Early growth for better prospects

New research suggests that higher birth weight and rapid growth in body length during the first two years of life are likely to lead to substantial improvements in height and levels of schooling, and offer some protection against risk factors for chronic disease in adulthood.

The research, published in The Lancet shows a benefit to rapid weight gain in early childhood, differing from fast weight gain after mid-childhood, which happens typically with children in low- and middle-income countries (LMICs), and puts children at higher risk of obesity and cardiovascular diseases in later life.

“Our results challenge several programmes in countries of low and middle income…[for example], traditional school feeding programmes that increase BMI [body mass index] with little effect on height might be doing more harm than good in terms of future health,” explains lead author Linda Adair from the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill in the USA.

“The present focus in LMICs on reducing the proportion of children under five years of age who are underweight might have detrimental repercussions if feeding interventions promote excess weight gain after the age of two years. Whereas, interventions that promote linear growth in early life could build human capital [height and levels of schooling] in adults without increasing the burden of non-communicable diseases.”

Most research has focused just on body weight rather than the separate effects of length and weight gain. Questions remain about whether promotion of infant and young child weight gain – important for survival and cognitive development – might also influence risk of adult chronic diseases later in life.

In this study, Linda Adair and colleagues working together in the COHORTS collaboration, compared the potential long-term effects of faster weight gain and linear growth in infancy and childhood on height, schooling, blood pressure, glucose metabolism, and body composition in young adulthood.

The study showed that higher weight at birth and faster linear growth in the first two years of life were linked with increased adult height and higher levels of schooling.

Conversely, children with high relative weight gain after the age of two years and later in childhood had higher blood pressure, BMI, body fat levels, and plasma glucose concentrations in young adulthood.

According to the authors, “New interventions that specifically promote linear growth instead of weight gain should be developed, tested, and promoted; exclusive breastfeeding, high-quality protein (eg, animal), and micronutrients could be further investigated.”

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