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Epidemiology
Research
Infant BMI peak as a predictor of overweight and obesity at age 2 years in a Chinese community-based cohort
  1. Jie Sun1,2,
  2. Bright I Nwaru3,4,5,
  3. Jing Hua6,
  4. Xiaohong Li7,
  5. Zhuochun Wu1
  1. 1 Department of Social Medicine, School of Public Health, Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
  2. 2 Department of Child Health Care, Jing’an Maternal and Child Health Care Center, Shanghai, China
  3. 3 School of Health Sciences, University of Tampere, Tampere, Finland
  4. 4 Asthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
  5. 5 Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
  6. 6 Department of Maternal and Child Health Care, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
  7. 7 Department of Health Policy and Management, School of Public Health, Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
  1. Correspondence to Professor Zhuochun Wu; zcwu{at}shmu.edu.cn

Abstract

Objectives Infant body mass index (BMI) peak has proven to be a useful indicator for predicting childhood obesity risk in American and European populations. However, it has not been assessed in China. We characterised infant BMI trajectories in a Chinese longitudinal cohort and evaluated whether BMI peak can predict overweight and obesity at age 2 years.

Methods Serial measurements (n=6–12) of weight and length were taken from healthy term infants (n=2073) in a birth cohort established in urban Shanghai. Measurements were used to estimate BMI growth curves from birth to 13.5 months using a polynomial regression model. BMI peak characteristics, including age (in months) and magnitude (BMI, in kg/m2) at peak and prepeak velocities (in kg/m2/month), were estimated. The relationship between infant BMI peak and childhood BMI at age 2 years was examined using binary logistic analysis.

Results Mean age at peak BMI was 7.61 months, with a magnitude of 18.33 kg/m2. Boys (n=1022) had a higher average peak BMI (18.60 vs 18.07 kg/m2, p<0.001) and earlier average achievement of peak value (7.54 vs 7.67 months, p<0.05) than girls (n=1051). With 1 kg/m2 increase in peak BMI and 1 month increase in peak time, the risk of overweight at age 2 years increased by 2.11 times (OR 3.11; 95% CI 2.64 to 3.66) and 35% (OR 1.35; 95% CI 1.21 to 1.50), respectively. Similarly, higher BMI magnitude (OR 2.69; 95% CI 2.00 to 3.61) and later timing of infant BMI peak (OR 1.35; 95% CI 1.08 to 1.68) were associated with an increased risk of childhood obesity at age 2 years.

Conclusions We have shown that infant BMI peak is valuable for predicting early childhood overweight and obesity in urban Shanghai. Because this is the first Chinese community-based cohort study of this nature, future research is required to examine infant populations in other areas of China.

  • body mass index
  • obesity
  • overweight
  • longitudinal study
  • infants

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2016-015122

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    Footnotes

    • Contributors JS, BIN and ZW had the core idea for this study. All authors either analysed the data or interpreted the results. JS wrote the draft of the article. All other authors commented on the manuscript.

    • Funding This study was funded by National Natural Science Foundation of China [71573049].

    • Competing interests None declared.

    • Ethics approval All procedures performed in this study were in accordance with the ethical standard. We gained approval (IRB#2015–TYSQ–03-11) for the current study from the Medical Research Ethics Committee, School of Public Health, Fudan University. Informed consent was obtained from all individual participants included in the study.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.