doi: 10.1161/01.CIR.0000161797.67671.A7
(Circulation. 2005;111:1897-1903.)
© 2005 American Heart Association, Inc.
Epidemiology |
Weight Gain in the First Week of Life and Overweight in Adulthood
A Cohort Study of European American Subjects Fed Infant Formula
From the Division of Gastroenterology and Nutrition (N.S., V.A.S.), The Children’s Hospital of Philadelphia, Philadelphia, Pa; Center for Clinical Epidemiology and Biostatistics and Department of Biostatistics and Epidemiology (N.S., A.B.T., J.Z., R.S., B.L.S.), University of Pennsylvania School of Medicine, Philadelphia, Pa; and The Fomon Infant Nutrition Unit (S.E.N., E.E.Z.), University of Iowa, Iowa City, Iowa.
Correspondence to Nicolas Stettler, MD, MSCE, Division of Gastroenterology and Nutrition, North 1559, The Children’s Hospital of Philadelphia, 36th St and Civic Center Blvd, Philadelphia, PA 19104-4399. E-mail nstettle{at}cceb.med.upenn.edu
Received November 1, 2004; revision received January 27, 2005; accepted February 9, 2005.
Background— Successful prevention of obesity and related cardiovascular risk factors requires a clear understanding of its determinants over the life course. Rapid infancy weight gain is associated with childhood obesity, whereas low infancy weight is associated with coronary heart disease. Our aim was to identify during which periods in infancy weight gain is associated with adult obesity.
Methods and Results— A cohort of European American formula-fed subjects, measured on 7 occasions during infancy as part of several infant formula studies, were contacted at age 20 to 32 years, when they reported usual adult weight and height. A life-course plot was used to identify critical periods of weight gain associated with adulthood overweight (body mass index 
25 kg/m2). These associations were tested with logistic regressions. Data were available for 653 subjects (72% of eligible subjects). Approximately 32% of them were overweight adults. The period between birth and age 8 days was identified as potentially critical. After adjustment for important confounding factors, weight gain during the first week of life was associated with adulthood overweight status (OR for each 100-g increase 1.28, 95% CI 1.08 to 1.52), as was weight gain during the first 112 days of life (OR 1.04, 95% CI 1.01 to 1.08). Similar results were obtained after standardization with z scores from a reference population.
Conclusions— In formula-fed infants, weight gain during the first week of life may be a critical determinant for the development of obesity several decades later. These results contribute to the understanding of chronic disease programming and suggest new approaches to obesity prevention.
Key Words: risk factors • infant formula • obesityfollow-up studiespediatrics
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