Abstract
Background
Despite early childhood weight gain being a key indicator of obesity risk, we do not have a good understanding of the different patterns that exist.
Objectives
To identify and characterise distinct groups of children displaying similar early-life weight trajectories.
Methods
A growth mixture model captured heterogeneity in weight trajectories between 0 and 60 months in 1390 children in the Avon Longitudinal Study of Parents and Children. Differences between the classes in characteristics and body size/composition at 9 years were investigated.
Results
The best model had five classes. The “Normal” (45%) and “Normal after initial catch-down” (24%) classes were close to the 50th centile of a growth standard between 24 and 60 months. The “High-decreasing” (21%) and “Stable-high” (7%) classes peaked at the ~91st centile at 12-18 months, but while the former declined to the ~75th centile and comprised constitutionally big children, the latter did not. The “Rapidly increasing” (3%) class gained weight from below the 50th centile at 4 months to above the 91st centile at 60 months. By 9 years, their mean body mass index (BMI) placed them at the 98th centile. This class was characterised by the highest maternal BMI; highest parity; highest levels of gestational hypertension and diabetes; and the lowest socio-economic position. At 9 years, the “Rapidly increasing” class was estimated to have 68.2% (95% confidence interval [CI] 48.3, 88.1) more fat mass than the “Normal” class, but only 14.0% (95% CI 9.1, 18.9) more lean mass.
Conclusions
Criteria used in growth monitoring practice are unlikely to consistently distinguish between the different patterns of weight gain reported here.
Despite early childhood weight gain being a key indicator of obesity risk, we do not have a good understanding of the different patterns that exist.
Objectives
To identify and characterise distinct groups of children displaying similar early-life weight trajectories.
Methods
A growth mixture model captured heterogeneity in weight trajectories between 0 and 60 months in 1390 children in the Avon Longitudinal Study of Parents and Children. Differences between the classes in characteristics and body size/composition at 9 years were investigated.
Results
The best model had five classes. The “Normal” (45%) and “Normal after initial catch-down” (24%) classes were close to the 50th centile of a growth standard between 24 and 60 months. The “High-decreasing” (21%) and “Stable-high” (7%) classes peaked at the ~91st centile at 12-18 months, but while the former declined to the ~75th centile and comprised constitutionally big children, the latter did not. The “Rapidly increasing” (3%) class gained weight from below the 50th centile at 4 months to above the 91st centile at 60 months. By 9 years, their mean body mass index (BMI) placed them at the 98th centile. This class was characterised by the highest maternal BMI; highest parity; highest levels of gestational hypertension and diabetes; and the lowest socio-economic position. At 9 years, the “Rapidly increasing” class was estimated to have 68.2% (95% confidence interval [CI] 48.3, 88.1) more fat mass than the “Normal” class, but only 14.0% (95% CI 9.1, 18.9) more lean mass.
Conclusions
Criteria used in growth monitoring practice are unlikely to consistently distinguish between the different patterns of weight gain reported here.
| Original language | English |
|---|---|
| Pages (from-to) | 557-568 |
| Number of pages | 12 |
| Journal | Paediatric and Perinatal Epidemiology |
| Volume | 35 |
| Issue number | 5 |
| Early online date | 7 May 2021 |
| DOIs | |
| Publication status | Published - Sept 2021 |
Bibliographical note
Funding Information:This work was funded by the UK Medical Research Council (WJ New Investigator Research Grant: MR/P023347/1). WJ acknowledges support from the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, which is a partnership between University Hospitals of Leicester NHS Trust, Loughborough University, and the University of Leicester. LM is supported by the SickKids, Centre for Global Child Health, Child Growth and Development Fellowship. RH is Director of the CLOSER consortium which is funded by the Economic and Social Research Council (ES/K000357/1). LDH is funded by a Career Development Award from the UK Medical Research Council MR/M020894/1 and works in a unit that receives funding from the University of Bristol and the UK Medical Research Council (MC_UU_12013/6). MSG is supported by The Alan Turing Institute (grant number EP/N510129/1). The UK Medical Research Council and Wellcome (Grant ref: 102215/2/13/2) and the University of Bristol provide core support for ALSPAC. This publication is the work of the authors, and WJ will serve as guarantor for the contents of this paper. A comprehensive list of grants funding is available on the ALSPAC website ( http://www.bristol.ac.uk/alspac/external/documents/grant‐acknowledgements.pdf ).
Publisher Copyright:
© 2021 The Authors. Paediatric and Perinatal Epidemiology published by John Wiley & Sons Ltd.
Keywords
- weight
- childhood
- growth
- ALSPAC
- body composition