Relative validation of 24-h urinary hippuric acid excretion as a biomarker for dietary flavonoid intake from fruit and vegetables in healthy adolescents.

PURPOSE: A biomarker for dietary flavonoid intake from fruit and vegetables (FlavFV) is needed to elucidate the relevance of flavonoids from these sources for the prevention of chronic diseases. Urinary hippuric acid (HA)-a major metabolite of flavonoids-is promising in this respect as it was shown to satisfyingly indicate fruit and vegetable consumption in different age groups. Therefore, we validated urinary HA as a biomarker for intake of FlavFV. METHODS: Analyses included data from 287 healthy adolescents of the DONALD Study (aged 9-16 years) for whom a minimum of two pairs of HA measurements from 24-h urine samples (test method) and FlavFV intake estimated from 3-day weighed dietary records (reference method) existed. Agreement between both methods was assessed by Spearman correlation and cross-classification analyses. Possible confounders of the association were identified by linear regression models. Analyses were performed using a split-sample approach allowing for consecutive exploration (n = 192) and confirmation (n = 95) of results. RESULTS: Agreement between urinary HA excretion and FlavFV intake was moderate according to correlation analysis in the exploratory sample (r unadjusted = 0.47, P < 0.0001). Yet, 79 % of the subjects were classified into same/adjacent quartiles, and only 5 % were misclassified into opposite quartiles. These findings were corroborated by analyses in the confirmatory sample (r unadjusted = 0.64; 88 % in same/adjacent vs. 4 % in opposite quartiles). Body surface area (BSA) was the only relevant covariate in the exploratory sample, and its adjustment improved cross-classification estimates in both subsamples. CONCLUSIONS: BSA-adjusted 24-h urinary HA excretion represents a suitable biomarker of habitual FlavFV intake in healthy adolescents.

Age and time trends in eating frequency and duration of nightly fasting of German children and adolescents.

PURPOSE: To describe age and time trends in eating occasion frequency (EOF), meal frequency (MF), snack frequency (SF) and duration of nightly fasting (DNF) in German children and adolescents. METHODS: 9757 3-day dietary records of 1246 3-18-year-old participants of the open DONALD cohort study, collected 1985-2014, were analyzed for age and time trends using polynomial mixed-effects regression models. Eating occasions were either assigned to meals or snacks (>10 or ≤10 % of daily total energy intake per eating occasion). DNF was defined as the longest time span without energy intake within one night. RESULTS: EOF, MF and SF decreased with age (EOF: linear, quadratic, cubic trend p < 0.0001; MF: linear trend p < 0.0001; SF: linear, quadratic trend p < 0.0001). Time trend analyses revealed a wavelike time course for EOF (linear trend p = 0.0580, quadratic trend = 0.0039, cubic trend = 0.0015) and SF (linear trend p = 0.0055, quadratic trend p = 0.0005, cubic trend p = 0.0003). MF slightly increased until 2000 and decreased thereafter (linear trend p = 0.0012, quadratic trend p = 0.0047). Effect sizes of time trends in EOF, MF and SF were small. Boys' and girls' DNF decreased with age (in both: linear, quadratic, cubic trend p < 0.0001) and increased over the study period (boys: linear trend p = 0.0011, interaction of age and time p < 0.0001; girls: linear trend p = 0.0167). CONCLUSION: EOF, MF and SF were higher in children than in adolescents, but, in contrast to other studies remained fairly stable over the study period. Decreasing DNF with age could reflect decreasing sleep durations. Additionally, DNF increased over the study period, probably due to an increase in breakfast skipping.

Commercial complementary food consumption is prospectively associated with added sugar intake in childhood.

Given that commercial complementary food (CF) can contain high levels of added sugar, a high consumption may predispose to a preference for sweet taste later in life. This study examined cross-sectional associations between commercial CF consumption and added sugar intake in infancy as well as its prospective relation to added sugar intake in pre-school and primary-school age children. In all, 288 children of the Dortmund Nutritional and Anthropometric Longitudinally Designed Study with 3-d weighed dietary records at 0·5 and 0·75 (infancy), 3 and 4 (pre-school age) and 6 and 7 years of age (primary-school age) were included in this analysis. Individual commercial CF consumption as percentage of total commercial CF (%cCF) was averaged at 0·5 and 0·75 years. Individual total added sugar intake (g/d, energy percentage/d) was averaged for all three age groups. Multivariable logistic and linear regression models were used to analyse associations between %cCF and added sugar intake. In infancy, a higher %cCF was associated with odds for high added sugar intake from CF and for high total added sugar intake (>75th percentile, P<0·033). Prospectively, a higher %cCF was related to higher added sugar intake in both pre-school (P<0·041) and primary-school age children (P<0·039), although these associations were attenuated in models adjusting for added sugar intake in infancy. A higher %cCF in infancy may predispose to higher added sugar intake in later childhood by virtue of its added sugar content. Therefore, offering home-made CF or carefully chosen commercial CF without added sugar might be one strategy to reduce sugar intake in infancy and later on.

Relevance of fruits, vegetables and flavonoids from fruits and vegetables during early life, mid-childhood and adolescence for levels of insulin-like growth factor (IGF-1) and its binding proteins IGFBP-2 and IGFBP-3 in young adulthood.

The growth hormone (GH) insulin-like growth factor (IGF) axis has been linked to insulin metabolism and cancer risk. Experimental evidence indicates that the GH-IGF axis itself can be influenced by dietary flavonoids. As fruit and vegetable (FV) intake is a major source of flavonoid consumption, FV's beneficial health effects may be explained via flavonoids' influence on the GH-IGF axis, but observational evidence is currently rare. We used data from Dortmund Nutritional and Anthropometric Longitudinally Designed Study participants to analyse prospective associations between FV, fruit intake and flavonoid intake from FV (FlavFV) with IGF-1 and its binding proteins IGFBP-2 and IGFBP-3. Subjects needed to provide a fasting blood sample in adulthood (18-39 years) and at least two 3-d weighed dietary records in early life (0·5-2 years, n 191), mid-childhood (3-7 years, n 265) or adolescence (girls: 9-15 years, boys: 10-16 years, n 261). Additional analyses were conducted among those providing at least three 24-h urine samples in adolescence (n 236) to address the predictor urinary hippuric acid (HA), a biomarker of polyphenol intake. Higher fruit intake in mid-childhood and adolescence was related to higher IGFBP-2 in adulthood (P=0·03 and P=0·045). Comparable trends (P=0·045-0·09) were discernable for FV intake (but not FlavFV) in all three time windows. Similarly, higher adolescent HA excretion tended to be related (P=0·06) to higher adult IGFBP-2 levels. Regarding IGFBP-3, a marginal (P=0·08) positive association was observed with FlavFV in mid-childhood only. None of the investigated dietary factors was related to IGF-1. In conclusion, higher fruit and FV intakes during growth may be relevant for adult IGFBP-2, but probably not for IGFBP-3 or IGF-1.

Increased intake of carbohydrates from sources with a higher glycemic index and lower consumption of whole grains during puberty are prospectively associated with higher IL-6 concentrations in younger adulthood among healthy individuals.

Chronic low-grade inflammation represents a likely intermediary in the relation between carbohydrate nutrition and both type 2 diabetes and cardiovascular disease. This study assessed the prospective association between carbohydrate quantity and quality [dietary glycemic index (GI), glycemic load (GL), and added sugar, fiber, and whole-grain intake] during puberty, a potentially critical period for later disease, and low-grade inflammation in younger adulthood. The analysis was based on 205 participants (113 girls and 92 boys) from the DONALD (Dortmund Nutritional and Anthropometric Longitudinally Designed) study with at least 2 3-d weighed dietary records during puberty (girls: 9-14 y, boys: 10-15 y) and blood samples in younger adulthood (18-36 y). Multivariable linear regression models were used to analyze the associations between carbohydrate nutrition and circulating concentrations of pro- and anti-inflammatory immune mediators [high-sensitivity C-reactive protein (hs-CRP), interleukin (IL) 6, IL-18, and adiponectin]. A higher intake of carbohydrates during puberty (P-trend = 0.005), particularly from higher-GI food sources (P-trend = 0.01), was prospectively related to higher concentrations of IL-6 in younger adulthood, independently of baseline BMI and early life, socioeconomic, and other nutritional factors. Furthermore, a higher dietary GL (P-trend = 0.002) and a lower intake of whole grains (P-trend = 0.01) were independently associated with higher IL-6 concentrations in adults. Dietary GI and added sugar and fiber intakes were not independently associated with IL-6 (P-trend ≥ 0.09). Carbohydrate nutrition during puberty was not independently related to hs-CRP, IL-18, and adiponectin concentrations (all P-trend > 0.1). During puberty, a higher intake of carbohydrates from higher-GI food sources and lower whole-grain consumption prospectively predict greater IL-6 concentrations in young adulthood. These data support the hypothesis that diet during puberty influences later inflammation and metabolic dysfunction.

Habitually higher dietary glycemic index during puberty is prospectively related to increased risk markers of type 2 diabetes in younger adulthood.

OBJECTIVE: Carbohydrate nutrition during periods of physiological insulin resistance such as puberty may affect future risk of type 2 diabetes. This study examined whether the amount or the quality (dietary glycemic index [GI], glycemic load [GL], and added sugar, fiber, and whole-grain intake) of carbohydrates during puberty is associated with risk markers of type 2 diabetes in younger adulthood. RESEARCH DESIGN AND METHODS: The analysis was based on 226 participants (121 girls and 105 boys) from the Dortmund Nutritional and Anthropometric Longitudinally Designed Study (DONALD) with an average of five 3-day weighed dietary records (range 2-6) during puberty (girls, age 9-14 years; boys, age 10-15 years) and fasting blood samples in younger adulthood (age 18-36 years) (average duration of follow-up 12.6 years). Multivariable linear regression was used to analyze the associations between carbohydrate nutrition and homeostasis model assessment-insulin resistance (HOMA-IR) as well as the liver enzymes alanine aminotransferase (ALT) and γ-glutamyltransferase (GGT) (n = 214). RESULTS: A higher dietary GI was prospectively related to greater values of HOMA-IR (P(trend) = 0.03), ALT (P(trend) = 0.02), and GGT (P(trend) = 0.04). After adjustment for sex, adult age, baseline BMI, and early life and socioeconomic factors as well as protein and fiber intake, predicted mean HOMA-IR values in energy-adjusted tertiles of GI were 2.37 (95% CI 2.16-2.60), 2.47 (2.26-2.71), and 2.59 (2.35-2.85). The amount of carbohydrates, GL, and added sugar, fiber, and whole-grain intake were not related to the analyzed markers. CONCLUSIONS: Our data indicate that a habitually higher dietary GI during puberty may adversely affect risk markers of type 2 diabetes in younger adulthood.

Anthocyanins in the diet of children and adolescents: intake, sources and trends.

PURPOSE: Anthocyanin intake estimations in large cohorts include almost exclusively adults. For the purpose of early dietary prevention, however, it is of great interest to estimate anthocyanin intake of children and adolescents. METHODS: Anthocyanidin content values from the USDA Database (excluding the values for bananas and nuts) were assigned to foods consumed by 4-18-year-old participants of the DONALD Study. Between 1990 and 2009, 920 participants provided 6,707 3-day weighed dietary records. Intake of anthocyanins (expressed as their aglycones anthocyanidins) and their food sources were determined. For investigating age and time trends in anthocyanidin density (mg/MJ), a polynomial mixed regression model was built. RESULTS: We found the estimated median anthocyanidin intake to be around 6 mg/day, strawberries representing the main source. Anthocyanidin density of the diet was about 0.2 mg/MJ higher in girls than in boys, decreased with age, decreased over time in the first half of the study period and increased over time thereafter. CONCLUSIONS: Anthocyanin intake in the young is characterised by differences in anthocyanidin density of the diet between girls and boys and by decreasing density from young childhood to adolescence. Observations in this German study population should be extended by further studies in other countries.

Liking of anthocyanin-rich juices by children and adolescents.

There is evidence that a diet rich in plant foods is protective against cardiovascular disease and cancer, partly attributable to secondary plant metabolites such as anthocyanins, a colourful group of flavonoids. As at present children and adolescents do not consume the recommended amounts of fruits and vegetables, one possible way of increasing intake, and particularly intake of anthocyanins, may be an anthocyanin-rich juice, since fruit juice is popular with young Germans. We produced eight different fruit products (six juices, two smoothies), and conducted hedonic tests with participants from the DONALD Study. Paired comparisons showed that most subjects preferred apple to apple-bilberry juice, but grape vs. grape-bilberry juice was liked equally frequently. Rated on a hedonic scale the grape-bilberry mixture was preferred to apple-bilberry, both as juice and as smoothie. With regard to viscosity, juices were preferred to smoothies, both as grape-bilberry and as apple-bilberry. Internal Preference Mapping revealed however consumer subgroups with different preferences, raising the question which product should be promoted in order to reach a large target group. The product richest in anthocyanins, grape-bilberry juice, was accepted very well and may therefore be suitable for promotion to children, although the high sugar content of this juice must be taken into account.

Longitudinal associations between reported sleep duration in early childhood and the development of body mass index, fat mass index and fat free mass index until age 7.

OBJECTIVE: Epidemiological studies in children and adolescents have revealed short sleep duration as a risk factor for weight gain. However, only few studies have addressed sleep in early childhood. Our aim was to determine whether sleep in the second year of life is associated with the development of body composition throughout childhood. METHODS: Analysis included 481 DONALD participants with parental reported data on sleep duration and annually measured body composition until age 7. Using median splits of sleeping time at 1.5 and 2 years we defined sleep duration categories: consistently short (CS, n = 122), inconsistent (I, n = 143) and consistently long (CL, n = 216). Polynomial mixed effects regression models were used to analyze differences in the trajectories of body mass index (BMI, kg/m(2)), fat mass index (FMI, kg/m(2)) and fat free mass index (FFMI, kg/m(2)) from ages 2-7 years between the sleep duration categories. RESULTS: Compared to CL-children, CS-sleepers differed in their FMI development with respect to linear, quadratic and cubic trend (all p < 0.04), resulting in progressively higher FMI levels until age 7 independently of early life or socioeconomic factors. Trajectories of BMI and FFMI did not differ between the sleep duration categories. CONCLUSION: Consistently short sleep duration in the critical window of early childhood appears to exert a moderate but sustained adverse effect on the development of fat mass - but not fat free mass - until age 7.

Anthocyanins in the diet of infants and toddlers: intake, sources and trends.

PURPOSE: Anthocyanins, a colourful group of flavonoids in many fruits and vegetables, are proposed to provide positive impact on human health. However, intake estimations have almost exclusively been conducted in adult populations. As infants and toddlers are a promising age group for health promotion, we examined their anthocyanin intake (as anthocyanidins), food sources and trends of age and time in anthocyanidin density. METHODS: Anthocyanidin content values from the USDA Database were assigned to foods consumed in 4,617 3-day weighed dietary records from 1990 to 2009 by 942 3-36-month-old subjects of the DONALD Study. As we assume that anthocyanidins found in bananas do not originate from anthocyanins, the anthocyanidin value for bananas was excluded from our analysis. To investigate age and time trends in anthocyanidin density, polynomial mixed regression models were used. RESULTS: Median anthocyanidin intake was zero in young infants and around 4 mg/day in older infants and toddlers, strawberries and pomaceous fruit representing the main sources. Anthocyanidin density increased from 6 to 18 months of age, followed by a slight decrease till 36 months of age. During the 20-year study period, a decrease in density in infants was observed, but a slight increase in toddlers. CONCLUSIONS: Anthocyanidin density in the diet seems to increase notably from infancy to toddlerhood and to have decreased in the youngest over the last 20 years. These first observations in a German population of infants and toddlers need to be extended by further studies examining anthocyanin intake in these age groups in other countries.

Body composition trajectories into adolescence according to age at pubertal growth spurt.

OBJECTIVE: To investigate whether the development of body composition into adolescence differs among children with an early, average, or late pubertal growth spurt (age at take-off [ATO]). METHODS: Mixed-effect polynomial models were applied to serial anthropometric measurements spanning from 4 years before to 4 years after ATO in 215 DONALD participants. Sex-specific trajectories of fat mass index (FMI, FM/m(2) ), fat-free mass index (FFMI, FFM/m(2) ), and their z-scores were compared among those with an early, average, or late ATO. RESULTS: Compared with girls with a late ATO (reference group), those with an early or average ATO experienced a significant increase in FFMI z-scores [ß (standard error) for linear trends in early and average ATO group: +0.15 (0.05) FFMI z-scores/year (P = 0.001) and +0.11 (0.04) FFMI z-scores/year (P = 0.005), respectively, adjusted for early life factors]. Similar differences were observed in boys [adjusted ß (standard error): +0.20 (0.06) FFMI z-scores/year (P = 0.0004) and +0.07 (0.05) FFMI z-scores/year (P = 0.1), respectively]. Graphical illustration of the predicted trajectories revealed that differences in relative FFMI emerged from ATO onward. For FMI, comparison with late maturers showed a more pronounced quadratic trend (kg/m(2) /years(2) ) (P = 0.01) among early-maturing girls and a reduced linear trend in FMI z-scores/year (P = 0.04) among early-maturing boys. CONCLUSIONS: This longitudinal study suggests that children who experience an early pubertal growth spurt accrue progressively more fat-free mass during the first years of puberty than late-maturing peers of the same age. Higher levels of adiposity commonly observed in adults with early puberty onset are, thus, likely to develop subsequently in later adolescence.

Trends in dietary carbohydrate quality during puberty from 1988 to 2007: a cause for concern?

The extent to which the quality of dietary carbohydrates (CHO) changes throughout puberty is not known. We analysed trends in the quantity and quality of CHO intake among German adolescents by separately examining trends during puberty (pubertal trends) and trends in CHO intake from 1988 to 2007 (secular trends). Linear mixed-effects regression analyses were performed in 216 participants of the Dortmund Nutritional and Anthropometric Longitudinally Designed Study who had provided weighed 3 d dietary records at the onset of the pubertal growth spurt (defined by age at take-off) and over the subsequent 4 years. Over the course of puberty, CHO quality changed little: added sugar intake from beverages increased in girls (0·25 (se 0·12) % energy (% E)/year, P = 0·04) and added sugar intake from sweets decreased in both sexes (boys: - 0·22 (se 0·11) % E/year, P = 0·049; girls: - 0·20 (se 0·10) % E/year, P = 0·04). For both sexes, significant upward secular trends were observed for CHO (% E), glycaemic load (g/MJ) and added sugar intakes from sources other than sweets and soft drinks (% E), while absolute fibre intake (g/d) decreased (P ≤ 0·04). Concomitant increases in total added sugar intake (% E) and decreases in fibre and whole-grain densities (g/MJ) (P = 0·001-0·02) were confined to boys only. The quality of dietary CHO consumed by healthy German adolescents shows notable secular declines, but does not change markedly during puberty. Public health initiatives should be tailored to improve the overall quality of CHO nutrition.

Longitudinal associations between endogenous melatonin production and reported sleep duration from childhood to early adulthood.

BACKGROUND/AIMS: The study objective was to assess longitudinal associations between melatonin secretion and reported sleep duration from childhood to early adulthood. METHODS: In the frame of the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) Study, 24-hour melatonin secretion and average daily sleep duration were determined once during childhood (4-< 11 years), adolescence (11-<16 years) and early adulthood (16-19 years) in 52 participants (23 males/29 females) aged 4-19 years. The associations between (1) melatonin secretion and sleep duration in childhood (cross-sectional); (2) melatonin secretion in childhood and sleep duration in early adulthood (prospective), and (3) changes in melatonin secretion and concurrent changes in sleep duration from childhood to early adulthood (concurrent) were analyzed. RESULTS: Melatonin secretion was associated with sleep duration in childhood (cross-sectional, 3.5 min/day/10 µg 6-hydroxymelatonin sulfate (6-OHMS)/day, p = 0.009) and tended to predict sleep duration in early adulthood (prospective, 9.8 min/day/10 µg 6-OHMS/day, p = 0.09). An individual increase in melatonin secretion between childhood and early adulthood was associated with a concurrent increase in sleep duration (concurrent, 6.9 min/day/10 µg 6-OHMS/day, p = 0.046). CONCLUSION: Our observational data suggest that pineal production of melatonin in childhood is correlated with alterations in sleep duration until early adulthood. Nevertheless, this observational evidence needs to be verified in clinical studies.

Relation of dietary glycemic index, glycemic load, and fiber and whole-grain intakes during puberty to the concurrent development of percent body fat and body mass index.

The authors prospectively examined whether change in dietary glycemic index (GI), glycemic load (GL), fiber intake, or whole-grain intake during puberty is associated with concurrent change in percentage of body fat (%BF) or body mass index (BMI; weight (kg)/height)(2). Linear mixed-effects regression analyses were performed in 215 participants from the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) Study (Dortmund, Germany) who possessed weighed 3-day dietary records and anthropometric data at puberty onset (defined by age at takeoff) and over the subsequent 4 years (1988-2007). Neither changes in dietary GI, GL, fiber intake, nor whole-grain intake were associated with concurrent changes in %BF throughout puberty (change in %BF: -0.03 (standard error (SE), 0.11) per standard deviation (SD) increase in GI (P = 0.8); -0.01 (SE, 0.11) per SD increase in GL (P = 0.9); 0.02 (SE, 0.14) per SD increase in fiber intake (P = 0.9); and 0.09 (SE, 0.13) per SD increase in whole-grain intake (P = 0.5)). Similarly, no concurrent associations were observed between these dietary factors and BMI SD scores. Associations of dietary GI with %BF and BMI SD score differed between overweight and normal-weight adolescents (for concurrent association, P for interaction was 0.03 for %BF and 0.08 for BMI SD score). Dietary GI, GL, and fiber and whole-grain intakes in healthy, free-living adolescents do not appear to be relevant to the development of %BF or BMI during puberty.

Effects of breastfeeding on trajectories of body fat and BMI throughout childhood.

OBJECTIVE: To investigate the effect of breastfeeding in healthy boys and girls on their trajectories of percent body fat (%BF) and BMI standard deviation scores (BMI-SDS) throughout childhood. METHODS AND PROCEDURES: Analyses of the DOrtmund Nutritional and Anthropometric Longitudinally Designed (DONALD) Study included data from 219 male and 215 female term participants, born between 1984 and 1999, with repeated anthropometric measurements between 0.5 and 7 years and prospective data on duration of breastfeeding. RESULTS: Among boys with an overweight mother (OW-M), analyses adjusted for potential confounders revealed that not or shortly breastfed (< or =17 weeks) boys did not experience the age-dependent decrease in %BF seen in all children with normal weight mothers (NW-Ms). In contrast, boys fully breastfed for >17 weeks were protected against the adverse effect of maternal overweight (effect of long breastfeeding vs. no/short breastfeeding among boys with OW-Ms: 0.46%/year; s.e. 0.18; P = 0.01). There was also a suggestion of an interaction between maternal overweight and breastfeeding for the BMI-SDS trajectory (0.08 SDS/year; s.e. 0.04; P = 0.07). Among boys with NW-Ms mothers and the corresponding subgroups of girls, breastfeeding had little effect on the development of %BF or BMI-SDS throughout childhood. DISCUSSION: Our study suggests that breastfeeding could offset a potential programming effect for childhood adiposity among boys with OW-Ms, to whom advice to breast-feed should thus be specifically targeted.

Rapid growth among term children whose birth weight was appropriate for gestational age has a longer lasting effect on body fat percentage than on body mass index.

BACKGROUND: It is not clear whether and how rapid growth in infancy, a risk factor for later obesity, differentially affects growth and body-composition development throughout childhood in term children with an appropriate-for-gestational age (AGA) birth weight. OBJECTIVE: The aim was to examine the effect of rapid growth in infancy on body mass index SD score (BMI SDS) and body fat percentage (%BF) trajectories until age 7 y. DESIGN: This analysis included 206 (50.5% female) AGA term participants of the Dortmund Nutritional and Anthropometric Longitudinally Designed Study. Repeated anthropometric measurements were obtained between 0.5 and 7 y of age. RESULTS: Fifty-nine of the 206 children (28.6%) displayed rapid growth (an increase in SDS for weight of >0.67 between birth and age 2 y). From 6 mo of age, their growth trajectories diverged from normal growers, and by age 7 y they had a higher BMI, more fat mass, and a higher risk of overweight (odds ratio: 6.2; 95% CI: 2.4, 16.5; P = 0.0002). Multilevel model analyses showed that the differences in BMI were achieved within the first 2 y of life [beta (+/-SE) SDS: 1.22 +/- 0.13], after which they persisted at this level until the age of 7 y, whereas differences in %BF, which were also already discernible by age 2 y (1.52 +/- 0.34%), became progressively larger over the next 5 y (adjusted difference: 0.23 +/- 0.11%/y; P = 0.03). CONCLUSIONS: Rapid growth in infancy and early childhood results in an increased BMI and %BF throughout childhood and an increased risk of overweight at age 7 y among AGA children. Rapid growth in AGA children has a more pronounced effect on %BF than on BMI.