Growth patterns in childhood and adolescence and adult body composition: a pooled analysis of birth cohort studies from five low and middle-income countries (COHORTS collaboration)

• Type of Material: Article
• Authors: Natalia E Poveda, Emory University; Linda S Adair, University of North Carolina Chapel Hill; Reynaldo Martorell, Emory University; Shivani Patel, Emory University; Manuel Ramirez-Zea, Institute of Nutrition of Central America and Panama (INCAP); Santosh K Bhargava, Safdarjang Hosp & Vardhman Mahavir Med Coll; Sonny A Bechayda, Univ San Carlos Talamban Campus; Delia B Carba, University of San Carlos - Talamban Campus; Maria F Kroker-Lobos, Institute of Nutrition of Central America and Panama (INCAP); Bernardo Lessa Horta, Federal University of Pelotas; Natália Peixoto Lima, Federal University of Pelotas; Mónica Mazariegos, Institute of Nutrition of Central America and Panama (INCAP); Ana Maria Baptista Menezes, Federal University of Pelotas; Shane Norris, Emory University; Lukhanyo H Nyati, University of Witwatersrand; Linda M Richter, University of Witwatersrand; Harshpal Sachdev, Sitaram Bhartia Institute of Science & Research; Fernando C Wehrmeister, Federal University of Pelotas; Aryeh Stein, Emory University
• Language: English
• Date: 2023-03-01
• Publisher: BMJ PUBLISHING GROUP
• Publication Version: Final Published Version
• Copyright Statement: © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1136/bmjopen-2022-068427
• Title of Journal or Parent Work: BMJ OPEN
• Volume: 13
• Issue: 3
• Start Page: e068427
• End Page: e068427
• Grant/Funding Information: Data collection in Brazil was funded by the Wellcome Trust (086974/Z/08/Z). The New Delhi Birth Cohort has also received funding from the Indian Council of Medical Research (50/1-3/TF/05-NCD-II; 3/1/2/2/15- RCH; 5/10/FR/10/2019-RCH; 5/4/8-7/2019-NCD-II), the Department of Biotechnology (BT/PR3874/MED/97/1/2011; BT/PR5317/FNS/20/552/2012), the United States National Center for Health Statistics (PL-480, RESEARCH PROJECT 0-1-658-2) and the British Heart Foundation (UKPG/05/046). South Africa (Birth to Thirty) funders are the South African Medical Research Council, Wellcome Trust (UK, 077210/Z/05/Z; 092097/Z/10/Z), University of the Witwatersrand and the DSINRF Centre of Excellence in Human Development. NEP was partially supported by a Fulbright - Colciencias Fellowship from Colombia.; The Bill and Melinda Gates Foundation (OPP1164115) funded the most recent wave of data collection in Guatemala, the Philippines, and South Africa, and data management and analysis in Brazil.
• Keywords: PROFILE UPDATE; FOLLOW-UP; MASS INDEX; OVERWEIGHT; Medicine, General & Internal; General & Internal Medicine; Science & Technology; OBESITY; SIZE; CARDIOVASCULAR-DISEASE; PUBLIC HEALTH; NUTRITION & DIETETICS; EPIDEMIOLOGY; RISK-FACTORS; POSTNATAL WEIGHT-GAIN; NUTRITION; Life Sciences & Biomedicine
• Research Categories: Health Sciences, Epidemiology; Health Sciences, Public Health

Abstract

OBJECTIVE: We examined associations among serial measures of linear growth and relative weight with adult body composition. DESIGN: Secondary data analysis of prospective birth cohort studies. SETTINGS: Six birth cohorts from Brazil, Guatemala, India, the Philippines and South Africa. PARTICIPANTS: 4173 individuals followed from birth to ages 22-46 years with complete and valid weight and height at birth, infancy, childhood and adolescence, and body composition in adult life. EXPOSURES: Birth weight and conditional size (standardised residuals of height representing linear growth and of relative weight representing weight increments independent of linear size) in infancy, childhood and adolescence. PRIMARY OUTCOME MEASURES: Body mass index, fat mass index (FMI), fat-free mass index (FFMI), fat mass/fat-free mass ratio (FM/FFM), and waist circumference in young and mid-adulthood. RESULTS: In pooled analyses, a higher birth weight and relative weight gains in infancy, childhood and adolescence were positively associated with all adult outcomes. Relative weight gains in childhood and adolescence were the strongest predictors of adult body composition (β (95% CI) among men: FMI (childhood: 0.41 (0.26 to 0.55); adolescence: 0.39 (0.27 to 0.50)), FFMI (childhood: 0.50 (0.34 to 0.66); adolescence: 0.43 (0.32 to 0.55)), FM/FFM (childhood: 0.31 (0.16 to 0.47); adolescence: 0.31 (0.19 to 0.43))). Among women, similar patterns were observed, but, effect sizes in adolescence were slightly stronger than in childhood. Conditional height in infancy was positively associated with FMI (men: 0.08 (0.03 to 0.14); women: 0.11 (0.07 to 0.16)). Conditional height in childhood was positively but weakly associated with women's adiposity. Site-specific and sex-stratified analyses showed consistency in the direction of estimates, although there were differences in their magnitude. CONCLUSIONS: Prenatal and postnatal relative weight gains were positive predictors of larger body size and increased adiposity in adulthood. A faster linear growth in infancy was a significant but weak predictor of higher adult adiposity.