Children with normal timing of body mass index (BMI) peak who experienced an early adiposity rebound or without any BMI decline after infancy appear to have the highest risk of developing an adverse cardiometabolic profile in adolescence, according to study results published in the International Journal of Epidemiology.

Research has shown that childhood and adolescent obesity often continues into adulthood, which increases the risk of developing subsequent chronic disorders such as diabetes. Thus, understanding the early life predictors of obesity in adulthood is important for developing and testing preventive interventions. In this study, data was used from Project Viva, an ongoing birth cohort study from Boston with repeated measures of BMI, to assess both independent and combined relationships of BMI peak and rebound with adiposity, insulin resistance, and metabolic risk later in life.

The cohort included 1681 children with BMI data from birth to mid-childhood and after adjustment for potential confounders of age and magnitude at infancy, age at BMI peak was positively associated with higher adiposity during adolescence. Earlier adiposity rebound was also strongly associated with greater adiposity, insulin resistance, and metabolic risk independent of BMI peak. Children who had normal timing of their BMI peak plus early rebound had an adverse cardiometabolic profile characterized by higher fat mass index (β, 2.2 kg/m2; 95% CI, 1.6-2.9), trunk fat mass index (β, 1.1 kg/m2; 95% CI, 0.8-1.5), insulin resistance (β, 0.2 units; 95% CI, 0.04-0.4), and metabolic risk score (β, 0.4 units; 95% CI, 0.2-0.5) vs children with a normal BMI peak and rebound pattern. In addition, children who did not experience a BMI peak also had an adverse metabolic profile in adolescence and poorer cardiometabolic outcomes.

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“Assessing patterns of BMI peak and rebound that predict later cardiometabolic health outcomes may identify individuals to target for preventive interventions,” wrote the researchers.

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Aris IM, Rifas-Shiman SL, Li LJ, et al. Patterns of body mass index milestones in early life and cardiometabolic risk in early adolescence [published online January 8, 2019]. Int J Epidemiol. doi:10.1093/ije/dyy286

This article originally appeared on Endocrinology Advisor