Читать книгу Clinical Obesity in Adults and Children - Группа авторов - Страница 55

Just like fetal growth, early postnatal growth is a strong predictor of later size. Because weight gain accompanies linear growth, weight gain in excess of linear growth is more interesting than weight gain alone. Obtaining accurate length measures is crucial for this effort [81]. Many studies, unfortunately, do not have accurate lengths and therefore resort to examining weight gain alone.

Independent of birth size, greater postnatal weight gain predicts later adiposity and related cardiometabolic risk [82,83]. Meta‐analyses have found that accelerated weight gain during the first weeks or months of life is associated with higher BMI or obesity later in life [84,85]. For example, Baird et al. [84] reviewed 10 studies that assessed the relationship of infant growth with subsequent obesity. Compared with other infants, among infants with more rapid growth the ORs and relative risks of later obesity ranged from 1.17 to 5.70. Associations were consistent for obesity at different ages and for people born over a period from 1927 to 1994.

Despite the seeming consistency of these studies, counterexamples exist. Among Finnish men, those who eventually developed coronary heart disease, compared with the cohort as a whole, appeared to have experienced declining height, weight, and BMI during the first year of life before increasing dramatically after the age of 2 years [86]. Gain in BMI in the first 2 years of life was associated with adult lean mass but not fat mass [87]. In contrast, BMI gain from 2 to 7 years was associated with higher fat as well as lean mass. Indian men and women who developed impaired glucose tolerance or type 2 diabetes in young adulthood appeared to follow the same pattern of slower early growth followed by faster growth in later childhood [88]. These discrepancies in the role of infant weight gain may be due to differing measurements or participant experiences across time or geography, but the true explanations are as yet unclear. In addition, the apparent cardiometabolic harms of rapid infant weight gain need to be balanced against its potential benefit for neurocognitive outcomes, especially in babies born preterm.