Rapid weight gain during infancy and obesity in young adulthood in a cohort of African Americans.
BACKGROUND
Obesity is increasing in the United States. Evidence-based prevention is a public health priority and should target well-defined risk factors and critical periods.


OBJECTIVE
We tested the hypothesis that rapid weight gain during early infancy is associated with obesity in African American young adults, a group at increased risk of obesity.


METHODS
A cohort of 300 African Americans born at full term was followed from birth to 20 y of age. A pattern of rapid weight gain was defined as an increase in weight-for-age > or = 1 SD between birth and 4 mo.


RESULTS
About 29% of subjects had a pattern of rapid weight gain during infancy; 8% were obese [body mass index (in kg/m(2)) > or = 30] at age 20 y. One-third of the obesity at age 20 y could be attributed to rapid weight gain in the first 4 mo of life. After adjustment for confounding factors, subjects with rapid weight gain during early infancy were more likely to become obese at age 20 y (odds ratio = 5.22; 95% CI: 1.55, 17.6; P = 0.008). The results were confirmed by using a combination of body mass index and skinfold thickness (odds ratio = 6.72; 95% CI: 1.93, 23.4; P = 0.003).


CONCLUSIONS
The results of the present study provide evidence that a pattern of rapid weight gain during early infancy is associated with obesity not only in childhood but also in young adulthood. We propose that early infancy constitutes a critical period for the development of obesity. Mechanisms of action and prevention strategies require further investigation.
Stettler
Nicolas
N
Division of Gastroenterology and Nutrition, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, 19104, USA. nstettle@cceb.med.upenn.edu
Kumanyika
Shiriki K
SK
Katz
Solomon H
SH
Zemel
Babette S
BS
Stallings
Virginia A
VA
D000328:Adult; D001741:Black or African American; D044383:Black People; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009765:Obesity / Q000208:ethnology* / Q000473:pathology / Q000503:physiopathology*; D016017:Odds Ratio; D012189:Retrospective Studies; D012885:Skinfold Thickness; D013997:Time Factors; D015430:Weight Gain