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This Article Full Text (Publish Ahead of Print[PDF]) All Versions of this Article: 89/5/1383    most recent ajcn.2008.27139v1 Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Adair, L. S Search for Related Content PubMed PubMed Citation Articles by Adair, L. S Agricola Articles by Adair, L. S

Size at birth, weight gain in infancy and childhood, and adult blood pressure in 5 low- and middle-income-country cohorts: when does weight gain matter?^1,2,3

¹ From the University of North Carolina at Chapel Hill, Chapel Hill, NC (LSA); the Hubert Department of Global Health, Emory University, Atlanta, GA (RM and ADS); Universidade Federal de Pelotas, Pelotas, Brazil (PCH and CGV); the Sitaram Bhartia Institute of Science and Research, New Delhi, India (HSS); the Centre for Chronic Disease Control, New Delhi, India (DP); the MRC Epidemiology Resource Centre, University of Southampton, Southampton, United Kingdom (AKW); the Department of Paediatrics, MRC Mineral Metabolism Research Unit, University of the Witwatersrand, Johannesburg, South Africa (SAN); the University of Leeds, Leeds, United Kingdom (DLD); and the Office of Population Studies Foundation, Cebu, Philippines (NRL).

Supported by a grant from the Wellcome Trust of the United Kingdom. Funding for each of the individual cohort studies was as follows: Guatemala INTC (US National Institutes of Health and the US National Science Foundation), Pelotas (recent phases of the cohort study supported by the Wellcome Trust's Health Consequences of Population Change Programme), New Delhi (original cohort study supported by the US National Center for Health Statistics and the Indian Council of Medical Research; more recent phases supported by the British Heart Foundation, the Medical Research Council UK, and the Indian Council of Medical Research), Birth-to-Twenty (the Wellcome Trust, Human Sciences Research Council, South African Medical Research Council, the Mellon Foundation, the South-African Netherlands Programme on Alternative Development, and the Anglo American Chairman's Fund), and Cebu, Philippines (most recent follow-up surveys supported by the US National Institutes of Health, Fogarty International Center R01 TW05596).

³ Reprints not available. Address correspondence to LS Adair, Carolina Population Center, University of North Carolina at Chapel Hill, CB# 8120, University Square, 123 West Franklin Street, Chapel Hill, NC 27516-2524. E-mail: linda_adair{at}unc.edu.

ABSTRACT

Background: Promoting catch-up growth in malnourished children has health benefits, but recent evidence suggests that accelerated child weight gain increases adult chronic disease risk.

Objective: We aimed to determine how birth weight (BW) and weight gain to midchildhood relate to blood pressure (BP) in young adults.

Design: We pooled data from birth cohorts in Brazil, Guatemala, India, the Philippines, and South Africa. We used conditional weight (CW), a residual of current weight regressed on prior weights, to represent deviations from expected weight gain from 0 to 12, 12 to 24, 24 to 48 mo, and 48 mo to adulthood. Adult BP and risk of prehypertension or hypertension (P/HTN) were modeled before and after adjustment for adult body mass index (BMI) and height. Interactions of CWs with small size-for-gestational age (SGA) at birth were tested.

Results: Higher CWs were associated with increased BP and odds of P/HTN, with coefficients proportional to the contribution of each CW to adult BMI. Adjusted for adult height and BMI, no child CW was associated with adult BP, but 1 SD of BW was related to a 0.5-mm Hg lower systolic BP and a 9% lower odds of P/HTN. BW and CW associations with systolic BP and P/HTN were not different between adults born SGA and those with normal BW, but higher CW at 48 mo was associated with higher diastolic BP in those born SGA.

Conclusions: Greater weight gain at any age relates to elevated adult BP, but faster weight gains in infancy and young childhood do not pose a higher risk than do gains at other ages.

Received for publication October 20, 2008. Accepted for publication February 12, 2009.

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