title: Life-Course Body Mass Index Trajectories Are Predicted by Childhood Socioeconomic Status but Not Exposure to Improved Nutrition during the First 1000 Days after Conception in Guatemalan Adults.
abstract: BACKGROUND
  Latin America has experienced increases in obesity. Little is known about the role of early life factors on body mass index (BMI) gain over the life course.
  
  
  OBJECTIVE
  The objective of this research was to examine the role of early life factors [specifically, nutrition supplementation during the first 1000 d (from conception to 2 y of age) and childhood household socioeconomic status (SES)] on the pattern of BMI gain from birth or early childhood through midadulthood by using latent class growth analysis.
  
  
  METHODS
  Study participants (711 women, 742 men) who were born in 4 villages in Guatemala (1962-1977) were followed prospectively since participating in a randomized nutrition supplementation trial as children. Sex-specific BMI latent class trajectories were derived from 22 possible measures of height and weight from 1969 to 2004. To characterize early life determinants of BMI latent class membership, we used logistic regression modeling and estimated the difference-in-difference (DD) effect of nutrition supplementation during the first 1000 d.
  
  
  RESULTS
  We identified 2 BMI latent classes in women [low (57%) and high (43%)] and 3 classes in men [low (38%), medium (47%), and high (15%)]. Nutrition supplementation during the first 1000 d after conception was not associated with BMI latent class membership (DD test: P > 0.15 for men and women), whereas higher SES was associated with increased odds of high BMI latent class membership in both men (OR: 1.98; 95% CI: 1.09, 3.61) and women (OR: 1.62; 95% CI: 1.07, 2.45) for the highest relative to the lowest tertile.
  
  
  CONCLUSIONS
  In a cohort of Guatemalan men and women, nutrition supplementation provided during the first 1000 d was not significantly associated with higher BMI trajectory. Higher childhood household SES was associated with increased odds of high BMI latent class membership relative to the poorest households. The pathways through which this operates still need to be explored.
authors.affiliation: Nutrition and Health Sciences Program, Laney Graduate School, and.
authors.forename: Nicole D
authors.identifier: http://orcid.org/0000-0002-6463-5094
authors.initials: ND
authors.lastname: Ford
authors.affiliation: Nutrition and Health Sciences Program, Laney Graduate School, and.|Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA; and.
authors.forename: Reynaldo
authors.identifier: http://orcid.org/0000-0001-8862-7243
authors.initials: R
authors.lastname: Martorell
authors.affiliation: Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA; and.
authors.forename: Neil K
authors.identifier: http://orcid.org/0000-0001-6671-8435
authors.initials: NK
authors.lastname: Mehta
authors.affiliation: Institute of Nutrition of Central America and Panama Research Center for the Prevention of Chronic Diseases (CIIPEC), Guatemala City, Guatemala.
authors.forename: Manuel
authors.identifier: http://orcid.org/0000-0001-5107-9175
authors.initials: M
authors.lastname: Ramirez-Zea
authors.affiliation: Nutrition and Health Sciences Program, Laney Graduate School, and aryeh.stein@emory.edu.|Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA; and.
authors.forename: Aryeh D
authors.identifier: http://orcid.org/0000-0003-1138-6458
authors.initials: AD
authors.lastname: Stein
mesh_terms: D000328:Adult; D000375:Aging; D015992:Body Mass Index; D002648:Child; D019587:Dietary Supplements; D005260:Female; D006166:Guatemala / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011247:Pregnancy; D039401:Prenatal Nutritional Physiological Phenomena; D012424:Rural Population; D012923:Social Class; D012959:Socioeconomic Factors
keywords: 1000 days; Guatemala; child nutrition; developmental origins; latent class growth analysis; obesity; socioeconomic status