title: Risk of obesity at 4 to 6 years of age among overweight or obese 18-month-olds: community-based cohort study.
abstract: OBJECTIVE
  To determine whether high weight for length at the 18-month well-baby visit is predictive of overweight or obese body mass index (BMI) at the 4- to 6-year well-child visit.
  
  
  METHODS
  Retrospective cohort study using objective electronic medical record measurements.
  
  
  METHODS
  Eighteen family practices forming a community family health organization in Peterborough, Ont.
  
  
  METHODS
  All children from the family health organization practices with at least 1 set of weight and length or height measurements at age 17 to 19 months and age 4 to 6 years (N=126).
  
  
  METHODS
  Relative risk (RR) of overweight BMI and RR of obese BMI at 4 to 6 years of age for normal versus overweight or obese 18-month-olds.
  
  
  RESULTS
  Children who were either overweight or obese at their 18-month visits (n=37) were more than twice as likely to be obese at age 4 to 6 years than children who had healthy weights at 18 months were (n=89; RR=2.71, 95% CI 1.13 to 6.47). The subgroup of obese 18-month-olds (n=13) were at more than 3 times the risk of being obese at age 4 to 6 years than their healthy-weight-for-length counterparts (RR=3.42, 95% CI 1.20 to 9.78). Thirty-one percent of obese 18-month-olds were obese at 4 to 6 years and a further 31% were overweight.
  
  
  CONCLUSIONS
  High weight for length at 18 months substantially increased a child's risk of being overweight or obese at 4 to 6 years of age. Most overweight and obese 18-month-olds in this study did not achieve healthy BMIs by 4 to 6 years of age. A brief glance at the 18-month weight-for-length chart can easily help identify these high-risk toddlers.
authors.affiliation: Queen's University, Department of Family Medicine, Peterborough-Kawartha Site, 737 Victory Cres, Peterborough, ON K9H 4T5. wheeler.jesse@gmail.com
authors.forename: Jesse J
authors.initials: JJ
authors.lastname: Wheeler
mesh_terms: D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009765:Obesity / Q000453:epidemiology*; D009864:Ontario / Q000453:epidemiology; D050177:Overweight / Q000453:epidemiology*; D011237:Predictive Value of Tests; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors