The Associations of Month of Birth With Body Mass Index, Waist Circumference, and Leg Length: Findings From the China Kadoorie Biobank of 0.5 Million Adults

BACKGROUND Season of birth (SoB) has been linked with various health outcomes. This study aimed to examine the associations between month of birth (MoB) and adult measures of leg length (LL), body mass index (BMI), and waist circumference (WC). METHODS We analysed survey data from 10 geographically diverse areas of China obtained through the China Kadoorie Biobank. Analysis included 487 529 adults with BMI ≥ 18.5 kg/m(2). A general linear model was used to examine the associations between MoB and adult measures of LL, BMI, and WC, adjusted for survey site, sex, age, education level, smoking habit, alcohol consumption, physical activity level, sedentary leisure time, height (only for WC and LL), and hip circumference (only for LL). RESULTS MoB was independently associated with both BMI and WC. Birth months in which participants had higher measures of adiposity were March-July for BMI and March-June for WC. The peak differences were 0.14 kg/m(2) for BMI and 0.47 cm for WC. The association between MoB and LL depended on survey site. Participants who were born in February-August in four sites (Harbin, Henan, Gansu, and Hunan) had the shortest LL (all P < 0.01). The peak difference in mean LL was 0.21 cm. No statistically significant association between MoB and LL was noted in the other sites (Qingdao, Suzhou, Sichuan, Zhejiang, Liuzhou, and Haikou). CONCLUSIONS These findings suggest that MoB is associated with variations in adult adiposity measures and LL among Chinese adults. Low exposure to ultraviolet B radiation and subsequent reduced levels of vitamin D during the late second and early third trimesters may be involved in these phenomena.