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Tracking the development of adiposity from one month of age to adulthood
M F Rolland-Cachera1, M Deheeger, M Guilloud-Bataille
1Section Nutrition, I.N.S.E.R.M., Le Vésinet.
Insights
Childhood adiposity trajectories vary significantly. Early adiposity rebound is linked to higher adult fatness, while late rebound may indicate regulatory processes or pathological development. Age at rebound predicts adult fatness.
Area of Science:
- Pediatric Endocrinology
- Human Development
- Nutritional Science
Background:
- Childhood obesity is a growing public health concern.
- Understanding the developmental trajectories of adiposity is crucial for early intervention.
- Longitudinal studies tracking body composition from infancy to adulthood are essential.
Purpose of the Study:
- To investigate the developmental pathways of adiposity from infancy to adulthood.
- To identify predictors of adult fatness based on early childhood body composition.
- To examine the role of adiposity rebound age in determining long-term fatness.
Main Methods:
- Longitudinal study following 164 subjects from one month to 21 years.
- Defined lean, medium, and fat categories using weight/height squared (W/H2) index percentiles.
- Analyzed age at adiposity rebound (second rise in adiposity) using skinfold thickness and W/H2 charts.
Main Results:
- Only 42% of children maintained their initial adiposity category from infancy to adulthood.
- Fat infants had twice the relative risk (2x) of becoming fat adults compared to non-fat infants.
- Earlier adiposity rebound age strongly correlated with higher adult adiposity (W/H2 index and subscapular skinfold).
Conclusions:
- Childhood adiposity is dynamic, with most children changing categories.
- Age at adiposity rebound is a significant indicator of future adult fatness.
- Adiposity rebound patterns can suggest regulatory processes or pathological development in children's growth.
Abstract:
The development of adiposity was followed in 164 subjects from the age of one month to adulthood. The 25th and 75th centiles of the weight/height2 (W/H2) index were chosen as cut-off points to define the lean, medium and fat subjects at both one and 21 years of age. Only 42% of the children remained in their original category, that is 41% of the lean infants at one year stayed lean, 42% of the medium infants stayed medium and 41% of the fat infants stayed fat. Accordingly, most fat infants did not stay fat, but twice as many fat as non-fat infants became fat adults (41 and 20% respectively). The relative risk of being fat adults was 1 for the lean, 1 for the medium and 2 for the fat infants at one year. Several paths of development emerged: they were related to age at the second rise in adiposity, termed adiposity rebound, which usually occurs at about six years, as observed on skinfold thickness and W/H2 charts. The earlier the rebound, the higher the adiposity at adult age, whether this was measured by W/H2 index or subscapular skinfold. The cohorts of children who left the channel they had been following included fat infants with a late rebound who subsequently returned to normal, and lean infants with an early rebound who grew fatter. Other cohorts remained in their original groups, for example, fat infants with an early rebound who stayed fat and lean infants with a late one who stayed lean. Age at rebound provided two indications: the existence of a regulartory process among the transiently fat or lean infants who returned to average after a late or early rebound respectively, and pathological development among the children who became fat or lean after an early or late rebound. Age at rebound is an indicator of the subsequent development of fatness.