Rapid weight gain in early infancy is associated with adult body fat percentage in young women
Environ Health Prev Med
Rapid weight gain in early infancy is associated with adult body fat percentage in young women
Mari Oyama 0 1
Toshiko Saito 0 1
Kazutoshi Nakamura 0 1
0 T. Saito Department of Health and Nutrition, Niigata University of Health and Welfare , Niigata , Japan
1 M. Oyama (&) K. Nakamura Division of Social and Environmental Medicine, Department of Community Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences , 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510 , Japan
Objectives Although rapid childhood weight gain has been suggested to be a risk factor for lifetime obesity and other chronic diseases, few studies have been conducted in Asian populations. The aim of this study was, therefore, to ascertain whether rapid childhood weight gain is associated with indices of obesity in adulthood and, if so, which period in early development provides the greatest predictive value of future obesity in young Japanese women. Methods A total of 86 female university students aged 18-21 years old participated in this study. Current height, weight, body fat percentage (BFP) as evaluated by bioelectrical impedance analysis, and BMI were measured. Body weight at birth, 3 and 6 months, and 1.5 and 3 years of age was obtained from the maternity record book (Boshi-techo), and body weight at 6 years was obtained from school health records. We assessed infant weight gain by the weight change Z-score. Results Current BFP was found to be significantly correlated with weight change between 0 and 3 months (r = 0.26, P = 0.034) and between 3 and 6 months of age (r = -0.28, P = 0.031). However, none of the physical activity indices correlated with BMI and BFP. Conclusions Rapid weight gain in early infancy positively associates with BFP in young Japanese women.
Body fat; Japanese; Infants; Rapid weight gain; Young women
Rapid weight gain in childhood has been suggested to be a
risk factor for lifetime obesity and other chronic diseases.
A number of epidemiologic studies have shown that rapid
weight gain between birth and 3 months of age correlates
with body mass index (BMI) and other indices of obesity in
]. While several such studies have been
conducted on Caucasian populations, few studies have been
conducted on Asian ones [
]. Because the prevalence of
obesity and other chronic diseases are not uniform across
ethnic groups, findings obtained from Europeans and North
Americans may not be applicable to Asians [
]. The aim of
this study was to ascertain whether rapid weight gain in
childhood is associated with indices of obesity in adulthood
and, if so, which period in early development provides
the greatest predictive value of future obesity in young
This was a retrospective cohort study in which first-year
female students at Niigata University of Health and
Welfare were asked to participate. We initially contacted all
215 first-year female students in 2001. Of those contacted,
89 (41.4%) agreed to participate in this study. However,
three students were excluded because they had diseases or
conditions that may have affected metabolism (one had
nephritic syndrome with long-term glucocorticoid
treatment, one underwent growth-hormone replacement
therapy, and one exceeded 3 standard deviations for body
weight). Thus, 86 students were ultimately enrolled in the
study. Written informed consent was obtained from all
participants, and the study was approved by the Ethics
Committee of Niigata University School of Medicine.
Current height, weight, and body fat percentage (BFP)
were measured in the afternoon using a segmental body
composition analyzer (BC-118D; Tanita Corp, Tokyo,
Japan). The BFP was determined by bioelectrical
impedance analysis (BIA) with 8-point contact electrodes at a
single-frequency (50 kHz) . The accuracy of the BIA
method has been experimentally verified in a comparison
study with dual-energy X-ray absorptiometry (DXA) [
The BMI was calculated by weight (kg) divided by the
square of height (m2). Information on current physical
activity was obtained through interviews in which
participants were asked to recall their physical activities during
the past 7 days. Metabolic equivalent (MET) intensities
were calculated according to the methodology of Sallis
et al. [
]. Each MET reflects the ratio of the associated
metabolic rate for a specific activity divided by the resting
metabolic rate. Participants were also asked whether their
activity levels in the past 7 days were lighter, similar, or
more strenuous than their routine activity levels for a
Body weight at birth, 3 and 6 months, and 1.5 and
3 years of age were obtained from the maternity record
books (Boshi-techo), which are provided to every pregnant
woman in Japan by their local municipality. All events
during pregnancy, delivery, and postpartum periods are
recorded in the record book by the obstetrician or midwife.
Body weight at 6 years of age was obtained from school
health records. Postnatal weight gain is greatly affected by
birth weight; however, a low-birth-weight (LBW) infant
may gain the same numerical weight as a high-birth-weight
(HBW) infant, but with drastically different implications
for rate of change. For this reason, the simple recording of
the numerical gain of kilograms insufficiently assesses an
infant’s weight and metabolic change. Therefore, in this
study, we used a change of weight Z-score to assess infant
weight gain [Z-score = (individual weight - standardized
weight)/standard deviation (SD)]. This score refers to the
degree of deviation from an average growth chart [
Data are expressed as means ± SD. Pearson’s product
moment correlation coefficient (r) was calculated between
the change in the infant weight Z-score and other variables.
Multiple regression analysis was used to determine
associations between predictor and outcome variables adjusted
for physical activity levels (METs index). Variables of
activity levels during the past 7 days (lighter, similar, or
more strenuous) were treated as dummy variables. Data
were analyzed utilizing SPSS for Windows ver. 17.0
(SPSS, Chicago, IL). A two-sided P value \0.05 was
considered to be statistically significant.
Results and discussion
Demographic and physical characteristics of the
participants are provided in Table 1. Some of the values for infant
weight were missing.
The results of the correlation analysis between the
weight change Z-scores during early development and
participants’ current BMI and BFP are shown in Table 2.
Current BFP was statistically correlated with the Z-scores
for weight change between 0 and 3 months (0–3 months)
(r = 0.26, P = 0.034) and between 3 and 6 months (3–6
months) (r = -0.28, P = 0.031). However, the METs
indices, suggestive of physical activity level, were not
significantly correlated with current BMI (r = 0.17,
P = 0.119) or BFP (r = 0.06, P = 0.571) (data not
shown). Associations between 0–3 month weight change
Z-scores and BFP [regression coefficient (b) = 1.338,
standard error (SE) = 0.628, P = 0.037] and between
3–6 month weight change Z-scores and BFP (b = -2.347,
SE = 0.907, P = 0.012) remained even after the METs
index and activity levels were taken into account (data not
shown). Figure 1 shows the relationship between current
BFP and 0–3 month weight change Z-scores in young
We found a significant positive correlation between the
BFP of young women and their 0–3 months weight gain
Z-score, which is in line results from previous studies.
Botton et al. [
] showed that weight gain velocity from
birth to 3 months of age is associated with fat mass,
overweight, and waist circumference in adolescence.
Leunissen et al. [
] also showed that rapid weight gain
during the first 3 months of life is associated with a higher
BFP and several determinants of subsequent chronic
diseases (i.e., cardiovascular diseases and type 2 diabetes).
Ekelund et al. [
] revealed that increasing weight gain
during infancy (0–6 months) was independently associated
with fat mass in Swedish young adults.
Our findings may reflect the ‘‘early programming
hypothesis’’ which occurs during the prenatal or early
infant period [
]. Several studies have recently focused
specifically on the immediate postnatal period. Stettler
et al. [
] found that weight gain in the first week of life
BFP Body fat percentage
* Two-sided P \ 0.05 was considered to be statistically significant according to Pearson’s product moment method
Pearson’s product moment correlation coefficient (r) was calculated between the infant weight change Z-scores and other variables. 0–3 and
3–6 month weight change Z-scores were significantly associated with current BFP in young Japanese women
was associated with overweight status two to three decades
later. These researchers pointed out that the importance of
their findings was not so much to predict those infants at
risk of becoming overweight adults, but more to highlight
the importance of physiological programming during short
early-life periods on the development of chronic disease
over a lifetime.
We also found a significant negative correlation between
weight change between 3 to 6 months of age and BFP.
Leunissen et al. [
] also showed a negative correlation
between weight gain between 3 and 6 months of life and
adult BFP, although their correlation coefficient was not
statistically significant. This may be considered a rebound
effect, i.e., slowdown of weight gain for compensation.
The correlation between very early infant weight gain
and later BFP may be particularly important for Asians.
Since Asians have a higher BFP than Caucasians at the
same BMI value, they are more likely to develop health
problems at lower BMIs than Caucasians [
]. In line with
this result, the World Health Organization Expert
Consultation concluded that a substantial proportion of Asians are
at high risk for type 2 diabetes and cardiovascular disease;
Asians have a lower BMI cut-off compared to the existing
WHO cut-off of 25 kg/m2 for being overweight [
The prevalence of obesity is not high in Japan. The
prevalence of BMI C25 was 5.4% in 20- to 29-year-old
Japanese women according to the National Nutrition
Survey in Japan [
] and 4.7% in our study population (data
not shown). Therefore, it is possible to generalize our
results to the Japanese population. It should be noted,
however, that we did not assess weight gain in early
infancy in relation to obesity because of the limited sample
size. Future studies will be needed to address this issue.
This study has several limitations. First, the sample size
was relatively small, possibly resulting in a limited
detection of other possible correlations. A total of 67 subjects is
required to detect a correlation coefficient of 0.3 with a
statistical power of 80% [
]. Second, we did not adjust for
possible confounding factors, such as current energy level
or nutritional intake. Third, participants were students of a
‘‘Health and Welfare’’ university, so generalizations based
on results of our study to the entire Japanese population
should be made with caution. According to the 2004
National Health and Nutrition Survey in Japan [
average BMI of 18- to 21-year-old women was 20.7 at the
time of the survey. The average BMI in our study
population was 21.3, which is slightly higher than the national
average. This difference should be taken into consideration
when generalizing the results. Fourth, we assessed current
physical activity levels, but we did not assess those during
the early growth phase. The latter should be addressed in
future studies. Lastly, given that this study statistically
compared many variables, our significant findings might
belong to type 1 errors.
Despite these limitations, our study is strengthened by
the power of available epidemiological data in the Japanese
population. Namely, we could obtain accurate infant
weight data using the maternity record book (Boshi-techo)
and school health records. Boshi-techo also records the
pregnancy weight of mothers. Although we did not use
these data, it would be interesting to study changes in
weight during pregnancy in relation to indices of obesity in
adulthood in the future.
In conclusion, our data suggest that rapid weight gain in
the early post-natal period and infancy positively correlates
to adult body fat mass in young Japanese women. This
finding should be confirmed in larger epidemiologic
Acknowledgments This study was supported in part by a
Grant-inAid for Scientific Research ( ) No.16500460 from the Japanese
Ministry of Education, Culture, Sports, Science and Technology.
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