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Childhood growth and coronary heart disease in later life
Johan G Eriksson1, Tom J Forsén
1National Public Health Institute, Department of Epidemiology and Health Promotion, Helsinki, Finland. Johan.Eriksson@ktl.fi
Insights
Early life growth significantly impacts adult coronary heart disease (CHD) risk. Small birth size combined with childhood catch-up growth elevates CHD risk, highlighting early growth optimization for prevention.
Area of Science:
- Cardiovascular Health
- Developmental Biology
- Public Health
Background:
- Coronary heart disease (CHD) risk is linked to early life factors.
- Inverse associations exist between birth size and adult CHD.
- Childhood growth patterns modify the risk associated with birth size.
Purpose of the Study:
- To investigate the role of early growth in coronary heart disease (CHD) risk.
- To understand how childhood growth modifies the association between birth size and adult CHD.
- To explore potential mechanisms linking early growth and CHD.
Main Methods:
- Analysis of existing studies on birth size, childhood growth, and adult CHD.
- Examination of factors influencing early growth (behavioral, physiological, hormonal, genetic).
- Consideration of socio-economic factors and biological programming.
Main Results:
- Small birth size coupled with childhood 'catch-up' growth presents the highest CHD risk.
- Increased body weight and body mass index in the first year of life are associated with reduced CHD risk.
- Socio-economic factors do not confound the association between slow fetal growth and CHD.
Conclusions:
- Optimizing early growth is crucial for the primary prevention of coronary heart disease (CHD).
- Biological programming, where early developmental stimuli have lifelong metabolic effects, is a proposed mechanism.
- Early growth represents a critical window for CHD prevention strategies.
Abstract:
Coronary heart disease (CHD) originates early in life and numerous studies have shown inverse associations between body size at birth and CHD in adult life. Recently it has been shown that the increased risk for CHD associated with a small body size at birth is modified by growth during childhood. The greatest risk for CHD is noted in individuals with small body size at birth and who 'catch-up' in weight and body size during childhood. An increase in body weight and body mass index during the first year of life is however associated with a reduced risk of CHD. These recent findings add to the evidence that optimizing early growth is an important area in primary prevention of CHD. There are several potential mechanisms explaining the association between a non-optimal early growth and CHD. Behavioral, physiological, hormonal and genetic factors influence growth. Although socio-economic factors influence the risk of CHD, the association between slow fetal growth and CHD is not caused by confounding socio-economic factors. Biological programming - the process whereby a stimulus during critical periods of development has long lasting or lifelong effects on metabolism - is proposed to mediate the effects between early growth and adult diseases.