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)
Shane A Norris,
Aryeh D Stein,
Fernando C Wehrmeister,
Natália Peixoto Lima,
Ana Maria Baptista Menezes,
Bernardo Lessa Horta,
Harshpal Sachdev,
María F Kroker-Lobos,
Manuel Ramírez-Zea,
Shivani A Patel,
Linda M Richter,
Santosh K Bhargava,
Linda S Adair,
Reynaldo Martorell,
Natalia E Poveda,
Sonny A Bechayda,
Delia B Carba,
Mónica Mazariegos,
Lukhanyo H Nyati
Affiliations
Shane A Norris
School of Human Development and Health, University of Southampton, Southampton, UK
Aryeh D Stein
1 Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
Fernando C Wehrmeister
6 Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
Natália Peixoto Lima
6 Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
Ana Maria Baptista Menezes
6 Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
Bernardo Lessa Horta
6 Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
Harshpal Sachdev
9 Senior Consultant Pediatrics and Clinical Epidemiology, Sitaram Bhartia Institute of Science and Research, New Delhi, India
María F Kroker-Lobos
3 INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala
Manuel Ramírez-Zea
3 INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala
Shivani A Patel
1 Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
Linda M Richter
8 DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
Santosh K Bhargava
4 Department of Pediatrics, Safdarjang Hospital and Vardhman Mahavir Medical College, New Delhi, India
Linda S Adair
2 Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
Reynaldo Martorell
1 Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
Natalia E Poveda
1 Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
Sonny A Bechayda
5 Office of Population Studies Foundation, University of San Carlos - Talamban Campus, Cebu City, The Philippines
Delia B Carba
5 Office of Population Studies Foundation, University of San Carlos - Talamban Campus, Cebu City, The Philippines
Mónica Mazariegos
3 INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala
Lukhanyo H Nyati
7 SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Pediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
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.