Rapid weight gain in first 2 years of life and BMI trajectories from 3 to <10 years: a population-based longitudinal study of 1.7 million Brazilian children.

Abstract

BACKGROUND: Obesity is considered a disease with negative health impacts at all life stages. Changes in growth patterns, such as postnatal rapid weight gain (RWG), can be important predictors of growth trajectories in children. We investigated the association between RWG during the first two years of life and subsequent BMI trajectories from the age 3-to 9 years, and whether the association differed by birth weight group. METHODS: We used the data of a population-based cohort from the Cadastro Único (CadÚnico) of the Federal Government, the linkage of the National Live Births System (SINASC) and the National Food and Nutritional Surveillance System (SISVAN). The sample comprised 1.7 million Brazilian children aged from zero to nine years from 2008 to 2017. Mixed-effects models were used to estimate mean age-trajectories for BMI by RWG group. FINDINGS: Children who experienced RWG during the first two years of life had higher mean BMI trajectories from 3 to 9 years, compared to those who did not. The difference was seen across all birth weight groups, and was more evident for the children with high birth weight. At age 9, the BMI difference between RWG and non-RWG children was 1.31 kg/m2 (boys) and 1.43 kg/m2 (girls) for children with adequate birth weight, 1.27 kg/m2 (boys) and 1.35 kg/m2 (girls) for low birth weight, and 2.25 kg/m2 (boys) and 2.86 kg/m2 (girls) for macrosomia. INTERPRETATION: Children who experienced RWG during the first two years of life had higher BMI trajectories than children who did not. The finding highlighted the importance of monitoring child growth, which allows the early identification of potential growth deviations and the implementation of necessary interventions to ensure that children grow healthy and reach their full developmental potential. FUNDING: Coordenação de Aperfeiçoamento de Pessoal de Nível Superior-CAPES, CAPES/Print/UFBA; University College London (UCL); National Institute for Health Research (NIHR) Great Ormond Street Hospital Biomedical Research Centre; Fundação de Amparo à Pesquisa do Estado de Minas Gerais-FAPEMIG; National Council for Scientific and Technological Development-CNPq; CNPq/CGFP/DECIT/SECTICS; Departamento de Ciência e Tecnologia da Secretaria de Ciência, Tecnologia, Inovação e Complexo da Saúde do Ministério da Saúde; Wellcome Trust