The following article will be published in The American Journal of Clinical Nutrition, a publication of the American Society for Nutrition. The full text of the article will be available at the URL listed below when the embargo lifts. Manuscripts published in The American Journal of Clinical Nutrition are embargoed until the article appears online either as in press (Advance Access) or in a journal issue.

Rockville, MD, August 16, 2019

Background: Compared to high-income countries, people in low-income countries are more likely to experience a dual burden of malnutrition - both over- and undernourishment. Both ends of this spectrum have been associated with increased risk of obesity and adult-onset cardiometabolic diseases such as type 2 diabetes and cardiovascular disease. Although studies have shown that these outcomes are associated with early childhood growth patterns, very few studies have explored the relationship between distinct growth trajectories and cardiometablic markers in a low-income urban population. In a recent study published in the August 2019 issue of The American Journal of Clinical Nutrition, Rasmus Wibaek (Steno Diabetes Center Copenhagen and University of Copenhagen) and colleagues examined distinct trajectories of adiposity-related body mass index in the first years of life and subsequent implications on markers of cardiometabolic risk and body composition in early childhood. Study results highlight the importance of timely interventions targeted at young children from low-income countries with unfavorable growth patterns.
Study Design: In this prospective birth cohort study, a total of 453 healthy and full-term Ethiopian children were included in the modeling of body mass index trajectories. Four distinct heterogeneous body mass index growth trajectories from birth to 5 years of age were identified: stable low body mass index, normal body mass index, rapid catch-up to high body mass index, and slow catch-up to high body mass index. Associations of the identified growth trajectories with cardiometabolic markers and body composition at 5 years were analyzed.
Results and Conclusions: Compared with the “normal body mass index” trajectory, children in the “rapid catch-up to high body mass index” trajectory had higher triglycerides, insulin production, fat mass, and fat-free mass. Children in the “stable low body mass index class had lower low-density lipoprotein cholesterol, high density lipoprotein cholesterol, fat mass, fat-free mass, but higher triglycerides at 5 years of age. The generalizability of these trajectories was supported by their similarity to body mass index trajectories identified in studies from high-income countries using similar data-driven modeling. The researchers hypothesized that rapid body mass index growth during a critical window of the first 6 months of life accelerates an increase of fat mass in relation to fat-free mass, which may result in unfavorable cardiometabolic changes early in childhood. Thus, the development of obesity and cardiometabolic risk may be established already in early childhood. Interventions should begin early in life and target young children from low-income countries with unfavorable growth patterns.
Wibaek R, Vistisen D, Girma T, Admassu B, Abera M, Mudie K, Kaestel P, Jorgensen ME, Wells JCK, Michaelsen KF, Friis H, Andersen GS. Body mass index in early childhood in relation to cardiometabolic risk profile and body composition at 5 years of age. The American Journal of Clinical Nutrition, nqz170,
For more information Full text of this article is available to journalists upon request. Contact Claire Neumann by phone at 212-726-6062 or by e-mail at to obtain copies. To contact the corresponding author, Rasmus Wibaek, please send an e-mail to .

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