title: Birth weight, growth and feeding pattern in early infancy predict overweight/obesity status at two years of age: a birth cohort study of Chinese infants.
abstract: OBJECTIVE
  To investigate the early determinants of overweight and obesity status at age two years.
  
  
  METHODS
  A total of 1098 healthy neonates (563 boys and 535 girls) were involved in this community-based prospective study in China. Data on body weight and length were collected at birth, the 3(rd) and 24(th) month. A self-administered questionnaire was used to collect data on social demography and feeding patterns of children, etc. Three multivariable logistic regression models were employed to make various comparisons of weight status, i.e., model 1 (obesity vs. non-obesity), model 2 (combined overweight and obesity vs. normal weight, and model 3 (obesity, overweight and normal weight).
  
  
  RESULTS
  Prevalences of overweight/obesity (95(th) >BMI ≥85(th) p and BMI ≥95(th) p, referring to WHO BMI standards) at 2 years of age are 15.8%/11.2% for boys and 12.9%/9.0% for girls, respectively. Being born with macrosomia (OR: 1.80-1.88), relatively greater BMI increment in the first 3 months (OR: 1.15-1.16) and bottle emptying by encouragement at age two (OR: 1.30-1.57) were found in all three models to be significant risk factors for higher BMI status at 2 years. Pre-pregnancy maternal BMI (OR: 1.09-1.12), paternal BMI (OR: 1.06), and mixed breastfeeding (OR: 1.54-1.57) or formula feeding (OR: 1.90-1.93) in the first month were identified as significant in models 2 and 3. Child-initiated bottle emptying at age two was observed to increase the risk of obesity by 1.31 times but only in model 1.
  
  
  CONCLUSIONS
  Fetal and early postnatal growth and feeding pattern appear to have significant impacts on early childhood overweight and obesity status independent of parental BMI. Policy-based and multidisciplinary approaches to promote breastfeeding and enhancement of feeding skills of care takers may be promising intervention strategies.
authors.affiliation: Department of Woman and Child's Care and Adolescence Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. jd_zh@mail.hust.edu.cn
authors.forename: Jianduan
authors.initials: J
authors.lastname: Zhang
authors.forename: John H
authors.initials: JH
authors.lastname: Himes
authors.forename: Yuan
authors.initials: Y
authors.lastname: Guo
authors.forename: Jingxiong
authors.initials: J
authors.lastname: Jiang
authors.forename: Liu
authors.initials: L
authors.lastname: Yang
authors.forename: Qiaozhen
authors.initials: Q
authors.lastname: Lu
authors.forename: Haiyan
authors.initials: H
authors.lastname: Ruan
authors.forename: Shuhua
authors.initials: S
authors.lastname: Shi
mesh_terms: D001724:Birth Weight; D015992:Body Mass Index; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005247:Feeding Behavior; D005260:Female; D057238:Growth Charts; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D050177:Overweight / Q000453:epidemiology / Q000209:etiology*; D063766:Pediatric Obesity / Q000453:epidemiology / Q000209:etiology*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D015430:Weight Gain