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Associations between early body mass index trajectories and later metabolic risk factors in European children: the IDEFICS study

  • DEVELOPMENTAL EPIDEMIOLOGY
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Abstract

Faster growth seems to be a common factor in several hypotheses relating early life exposures to subsequent health. This study aims to investigate the association between body mass index (BMI) trajectories during infancy/childhood and later metabolic risk in order to identify sensitive periods of growth affecting health. In a first step, BMI trajectories of 3301 European children that participated in the multi-centre Identification and Prevention of Dietary and Lifestyle-induced Health Effects in Children and Infants (IDEFICS) study were modelled using linear-spline mixed-effects models. The estimated random coefficients indicating initial subject-specific BMI and rates of change in BMI over time were used as exposure variables in a second step and related to a metabolic syndrome (MetS) score and its single components based on conditional regression models (mean age at outcome assessment: 8.5 years). All exposures under investigation, i.e. BMI at birth, rates of BMI change during infancy (0 to <9 months), early childhood (9 months to <6 years) and later childhood (≥6 years) as well as current BMI z-score were significantly associated with the later MetS score. Associations were strongest for the rate of BMI change in early childhood (1.78 [1.66; 1.90]; β estimate and 99 % confidence interval) and current BMI z-score (1.16 [0.96; 1.38]) and less pronounced for BMI at birth (0.62 [0.47; 0.78]). Results slightly differed with regard to the single metabolic factors. Starting from birth rapid BMI growth, especially in the time window of 9 months to <6 years, is significantly related to later metabolic risk in children. Much of the associations of early BMI growth may further be mediated through the effects on subsequent BMI growth.

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Acknowledgments

This work was done as part of the IDEFICS study (www.idefics.eu). We gratefully acknowledge the financial support of the European Community. The authors wish to thank the IDEFICS children and their parents for participating in the extensive examination procedures involved in this study. We are grateful for the support by school boards, headmasters and communities.

Author contributions

This manuscript represents original work that has not been published previously and is currently not considered by another journal. Each author has seen and approved the contents of the submitted manuscript. All authors contributed to conception and design, acquisition of data, analysis or interpretation of data.

Funding

This work was supported by the European Community and was funded within the Sixth RTD Framework Programme [Contract No. 016181 (FOOD)].

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Authors and Affiliations

  1. Leibniz Institute for Prevention Research and Epidemiology – BIPS, Achterstr. 30, 28359, Bremen, Germany

    Claudia Börnhorst, Wolfgang Ahrens & Iris Pigeot

  2. School of Social and Community Medicine, University of Bristol, Bristol, UK

    Kate Tilling & Yoav Ben-Shlomo

  3. Institute of Food Sciences, National Research Council, Avellino, Italy

    Paola Russo

  4. Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia

    Yannis Kourides

  5. Department of Public Health, Ghent University, Ghent, Belgium

    Nathalie Michels

  6. Department of Pediatrics, University of Pécs, Pecs, Hungary

    Denés Molnár

  7. GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain

    Gerado Rodríguez & Luis A. Moreno

  8. IIS Aragón (Aragon Health Research Institute), Zaragoza, Spain

    Gerado Rodríguez

  9. Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

    Vittorio Krogh

  10. Institute of Statistics, Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany

    Wolfgang Ahrens & Iris Pigeot

Authors
  1. Claudia Börnhorst
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  2. Kate Tilling
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  3. Paola Russo
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  4. Yannis Kourides
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  5. Nathalie Michels
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  6. Denés Molnár
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  9. Vittorio Krogh
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  10. Yoav Ben-Shlomo
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  11. Wolfgang Ahrens
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Correspondence to Claudia Börnhorst.

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Statement of ethics and informed consent

We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during this research. Approval by the appropriate Ethics Committees was obtained by each centre doing the fieldwork. Study children did not undergo any procedures unless both they and their parents had given consent for examinations, collection of samples, subsequent analysis and storage of personal data and collected samples. Study subjects and their parents could consent to single components of the study while abstaining from others. All procedures were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Börnhorst, C., Tilling, K., Russo, P. et al. Associations between early body mass index trajectories and later metabolic risk factors in European children: the IDEFICS study. Eur J Epidemiol 31, 513–525 (2016). https://doi.org/10.1007/s10654-015-0080-z

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