Elsevier

Preventive Medicine

Volume 49, Issues 2–3, August–September 2009, Pages 172-178
Preventive Medicine

High birth weight and overweight or obesity among Chinese children 3–6 years old

https://doi.org/10.1016/j.ypmed.2009.07.013Get rights and content

Abstract

Objective

To investigate the association between different levels of birth weight and the risk of overweight and obesity in children aged 3–6 years.

Methods

A retrospective longitudinal study of 15,852 children aged 3–6 years in Tianjin, China. Body weight and height, and other factors (age, gestational age, past and current health status, father's and mother's education, occupation and health status, family income, and sex) were obtained using standardized methods.

Results

After adjustment for the above other factors, Chinese children who were born with a birth weight below 2500 g are less likely to become overweight or obese (body mass index more than the 85th percentiles for age and gender specific distribution using the World Health Organization growth reference) during childhood (odd ratio [OR] 0.84, 95% confidence interval [CI] 0.47–1.52) when compared to the reference group (2500–2999 g). However, the odds ratios of becoming overweight or obese during childhood increase significantly when birth weights are 3000–3499 g (OR 1.58, 95% CI 1.33–1.88), 3500–3999 g (OR 2.09, 95% CI 1.76–2.49), and more than 4000 g (OR 3.14, 95% CI 2.60–3.79).

Conclusions

High levels of birth weight, defined as birth weight > 3000 g, were a stronger predictor for overweight and obesity among the Chinese children aged 3–6 years.

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.

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