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Early Childhood Predictors of Life course BMI Latent Class Trajectories in a Guatemalan Cohort
Author(s) -
Ford Nicole D.,
RamirezZea Manuel,
Martorell Reynaldo,
Stein Aryeh D.
Publication year - 2016
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.30.1_supplement.33.2
Subject(s) - demography , body mass index , medicine , latent class model , obesity , socioeconomic status , cohort , odds , logistic regression , odds ratio , gerontology , population , environmental health , statistics , mathematics , sociology
Objective In recent years, Latin America has experienced dramatic increases in obesity. Programming to address under‐nutrition can also potentially affect obesity trends – especially among children outside the critical window of the first 1,000 days. We examined the role of early childhood factors on the timing and rate of body mass index (BMI) gain using latent class trajectories in a Guatemalan cohort. Methods Study participants (741 men, 711 women) were born in the El Progreso department of Guatemala from 1962–77 and have been followed prospectively since participating in a nutrition supplementation trial as children. Sex‐specific BMI latent class trajectories were derived from 22 possible measures of height and weight: 5 from 1–12 months; 3 from 13–23 months; 5 from 24–50 months; 3 from 51–84 months; 2 from 10–20y; and 4 from 21–42y. We estimated the role of the type of nutrition supplement ( Atole vs. control beverage), timing of exposure (conception through age 2 y vs. other), and their interaction (using a difference‐in‐difference interaction test), and childhood household socioeconomic status (SES) on BMI latent class using multinomial logistic regression. Results We identified 3 BMI latent classes (low (39%), medium (46%), and high (14%)) in men and 2 classes (low (57%) and high (43%)) in women. Atole status and timing of exposure differed significantly by BMI latent class in both men ( p <.01) and women ( p <.0001). High SES tertile was associated with increased odds of high BMI latent class membership in both men (OR 2.07; 95% CI 1.19, 3.59) and women (OR 1.92; 95% CI 1.29, 2.84) relative to the lowest tertile. Among women, middle SES tertile was also associated with increased odds of high BMI latent class membership (OR 1.60; 95% CI 1.07, 2.38) relative to the lowest tertile. Exposure to Atole during the first 1,000 days was not significantly associated with BMI latent class membership (difference‐in‐difference test ‐ p >0.2 for men; p >0.6 for women). Conclusion Exposure to Atole during the first 1,000 days was not significantly associated with BMI latent class membership, suggesting that programs to improve nutritional status are unlikely to adversely affect BMI trajectories. Childhood household SES was associated with increased odds of high BMI latent class membership – the pathways through which this operates still need to be explored. Support or Funding Information Funding: This research was funded by the National Institutes of Health.