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This Article Full Text Full Text (PDF) Supplemental data All Versions of this Article: 90/3/547    most recent ajcn.2008.27318v1 Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Corvalán, C. Articles by Martorell, R. PubMed PubMed Citation Articles by Corvalán, C. Articles by Martorell, R. Agricola Articles by Corvalán, C. Articles by Martorell, R.

Effect of growth on cardiometabolic status at 4 y of age^1,2,3

¹ From the Nutrition and Health Sciences Program, Graduate Division of Biological and Biomedical Sciences, Emory University, Atlanta, GA (CC, ADS, and RM); the Epidemiology Department, School of Public Health, Faculty of Medicine, University of Chile, Santiago, Chile (CC); the Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile (RU and JK); and the Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA (ADS and RM).

² Supported by the Ellison Medical Foundation/International Nutrition Foundation and the Chilean National Science and Technology Fund (Fondecyt) project no. 1060785.

³ Address correspondence to C Corvalán, School of Public Health, Faculty of Medicine, University of Chile, Av. Independencia 1027, Santiago, Chile. E-mail: ccorvalan{at}meduchile.cl.

Background: Cardiovascular disease (CVD) risks are increasingly being diagnosed in children and track into adulthood. Growth is associated with CVD risk in adulthood; however, its contribution to CVD risks in children facing the obesity epidemic is unclear.

Objective: The objective was to assess relations between growth from age 0 to 4 y and CVD status at 4 y in 323 Chilean children with normal birth weight.

Design: From health records we obtained weight and height every 6 mo from age 0 to 3 y and calculated body mass index (BMI; weight/height²). At age 4 y, we measured height, waist circumference, insulin, glucose, and plasma lipids; infant feeding information was provided by the mothers. Outcomes were metabolic score (waist-to-height ratio + glucose + insulin + triglycerides – HDL-cholesterol z scores/5), total cholesterol (TC):HDL cholesterol, and homeostasis model of assessment of insulin resistance.

Results: At 4 y, the prevalence of obesity was 13%. Changes in BMI, particularly from 6 to 24 mo, predicted a higher metabolic score (standardized regression coefficient = 0.29; 95% CI: 0.16, 0.42) but were unrelated to homeostasis model of assessment of insulin resistance and TC:HDL cholesterol. Height changes were not associated with CVD risks at the age of 4 y. Mode of infant feeding was unrelated to CVD status at 4 y; however, in children who were exclusively breastfed at 4 mo, an increase in BMI from 0 to 6 mo was positively associated with TC:HDL cholesterol at 4 y (standardized regression coefficient = 0.24; 95% CI: –0.02, 0.50), whereas in children who were partially or nonbreastfed at 4 mo, it was negatively associated with TC:HDL cholesterol at 4 y (standardized regression coefficient = –0.30; 95% CI: –0.52, –0.08).

Conclusion: In children with normal birth weight and a high prevalence of obesity at 4 y, changes in BMI after 6 mo predicted a higher overall CVD risk at 4 y.