Low Birth Weight, Weight Gain Trajectory in Infancy, Adiposity Rebound, and Risk of Adult Coronary Heart Disease.

Blond et al reported the associations between weight gain trajectories from birth to 12 months and risk of adult coronary heart disease (CHD) in Danish persons born between 1959 and 1961, in relation to birth weight influenced by prenatal exposures affecting fetal growth.1Blond K. Jensen B.W. Petersen J. Baker J.L. Bjerregaard L.G. Trajectories of infant weight gain from birth to 12 months and adult-onset coronary heart disease.J Pediatr. 2021; 246: 123-130Abstract Full Text Full Text PDF Scopus (1) Google Scholar The authors concluded that the future risk of CHD is determined by having a low birth weight, regardless of rapid weight gain patterns during infancy. CHD was more strongly related to low birth weight and lost its significant correlation with the rate of weight gain in the first year of life.1Blond K. Jensen B.W. Petersen J. Baker J.L. Bjerregaard L.G. Trajectories of infant weight gain from birth to 12 months and adult-onset coronary heart disease.J Pediatr. 2021; 246: 123-130Abstract Full Text Full Text PDF Scopus (1) Google Scholar This is an unexpected finding because most previous studies have shown an association between rapid growth in infancy and future cardiometabolic risk.2Zheng M. Lamb K.E. Grimes C. Laws R. Bolton K. Ong K.K. et al.Rapid weight gain during infancy and subsequent adiposity: a systematic review and meta-analysis of evidence.Obes Rev. 2018; 19: 321-332Crossref PubMed Scopus (210) Google Scholar,3Woo J.G. Infant growth and long-term cardiometabolic health: a review of recent findings.Nutr Rep. 2019; 8: 29-41Crossref Scopus (25) Google Scholar The authors do mention that it may be necessary to confirm the finding in more recent birth cohorts born during the obesity epidemic.1Blond K. Jensen B.W. Petersen J. Baker J.L. Bjerregaard L.G. Trajectories of infant weight gain from birth to 12 months and adult-onset coronary heart disease.J Pediatr. 2021; 246: 123-130Abstract Full Text Full Text PDF Scopus (1) Google Scholar Adiposity rebound is defined as the second rise in body mass index that usually occurs in early childhood, and early adiposity rebound, reflecting a pattern of rapid childhood growth,4Belsky D.W. Moffitt T.E. Houts R. Bennett G.G. Biddle A.K. Blumenthal J.A. et al.Polygenic risk, rapid childhood growth, and the development of obesity: evidence from a 4-decade longitudinal study.Arch Pediatr Adolesc Med. 2012; 166: 515-521Crossref PubMed Scopus (107) Google Scholar is known to increase the risk of future cardiovascular diseases.5Rolland-Cachera M.F. Deheeger M. Maillot M. Bellisle F. Early adiposity rebound: causes and consequences for obesity in children and adults.Int J Obes (Lond). 2006; 30: 11-17Crossref PubMed Scopus (355) Google Scholar,6Koyama S. Ichikawa G. Kojima M. Shimura N. Sairenchi T. Arisaka O. Adiposity rebound and the development of metabolic syndrome.Pediatrics. 2014; 133: e114-e119Crossref PubMed Scopus (108) Google Scholar In our studies, we have found no association between body weight gain from birth to 12 months and the timing of adiposity rebound in early childhood, suggesting that infantile weight gain is rarely related to childhood obesity or to cardiometabolic risk through adiposity rebound.7Koyama S. Sairenchi T. Shimura N. Arisaka O. Association between timing of adiposity rebound and body weight gain during infancy.J Pediatr. 2015; 166: 309-312Abstract Full Text Full Text PDF PubMed Scopus (14) Google Scholar,8Arisaka O. Ichikawa G. Koyama S. Sairenchi T. Is childhood cardiometabolic status a risk factor from early infancy or toddler age?.J Pediatr. 2017; 188: 314-315Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar The mechanism of adiposity rebound is not yet fully understood, but low birth weight has been identified as a factor that accelerates the timing of adiposity rebound.9Cissé A.H. Lioret S. de Lauzon-Guillain B. Forhan A. Ong K.K. Charles M.A. et al.Association between perinatal factors, genetic susceptibility to obesity and age at adiposity rebound in children of the EDEN mother-child cohort.Int J Obes (Lond). 2021; 45: 1802-1810Crossref PubMed Scopus (15) Google Scholar Although epidemiologic, clinical, and basic science research have shown that intrauterine growth retardation is associated with an increased risk of CHD through fetal programming,10Faienza M.F. Urbano F. Lassandro G. Valente F. D’Amato G. Portincasa P. et al.The cardiovascular disease (CVD) risk continuum from prenatal life to adulthood: a literature review.Int J Environ Res Public Health. 2022; 19: 8282Crossref PubMed Scopus (6) Google Scholar the mechanism by which low birth weight infants have an increased the risk of CHD via adiposity rebound also need to be elucidated. ReplyThe Journal of PediatricsVol. 255PreviewWe thank Dr Arisaka et al for raising the question as to whether adiposity rebound may mediate the association we found between low birth weight and the risk of coronary heart disease (CHD). They note that a low birth weight has been identified as a factor that accelerates the timing of adiposity rebound.1 This interesting observation has been reported previously, but not consistently.2-4 In agreement with this potential role of adiposity rebound as a mediator, previous studies using the Helsinki birth cohorts showed that a low ponderal index at birth was associated with earlier adiposity rebound. 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