High birth weight and overweight or obesity among Chinese children 3–6 years old
Introduction
Overweight and obesity are important lifestyle-related public health problems worldwide (World Health Organisation, 2000). Overweight in childhood and adolescence has more than doubled over the past decades for instance in the United States (Ogden et al., 2002), some European countries, and Japan (World Health Organisation, 2000, Ogden et al., 2002). In China, following rapid economic development from 1980s, Chinese people have rapidly changed their lifestyles; this has resulted in an increased prevalence of overweight and obesity in children and adults (Wu, 2006). At the same time, a rapidly increased rate of newborn macrosomia (birth weight ≥ 4000 g) has been documented in China. For instance, in Shanghai, the cases of newborn macrosomia increased by 50% from 1989 to 1999 with the greatest increase being observed in urban areas (Sheng and Zhao, 2002).
Some studies have indicated that higher birth weight may be a risk factor of both type 1 and type 2 diabetes in children (Dahlquist et al., 1996, Virtanen and Knip, 2003, Wei et al., 2003) and increase the risk of morbidity and mortality in adulthood (Barker, 1990). Recently, a systematic review (Parsons et al., 1999) and several studies have shown that higher birth weights are associated with higher levels of body weight or body mass index (BMI) in childhood (Tanaka et al., 2001, Takahashi et al., 1999, Whitaker, 2004, Parsons et al., 2001, Yu et al., 2008). However, few studies examine the extent to which birth weight is associated with overweight or obesity status in pre-school and young school aged Chinese children (Yu et al., 2008). It is very important to answer this question because the rapid increase of the prevalence of overweight and obesity among Chinese infants and adolescents (Wu, 2006) might be associated with relatively higher levels of their birth weight. Moreover, most of the previous studies chose traditional categories of birth weight (Takahashi et al., 1999, Whitaker, 2004, Parsons et al., 2001, Yu et al., 2008), and few studies assessed full-range associations of birth weight as a continuous variable with the risk of obesity to identify any cut-off values or thresholds (Tanaka et al., 2001). The aim of the present study is to investigate the associations of different levels of birth weight with risks of overweight or obesity in children aged 3–6 years in Tianjin, China.
Section snippets
Study sample
A retrospective longitudinal study was carried out in 71 kindergartens in Tianjin, China, from March to September, 2005 (Tian et al., in press). The city of Tianjin, located in the north central China, is the fourth largest city and a municipality of provincial status in China. Beside provinces, China also has province-level regions including autonomous regions, municipalities, and special administrative regions. Four current municipalities are Beijing, Tianjin, Shanghai, and Chongqing. At the
Results
General characteristics of the study population are presented in Table 1. Subjects with the history of any diseases, any current disease, and history of any diseases of the father or mother are few (< 3.0%). There were positive associations of birth weight with Z scores for weight for age, height for age, and BMI for age (Table 2).
The multivariable-adjusted (age, area, gestational age, history of illness status, current health status, father's and mother's education, occupation and health
Discussion
This study indicated that higher levels of birth weight, defined as birth weight more than 3000 g, were associated with an increased risk of overweight or obesity among the Chinese children aged 3–6 years. This association was present both in children aged 3–4 years and 5–6 years, and in children living in urban and rural areas.
Several studies have examined the association between high birth weight with high levels of body weight or BMI in childhood (Takahashi et al., 1999, Whitaker, 2004,
Conclusions
The present study demonstrates that a higher level of birth weight is an important predictor of overweight or obesity among Chinese children aged 3–6 years. Understanding the effect of intrauterine and pediatric nutrition on body weight during infancy may help in designing targeted interventions for the early prevention of obesity and related cardio-metabolic disease.
Conflict of interest statement
The authors declare that there are no conflicts of interest.
Acknowledgments
This study was supported by a grant from Tianjin Women and Children's Health Center.
References (32)
- et al.
Predicting overweight and obesity in adulthood from body mass index values in childhood and adolescence
Am. J. Clin. Nutr.
(2002) - et al.
Influence factors on the development of obesity in 3-year-old children based on the Toyama study
Prev. Med.
(1999) - et al.
Nutritional risk predictors of beta cell autoimmunity and type 1 diabetes at a young age
Am. J. Clin. Nutr.
(2003) - et al.
Tracking of body mass index from childhood to adolescence: a 6-y follow-up study in China
Am. J. Clin. Nutr.
(2000) - et al.
Thresholds of risk factors for ischemic stroke in type 2 diabetic patients with and without albuminuria: a non-linear approach
Clin. Neurol. Neurosurg.
(2008) The fetal and infant origins of adult disease
BMJ
(1990)- et al.
Association of overweight with increased risk of coronary heart disease partly independent of blood pressure and cholesterol levels: a meta-analysis of 21 cohort studies including more than 300 000 persons
Arch. Intern. Med.
(2007) - et al.
Establishing a standard definition for child overweight and obesity worldwide: international survey
BMJ
(2000) - et al.
Intrauterine growth pattern and risk of childhood onset insulin dependent (type I) diabetes: population based case-control study
BMJ
(1996) Early growth and adult health outcomes—lessons learned from the Helsinki Birth Cohort Study
Matern. Child Nutr.
(2005)
The relation of overweight to cardiovascular risk factors among children and adolescents: the Bogalusa Heart Study
Pediatrics
Regression Modelling Strategies with Applications to Linear Models, Logistic Regression, and Survival Analysis
Adiposity as compared with physical activity in predicting mortality among women
N. Engl. J. Med.
Relationship of physical activity and body mass index to the risk of hypertension: a prospective study in Finland
Hypertension
Physical activity, body mass index, and risk of type 2 diabetes in patients with normal or impaired glucose regulation
Arch. Intern. Med.
Joint effects of physical activity, body mass index, waist circumference and waist-to-hip ratio with the risk of cardiovascular disease among middle-aged Finnish men and women
Eur. Heart J.
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