Racial differences in crossing major growth percentiles in infancy

We examined associations of ever crossing upwards ≥2 (vs <2) major weight-for-length (WFL) percentiles in the first 24 months with obesity at 5 years among white and black children.

We included 10 979 white and 1245 black children from the Linked CENTURY Study with percentile crossing data in all four 6-month periods in the first 24 months and obesity (age-specific and sex-specific body mass index ≥95th percentile) at 5 years. We used adjusted logistic regression models and stratified by race.

64% of children crossed upwards ≥2 major WFL percentiles in the first 2 years. Among white children, 12% were obese vs 7% for <2 crossings, while among black children the frequencies were 23% vs 9%. Black children (adjusted OR 2.94, 2.04 to 4.23) who had ever crossed upwards ≥2 major WFL percentiles had a higher odds of obesity at age 5 than white children (adjusted OR 1.89, 1.64 to 2.18) (interaction p=0.02).

Our results suggest that rapid weight gain in infancy is more deleterious among black than white children for later obesity.