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Associations of linear growth and relative weight gain during early life with adult health and human capital in countries of low and middle income: findings from five birth cohort studies

Associations of linear growth and relative weight gain during early life with adult health and human capital in countries of low and middle income: findings from five birth cohort studies
Associations of linear growth and relative weight gain during early life with adult health and human capital in countries of low and middle income: findings from five birth cohort studies
Background: Fast weight gain and linear growth in children in low-income and middle-income countries are associated with enhanced survival and improved cognitive development, but might increase risk of obesity and related adult cardiometabolic diseases. We investigated how linear growth and relative weight gain during infancy and childhood are related to health and human capital outcomes in young adults.

Methods: We used data from five prospective birth cohort studies from Brazil, Guatemala, India, the Philippines, and South Africa. We investigated body-mass index, systolic and diastolic blood pressure, plasma glucose concentration, height, years of attained schooling, and related categorical indicators of adverse outcomes in young adults. With linear and logistic regression models, we assessed how these outcomes relate to birthweight and to statistically independent measures representing linear growth and weight gain independent of linear growth (relative weight gain) in three age periods: 0-2 years, 2 years to mid-childhood, and mid-childhood to adulthood.

Findings: We obtained data for 8362 participants who had at least one adult outcome of interest. A higher birthweight was consistently associated with an adult body-mass index of greater than 25 kg/m(2) (odds ratio 1·28, 95% CI 1·21-1·35) and a reduced likelihood of short adult stature (0·49, 0·44-0·54) and of not completing secondary school (0·82, 0·78-0·87). Faster linear growth was strongly associated with a reduced risk of short adult stature (age 2 years: 0·23, 0·20-0·52; mid-childhood: 0·39, 0·36-0·43) and of not completing secondary school (age 2 years: 0·74, 0·67-0·78; mid-childhood: 0·87, 0·83-0·92), but did raise the likelihood of overweight (age 2 years: 1·24, 1·17-1·31; mid-childhood: 1·12, 1·06-1·18) and elevated blood pressure (age 2 years: 1·12, 1·06-1·19; mid-childhood: 1·07, 1·01-1·13). Faster relative weight gain was associated with an increased risk of adult overweight (age 2 years: 1·51, 1·43-1·60; mid-childhood: 1·76, 1·69-1·91) and elevated blood pressure (age 2 years: 1·07, 1·01-1·13; mid-childhood: 1·22, 1·15-1·30). Linear growth and relative weight gain were not associated with dysglycaemia, but a higher birthweight was associated with decreased risk of the disorder (0·89, 0·81-0·98).

Interpretation: Interventions in countries of low and middle income to increase birthweight and linear growth during the first 2 years of life are likely to result in substantial gains in height and schooling and give some protection from adult chronic disease risk factors, with few adverse trade-offs.

Funding: Wellcome Trust and Bill & Melinda Gates Foundation.
0140-6736
525-534
Adair, Linda S.
cbc191bc-8c0f-468f-99be-394f8930392d
Fall, Caroline H.D.
7171a105-34f5-4131-89d7-1aa639893b18
Osmond, Clive
2677bf85-494f-4a78-adf8-580e1b8acb81
Stein, Aryeh D.
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Martorell, Reynaldo
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Ramirez-Zea, Manuel
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Sachdev, Harshpal Singh
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Dahly, Darren L.
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Bas, Isabelita
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Norris, Shane A.
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Micklesfield, Lisa
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Hallal, Pedro
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Victora, Cesar G.
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Adair, Linda S.
cbc191bc-8c0f-468f-99be-394f8930392d
Fall, Caroline H.D.
7171a105-34f5-4131-89d7-1aa639893b18
Osmond, Clive
2677bf85-494f-4a78-adf8-580e1b8acb81
Stein, Aryeh D.
5ee08d0c-2313-4d74-bfcf-49e9bfabc36d
Martorell, Reynaldo
d120786d-e651-446d-a96a-d175de202d5b
Ramirez-Zea, Manuel
fc06cfd0-de37-4df6-aa63-5dfbf0d31d43
Sachdev, Harshpal Singh
2fca6c24-2750-47b4-b675-7c7da6e5c987
Dahly, Darren L.
198287fe-09cf-409f-9225-e5f69d307800
Bas, Isabelita
31fc2cff-9240-492e-a0c6-57e5821b6370
Norris, Shane A.
8e447b41-9493-4491-86bc-e7a9e72ef23b
Micklesfield, Lisa
4c625289-a9ed-47e1-8dec-a1d445481206
Hallal, Pedro
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Victora, Cesar G.
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Adair, Linda S., Fall, Caroline H.D., Osmond, Clive, Stein, Aryeh D., Martorell, Reynaldo, Ramirez-Zea, Manuel, Sachdev, Harshpal Singh, Dahly, Darren L., Bas, Isabelita, Norris, Shane A., Micklesfield, Lisa, Hallal, Pedro and Victora, Cesar G. (2013) Associations of linear growth and relative weight gain during early life with adult health and human capital in countries of low and middle income: findings from five birth cohort studies. Lancet, 382 (9891), 525-534. (doi:10.1016/S0140-6736(13)60103-8). (PMID:23541370)

Record type: Article

Abstract

Background: Fast weight gain and linear growth in children in low-income and middle-income countries are associated with enhanced survival and improved cognitive development, but might increase risk of obesity and related adult cardiometabolic diseases. We investigated how linear growth and relative weight gain during infancy and childhood are related to health and human capital outcomes in young adults.

Methods: We used data from five prospective birth cohort studies from Brazil, Guatemala, India, the Philippines, and South Africa. We investigated body-mass index, systolic and diastolic blood pressure, plasma glucose concentration, height, years of attained schooling, and related categorical indicators of adverse outcomes in young adults. With linear and logistic regression models, we assessed how these outcomes relate to birthweight and to statistically independent measures representing linear growth and weight gain independent of linear growth (relative weight gain) in three age periods: 0-2 years, 2 years to mid-childhood, and mid-childhood to adulthood.

Findings: We obtained data for 8362 participants who had at least one adult outcome of interest. A higher birthweight was consistently associated with an adult body-mass index of greater than 25 kg/m(2) (odds ratio 1·28, 95% CI 1·21-1·35) and a reduced likelihood of short adult stature (0·49, 0·44-0·54) and of not completing secondary school (0·82, 0·78-0·87). Faster linear growth was strongly associated with a reduced risk of short adult stature (age 2 years: 0·23, 0·20-0·52; mid-childhood: 0·39, 0·36-0·43) and of not completing secondary school (age 2 years: 0·74, 0·67-0·78; mid-childhood: 0·87, 0·83-0·92), but did raise the likelihood of overweight (age 2 years: 1·24, 1·17-1·31; mid-childhood: 1·12, 1·06-1·18) and elevated blood pressure (age 2 years: 1·12, 1·06-1·19; mid-childhood: 1·07, 1·01-1·13). Faster relative weight gain was associated with an increased risk of adult overweight (age 2 years: 1·51, 1·43-1·60; mid-childhood: 1·76, 1·69-1·91) and elevated blood pressure (age 2 years: 1·07, 1·01-1·13; mid-childhood: 1·22, 1·15-1·30). Linear growth and relative weight gain were not associated with dysglycaemia, but a higher birthweight was associated with decreased risk of the disorder (0·89, 0·81-0·98).

Interpretation: Interventions in countries of low and middle income to increase birthweight and linear growth during the first 2 years of life are likely to result in substantial gains in height and schooling and give some protection from adult chronic disease risk factors, with few adverse trade-offs.

Funding: Wellcome Trust and Bill & Melinda Gates Foundation.

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e-pub ahead of print date: 28 March 2013
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 352014
URI: http://eprints.soton.ac.uk/id/eprint/352014
ISSN: 0140-6736
PURE UUID: 9961f4ad-a1c9-4bd2-b435-d13656b11ed9
ORCID for Caroline H.D. Fall: ORCID iD orcid.org/0000-0003-4402-5552
ORCID for Clive Osmond: ORCID iD orcid.org/0000-0002-9054-4655

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Date deposited: 01 May 2013 10:48
Last modified: 18 Feb 2021 16:45

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Contributors

Author: Linda S. Adair
Author: Clive Osmond ORCID iD
Author: Aryeh D. Stein
Author: Reynaldo Martorell
Author: Manuel Ramirez-Zea
Author: Harshpal Singh Sachdev
Author: Darren L. Dahly
Author: Isabelita Bas
Author: Shane A. Norris
Author: Lisa Micklesfield
Author: Pedro Hallal
Author: Cesar G. Victora

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