Risky vs rapid growth in infancy: Refining pediatric screening for childhood overweight

Darcy E. Gungor, Ian Paul, Leann L. Birch, Cynthia J. Bartok

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Objectives: To systematically analyze growth data from infant health maintenance records to characterize infant weight gain increasing risk for childhood overweight, and to identify additional information from those records that could refine risky infant weight gain as a screening tool. Design: Retrospective cohort study. Setting: A pediatric office in central Pennsylvania. Participants: Children aged 6 to 8 years (n = 129) born in 2000 or later who attended health maintenance visits. Main Exposures: Risky infant weight gain was a cutoff selected after considering its sensitivity and specificity during the interval best predicting childhood overweight risk as determined with receiver operating characteristic curve analysis. We identified demographic, growth pattern, and parental feeding choice differences between at-risk infants who did and did not become overweight children. Main Outcome Measure: Childhood overweight, defined as a sex- and age-specific body mass index of the 85th percentile or higher at ages 6 to 8 years according to 2000 Centers for Disease Control and Prevention growth charts. Results: Childhood overweight prevalence was 24.8%. At-risk infants gained at least 8.15 kg from ages 0 to 24 months. While 31.4% of at-risk infants became overweight children, 68.6% were resilient. At-risk, resilient participants had parents with more education, had lower weight gain from ages 18 to 24 months and 0 to 24 months and a smaller area under the weight-gain curve from ages 0 to 24 months, were more often exclusively breastfed for 6 months or longer, and were introduced to solid foods later than at-risk, overweight participants. Conclusions: While most researchers would not recognize weight gain of 8.15 kg or more from ages 0 to 24 months as rapid growth, it was a fair screening tool for childhood overweight in our sample and had the potential to be refined using information about demographic characteristics, growth patterns, and parental feeding choices.

Original languageEnglish (US)
Pages (from-to)1091-1097
Number of pages7
JournalArchives of Pediatrics and Adolescent Medicine
Volume164
Issue number12
DOIs
StatePublished - Dec 1 2010

Fingerprint

Pediatrics
Weight Gain
Growth
Feeding Behavior
Demography
Growth Charts
Centers for Disease Control and Prevention (U.S.)
ROC Curve
Body Mass Index
Cohort Studies
Retrospective Studies
Parents
Research Personnel
Outcome Assessment (Health Care)
Education
Sensitivity and Specificity
Food
Health

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

Cite this

Gungor, Darcy E. ; Paul, Ian ; Birch, Leann L. ; Bartok, Cynthia J. / Risky vs rapid growth in infancy : Refining pediatric screening for childhood overweight. In: Archives of Pediatrics and Adolescent Medicine. 2010 ; Vol. 164, No. 12. pp. 1091-1097.
@article{23c0b15ffbea4947abd710f97d744c73,
title = "Risky vs rapid growth in infancy: Refining pediatric screening for childhood overweight",
abstract = "Objectives: To systematically analyze growth data from infant health maintenance records to characterize infant weight gain increasing risk for childhood overweight, and to identify additional information from those records that could refine risky infant weight gain as a screening tool. Design: Retrospective cohort study. Setting: A pediatric office in central Pennsylvania. Participants: Children aged 6 to 8 years (n = 129) born in 2000 or later who attended health maintenance visits. Main Exposures: Risky infant weight gain was a cutoff selected after considering its sensitivity and specificity during the interval best predicting childhood overweight risk as determined with receiver operating characteristic curve analysis. We identified demographic, growth pattern, and parental feeding choice differences between at-risk infants who did and did not become overweight children. Main Outcome Measure: Childhood overweight, defined as a sex- and age-specific body mass index of the 85th percentile or higher at ages 6 to 8 years according to 2000 Centers for Disease Control and Prevention growth charts. Results: Childhood overweight prevalence was 24.8{\%}. At-risk infants gained at least 8.15 kg from ages 0 to 24 months. While 31.4{\%} of at-risk infants became overweight children, 68.6{\%} were resilient. At-risk, resilient participants had parents with more education, had lower weight gain from ages 18 to 24 months and 0 to 24 months and a smaller area under the weight-gain curve from ages 0 to 24 months, were more often exclusively breastfed for 6 months or longer, and were introduced to solid foods later than at-risk, overweight participants. Conclusions: While most researchers would not recognize weight gain of 8.15 kg or more from ages 0 to 24 months as rapid growth, it was a fair screening tool for childhood overweight in our sample and had the potential to be refined using information about demographic characteristics, growth patterns, and parental feeding choices.",
author = "Gungor, {Darcy E.} and Ian Paul and Birch, {Leann L.} and Bartok, {Cynthia J.}",
year = "2010",
month = "12",
day = "1",
doi = "10.1001/archpediatrics.2010.238",
language = "English (US)",
volume = "164",
pages = "1091--1097",
journal = "JAMA Pediatrics",
issn = "2168-6203",
publisher = "American Medical Association",
number = "12",

}

Risky vs rapid growth in infancy : Refining pediatric screening for childhood overweight. / Gungor, Darcy E.; Paul, Ian; Birch, Leann L.; Bartok, Cynthia J.

In: Archives of Pediatrics and Adolescent Medicine, Vol. 164, No. 12, 01.12.2010, p. 1091-1097.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Risky vs rapid growth in infancy

T2 - Refining pediatric screening for childhood overweight

AU - Gungor, Darcy E.

AU - Paul, Ian

AU - Birch, Leann L.

AU - Bartok, Cynthia J.

PY - 2010/12/1

Y1 - 2010/12/1

N2 - Objectives: To systematically analyze growth data from infant health maintenance records to characterize infant weight gain increasing risk for childhood overweight, and to identify additional information from those records that could refine risky infant weight gain as a screening tool. Design: Retrospective cohort study. Setting: A pediatric office in central Pennsylvania. Participants: Children aged 6 to 8 years (n = 129) born in 2000 or later who attended health maintenance visits. Main Exposures: Risky infant weight gain was a cutoff selected after considering its sensitivity and specificity during the interval best predicting childhood overweight risk as determined with receiver operating characteristic curve analysis. We identified demographic, growth pattern, and parental feeding choice differences between at-risk infants who did and did not become overweight children. Main Outcome Measure: Childhood overweight, defined as a sex- and age-specific body mass index of the 85th percentile or higher at ages 6 to 8 years according to 2000 Centers for Disease Control and Prevention growth charts. Results: Childhood overweight prevalence was 24.8%. At-risk infants gained at least 8.15 kg from ages 0 to 24 months. While 31.4% of at-risk infants became overweight children, 68.6% were resilient. At-risk, resilient participants had parents with more education, had lower weight gain from ages 18 to 24 months and 0 to 24 months and a smaller area under the weight-gain curve from ages 0 to 24 months, were more often exclusively breastfed for 6 months or longer, and were introduced to solid foods later than at-risk, overweight participants. Conclusions: While most researchers would not recognize weight gain of 8.15 kg or more from ages 0 to 24 months as rapid growth, it was a fair screening tool for childhood overweight in our sample and had the potential to be refined using information about demographic characteristics, growth patterns, and parental feeding choices.

AB - Objectives: To systematically analyze growth data from infant health maintenance records to characterize infant weight gain increasing risk for childhood overweight, and to identify additional information from those records that could refine risky infant weight gain as a screening tool. Design: Retrospective cohort study. Setting: A pediatric office in central Pennsylvania. Participants: Children aged 6 to 8 years (n = 129) born in 2000 or later who attended health maintenance visits. Main Exposures: Risky infant weight gain was a cutoff selected after considering its sensitivity and specificity during the interval best predicting childhood overweight risk as determined with receiver operating characteristic curve analysis. We identified demographic, growth pattern, and parental feeding choice differences between at-risk infants who did and did not become overweight children. Main Outcome Measure: Childhood overweight, defined as a sex- and age-specific body mass index of the 85th percentile or higher at ages 6 to 8 years according to 2000 Centers for Disease Control and Prevention growth charts. Results: Childhood overweight prevalence was 24.8%. At-risk infants gained at least 8.15 kg from ages 0 to 24 months. While 31.4% of at-risk infants became overweight children, 68.6% were resilient. At-risk, resilient participants had parents with more education, had lower weight gain from ages 18 to 24 months and 0 to 24 months and a smaller area under the weight-gain curve from ages 0 to 24 months, were more often exclusively breastfed for 6 months or longer, and were introduced to solid foods later than at-risk, overweight participants. Conclusions: While most researchers would not recognize weight gain of 8.15 kg or more from ages 0 to 24 months as rapid growth, it was a fair screening tool for childhood overweight in our sample and had the potential to be refined using information about demographic characteristics, growth patterns, and parental feeding choices.

UR - http://www.scopus.com/inward/record.url?scp=78649954724&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78649954724&partnerID=8YFLogxK

U2 - 10.1001/archpediatrics.2010.238

DO - 10.1001/archpediatrics.2010.238

M3 - Article

C2 - 21135336

AN - SCOPUS:78649954724

VL - 164

SP - 1091

EP - 1097

JO - JAMA Pediatrics

JF - JAMA Pediatrics

SN - 2168-6203

IS - 12

ER -