Johnson William, Nyati Lukhanyo H, Ariff Shabina, Ahmad Tanvir, Byrne Nuala M, Cheikh Ismail Leila I, Costa Caroline S, Demerath Ellen W, Priscilla Divya J, Hills Andrew P, Kuriyan Rebecca, Kurpad Anura V, Loechl Cornelia U, Lucas M Nishani, Santos Ina S, Slater Christine, Wickramasinghe V Pujitha, Norris Shane A, Murphy-Alford Alexia J
School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
SAMRC Developmental Pathways for Health Research Unit, Department of Pediatrics, University of the Witwatersrand, Johannesburg, South Africa.
Eur J Clin Nutr. 2025 Mar;79(3):237-248. doi: 10.1038/s41430-024-01534-5. Epub 2024 Nov 5.
There is extensive evidence that rapid infant weight gain increases the risk of childhood obesity, but this is normally based on childhood body mass index (BMI) only and whether or not this is because infants with rapid weight gain accrue greater fat mass is unknown.
The primary objective of our study was to test whether the proportion of infant weight gain due to concurrent increases in fat mass is greater in infants with rapid weight gain as compared to those with normal growth.
Body composition was assessed by (1) air-displacement plethysmography (ADP) at 0 and 6 months in 342 infants from Australia, India, and South Africa and (2) deuterium dilution (DD) at 3 and 24 months in 555 infants from Brazil, Pakistan, South Africa, and Sri Lanka. Weight gain and length growth were each categorized as slow, normal, or rapid using cut-offs of <-0.67 or >+0.67 Z-scores. Regression was used to estimate and contrast the percentages of weight change due to fat mass change.
Approximately 40% of the average weight gain between 0 and 6 months and 20% of the average weight gain between 3 and 24 months was due to increase in fat mass. In both samples, compared to the normal group, the proportion of weight gain due to fat mass was higher on average among infants with rapid weight gain and lower among infants with slow weight gain, with considerable individual variability. Conversely, slow and rapid length growth was not associated with differential gains in fat mass.
Pediatricians should monitor infant growth with the understanding that, while crossing upward through the weight centiles generally is accompanied by greater adiposity gains (not just higher BMI), upward crossing through the length centiles is not.
有大量证据表明婴儿体重快速增加会增加儿童期肥胖的风险，但这通常仅基于儿童期体重指数（BMI），而体重快速增加的婴儿是否积累了更多脂肪尚不清楚。
我们研究的主要目的是测试与正常生长的婴儿相比，体重快速增加的婴儿因脂肪量同时增加而导致的体重增加比例是否更高。
对来自澳大利亚、印度和南非的342名婴儿在0个月和6个月时通过（1）空气置换体积描记法（ADP）评估身体成分，对来自巴西、巴基斯坦、南非和斯里兰卡的555名婴儿在3个月和24个月时通过（2）氘稀释法（DD）评估身体成分。使用<-0.67或>+0.67 Z分数的临界值将体重增加和身长增长分别分为缓慢、正常或快速。采用回归分析来估计和对比因脂肪量变化导致的体重变化百分比。
0至6个月期间平均体重增加的约40%以及3至24个月期间平均体重增加的20%是由于脂肪量增加。在两个样本中，与正常组相比，体重快速增加的婴儿中因脂肪量导致的体重增加比例平均较高，体重缓慢增加的婴儿中该比例较低，个体差异较大。相反，身长增长缓慢和快速与脂肪量的差异增加无关。
儿科医生在监测婴儿生长时应明白，虽然体重百分位数向上跨越通常伴随着更高的肥胖增加（不仅仅是更高的BMI），但身长百分位数向上跨越则不然。
