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ORIGINAL RESEARCH COMMUNICATION |
1 From the Department of Pediatrics, Sunder Lal Jain Hospital, Delhi, India (SKB); the Department of Pediatrics, Maulana Azad Medical College, New Delhi, India (HSS); the Medical Research Council Epidemiology Resource Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom (CHDF, CO, SDL, and DJPB); the Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India (RL and KSR); and the Indian Council of Medical Research, New Delhi, India (SKDB)
Background: South Asians have a muscle-thin but adipose body phenotype and high rates of obesity-related disease. Adult body composition may be predictable in early life.
Objective: Anthropometric indexes of adult body composition were examined in relation to birth size and body mass index (BMI) during childhood.
Design: A population-based cohort of 1526 men and women aged 26–32 y in Delhi, India, who were measured sequentially from birth until 21 y of age were followed up. Adult weight, height, skinfold thicknesses, and waist and hip circumferences were measured. BMI and indexes of adiposity (sum of skinfold thicknesses), central adiposity (waist-hip ratio), and lean mass (residual values after adjustment of BMI for skinfold thicknesses and height) were derived.
Results: Mean birth weight was 2851 g. As children, many subjects were underweight-for-age (>2 SDs below the National Center for Health Statistics mean; 53% at 2 y), but as adults, 47% were overweight, 11% were obese, and 51% were centrally obese (according to World Health Organization criteria). Birth weight was positively related to adult lean mass (P < 0.001) and, in women only, to adiposity (P = 0.006) but was unrelated to central adiposity. BMI from birth to age 21 y was increasingly strongly positively correlated with all outcomes. BMI and BMI gain in infancy and early childhood were correlated more strongly with adult lean mass than with adiposity or central adiposity. Higher BMI and greater BMI gain in late childhood and adolescence were associated with increased adult adiposity and central adiposity.
Conclusions: Birth weight and BMI gain during infancy and early childhood predict adult lean mass more strongly than adult adiposity. Greater BMI gain in late childhood and adolescence predicts increased adult adiposity.
Key Words: Body composition • lean mass • obesity • developmental origins of adult disease • birth weight • childhood growth • nutritional transition • India
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