Developmental trajectories of overweight during childhood: Role of early life factors

Objective: Our goal was to identify developmental trajectories of overweight in children and to assess early life influences on these trajectories. Research Methods and Procedures: Participants consisted of 1739 white, black, and Hispanic children who were younger than 2 years at the first survey and were followed up to 12 years of age. Repeated measures of overweight, defined as BMI >= 95th percentile, were used to identify overweight trajectories with a latent growth mixture modeling approach. Results: Three distinct overweight trajectories were identified: 1) early onset overweight (10.9%), 2) late onset overweight (5.2%), and 3) never overweight (83.9%). After adjustment for multiple potential risk factors, male gender [odds ratio (OR), 1.5; 95% confidence interval (CI), 1.0 to 2.2], black ethnicity (OR, 1.7; 95% Cl, 1.1 to 2.6), maternal 25 <= BMI < 30 kg/m(2) (OR, 2.2; 95% Cl, 1.3 to 3.7) or :30 kg/m(2) (OR, 5.1; 95% CI, 2.9 to 9.1), maternal weight gain during pregnancy :>= 20.43 kg (OR, 1.7; 95% Cl, 1.0 to 2.9) and birth weight >= 4000 g (OR, 2.0; 95% Cl, 1.2 to 3.4 were associated with an increased risk of early onset over-weight. These risk factors, except maternal weight gain, exerted similar effects on late onset overweight. In addition, maternal smoking (OR, 1.6; 95% Cl, 0.8 to 3.1) and birth order :3 (OR, 2.3; 95% Cl, 1.0 to 5.2) were associated with an increased risk of late onset overweight only. Breastfeeding >= 4 months was associated with a decreased risk of both early (OR, 0.7; 95% Cl, 0.3 to 1.3) and late onset overweight (OR, 0.7; 95% Cl, 0.3 to 1.7). Discussion: Two trajectories of overweight and one never overweight group were identified. Early life predictors may have a significant influence on the developmental trajectories of overweight in children.