Acceleration of BMI in Early Childhood and Risk of Sustained Obesity

The LIFE Child study is a large population-based longitudinal childhood cohort study conducted in the city of Leipzig, Germany. As a part of LIFE, a research project conducted at the Leipzig Research Center for Civilization Diseases, it aims to monitor healthy child development from birth to adulthood and to understand the development of lifestyle diseases such as obesity. The study consists of three interrelated cohorts; the birth cohort, the health cohort, and the obesity cohort. Depending on age and cohort, the comprehensive study program comprises different medical, psychological, and sociodemographic assessments as well as the collection of biological samples. Optimal data acquisition, process management, and data analysis are guaranteed by a professional team of physicians, certified study assistants, quality managers, scientists and statisticians. Due to the high popularity of the study, more than 3000 children have already participated until the end of 2015, and two-thirds of them participate continuously. The large quantity of acquired data allows LIFE Child to gain profound knowledge on the development of children growing up in the twenty-first century. This article reports the number of available and analyzable data and demonstrates the high relevance and potential of the study.

Background Obesity among children and adolescents is a growing public health problem. The aim of the present paper is to identify potential determinants of obesity and risk groups among 3- to 17-year old children and adolescents to provide a basis for effective prevention strategies. Methods Data were collected in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), a nationally representative and comprehensive data set on health behaviour and health status of German children and adolescents. Body height and weight were measured and body mass index (BMI) was classified according to IOTF cut-off points. Statistical analyses were conducted on 13,450 non-underweight children and adolescents aged 3 to 17 years. The association between overweight, obesity and several potential determinants was analysed for this group as well as for three socio-economic status (SES) groups. A multiple logistic regression model with obesity as the dependent variable was also calculated. Results The strongest association with obesity was observed for parental overweight and for low SES. Furthermore, a positive association with both overweight (including obesity) and obesity was seen for maternal smoking during pregnancy, high weight gain during pregnancy (only for mothers of normal weight), high birth weight, and high media consumption. In addition, high intakes of meat and sausages, total beverages, water and tea, total food and beverages, as well as energy-providing food and beverages were significantly associated with overweight as well as with obesity. Long sleep time was negatively associated with obesity among 3- to 10-year olds. Determinants of obesity occurred more often among children and adolescents with low SES. Conclusion Parental overweight and a low SES are major potential determinants of obesity. Families with these characteristics should be focused on in obesity prevention.

To identify groups of children with distinct developmental trajectories of body mass index (BMI), calculated as weight in kilograms divided by height in meters squared, between the ages of 5 months and 8 years and identify early-life risk factors that distinguish children in an atypically elevated BMI trajectory group. Prospective cohort study. Families with a child born between October 1997 and July 1998 in the province of Quebec, Canada. A representative sample of children (N = 2120) selected through birth registries for the Quebec Longitudinal Study of Child Development. Children for whom BMI data were available for at least 5 time points were retained in the present study (n = 1957). Early-life factors putatively associated with BMI, assessed by maternal report. Group-based trajectories of children's BMI, identified with a semiparametric modeling method from raw BMI values at each age. Three trajectories of BMI were identified: low-stable (54.5% of children), moderate (41.0%), and high-rising (4.5%). The high-rising group was characterized by an increasing average BMI, which exceeded international cutoff values for obesity by age 8 years. Two maternal risk factors were associated with the high-rising group as compared with the low-stable and moderate groups combined: maternal BMI (odds ratio, 2.38; 95% confidence interval, 1.38-4.54 for maternal overweight and 6.33; 3.82-11.85 for maternal obesity) and maternal smoking during pregnancy (2.28; 1.49-4.04). Children continuing on an elevated BMI trajectory leading to obesity in middle childhood can be distinguished from children on a normative BMI trajectory as early as age 3.5 years. Important and preventable risk factors for childhood obesity are in place before birth.