A study published in in The Journal of Nutrition suggests that overweight/obesity in early childhood strongly predicts higher cardiometabolic risk factors at ages 5 – 16 years in an American Indian population.

Growth abnormalities in childhood have been related to later cardiometabolic risks.  However, little is known about these associations in populations at high risk of obesity and type 2 diabetes, and whose growth patterns differ from the general pediatric population in the United States. To bridge this knowledge gap, researcher Maria Ramirez-Luzuriaga (National Institutes of Health) and colleagues examined the associations of growth patterns, including weight and height at ages 1- 59 months, with cardiometabolic risk factors at ages 5 – 16 years.

Anthropometric data collected at ages 1 – 59 months was linked to cardiometabolic data obtained from a longitudinal study in a southwestern American Indian population at high risk of type 2 diabetes. Analyses, which included 701 children, evaluated age- and sex-specific weight-for-height z-scores and height-for-age z-scores at ages 1 – 59 months. The highest weight-for-height z-score and the lowest height-for-age z-score at ages 1 – 59 months were selected, and their categories were analyzed for associations with cardiometabolic outcomes at ages 5 – 16 years.

Overweight/obesity at ages 1 – 59 months was significantly associated with increased body mass index, fasting and 2-hour post-load blood glucose, fasting and 2-hour insulin, triglycerides, systolic blood pressure, diastolic blood pressure, and decreased high density lipoprotein cholesterol at ages 5 – 16 years relative to normal weight-for-age z-scores. Low height-for-age  at ages 1 – 59 months was associated with lower high density lipoprotein cholesterol values and higher 2-hour insulin at ages 10 – 16 years relative to normal height-for-age z-scores.

In this longitudinal analysis, growth abnormalities such as persistent overweight/obesity and low height-for-age were observed early in this high-risk population. Findings suggest a strong contribution of overweight/obesity in early childhood to cardiometabolic risks in later childhood and adolescence. Taken together, study results suggest that overweight/obesity contributes substantially to adverse cardiometabolic risks in this population, and the effects of higher adiposity that occur early in childhood track to adolescence. These findings highlight early life as a potentially important target for interventions to decrease risks of cardiometabolic disease.

A companion editorial by Daniel Hoffman (Rutgers, the State University of New Jersey) provides further insights regarding the need for innovative approaches to better study growth and how growth faltering influences health and disease risk in vulnerable populations.


María J Ramírez-Luzuriaga, Sayuko Kobes, Madhumita Sinha, William C Knowler, Robert L Hanson, Increased Adiposity and Low Height-for-Age in Early Childhood Are Associated With Later Metabolic Risks in American Indian Children and Adolescents, The Journal of Nutrition, Volume 152, Issue 8, August 2022, Pages 1872–1885, https://doi.org/10.1093/jn/nxac031.

Daniel J Hoffman, Childhood Growth and Adult Health: Is It Time to Modify the Methods Used to Study Growth?, The Journal of Nutrition, Volume 152, Issue 8, August 2022, Pages 1803–1804, https://doi.org/10.1093/jn/nxac111.

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