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Updated: Aug 30, 2025
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Body composition trajectories from birth to 5 years and hepatic fat in early childhood
Catherine C Cohen1,2, Kylie K Harrall2, Stephanie P Gilley1
1Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Insights
A smaller birth size and faster early childhood adiposity predict higher liver fat in children. Promoting healthy body composition from birth is key for preventing pediatric nonalcoholic fatty liver disease (NAFLD).
Area of Science:
- Pediatric Endocrinology
- Metabolic Health
- Developmental Pediatrics
Background:
- Pediatric nonalcoholic fatty liver disease (NAFLD) is linked to adiposity, but early life body composition's role is unclear.
- Understanding how body composition at birth and its changes influence liver fat is crucial for early intervention.
Purpose of the Study:
- To investigate the association between body composition at birth and its trajectory to early childhood with hepatic fat.
- To identify early life factors predicting liver fat accumulation in children.
Main Methods:
- Longitudinal study of over 1200 children, assessing body composition (FFMI, FMI, BF%, BMI) at birth and ~5 years.
- Hepatic fat measured by MRI in a subset; body composition trajectories modeled using mixed-effects models.
- Multivariable regression analyzed associations between body composition deviations and hepatic fat.
Main Results:
- Lower birth fat-free mass index (FFMI), fat mass index (FMI), body fat percentage (BF%), and BMI were linked to lower hepatic fat at ~5 years.
- Faster increases in BF% and BMI from birth to ~5 years were associated with higher hepatic fat.
- The association of rapid adiposity gain with hepatic fat was explained by initial body composition at birth.
Conclusions:
- A smaller size at birth combined with rapid adiposity gain in early childhood predicts increased hepatic fat.
- Early life body composition patterns are critical determinants of pediatric NAFLD risk.
- Interventions promoting healthy body composition in infancy and early childhood may prevent NAFLD.
Background:
Adiposity is an established risk factor for pediatric nonalcoholic fatty liver disease (NAFLD), but little is known about the influence of body composition patterns earlier in life on NAFLD risk.
Objectives:
We aimed to examine associations of body composition at birth and body composition trajectories from birth to early childhood with hepatic fat in early childhood.
Methods:
Data were from the longitudinal Healthy Start Study in Colorado. Fat-free mass index (FFMI), fat mass index (FMI), percentage body fat (BF%), and BMI were assessed at birth and/or ∼5 y in >1200 children by air displacement plethysmography and anthropometrics. In a subset (n = 285), hepatic fat was also assessed at ∼5 y by MRI. We used a 2-stage modeling approach: first, we fit body composition trajectories from birth to early childhood using mixed models with participant-specific intercepts and linear slopes (i.e., individual deviations from the population average at birth and rate of change per year, respectively); second, associations of participant-specific trajectory deviations with hepatic fat were assessed by multivariable-adjusted linear regression.
Results:
Participant-specific intercepts at birth for FFMI, FMI, BF%, and BMI were inversely associated with log-hepatic fat in early childhood in models adjusted for offspring demographics and maternal/prenatal variables [back-transformed β (95% CI) per 1 SD: 0.93 (0.88, 0.99), 0.94 (0.88, 0.99), 0.94 (0.89, 0.99), and 0.90 (0.85, 0.96), respectively]. Whereas, faster velocities for BF% and BMI from birth to ∼5 y were positively associated with log-hepatic fat [back-transformed β (95% CI) per 1 SD: 1.08 (1.01, 1.15) and 1.08 (1.02, 1.15), respectively]. These latter associations of BF% and BMI velocities with childhood hepatic fat were attenuated to the null when adjusted for participant-specific intercepts at birth.
Conclusions:
Our findings suggest that a smaller birth weight, combined with faster adiposity accretion in the first 5 y, predicts higher hepatic fat in early childhood. Strategies aiming to promote healthy body composition early in life may be critical for pediatric NAFLD prevention.This study was registered voluntarily at clinicaltrials.gov as NCT02273297.
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