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Am J Clin Nutr. 2009 May;89(5):1383-92. doi: 10.3945/ajcn.2008.27139. Epub 2009 Mar 18.

Size at birth, weight gain in infancy and childhood, and adult blood pressure in 5 low- and middle-income-country cohorts: when does weight gain matter?

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  • 1University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Abstract

BACKGROUND:

Promoting catch-up growth in malnourished children has health benefits, but recent evidence suggests that accelerated child weight gain increases adult chronic disease risk.

OBJECTIVE:

We aimed to determine how birth weight (BW) and weight gain to midchildhood relate to blood pressure (BP) in young adults.

DESIGN:

We pooled data from birth cohorts in Brazil, Guatemala, India, the Philippines, and South Africa. We used conditional weight (CW), a residual of current weight regressed on prior weights, to represent deviations from expected weight gain from 0 to 12, 12 to 24, 24 to 48 mo, and 48 mo to adulthood. Adult BP and risk of prehypertension or hypertension (P/HTN) were modeled before and after adjustment for adult body mass index (BMI) and height. Interactions of CWs with small size-for-gestational age (SGA) at birth were tested.

RESULTS:

Higher CWs were associated with increased BP and odds of P/HTN, with coefficients proportional to the contribution of each CW to adult BMI. Adjusted for adult height and BMI, no child CW was associated with adult BP, but 1 SD of BW was related to a 0.5-mm Hg lower systolic BP and a 9% lower odds of P/HTN. BW and CW associations with systolic BP and P/HTN were not different between adults born SGA and those with normal BW, but higher CW at 48 mo was associated with higher diastolic BP in those born SGA.

CONCLUSIONS:

Greater weight gain at any age relates to elevated adult BP, but faster weight gains in infancy and young childhood do not pose a higher risk than do gains at other ages.

PMID:
19297457
PMCID:
PMC2720838
DOI:
10.3945/ajcn.2008.27139
[PubMed - indexed for MEDLINE]
Free PMC Article
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