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BMJ Open. 2017 Oct 6;7(10):e015122. doi: 10.1136/bmjopen-2016-015122.

Infant BMI peak as a predictor of overweight and obesity at age 2 years in a Chinese community-based cohort.

Sun J1,2, Nwaru BI3,4,5, Hua J6, Li X7, Wu Z1.

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Department of Social Medicine, School of Public Health, Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China.
Department of Child Health Care, Jing'an Maternal and Child Health Care Center, Shanghai, China.
School of Health Sciences, University of Tampere, Tampere, Finland.
Asthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.
Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
Department of Maternal and Child Health Care, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China.
Department of Health Policy and Management, School of Public Health, Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China.



Infant body mass index (BMI) peak has proven to be a useful indicator for predicting childhood obesity risk in American and European populations. However, it has not been assessed in China. We characterised infant BMI trajectories in a Chinese longitudinal cohort and evaluated whether BMI peak can predict overweight and obesity at age 2 years.


Serial measurements (n=6-12) of weight and length were taken from healthy term infants (n=2073) in a birth cohort established in urban Shanghai. Measurements were used to estimate BMI growth curves from birth to 13.5 months using a polynomial regression model. BMI peak characteristics, including age (in months) and magnitude (BMI, in kg/m2) at peak and prepeak velocities (in kg/m2/month), were estimated. The relationship between infant BMI peak and childhood BMI at age 2 years was examined using binary logistic analysis.


Mean age at peak BMI was 7.61 months, with a magnitude of 18.33 kg/m2. Boys (n=1022) had a higher average peak BMI (18.60 vs 18.07 kg/m2, p<0.001) and earlier average achievement of peak value (7.54 vs 7.67 months, p<0.05) than girls (n=1051). With 1 kg/m2 increase in peak BMI and 1 month increase in peak time, the risk of overweight at age 2 years increased by 2.11 times (OR 3.11; 95% CI 2.64 to 3.66) and 35% (OR 1.35; 95% CI 1.21 to 1.50), respectively. Similarly, higher BMI magnitude (OR 2.69; 95% CI 2.00 to 3.61) and later timing of infant BMI peak (OR 1.35; 95% CI 1.08 to 1.68) were associated with an increased risk of childhood obesity at age 2 years.


We have shown that infant BMI peak is valuable for predicting early childhood overweight and obesity in urban Shanghai. Because this is the first Chinese community-based cohort study of this nature, future research is required to examine infant populations in other areas of China.


body mass index; infants; longitudinal study; obesity; overweight

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Conflict of interest statement

Competing interests: None declared.

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