Development of centrality indices of subcutaneous fat during growth

Changes of fat distribution were followed up in Czech and Slovak children from 1.5 to 15 years of age, using centrality indices, which relate the values of skinfolds on the trunk to the skinfolds on the extremities, head and neck. Up to 5 years of age, subcutaneous fat was deposited relatively more on the extremities, head and neck than on the trunk, which was expressed by lower values of the centrality indices. After the age of 5 years, the accumulation of subcutaneous fat was greater on the trunk, which was also expressed by higher values of the centrality indices. The comparison of the individual indices revealed in both genders a relatively higher amount of subcutaneous fat on the trunk in boys until 12 years of age. During puberty subcutaneous fat over triceps and on the forearm was reduced. In girls the deposition of the subcutaneous fat was relatively greater at different sites of the trunk than in boys, with the exception of the age of 14-15 years. The deposition of subcutaneous fat was greater on the trunk than on the head (cheek) and on the extremities in Czech compared to Slovak children, except for 12-year-old girls. During the period between the fifties and the seventies of the last century, in Czech children, especially in girls, the deposition of subcutaneous fat on the trunk was relatively smaller than on other parts of the body surface, which was expressed by the reduction of the centrality indices. Index 12 was therefore considered as the most valuable for the characterization of fat distribution on the body surface.     

Long-term yersiniosis surveillance project in Czechoslovakia

The paper presents an epidemiological analysis of 8,232 cases of yersiniosis caused by Y. enterocolitica 03 over 1972-1988 as reported by Hygienic Stations. The steady epidemiological characteristics of yersiniosis were the prevalence of children and boys and a typical seasonal pattern with differences between the Czech and Slovak Republics. In the Czech Republic, there were several incidence peaks following, when summarized, the incidence curve of other alimentary infections, whereas in the Slovak Republic morbidity reached its peak during winter months. The numbers of isolated strains oscillated significantly between districts and by years. It appears that the number of positive findings in different districts is not only an objective value reflecting a mosaic-like pattern of incidence but also depends on the quality of microbiological diagnostics.     

Long-term changes in body weight, BMI, and adiposity rebound among children and adolescents in the Czech republic

The Czech Republic has undergone rapid political, social, and economic transformation since the late 1980s. While obesity rates among children and adolescents in the Czech Republic have been previously relatively low, this has changed in recent years. Across the past 50 years, body weight, body mass index (BMI)-for-age, and adiposity rebound (AR) (the time when a child reaches the lowest BMI before their BMI gradually begins to increase until adulthood) occurs earlier. The most dramatic changes have been observed among school-aged children, where BMI values have increased at the 50th, 90th, and 97th percentiles. In contrast, adolescent girls appear to be thinner than in the past. The analyses of weight-for-height percentiles indicated that the 50th percentile of the body weight among boys and girls remained similar in nearly all age categories across the past 50 years. Although the growth pattern of children at the 50th percentile has not changed, the 10th and 90th percentiles have expanded. Our findings suggest that the secular trend of increased height, accelerated growth, and earlier maturation is responsible for Czech children experiencing adiposity rebound at earlier ages compared to the past.     

Regional, age and sexual differences of BMI of the Czech and Slovak adult populations at the end of the 20th century

Nowadays the Body Mass Index (BMI) is used everywhere as the coefficient of normal weight, overweight and obesity. In the years 1987-1988 an anthropometrical survey was carried out in the whole region of the former Czechoslovakia, which was done on 20,232 adult males and females, aged from 18 to more than 70 years. The research was made on the basis of three grade statistical choice and is representative for the entire territory of the Czech and Slovak Republics. Body height and body weight were determined according to Martin & Saller (1957; M 1, M 71). For the assessment of regional differences the whole set of data was divided into 12 separate groups in accordance to the administrative regions existing at that time. Each group was then analyzed considering eleven age classes.     

Secular changes are different in distinct subgroups of the growing population

The change of living conditions in East Germany after the German reunification in 1990 led to intensive secular changes in growth and development. Anthropometric data of height, weight, BMI and thickness of the subcutaneous fat layer are compared from two cross-sectional samples of German children and adolescents aged 6 to 18 years. The first sample was measured around 1989 and the second 10 years later around 1999. Both samples contain children and adolescents from the urban as well as from the rural population. The secular changes reported here are based on the comparison of medians of height, weight, BMI and subcutaneous fat layer thickness calculated for yearly age categories. Subsequently, medians of the 10% border categories are compared. These border categories contain the 10% smallest, lightest, slimmest or leanest subjects and the 10% tallest, heaviest, most corpulent or most obese subjects respectively of a yearly age category. The young generation shifted between 1989 and 1999 to a taller stature in the small as well as in the tall category. The secular pattern of measurements, which mark corpulence, is sex-specific and differs from that of length measurements. In general the light or lean subjects changed only little, however, there are clear age- and sex-specific changes in the upper border categories. Weight and BMI increased markedly in the upper border categories in young preadolescent children, but did not change much in adolescent boys of these category aged 15 and 16 and decreased in adolescent girls. Also the subcutaneous fat layer increased in the upper border category in preadolescent children, but decreased in adolescent boys and girls.     

Early Postnatal BMI Adaptation Is Regulated During a Fixed Time Period and Mainly Depends on Maternal BMI

In the present study, we investigated whether there are critical time periods which influence the course of BMI during the first 6 years of life. From 5,433 children who participated in preschool examinations those 212 children were selected who crossed the BMI percentiles as a result of an extreme postnatal BMI rise (from <10th to 90th percentile) or fall (from >90th to <10th percentile) or who have persistently low or high BMI both at birth and at the age of 6 years. Forty children with a BMI close to the 50th percentile both at birth and age 6 years were selected to serve as controls. The courses of weight and height during the first 6 years of age were assessed and BMI was calculated. To identify influences connected with BMI development, we investigated genetic, social, nutritional, and other factors proceeding from the mother during pregnancy. Finally completed data sets of 57 children were available. Our study shows that during two critical time periods a significant move toward low or high BMI takes place among the groups: in early infancy from ～0.5 to 1.5 years and again from 5 to 6 years. At the age of 1.5 years the final state of BMI is already fixed in all study groups. Mothers of overweight 6‐year‐old children are overweight, whereas mothers of underweight 6‐year‐old children have a below‐normal BMI. All other investigated factors only had a minor influence on postnatal BMI development. We conclude that postnatal BMI development follows a fixed genetic program and is mainly programmed by maternal metabolism.     

Relationship between change in BMI with age and delayed menarche in female athletes

Body mass index (BMI) is widely used as an index of obesity in people from the school age children to adults. However, the relationship between the change in BMI with age and the coming of menarche has not been discussed as there are few reports on the changes in BMI with age. In this study, the change in BMI with age was examined by applying the wavelet interpolation method (WIM), and a critical period for body fat in terms of the coming of menarche was estimated from the growth velocity. We investigated delayed menarche according to the influence of stress in athletes by comparing delayed menarche between athletes and non-athletes in relation to the critical period. Data were obtained from 144 female athletes in their first year at university in the Tokai area, all of whom had competed in a national sports competition in high school (athlete group). Health examination records showing these subjects' heights and weights from the first grade of elementary school to the final year of high school (1984-1995) were collected and BMI was calculated for each grade. Ages at menarche were ascertained from questionnaires. A control group of 73 non-athletes was similarly examined. The age at maximum peak velocity (MPV) derived from the growth (aging) distance curve of BMI was determined in the control group to be 11.96+/-0.97 years old. This age at MPV of BMI was almost the same as the age at menarche (12.11+/-0.93 years old). Therefore, this age at MPV of BMI is estimated to be the critical period of body fat for the coming of menarche. The interval between the age at MPV of BMI and age at menarche was 0.74+/-1.30 years in the athlete group and 0.15+/-0.81 years in the control group, so there was a significant difference (P<0.01) between the two groups. It is suggested that the delayed menarche in athletes is influenced by the stress of regular sports training.     

Constant multiple birth rates in the Czech Republic and the Slovak Republic until recently, 1972-1995.

Using vital statistics, yearly changes in the twinning and triplet rates by zygosity were investigated in the Czech Republic and the Slovak Republic during the period 1972-1995. Monozygotic (MZ) twinning rates in both countries had remained nearly constant (about 3 per 1000 total births) during that period. With a few exceptions, the dizygotic (DZ) twinning rates remained constant from 1972 to 1994, and increased in 1995 for both countries. MZ twinning rates for both countries were the lowest in Europe. As for triplet rates, overall rates increased significantly year by year in the Czech Republic, but not in the Slovak Republic. The triplet rate was significantly higher in 1995 than in the period 1972-1982 for both countries. The MZ triplet rate remained constant during that period in the Czech Republic. The trizygotic (TZ) triplet rates increased 3-fold for the Czech Republic and 4-fold for the Slovak Republic in 1972-1976 and 1992-1995. In the later period, the TZ rate was 1.5-fold higher in the Czech Republic than in the Slovak Republic. The quadruplet rate increased 2.3-fold from 2.9 per million births in 1982-1986 to 6.7 in 1992-1995 in the Czech Republic. The corresponding values were 2.7, 2.20 and 5.9-fold in the Slovak Republic. Both the Czech and the Slovak Republics were not affected by fertility drugs and assisted reproductive techniques until recently.     

Body mass index of married Bangladeshi women: trends and association with socio-demographic factors

Body mass index (BMI) is a good indicator of nutritional status in a population. In underdeveloped countries like Bangladesh, this indicator provides a method that can assist intervention to help eradicate many preventable diseases. This study aimed to report on changes in the BMI of married Bangladeshi women who were born in the past three decades and its association with socio-demographic factors. Data for 10,115 married and currently non-pregnant Bangladeshi women were extracted from the 2007 Bangladesh Demographic and Health Survey (BDHS). The age range of the sample was 15-49 years. The mean BMI was 20.85 ± 3.66 kg/m(2), and a decreasing tendency in BMI was found among birth year cohorts from 1972 to 1992. It was found that the proportion of underweight females has been increasing in those born during the last 20 years of the study period (1972 to 1992). Body mass index increased with increasing age, education level of the woman and her husband, wealth index, age at first marriage and age at first delivery, and decreased with increasing number of ever-born children. Lower BMI was especially pronounced among women who were living in rural areas, non-Muslims, employed women, women not living with their husbands (separated) or those who had delivered at home or non-Caesarean delivery.     

Cardiovascular regulation profile predicts developmental trajectory of BMI and pediatric obesity

The present study examined the role of cardiovascular regulation in predicting pediatric obesity. Participants for this study included 268 children (141 girls) obtained from a larger ongoing longitudinal study. To assess cardiac vagal regulation, resting measures of respiratory sinus arrhythmia (RSA) and RSA change (vagal withdrawal) to three cognitively challenging tasks were derived when children were 5.5 years of age. Heart period (HP) and HP change (heart rate (HR) acceleration) were also examined. Height and weight measures were collected when children were 5.5, 7.5, and 10.5 years of age. Results indicated that physiological regulation at age 5.5 was predictive of both normal variations in BMI development and pediatric obesity at age 10.5. Specifically, children with a cardiovascular regulation profile characterized by lower levels of RSA suppression and HP change experienced significantly greater levels of BMI growth and were more likely to be classified as overweight/at-risk for overweight at age 10.5 compared to children with a cardiovascular regulation profile characterized by high levels of RSA suppression and HP change. However, a significant interaction with racial status was found suggesting that the association between cardiovascular regulation profile and BMI growth and pediatric obesity was only significant for African-American children. An autonomic cardiovascular regulation profile consisting of low parasympathetic activity represents a significant individual risk factor for the development of pediatric obesity, but only for African-American children. Mechanisms by which early physiological regulation difficulties may contribute to the development of pediatric obesity are discussed.     

Complement-fixing antibodies against rotaviruses in healthy children in the Czech Socialist Republic and People's Democratic Republic of Yemen

Levels of complement-fixing antibodies against rotaviruses were evaluated in the sera of 900 healthy children aged 1-9 years 300 sera were collected in the People's Democratic Republic of Yemen in September-October 1985, 300 sera were obtained in the Czech Socialist Republic in the same period and another 300 also in the Czech Socialist Republic in September-October 1986. The latter two groups were investigated in the framework of immunological surveys. A complement-fixation antigen was prepared from a simian strain of the rotavirus type SA-11 in a tissue cell line MA-104. The sera from Yemen featured lower mean titres in the age groups and thus the lowest overall titre. As the antibody titre increased, the portion of seropositive sera from Yemen declined by far more rapidly than in the Czech children, where it remained virtually the same. The sera from Yemen showed the lowest negative rate and lowest ratio of high titres. The antibody titre of 1:64 and higher was not detected in children from Yemen, while they occurred in the two groups of Czech children. There was no correlation between antibody titres and probands' sex, nor was there linear dependence of titre magnitude on age. The mean positivity rate in each group as assessed by the antibody titres was the lowest in the sera from Yemen. The percentage of positive sera in all age groups was higher in the Czech children with the exception of children from Yemen aged 6 and 9 years. The aim of the present study was to evaluate the antibody status in infant populations and thus expand knowledge of rotavirus epidemiology.     

Probability of Adult Overweight and Risk Change during the BMI Rebound Period

Objective: To develop a probability chart of adult overweight based on childhood body mass index (BMI) values and to evaluate the BMI change during the BMI rebound period during childhood, in different populations, with the use of risk function curves. Research Methods and Procedures: A longitudinal growth study of 3650 full-term healthy Swedish children followed from birth to 18 years of age. Weight and height values of our subjects were obtained. Results: A probability chart for reaching a BMI > 23 kg/m² at 18 years of age was constructed for boys and girls. For example, a BMI of 18 kg/m² at 4 years of age is associated with 0.70 probability of attaining a BMI > 23 kg/m² at 18 years of age in boys; a BMI of 16 kg/m² at 4 years of age leads to 0.40 probability of having a BMI > 23 kg/m² at 18 years of age in girls. Children with an obvious BMI rebound before 8 years of age have a high risk of being overweight at 18 years of age. There is a clear trend of BMI increase from the 1970s to the 1990s in U.S. children from a parallel dataset, and Hispanic children are at the highest risk of adult overweight. Discussion: The probability chart for adult overweight developed here provides a functional method of defining childhood obesity that is based on the risk of long-term ill health rather than on a certain statistical cut-off point. It will help pediatricians or healthcare workers identify those children who are at a high risk of becoming overweight in adulthood, which will allow clinical intervention at younger ages.     

Racial Differences in the Tracking of Childhood BMI to Adulthood

Objective: The possibility that there are racial differences in the patterns of BMI (kilograms per meter squared) change throughout life has not been examined. For example, the high prevalence of obesity among black women could result from a higher prevalence of obesity among black girls or because normal‐weight black girls experience larger BMI increases in adolescence or adulthood than do their white counterparts. Therefore, we examined the tracking of childhood BMI into adulthood in a biracial (36% black) sample. Research Methods and Procedures: Five‐ to 14‐year‐old children (2392) were followed for (mean) 17 years. Childhood overweight was defined as BMI ≥ 95th percentile, and adult obesity was defined as BMI ≥ 30 kg/m². Results: The tracking of childhood BMI differed between whites and blacks. Among overweight children, 65% of white girls vs. 84% of black girls became obese adults, and predictive values among boys were 71% (whites) vs. 82% (blacks). These racial differences reflected contrasting patterns in the rate of BMI change. Although the initial BMI of black children was not higher than that of white children, BMI increases with age were larger among black girls and overweight black boys than among their white counterparts. In contrast, relatively thin (BMI < 50th percentile) white boys were more likely to become overweight adults than were their black counterparts. Discussion: These findings emphasize the black/white differences in BMI changes with age. Because of the adult health consequences of childhood‐onset obesity, early prevention should be given additional emphasis.     

Age at Puberty and the Emerging Obesity Epidemic

Background

Recent studies have shown that puberty starts at younger ages than previously. It has been hypothesized that the increasing prevalence of childhood obesity is contributing to this trend. The purpose of this study was to analyze the association between prepubertal body mass index (BMI) and pubertal timing, as assessed by age at onset of pubertal growth spurt (OGS) and at peak height velocity (PHV), and the secular trend of pubertal timing given the prepubertal BMI.

Methodology/Principal Findings

Annual measurements of height and weight were available in all children born from 1930 to 1969 who attended primary school in the Copenhagen municipality; 156,835 children fulfilled the criteria for determining age at OGS and PHV. The effect of prepubertal BMI at age seven on these markers of pubertal development within and between birth cohorts was analyzed. BMI at seven years was significantly inversely associated with age at OGS and PHV. Dividing the children into five levels of prepubertal BMI, we found a similar secular trend toward earlier maturation in all BMI groups.

Conclusion/Significance

The heavier both boys and girls were at age seven, the earlier they entered puberty. Irrespective of level of BMI at age seven, there was a downward trend in the age at attaining puberty in both boys and girls, which suggests that the obesity epidemic is not solely responsible for the trend.     

Epidemiology of Helicobacter pylori Infection in Asymptomatic Children: A Prospective Population-Based Study from the Czech Republic. Application of a Monoclonal-Based Antigen-in-Stool Enzyme Immunoassay

Background:  Acquisition of Helicobacter pylori occurs mainly in childhood and is significantly influenced by geographical variations. The aim of this study is to evaluate the prevalence of H. pylori infection in a population-based sample of asymptomatic children in the Czech Republic. Furthermore, this study aims to identify potential risk factors associated with this infection.
Materials and Methods:  A prospective, cross-sectional, population-based study was undertaken in 1545 asymptomatic Czech children (aged 0–15 years; male 49.3%). Active H. pylori infection was diagnosed by monoclonal antibody-based antigen-in-stool enzyme immunoassay. Socio-demographic details of each subject were analyzed using a self-administered standardized questionnaire. Multiple regression analysis was performed.
Results:  Overall, 7.1% of asymptomatic children were diagnosed with H. pylori infection. Of the infected children, 5.8% lived in the general population. A positive association was found with increasing age, although not with gender. Independent risk factors associated with H. pylori infection in our pediatric population were: the number of children in a household (odds ratio [OR] 4.26; confidence interval [CI] 1.91–9.80); lack of formal education of fathers (OR 0.23; CI 0.18–0.64) and institutionalized children (OR 6.33; CI 2.25–26.50).
Conclusions:  This study of a large cohort of children demonstrated that, independent of gender, H. pylori infection in the Czech Republic is among the lowest reported in Europe. Socioeconomically disadvantaged children, unfortunately, are still at risk of harboring this potentially preventable infection in this low-prevalence region.     

Comparison of BMI and percentage of body fat of Indian and German children and adolescents

Today, serious health problems as overweight and obesity are not just constricted to the developed world, but also increase in the developing countries (Prentice 2006, Ramachandram et al. 2002). Focusing on this issue, BMI and percentage of body fat were compared in 2094 schoolchildren from two cross-sectional studies from India and Germany investigated in 2008 and 2009. The German children are in all age groups significantly taller, whereas the Indian children show higher values in BMI (e.g. 12 years: Indian: around 22 kg/m2; German: around 19 kg/m2) and in the percentage of body fat (e.g. 12 years: Indian: around 27%; German: around 18-20%) in most of the investigated age groups. The Indian children have significantly higher BMI between 10 and 13 (boys) respectively 14 years (girls). Indian children showed significant higher percentage of body fat between 10 and 15 years (boys) and between 8 and 16 years (girls). The difference in overweight between Indian and German children was strongest at 11 (boys) and 12 (girls) years: 70% of the Indian but 20% of the German children were classified as overweight. In countries such as India that undergo nutritional transition, a rapid increase in obesity and overweight is observed. In contrast to the industrialized countries, the risk of overweight in developing countries is associated with high socioeconomic status. Other reasons of the rapid increase of overweight in the developing countries caused by different environmental or genetic factors are discussed.     

Circulatory and respiratory responses to muscular exercise in Czech and Norwegian children

This paper presents a comparison between Czech and Norwegian rural healthy children with regard to the functional characteristics of the circulatory and respiratory system based upon work physiological variables and measurements of some pulmonary volumes. The study included randomised samples of boys and girls at the age of 8, 12 and 16 years, 66 Czech boys and 63 girls, 54 Norwegian boys and 57 girls. At the age of 8 years the maximal aerobic power was closely similar in both countries, but in the older age groups the Norwegian children exhibited lower physical fitness. The maximal heart rate was close to 200 min-1 on the average without any sex, age or ethnic differences. In agreement with the higher maximal aerobic power the 12 and 16 year old Czech children had lower submaximal heart rates for the same oxygen uptake than the Norwegian children. The forced vital capacity and forced expiratory volume in one second was significantly higher on the average in Czech than in Norwegian children but the latter, expressed in percent age of the former, averaged 87 to 91% without any sex, age or ethnic differences. The maximal ventilation volumes during muscular exercise reached higher values in Czech than in Norwegian children of the same age, but the mean maximal respiratory rate was close to 60 min-1, being independent of age, sex and cultural differences. During heavy exercise only 40 to 50% of the vital capacity and 45 to 55% of the forced expiratory volume were taken into account and this index of pulmonary function did not differ with sex, age or ethnic differences.     

Increasing incidence and age at diagnosis among children with type 1 diabetes mellitus over a 20-year period in Auckland (New Zealand)

Background

We aimed to evaluate the incidence of type 1 diabetes mellitus in children <15 years of age (yr) in the Auckland region (New Zealand) over 20 years (1990–2009).

Methods

We performed a retrospective review of all patients <15 yr diagnosed with type 1 diabetes, from an unselected complete regional cohort.

Results

There were 884 new cases of type 1 diabetes, and age at diagnosis rose from 7.6 yr in 1990/1 to 8.9 yr in 2008/9 (r² = 0.31, p = 0.009). There was a progressive increase in type 1 diabetes incidence among children <15 yr (p<0.0001), reaching 22.5 per 100,000 in 2009. However, the rise in incidence did not occur evenly among age groups, being 2.5-fold higher in older children (10–14 yr) than in the youngest group (0–4 yr). The incidence of new cases of type 1 diabetes was highest in New Zealand Europeans throughout the study period in all age groups (p<0.0001), but the rate of increase was similar in New Zealand Europeans and Non-Europeans. Type 1 diabetes incidence and average annual increase were similar in both sexes. There was no change in BMI SDS shortly after diagnosis, and no association between BMI SDS and age at diagnosis.

Conclusions

There has been a steady increase in type 1 diabetes incidence among children <15 yr in Auckland over 20 years. Contrary to other studies, age at diagnosis has increased and the greatest rise in incidence occurred in children 10–14 yr. There was little change in BMI SDS in this population, providing no support for the ‘accelerator hypothesis’.     

Two centuries of growth among Czech children and youth

The trend of increasing height can be interpreted as a reflection of the unfolding progress of civilization. Height changes among children and adolescents are good markers of this trend. We analyze the secular trend in the heights of children and adolescents in the Czech Republic on the basis of data from anthropological surveys. The earliest height data pertain to Czech youths who attended the Military Schools in Austria in 1800-1809. Data also exist for 1895 and continue in 1951 and at 10-year intervals thereafter. Growth curves were obtained for separate age groups by fitting mean values via third-order polynomial smoothing splines. Between 1951 and 2001, the mean heights of boys and girls aged 2.5 years increased by 2.7 and 3 cm, respectively. Since 1895, the mean height of 13-year-old boys has increased by 19.4 cm, and the mean height of girls has increased by 18.3 cm.     

Changes in ponderal index and body mass index across childhood and their associations with fat mass and cardiovascular risk factors at age 15

Background

Little is known about whether associations between childhood adiposity and later adverse cardiovascular health outcomes are driven by tracking of overweight from childhood to adulthood and/or by vascular and metabolic changes from childhood overweight that persist into adulthood. Our objective is to characterise associations between trajectories of adiposity across childhood and a wide range of cardiovascular risk factors measured in adolescence, and explore the extent to which these are mediated by fat mass at age 15.

Methods and Findings

Using data from the Avon Longitudinal Study of Parents and Children, we estimated individual trajectories of ponderal index (PI) from 0–2 years and BMI from 2–10 years using random-effects linear spline models (N = 4601). We explored associations between PI/BMI trajectories and DXA-determined total-body fat-mass and cardiovascular risk factors at 15 years (systolic and diastolic blood pressure, fasting LDL- and HDL-cholesterol, triglycerides, C-reactive protein, glucose, insulin) with and without adjustment for confounders. Changes in PI/BMI during all periods of infancy and childhood were associated with greater DXA-determined fat-mass at age 15. BMI changes in childhood, but not PI changes from 0–2 years, were associated with most cardiovascular risk factors in adolescence; associations tended to be strongest for BMI changes in later childhood (ages 8.5–10), and were largely mediated by fat mass at age 15.

Conclusion

Changes in PI/BMI from 0–10 years were associated with greater fat-mass at age 15. Greater increases in BMI from age 8.5–10 years are most strongly associated with cardiovascular risk factors at age 15, with much of these associations mediated by fat-mass at this age. We found little evidence supporting previous reports that rapid PI changes in infancy are associated with future cardiovascular risk. This study suggests that associations between early overweight and subsequent adverse cardiovascular health are largely due to overweight children tending to remain overweight.