CHILDREN WHO GAIN a lot of weight quickly after mid-childhood are at higher risk of obesity and heart disease in later life – but higher birth weight and rapid growth could end up offering some protection against chronic disease.

New research published in The Lancet suggests that children in low- and middle-income countries who undergo fast weight gain after mid-childhood are at higher risk of obesity and cardiovascular diseases in later life.

However, higher birthweight and rapid growth in body length during the first two years of life are likely to lead to substantial improvements in height and levels of schooling, and offer some protection against risk factors for chronic disease in adulthood.

The researchers say there are questions about whether the promotion of infant and young child weight gain might also influence risk of adult chronic diseases later in life.

Challenge

Lead author Linda Adair from the Gillings School of Global Public Health at the University of North Carolina in the USA said that the results of this research “challenge several programmes in countries of low and middle income countries”. For example, traditional school feeding programmes that increase BMI [body mass index] with little effect on height might be doing more harm than good in terms of future health.

She said that the present focus in such countries on reducing the proportion of children under five who are underweight might have detrimental repercussions if they promote excess weight gain after the age of two.

Whereas, interventions that promote linear growth in early life could build human capital [height and levels of schooling] in adults without increasing the burden of non-communicable diseases.

Until now, most early child growth research has focused on body weight and outcomes in later life rather than on the separate effects of length and weight gain.

Additionally, questions remain about whether the promotion of infant and young child weight gain- important for survival and cognitive development – might also influence risk of adult chronic diseases later in life.

In this study, Linda Adair and colleagues working together in the COHORTS collaboration compared the potential long-term effects of faster weight gain and linear growth in infancy and childhood on height, schooling, blood pressure, glucose metabolism, and body composition in young adulthood.

Analysing data from five prospective birth cohort studies from Brazil, Guatemala, India, the Philippines, and South Africa, they showed that higher weight at birth and faster linear growth in the first two years of life were linked with increased adult height and higher levels of schooling.

Conversely, children with weight gain above what would be expected given their height after the age of two years and later in childhood had higher blood pressure, BMI, body fat levels, and plasma glucose concentrations in young adulthood.

According to the authors:

New interventions that specifically promote linear growth instead of weight gain should be developed, tested, and promoted; exclusive breastfeeding, high-quality protein (eg, animal), and micronutrients could be further investigated.

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