Growth of children at high risk of obesity during the first 6 y of life: implications for prevention

Background: The contribution of familial factors to adiposity in children is poorly understood. Objective: The objective was to assess differences in growth in the first 6 y of life in children born to either overweight or lean mothers. Design: The body size and composition of 33 children at high risk and 37 children at low risk of obesity on the basis of the mother's overweight [body mass index (BMI; in kg /m(2)) of 30.2 +/- 4.2 and 19.5 +/- 1.1, respectively] were measured repeatedly from 3 mo to 6 y of age at the Children's Hospital of Philadelphia. Results: At year 2, no significant differences in any measure were observed between the high- and low-risk groups. By year 4, weight, BMI, and lean body mass were greater in the high-risk than in the low-risk children. By year 6, weight was even greater in the high-risk than in the low-risk children (23.4 +/- 6.4 compared with 20.4 +/- 2.1 kg; P < 0.02), and, for the first time, fat mass was greater in the high-risk than in the low-risk children (6.7 +/- 5.7 compared with 3.8 +/- 1.2 kg; P < 0.02). Ten of 33 high-risk children exceeded the 85th percentile of BMI at year 6 compared with I of 37 low-risk children (odds ratio = 15.7). Accelerated weight gain was predicted by high-risk group status, greater weight at year 2, and lower family income. Conclusion: Anthropometric measures were not significantly different between groups at year 2; weight and lean body mass were greater at years 4 and 6, and fat mass was greater at year 6 in high-risk children.