School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
Centre for Longitudinal Studies, UCL Institute of Education, London, UK.
Arch Dis Child. 2018 Oct;103(10):974-980. doi: 10.1136/archdischild-2017-314079. Epub 2018 Apr 19.
To investigate how the relationship of infant weight gain with adolescent body mass index (BMI) differs for individuals born during and before the obesity epidemic era.
Data from two British birth cohorts, the 1946 National Survey of Health and Development (NSHD, n=4199) and the 2001 Millennium Cohort Study (MCS, n=9417), were used to estimate and compare associations of infant weight gain between ages 0 and 3 years with adolescent outcomes.
BMI Z-scores and overweight/obesity at ages 11 and 14 years.
Infant weight gain, in Z-scores, was positively associated with adolescent BMI Z-scores in both cohorts. Non-linearity in the MCS meant that associations were only stronger than in the NSHD when infant weight gain was above -1 Z-score. Using decomposition analysis, between-cohort differences in association accounted for 20%-30% of the differences (secular increases) in BMI Z-scores, although the underlying estimates were not precise with 95% CIs crossing 0. Conversely, between-cohort differences in the distribution of infant weight gain accounted for approximately 9% of the differences (secular increases) in BMI Z-scores, and the underlying estimates were precise with 95% CI not crossing 0. Relative to normal weight gain (change of -0.67 to +0.67 Z-scores between ages 0 and 3 years), very rapid infant weight gain (>1.34), but not rapid weight gain (+0.67 to +1.34), was associated with higher BMI Z-scores more strongly in the MCS (β=0.790; 95% CI 0.717 to 0.862 at age 11 years) than in the NSHD (0.573; 0.466 to 0.681) (p<0.001 for between-cohort difference). The relationship of slow infant weight gain (<-0.67) with lower adolescent BMI was also stronger in the MCS. Very rapid or slow infant weight gain was not, however, more strongly associated with increased risk of adolescent overweight/obesity or thinness, respectively, in the more recently born cohort.
Greater infant weight gain, at the middle/upper end of the distribution, was more strongly associated with higher adolescent BMI among individuals born during (compared with before) the obesity epidemic. Combined with a secular change towards greater infant weight gain, these results suggest that there are likely to be associated negative consequences for population-level health and well-being in the future, unless effective interventions are developed and implemented.
探究婴儿体重增长与青少年体重指数（BMI）之间的关系在肥胖流行前后出生的个体中有何不同。
本研究使用了来自两个英国出生队列的数据，即 1946 年全国健康与发展调查（NSHD，n=4199）和 2001 年千禧年队列研究（MCS，n=9417），以估计和比较婴儿 0 至 3 岁时体重增长与青少年期结局之间的关联。
11 岁和 14 岁时的 BMI Z 评分和超重/肥胖。
在两个队列中，婴儿体重增长的 Z 评分与青少年 BMI Z 评分呈正相关。在 MCS 中，由于存在非线性关系，当婴儿体重增长超过-1 Z 评分时，关联才比 NSHD 更强。通过分解分析，队列间关联的差异解释了 BMI Z 评分差异（随时间变化的增加）的 20%-30%，尽管估计值并不精确，95%CI 跨越 0。相反，婴儿体重增长分布的队列间差异解释了 BMI Z 评分差异（随时间变化的增加）的约 9%，并且基础估计值非常精确，95%CI 不跨越 0。与正常体重增长（0 至 3 岁时体重变化在-0.67 到+0.67 Z 评分之间）相比，在 MCS 中，婴儿体重增长过快（>1.34）而非快速增长（+0.67 至+1.34）与青少年 BMI 更高的关联更强（β=0.790；11 岁时 95%CI 为 0.717 至 0.862），而在 NSHD 中关联较弱（0.573；0.466 至 0.681）（p<0.001，队列间差异）。婴儿体重增长缓慢（<-0.67）与青少年 BMI 较低的关系在 MCS 中也更强。然而，在最近出生的队列中，婴儿体重增长过快或过慢与青少年超重/肥胖或消瘦的风险增加并无更强的关联。
在肥胖流行期间（而非流行前）出生的个体中，婴儿体重增长较多，且分布在中上部分，与青少年 BMI 较高的关联更强。这些结果结合了婴儿体重增长向更大的随时间变化的趋势，表明在未来，除非开发和实施有效的干预措施，否则人口健康和福祉可能会出现相关的负面后果。
