Early-life weight and weight gain as predictors of obesity in Brazilian
adolescents

Fernandes, Maria Teresa Bechere; Ferraro, Alexandre Archanjo; Pires, Adriana; Santos, Erica; Schvartsman, Claudio

doi:10.6061/clinics/2013(11)04

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Brasil

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Sumário

CLINICAL SCIENCE • Clinics 68 (11) • Nov 2013 • https://doi.org/10.6061/clinics/2013(11)04 copy

Early-life weight and weight gain as predictors of obesity in Brazilian adolescents

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE:

To test whether weight and the weight gain rate during different age periods are associated with being overweight/obese at 10 years of age.

METHODS:

A nested case-control study was performed in a clinical historic cohort that was selected based on medical records from the Albert Einstein Hospital Social Program in São Paulo, Brazil. A sample of 378 eutrophic and overweight/obese children was analyzed.

RESULTS:

After adjusting for birth weight and gestational age, the likelihood of being overweight/obese at 10 years of age was 4.04-fold greater when progressing from one quartile of weight gain to the immediately superior quartile in the first semester of life and 3.24-fold greater when this occurred from 2-5 years of age. A one-quartile change in weight gain in the first semester was associated with a 0.5 z-score increase in BMI at age 10. A robust independent effect of weight at age 5 confirmed that earlier weight gain was an important predictor.

CONCLUSIONS:

The amount of weight gain during the first 6 months of life and between 2 and 5 years of age and weight at age 5 were important predictors of overweight/obesity at 10 years of age.

Obesity; Weight Gain; Weight; Pediatrics; Low Income

Variable	Category or unit	Eligible subjects (n = 378)	Studied subsample (n = 147)	p-value
Gender	♂	50.8	44.9	0.225
Gestational age	preterm	4.9	6.1	0.576
Delivery	vaginal	66.5	68.9	0.832
	cesarean	28.8	27.4
	forceps	4.7	3.7
Excess weight prevalence	overweight	16.7	19.1	0.518
	obesity	5.2	6.1	0.895

Exclusive breastfeeding	months	2 (0.54-4)	2 (0-4)	0.247
Birth weight	kg	3.11 (2.82-3.5)	3.09 (2.8-3.4)	0.069
BMI 6 months	kg/m²	17.89 (16.73-18.77)	17.93 (16.82-18.81)	0.952
BMI 1 year	kg/m²	17.63 (16.64-18.66)	17.68 (16.87-18.6)	0.367
BMI 2 years	kg/m²	16.44 (15.62-17.26)	16.54 (15.73-17.41)	0.112
BMI 5 years	kg/m²	15.4 (14.62-16.29)	15.37 (14.43-16.3)	0.903
BMI 10 years	kg/m²	16.53 (15.60-17.99)	16.36 (15.3-18.51)	0.121

Weight Gain Period^† †Weight gain in quartiles; in the logistic regression, OR indicates the risk of progressing from one quartile to the immediately superior quartile; in the linear regression, the coefficient indicates by how many z-score units the BMI at age 10 would increase by progressing from one quartile to the immediately superior quartile. ) Logistic regression		Univariate Analyses			Multivariate Analyses^* *Adjusted reciprocally and for birth weight and prematurity. )
	OR	95% CI	p-value	OR	95% CI	p-value
Birth to 6 months	1.30	0.94-1.81	0.112	4.04	2.01-8.15	<0.000
6-12 months	1.22	0.88-1.69	0.235	1.96	1.15-3.32	0.013
1-2 years	1.32	1.01-1.73	0.042	1.26	0.80-1.98	0.323
2-5 years	1.69	1.33-2.14	<0.001	3.24	1.93-5.42	<0.001
5-10 years	1.75	1.38-2.22	<0.001	2.98	1.79-4.95	<0.001

Linear regression	Coefficient	95% CI	p-value	Coefficient	95% CI	p-value
Birth to 6 months	0.12	-0.01-0.24	0.064	0.50	0.36-0.63	<0.000
6-12 months	0.10	-0.03-0.22	0.128	0.27	0.15-0.38	<0.000
1-2 years	0.23	0.12-0.34	<0.000	0.21	0.11-0.31	<0.000
2-5 years	0.25	0.17-0.33	<0.001	0.39	0.29-0.49	<0.000
5-10 years	0.26	0.17-0.34	<0.001	0.30	0.20-0.41	<0.000

	Coefficient	Overweight/obesity, age 10, 95% CI	p-value
Birth weight	0.011	-0.07-0.09	0.782
Weight at 1 year	0.35	0.26-0.45	<0.001
Weight at 2 years	0.54	0.37-0.70	<0.001
Weight at 5 years	0.89	0.76-1.03	<0.001

Faculdade de Medicina / USP Rua Dr Ovídio Pires de Campos, 225 - 6 and., 05403-010 São Paulo SP - Brazil, Tel.: (55 11) 2661-6235 - São Paulo - SP - Brazil
E-mail: clinics@hc.fm.usp.br

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[TFN01t01] BMI = body mass index; categorical variables reported as the% and tested with chi-square; continuous variables reported as the median and interquartile interval and tested with the Wilcoxon test.