Obesity Facts (Mar 2022)

Relationship between birth weight, early growth rate and body composition in 5 to 7-year-old children

  • Isabel Gätjens,
  • Svenja Fedde,
  • Steffen Christian Ekkehard Schmidt,
  • Mario Hasler,
  • Sandra Plachta-Danielzik,
  • Manfred James Müller,
  • Anja Bosy-Westphal

DOI
https://doi.org/10.1159/000522509

Abstract

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Background: Programming of body composition during intrauterine growth may contribute to the higher risk for cardio-metabolic disease in individuals born small or large for gestational age (SGA, LGA). Compensations of intrauterine growth by catch-up or catch-down postnatal growth may lead to adverse consequences like a thin-fat phenotype. Methods: The impact of (i) birth weight as well as (ii) the interaction between birth weight and catch-up or catch-down growth during the first two years of life on fat free mass index (FFMI) and fat mass index (FMI) in 3204 5-7-year-old children was investigated using Hattori`s body composition chart. Body composition results were compared to appropriate for gestational age birth weight (AGA) with the same BMI. Results: 299 children at age 5-7 years were categorized as SGA, 2583 as AGA and 322 as LGA. When compared to AGA-children, BMI at 5-7-years of age was higher in LGA-children (15.5 kg/m² vs. 16.2 kg/m²; p<0.001) but not different in SGA-children. Compared to AGA with the same BMI, LGA was associated with higher FMI and a lower FFMI in 5-7-year-old girls. This phenotype was also seen for both sexes with catch-down growth during the first 2 years of life whereas catch-up growth prevented the higher FMI and lower FFMI per BMI. By contrast, SGA was associated with a higher FFMI and lower FMI in 5-7-year-old boys compared to AGA boys with the same BMI. This phenotype was also seen with catch-down growth in both genders whereas catch-up growth in girls led to more gain in FMI per BMI. Conclusion: LGA with a compensatory catch-down postnatal growth maybe a risk factor for the development of disproportionate gain in fat over lean mass whereas SGA with a catch-down postnatal growth seems to favor the subsequent accretion of lean over fat mass. A higher propensity of lean mass accretion during postnatal growth in boys compared to girls explains sex-differences in these phenotypes.