analyses showed consistency in the direction of estimates, although there were differences in their magnitude. Conclusions Prenatal and postnatal relative weight gains were positive predictors of larger body size and increased adiposity in adulthood. A faster linear growth in infancy was a significant but weak predictor of higher adult adiposity. Keywords: EPIDEMIOLOGY, PUBLIC HEALTH, NUTRITION & DIETETICS

CITATION EXPORT

Natalia E Poveda, Linda S Adair, Reynaldo Martorell et al.. Growth patterns in childhood and adolescence and adult body composition: a pooled analysis of birth cohort studies from five low and middle-income countries (COHORTS collaboration). BMJ Open. (2023). https://doi.org/10.1136/bmjopen-2022-068427

AUTHORS

19 · 9 CENTRES

Natalia E Poveda, Linda S Adair, Reynaldo Martorell, Shivani A Patel, Manuel Ramirez-Zea, Santosh K Bhargava, Sonny A Bechayda, Delia B Carba, Maria F Kroker-Lobos, Bernardo Lessa Horta, Natália Peixoto Lima, Mónica Mazariegos, Ana Maria Baptista Menezes, Shane A Norris, Lukhanyo H Nyati, Linda M Richter, Harshpal Sachdev, Fernando C Wehrmeister, Aryeh D Stein

1 Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
2 Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
3 INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala
4 Department of Pediatrics, Safdarjang Hospital and Vardhman Mahavir Medical College, New Delhi, India
5 Office of Population Studies Foundation, University of San Carlos - Talamban Campus, Cebu City, The Philippines
6 Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
7 SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Pediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
8 DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
9 Senior Consultant Pediatrics and Clinical Epidemiology, Sitaram Bhartia Institute of Science and Research, New Delhi, India