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BMI in Early Childhood and Sustained Obesity
Study Questions:
Is the risk for sustained obesity highest at a specific age among children from birth to adolescence?
Methods:
Data from the CrescNet patient registry, which is a German network for monitoring clinical parameters of growth data among children, was populated with deidentified data from participating pediatricians. Children with at least one visit in childhood and one visit in adolescence with a participating pedestrian where anthropometric data were available were included in this population-based sample of 51,505 children. Data were collected during childhood (birth to 14 years of age) and adolescence (15-18 years of age). Body mass index (BMI) was calculated annually during these years among 34,196 children and evaluated as change in BMI standard-deviation score per year.
Results:
A majority of the adolescents with normal weight had always had a normal weight throughout childhood. A majority of the adolescents who were obese had had a normal weight as infants, but by the time they were 5 years of age, they had already become overweight or obese. Among these children, the BMI standard-deviation score further increased with age. Almost 90% of the children who were obese at 3 years of age were overweight or obese in adolescence. Among the adolescents who were obese, the greatest acceleration in annual BMI increments had occurred between 2 and 6 years of age, with a further rise in BMI percentile thereafter. High acceleration in annual BMI increments during the preschool years (but not during the school years) was associated with a risk of overweight or obesity in adolescence that was 1.4 times as high as the risk among children who had had a stable BMI. The rate of overweight or obesity in adolescence was higher among children who had been large for gestational age at birth (43.7%) than among those who had been at an appropriate weight for gestational age (28.4%) or small for gestational age (27.2%), which corresponded to a risk of adolescent obesity that was 1.55 times as high among those who had been large for gestational age as among the other groups.
Conclusions:
The authors concluded that among obese adolescents, the most rapid weight gain had occurred between 2 and 6 years of age; most children who were obese at that age were obese in adolescence.
Perspective:
These data provide important information for families, pediatricians, and public health experts. Prevention of overweight and obesity must start early in childhood. Given that cardiometabolic risk in young adulthood is associated with elevated BMI in childhood and adolescence, prevention and management among children who increase weight between the ages of 2 and 6 would be recommended.
Keywords: Adolescent, Body Mass Index, Body Weight, Child, Gestational Age, Infant, Metabolic Syndrome, Obesity, Overweight, Pediatric Obesity, Primary Prevention, Public Health, Weight Gain
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