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Background: Accelerated weight and height gain in infancy have been associated with premature adrenarche. However, the exact tempo of these events remains undefined. Thus, our goal was to assess the relationship between early BMI and height growth in different periods before 7 years of age and plasma DHEAS levels at 7 years of age., Methods: This is a longitudinal follow-up of participants of the Growth and Obesity Chilean Cohort Study (GOCS) that represents Chilean children from low- to middle-income families. The subjects were 972 children (48% girls) with birth weights of 2,500-4,500 g for whom serial weight and height measurements from birth until 7 years were available. At 7 years of age, we also measured DHEAS, IGF-I, leptin, insulin, and other metabolic markers in serum. The main outcome of interest was plasma DHEAS concentrations at 7 years of age., Results: At 7 years of age, children with DHEAS >75th percentile of the sample were taller and fatter and presented higher HOMA-IR and IGF-I than their counterparts (p < 0.05). Children with higher DHEAS were heavier at 4 years of age and beyond compared to their counterparts (higher BMI [BMI SDS at 4 years: 1.16, 95% CI 1.02-1.29 vs. 0.83, 95% CI 0.76-0.91, p < 0.001]) and taller at 7 years of age (height SDS at 7 years: 0.19, 95% CI -0.08 to 0.31 vs. -0.001, 95% CI -0.06 to 0.06, p < 0.005)., Conclusions: We observed weight and BMI from 2 to 4 years, and height gains from 4 to 7 years were associated with higher DHEAS levels at 7 years., (© 2016 S. Karger AG, Basel.)

Background/objective: In Chile, approximately one in three children under 6 years of age reported overweight/obese, while one in four children in elementary school suffer from obesity. There is a paucity of population-based information on the influence of childhood eating behavior on anthropometric measures related to obesity. To assess the association between eating behavior scores and Body Mass Index (BMI) z-scores in 7-10-year-old Chilean children., Subjects/methods: We conducted a cross-sectional study in 1058 children aged 7-10 (51% girls) from the 'Growth and Obesity Chilean Cohort Study' (GOCS). Direct measures of weight and height were used to compute BMI z-scores according to World Health Organization (WHO) curves. Children were classified as normal weight (-1<1 s.d.), overweight (1<2 s.d.) and obese (⩾2 s.d.). Eating behavior scores were measured through the Child Eating Behavior Questionnaire (CEBQ), previously adapted and validated for Chilean children. Multiple linear regressions were carried out using BMI z-score as the outcome and eating behavior scores as explanatory variables. All models were adjusted by age and gender., Results: BMI z-scores were positively associated with pro-intake scores in the subscales 'enjoyment of food', 'emotional overeating' and 'food responsiveness' (P<0.0001). Contrary to other studies, 'desire for drinks' scores were also associated with BMI z-scores (P<0.0001). In contrast, food-avoidant 'satiety responsiveness', 'slowness in eating' and 'food-fussiness' scores were negatively associated with BMI z-scores (P<0.0001)., Conclusion: We found a significant relationship between eating behavior scores and BMI z-scores in Chilean children, showing that BMI in 7-10-year-old Chilean children is positively associated with pro-intake eating behavior scores and negatively associated with anti-intake eating behavior scores. The identification of specific eating behaviors patterns related to obesity will provide important information for the implementation of prevention programs for this disease.

Objective: To assess the effect of pre-pregnancy body mass index (BMI), gestational weight gain (GWG), and other maternal factors on the timing of adiposity rebound (AR)., Methods: In this study, 594 mothers (mothers who do not have diabetes and not underweight) from the longitudinal Growth and Obesity Chilean Cohort Study self-reported their weights at the beginning and end of their pregnancies, and their heights were measured. Pre-pregnancy BMI was categorized as normal weight, overweight, or obesity, and GWG was assessed according to Institute of Medicine guidelines. For children, weight and height measurements from 0 to 3 years were retrieved from records, and they were measured from age 4 to 7 years. BMI curves from 0 to 7 years were used to estimate the age at AR, which was categorized as early (<5 years), intermediate (5-7 years), or late (>7 years). The associations between pre-pregnancy BMI and GWG and early AR were tested using logistic regression models., Results: In total, 33% of the mothers had excess pre-pregnancy weight, 31.2% exceeded Institute of Medicine recommendations, and 45% of children had early AR. The pre-pregnancy BMI and parity were associated with earlier AR (OR = 1.07, 95% CI = 1.02-1.11; OR = 0.86; 95% CI = 0.74-0.99, respectively), but GWG was unrelated., Conclusions: These results suggest that preventive strategies for promoting normal pre-pregnancy BMI, especially in women's first pregnancies, could delay the timing of AR, with protective metabolic effects on offspring., (© 2016 The Obesity Society.)

Addressing malnutrition in all its forms represents an integrated agenda addressing the root causes of malnutrition at all stages of the life course. The issue is not about choosing between addressing undernutrition in the poor versus overnutrition in the affluent. We must recognize that the interventions required to address stunting are different from those needed to reduce underweight and wasting. In most developing regions, there is a coexistence between underweight and stunting in infants and children, while in the adult population it may be overweight and stunting. Malnutrition in all its forms refers to both underweight and overweight. Underweight is defined by a low weight-for-age, a child is underweight because of wasting (low weight-for-height) or stunting (low length-for-age). Stunting refers to low height-for-age independent of their weight-for-age, some stunted children may have excess weight for their stature length. Overweight is excess weight-for-length/-height or high-BMI-for-age. The prevention of nutrition-related chronic diseases is a life-long process that starts in fetal life and continues throughout infancy and later stages of life. It requires promoting healthy diets and active living at each stage. The agenda requires that we tackle malnutrition in all its forms., (© 2014 Nestec Ltd., Vevey/S. Karger AG, Basel.)

Background: It has been shown that excess weight gain during childhood is associated with a greater risk of obesity; this relationship may be mediated by growth in height., Aim: To quantify the associations between z scores for body mass index (BMIZ) and height for age (HAZ) from birth to 5 years of age and to assess how this association varies according to age and adiposity., Material and Methods: Weight and height were recorded at 11 occasions from birth on a cohort of 1089 Chilean five year-old children with a birth weight > 2500 g. BMI, BMIZ, HAZ and prevalence of obesity were calculated. We determined the cross-sectional association between BMIZ and HAZ for the total sample and by 3 BMI Z categories, using Pearson correlation. We determined the probability of obesity according to four HAZ categories., Results: Obesity increased continuously reaching approximately 16% at 5 years. Stunting was virtually nonexistent. No association between BMIZ and HAZ was observed at birth, while at 1 and 2 months, leaner infants had lower stature. No association between these parameters was observed between 6-24 months, while after 3 years, a clear relationship was observed., Conclusions: The probability of a preschool child of being obese is less than 10% with a HAZ is < 0. Nevertheless, children with heights above the median (even within the normal range) have an increased risk of obesity, especially after 3 y of age. Between 0-5 years, the relationship between weight and height varies by age and adiposity.

Because the results of the nutritional status released by Chilean institutions which collect anthropometric data on their population under control, show different increments in the prevalence of obesity between preschoolers and children in 1st grade, we decided to verify the real magnitude of this increase. This study is based on a longitudinal investigation which began in 2006 and included 1100, three-year old children, which we evaluated when they were 4, 5 and 6 y. The nutritional status was determined according to BMI Z and WHO References 2006/2007. The information was also used to determine the concordance between the anthropometric data collected on first graders by teachers from public schools in 2009 (JUNAEB data set) and the same children assessed in parallel by INTA (INTA data set). The sample included 474, six-year olds. No differences were found between the average BMI Z and HAZ of the two data sets, and the degree of concordance between the BMI Z's was good (rho = 0.73), however there were differences in the nutritional status, since the prevalence of low weight was significantly greater when assessed with JUNAEB's data (9.5% vs. 3.6% ), while that for obesity was lower with INTA's data, 17.5% vs. 19.2% (not significantly different). At 4 and 5 y, obesity prevalence of the children was 13.3% and 15.7% respectively (INTA's data). Considering the observed nutritional trajectory, it is likely that the rise in obesity between 4 and 6 y of age, was 4 percentage points and not 6, as was determined with INTA's data.

Background: Cardiovascular disease (CVD) risks are increasingly being diagnosed in children and track into adulthood. Growth is associated with CVD risk in adulthood; however, its contribution to CVD risks in children facing the obesity epidemic is unclear., Objective: The objective was to assess relations between growth from age 0 to 4 y and CVD status at 4 y in 323 Chilean children with normal birth weight., Design: From health records we obtained weight and height every 6 mo from age 0 to 3 y and calculated body mass index (BMI; weight/height(2)). At age 4 y, we measured height, waist circumference, insulin, glucose, and plasma lipids; infant feeding information was provided by the mothers. Outcomes were metabolic score (waist-to-height ratio + glucose + insulin + triglycerides - HDL-cholesterol z scores/5), total cholesterol (TC):HDL cholesterol, and homeostasis model of assessment of insulin resistance., Results: At 4 y, the prevalence of obesity was 13%. Changes in BMI, particularly from 6 to 24 mo, predicted a higher metabolic score (standardized regression coefficient = 0.29; 95% CI: 0.16, 0.42) but were unrelated to homeostasis model of assessment of insulin resistance and TC:HDL cholesterol. Height changes were not associated with CVD risks at the age of 4 y. Mode of infant feeding was unrelated to CVD status at 4 y; however, in children who were exclusively breastfed at 4 mo, an increase in BMI from 0 to 6 mo was positively associated with TC:HDL cholesterol at 4 y (standardized regression coefficient = 0.24; 95% CI: -0.02, 0.50), whereas in children who were partially or nonbreastfed at 4 mo, it was negatively associated with TC:HDL cholesterol at 4 y (standardized regression coefficient = -0.30; 95% CI: -0.52, -0.08)., Conclusion: In children with normal birth weight and a high prevalence of obesity at 4 y, changes in BMI after 6 mo predicted a higher overall CVD risk at 4 y.

Background: BMI and waist circumference (WC) are used to screen for cardio-metabolic risk; however it is unclear how well these indices perform in populations subject to childhood stunting., Objectives: To evaluate BMI and WC as indicators of cardio-metabolic risk and to determine optimal cut-off points among 1,325 Guatemalan adults (44 % stunted: 162 cm men)., Methods: Cardio-metabolic risk factors were systolic/diastolic blood pressure 85 mmHg, glucose 5 mmol/l, TAG 7 mmol/l, ratio of total cholesterol to HDL-cholesterol 0, and the presence of two or more and three or more of the preceding risk factors. Receiver operating characteristic (ROC) curve analysis was used., Results: Areas under the ROC curve were in the range of 005978 for WC among men and 006472 among women, respectively. Optimal cut-off points for BMI were 242651 kg/m2 stunted; 242656 kg/m2 among women (262769 kg/m2 non-stunted). Optimal cut-off points for WC were 879134 cm stunted; 889333 cm among women (909486 cm non-stunted)., Conclusion: Optimal cut-off points for BMI were slightly higher among women than men with no meaningful differences by stature. Optimal cut-off points for WC were several centimetres lower for stunted compared with non-stunted men, and both were substantially lower than the current recommendations among Western populations. Cut-off points derived from Western populations may not be appropriate for developing countries with a high prevalence of stunting.

Background:Early adiposity rebound (AR <5 years) has been consistently associated with increased obesity risk, but its relationship with metabolic markers is less clear; in addition, the biologic mechanisms involved in these associations have not been established.Objective:The objective of this study was to assess the association between timing of AR and metabolic status at age 7 years, evaluating the potential role of adiposity, adipose functionality and skeletal maturation in this association.Design:We estimated the age of AR from the body mass index (BMI) trajectories from 0 to 7 years in 910 children from the Growth and Obesity Chilean Cohort Study (GOCS). At 7 years, we measured waist circumference (WC) and blood glucose, insulin, triglycerides and high-density lipoprotein-cholesterol levels and constructed a metabolic risk score. We also measured percent fat mass (adiposity), plasma concentrations of leptin and adiponectin (adipose functionality) and bone age using wrist ultrasound (skeletal maturation).Results:We found that 44% of the children had an AR <5 years. Earlier AR was associated with larger WC (β: 5.10 (95% confidence interval (CI): 4.29-5.91)), higher glucose (β: 1.02 (1.00-1.03)), insulin resistance (β Homeostatic Model Assessment: 1.06 (1.03-1.09)), triglycerides (β: 10.37 (4.01-6.73)) and adverse metabolic score (β: 0.30 (0.02-0.37)). Associations decreased significantly if adiposity was added to the models (i.e. β WC: 0.85 (0.33-1.38)) and, to a lesser extent, when adipokines (i.e. β WC: 0.73 (0.14-1.32)) and skeletal maturation (i.e. β WC: 0.65 (0.10-1.20)) were added.Conclusion:In GOCS children, AR at a younger age predicts higher metabolic risk at 7 years; these associations are mostly explained by increased adiposity, but adipose dysfunction and accelerated skeletal maturation also have a role. [ABSTRACT FROM AUTHOR]