Thin newborns are more insulin resistant at 10 years of age.

AIMS: To investigate the relation between ponderal index or birth weight and insulin resistance in late childhood. METHODS: An observational study of 92-term appropriate-for-gestational age infants was carried out. Weight and length were measured at birth and at 9 months and duration of breast feeding was noted at 9 months. Follow-up examinations at 10 years of age included measurement of weight, height, pubertal status, fasting insulin and glucose concentrations. RESULTS: Ponderal index at birth was negatively (B±SE=-0.05±0.02; p=0.025) and current BMI was positively (B±SE=0.14±0.02; p<0.001) associated with insulin resistance measured as homeostasis model assessment (HOMA) at 10 years of age adjusted for gender and pubertal stage. Current BMI and ponderal index at birth were still significant after adjusting for weight at 9 months. Birth weight and weight at 9 months was not correlated with HOMA (p=0.58) adjusted for current BMI, gender and pubertal stage. HOMA was higher in the tertile with the lowest ponderal index than in the two remaining tertiles (p=0.024). CONCLUSION: Relative thinness at birth, but neither birth weight nor weight gain from 0-9 months, was associated with higher insulin resistance at 10 years of age in this cohort with a low prevalence of overweight at 10 years of age and normal birth weight.

Determinants of blood glucose and insulin in healthy 9-month-old term Danish infants; the SKOT cohort.

AIMS: Insulin secretion is important for early regulation of growth, but high insulin concentration is also a risk factor for insulin resistance later in life. It is therefore important to better understand how insulin and glucose are associated with early diet and growth. The aim of this study was to examine blood glucose and insulin concentration in relation to anthropometric measurements, growth, breastfeeding practice and complementary feeding in 9-month-old infants. METHODS: This was a cross-sectional study (SKOT cohort), examining 312 healthy term infants from the age of 9 months. Of these, 265 infants had data on insulin and glucose and were included in this study. Measurements include weight, length, skinfold thickness, waist circumference, 7-day food records, 2-h fasting venous glucose and insulin analysis, and questionnaire. RESULTS: At 9 months of age there was a strong negative association between number of breastfeedings per day and insulin concentration (P=0.0015). Insulin concentration was positively associated to waist circumference (P=0.042) and change in Z-score for weight-for-age between 5 and 9 months (P=0.004). Glucose concentration was positively associated to subscapular skinfold (P=0.002) and sum of skinfolds thicknesses (P=0.006). CONCLUSION: At 9 months, breastfeeding still had a strong negative effect on insulin concentrations, which were positively associated with weight gain and current waist circumference, while glucose concentrations were associated with subcutaneous fat. These results are of interest in disentangling the association between early growth and later risk of disease.

Gestational weight gain in relation to offspring body mass index and obesity from infancy through adulthood.

OBJECTIVE: Gestational weight gain (GWG) is associated with childhood obesity. We analyzed whether this effect persists into adulthood and is mediated by effects in childhood. DESIGN: The design of the study a prospective birth cohort study established in 1959-1961. SUBJECTS: The subjects were offspring (n = 4234 of whom 2485 had information from the last follow-up) of mothers included in 'The Copenhagen Perinatal Cohort' during pregnancy or at birth. MEASUREMENTS: Information on maternal pre-pregnancy body mass index (BMI), GWG and several potential confounders were collected around delivery. Information on offspring BMI was available from various follow-up examinations from 1 to 42 years of age. The association of GWG with offspring BMI was analyzed by regression models including confounders. Using path analysis, the association of GWG with adult BMI was disentangled into an association mediated through childhood BMI and one independent hereof. RESULTS: GWG was associated with offspring BMI at all ages. At the age of 42 years (n = 1540), there was an increasing risk of obesity (odds ratio (OR) 1.08, 95% confidence interval (CI) 1.03-1.14 per kg GWG, P = 0.003). Only half of the association of GWG on offspring adult BMI was mediated through birth weight and BMI up to 14 years of age. CONCLUSION: Greater GWG is associated with an increased BMI in childhood through adulthood and with an increased risk of obesity in adults. Only part of the association with adult BMI is mediated by childhood BMI, suggesting that excessive GWG induces a persisting susceptibility to obesogenic environments. As GWG is greater in women with small pre-pregnancy body weight, this implies a reinforcement of the obesity epidemic in the next generation. Our findings provide support for avoiding excessive GWG.

Weight history from birth through childhood and youth in relation to adult lung function, in Danish juvenile obese and non-obese men.

OBJECTIVE: To investigate the associations of birth weight, body mass index (BMI) during childhood and youth, and current BMI with adult lung function. DESIGN: Population-based longitudinal study of juvenile obese and non-obese men, who were identified at draft board examination (age range: 19-27 y) and who participated in a follow-up examination in 1981-1983 (age range: 25-48 y). Birth weight, childhood weight and height measurements from 7 to 13 y of age were obtained from school health records. Current BMI and lung function were assessed at follow-up. SETTING: Copenhagen and adjacent regions, Denmark. SUBJECTS: In total, 193 juvenile obese men at draft board examination and 205 randomly selected nonobese controls from the same population. MAIN OUTCOME MEASURES: Lung function measured by forced expiratory volume in 1 s (FEV(1)) and forced vital capacity (FVC), adjusted for age and height. RESULTS: After adjusting for current BMI, smoking and education, birth weight was positively related to FEV(1), although only with borderline statistical significance. BMI at age 7 y was positively associated with both FEV(1) and FVC, whereas BMI at later ages in childhood and in youth was not associated with these measures. There was a strong negative linear relation between current BMI and lung function among those currently overweight and obese (BMI 25 kg/m(2)), whereas no association was seen in the non-obese (BMI <25 kg/m(2)). CONCLUSION: Our findings confirm the detrimental effect of high current BMI on adult lung function, and further suggest that early childhood growth has a protective influence.

Blood pressure in relation to relative weight at birth through childhood and youth in obese and non-obese adult men.

OBJECTIVE: To determine the influence on blood pressure of relative weight from birth through adulthood in non-obese and juvenile obese men. DESIGN: Case-cohort study of obesity in Danish men, identified at age (mean+/-s.d.) 19.8+/-1.6 y at draft board examination, who participated in at least one of two follow-up studies in adulthood (age 36.8+/-6.7 and 47.9+/-6.8 y at first and second follow-up, respectively). Birth weight and weight and height from the age of 7-13 y were collected from school health records. SUBJECTS: Three hundred and twenty-seven non-obese men (controls) selected as 0.5% of the draft board population and 285 obese men with body mass index (BMI)> or =31 kg/m(2) at draft board examination. MAIN OUTCOME MEASURES: Systolic and diastolic blood pressure measured twice in adulthood adjusted for current age. RESULTS: Birth weight was inversely related to systolic blood pressure at first and second follow-up, but only significantly so when adjusted for current BMI (regression coefficients in mmHg per unit Z-score (95% confidence interval (CI))-1.2 (-2.3, -0.1) and -1.6 (-3.1, 0.0)). Change in Z-score from birth weight to BMI at the age of 7 y was significantly positively related to systolic blood pressure, but the relationship weakened by adjustment for current BMI (0.8 (0.1, 1.6) and 0.6 (-0.4, 1.6), respectively). If both birth weight and change until 7 y were included in the same model, their effects were both positive and significant, but they weakened and became not significant when adjusted for current BMI. BMI since the age of 7 y had no significant effect on blood pressure beyond that of current BMI. CONCLUSION: In a wide range of adult BMI in men, the birth weight was inversely related to systolic blood pressure, even when controlled for BMI since the age of 7 y. However, the effect may reflect the weight change between birth and 7 y of age. After that age BMI had no additional effect on blood pressure beyond the effect of current BMI.