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 > or = 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% CI, 1.1 to 2.6), maternal 25 < or = BMI < 30 kg/m2 (OR, 2.2; 95% CI, 1.3 to 3.7) or > or = 30 kg/m2 (OR, 5.1; 95% CI, 2.9 to 9.1), maternal weight gain during pregnancy > or = 20.43 kg (OR, 1.7; 95% CI, 1.0 to 2.9), and birth weight > or = 4000 g (OR, 2.0; 95% CI, 1.2 to 3.4) were associated with an increased risk of early onset overweight. These risk factors, except maternal weight gain, exerted similar effects on late onset overweight. In addition, maternal smoking (OR, 1.6; 95% CI, 0.8 to 3.1) and birth order > or = 3 (OR, 2.3; 95% CI, 1.0 to 5.2) were associated with an increased risk of late onset overweight only. Breastfeeding > or = 4 months was associated with a decreased risk of both early (OR, 0.7; 95% CI, 0.3 to 1.3) and late onset overweight (OR, 0.7; 95% CI, 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.