Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan.
Department of Early Childhood and Elementary Education, Jumonji University, Niiza, Japan.
Arch Dis Child. 2019 Jan;104(1):53-57. doi: 10.1136/archdischild-2018-314862. Epub 2018 Jun 5.
Healthy-weight children tend to gain weight during winter but lose weight during summer. However, overweight elementary school children have shown accelerated summertime weight gain. Whether this seasonal growth variation occurs during preschool period is of substantial interest.
Data were derived from a nationwide retrospective cohort of nursery school children. Eight consecutive sets of longitudinal measurements on height and weight were obtained from 15 259 preschool children. Thereafter, growth in height, weight and body mass index (BMI) over a period of 6 months was calculated. Summertime growth was defined as that from April to October, whereas wintertime growth was defined as that from October to April of the following year. Longitudinal growth seasonality was analysed by classifying children according to their BMI status at the age of elementary school entry.
Accelerated summertime weight and BMI gain were observed among children with obesity. This distinctive growth seasonality was detected from around age 2. Children having this growth seasonality at approximately 2 years of age tended to be obese at the age of elementary school entry (OR: 3.7; 95% CI: 2.9 to 4.6; p<0.0001). In height gain, obese children were growing apparently faster than those in the other groups at all ages.
Early excessive growth with distinct seasonality was observed in preschool obese children. These findings suggest that individuals involved in child healthcare should pay closer attention to early excessive growth with distinct seasonality in preschool obesity.
健康体重的儿童在冬季往往会体重增加,而在夏季则会体重减轻。然而,超重的小学生夏季体重增长加快。这种季节性生长差异是否在学龄前发生,这是一个非常重要的问题。
数据来自全国性的幼儿园儿童回顾性队列研究。从 15259 名学龄前儿童中获得了 8 组连续的身高和体重纵向测量数据。此后,计算了 6 个月内身高、体重和体重指数(BMI)的增长情况。夏季生长定义为 4 月至 10 月,冬季生长定义为次年 10 月至 4 月。根据儿童在进入小学时的 BMI 状况对其进行分类,分析了纵向生长季节性。
肥胖儿童在夏季体重和 BMI 增长加快。这种独特的生长季节性在大约 2 岁时就可以观察到。大约 2 岁时具有这种生长季节性的儿童在进入小学时往往肥胖(OR:3.7;95%CI:2.9 至 4.6;p<0.0001)。在身高增长方面,肥胖儿童在所有年龄段的生长速度都明显快于其他组。
在学龄前肥胖儿童中观察到早期明显的过度生长和明显的季节性。这些发现表明,参与儿童保健的人员应更加关注学龄前肥胖儿童中早期明显的过度生长和明显的季节性。