October 29, 2012

Rapid Growth from 12 to 23 Months of Life Predicts Obesity in a Population of Pacific Island Children

May Okihiro, M.D., M.S.; James Davis, Ph.D.; Lon White, M.D., M.P.H.; Chris Derauf, M.D.

Ethnicity & Disease

Background—Rapid growth (RG) in early childhood has been associated with increased risk of obesity. The specific intervals when risk is highest have not been well examined and may help identify modifiable risk factors.

Objective—To determine the correlation between RG in consecutive time intervals during the first 2 years of life with obesity at 4–5 years.

Methods—This was a retrospective study of children attending the largest community health center in Hawaii. Children, aged 4–5 years, with a pre-kindergarten (PreK) well-child physical examination were included; data were abstracted from medical charts.

Analyses—Children were classified as overweight (BMI for age/sex 85–94%) or obese (BMI for age/sex ≥ 95%). Moderate and severe rapid growth was defined as an increase in weight-forheight z-score of .67–1.0 SD and ≥1.0, respectively. Relationship between RG and PreK obesity was assessed using logistic regression analyses.

Results—389 children were included: 66% Hawaiian, 21.6% Samoan and 12.3% Filipino. At the PreK 19.6% were obese, and 20.9% were overweight. Severe RG from 12 to 23 months was strongly associated with PreK obesity (OR 4.36, 95% CI 1.85–10.27). Of children with severe RG from 12–23 months, 48% were obese at PreK compared with 16.7% of children with moderate RG and 19.3% of children without RG.

Conclusion—Rapid growth between 12 and 23 months, a key period of nutritional transition in toddlers, was strongly associated with obesity at 4 to 5 years of age in this high-risk population of Pacific Island minority subgroups.

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