The Relation of Adiposity Rebound to Subsequent BMI in a Large Electronic Health Record Database.

Objective: The beginning of postinfancy increase in BMI has been termed the adiposity rebound, and an early rebound increases the risk for obesity in adolescence and adulthood. We examined whether the relation of the age at BMI rebound (age _rebound ) to subsequent BMI is independent of childhood BMI. Design: From the electronic health records of 2.8 million children, we selected 17,077 children examined at least once each year between ages 2 and <8 years, and who were reexamined between age 10 and <16 years. The mean age at the last visit was 12 years (SD = 1). We identified age _rebound for each child using lowess, a smoothing technique. Results: Children who had an age _rebound <3 years were, on average, 6.8 kg/m ² heavier after age 10 years than were children with an age _rebound >7 years. However, BMI after age 10 years was more strongly associated with BMI at the rebound (BMI _rebound ) than with age _rebound ( r  = 0.63 vs. -0.49). Although the relation of age _rebound to BMI at the last visit was mostly independent of the BMI _rebound , adjustment for age-5 BMI reduced the association's magnitude by about 55%. Conclusions: Both age _rebound and the BMI _rebound are independently related to BMI and obesity after age 10 years. However, a child's BMI _rebound and at ages 5 and 7 years accounts for more of the variability in BMI levels after age 10 years than does age _rebound .