Stettler Nicolas, Kumanyika Shiriki K, Katz Solomon H, Zemel Babette S, Stallings Virginia A
Division of Gastroenterology and Nutrition, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, 19104, USA.
Am J Clin Nutr. 2003 Jun;77(6):1374-8. doi: 10.1093/ajcn/77.6.1374.
Obesity is increasing in the United States. Evidence-based prevention is a public health priority and should target well-defined risk factors and critical periods.
We tested the hypothesis that rapid weight gain during early infancy is associated with obesity in African American young adults, a group at increased risk of obesity.
A cohort of 300 African Americans born at full term was followed from birth to 20 y of age. A pattern of rapid weight gain was defined as an increase in weight-for-age > or = 1 SD between birth and 4 mo.
About 29% of subjects had a pattern of rapid weight gain during infancy; 8% were obese [body mass index (in kg/m(2)) > or = 30] at age 20 y. One-third of the obesity at age 20 y could be attributed to rapid weight gain in the first 4 mo of life. After adjustment for confounding factors, subjects with rapid weight gain during early infancy were more likely to become obese at age 20 y (odds ratio = 5.22; 95% CI: 1.55, 17.6; P = 0.008). The results were confirmed by using a combination of body mass index and skinfold thickness (odds ratio = 6.72; 95% CI: 1.93, 23.4; P = 0.003).
The results of the present study provide evidence that a pattern of rapid weight gain during early infancy is associated with obesity not only in childhood but also in young adulthood. We propose that early infancy constitutes a critical period for the development of obesity. Mechanisms of action and prevention strategies require further investigation.
肥胖在美国呈上升趋势。基于证据的预防是公共卫生的重点,应针对明确的风险因素和关键时期。
我们检验了这样一个假设,即婴儿早期体重快速增加与肥胖风险增加的非裔美国青年成人肥胖有关。
对300名足月出生的非裔美国人进行队列研究,从出生随访至20岁。快速体重增加模式定义为出生至4个月期间年龄别体重增加≥1个标准差。
约29%的受试者在婴儿期有快速体重增加模式;20岁时8%的人肥胖[体重指数(kg/m²)≥30]。20岁时三分之一的肥胖可归因于生命最初4个月的快速体重增加。在调整混杂因素后,婴儿早期体重快速增加的受试者在20岁时更有可能肥胖(优势比=5.22;95%可信区间:1.55, 17.6;P = 0.008)。使用体重指数和皮褶厚度相结合的方法证实了该结果(优势比=6.72;95%可信区间:1.93, 23.4;P = 0.003)。
本研究结果提供了证据,表明婴儿早期体重快速增加模式不仅与儿童期肥胖有关,也与青年期肥胖有关。我们提出婴儿早期是肥胖发生的关键时期。作用机制和预防策略需要进一步研究。