The Terneuzen Birth Cohort: BMI change between 2 and 6 years is most predictive of adult cardiometabolic risk.

Background: We recently reported the age interval 2-6y being the earliest and most critical for adult overweight. We now aim to determine which age intervals are predictive of cardiometabolic risk at young adulthood.

Methods And Findings: We analyzed data from 642 18-28 years olds from the Terneuzen Birth Cohort. Individual BMI SDS trajectories were fitted by a piecewise linear model. By multiple regression analyses relationships were assessed between subsequent conditional BMI SDS changes and components of the metabolic syndrome (MetS), skinfold thickness and hsCRP at young adulthood. Results were adjusted for gender and age, and other confounders. Gender was studied as an effect modifier. All BMI SDS changes throughout childhood were related to waist circumference and skinfold thickness. No other significant relationship was found before the age of 2 years, except between the BMI SDS change 0-1y and hsCRP. Fasting blood glucose was not predicted by any BMI SDS change. BMI SDS change 2-6y was strongly related to most outcome variables, especially to waist circumference (ß 0.47, SE 0.02), systolic and diastolic blood pressure (ß 0.20 SE 0.04 and ß 0.19 SE 0.03), and hsCRP (ß 0.16 SE 0.04). The BMI SDS change 10-18y was most strongly related to HDL cholesterol (ß -0.10, SE 0.03), and triglycerides (ß 0.21, SE 0.03). To a lesser degree, the BMI SDS change 6-10y was related to most outcome variables. BMI SDS changes 2-6y and 10-18y were significantly related to MetS: the OR was respectively 3.39 (95%CI 2.33-4.94) and 2.84 (95%CI 1.94-4.15).

Conclusion: BMI SDS changes from 2y onwards were related to cardiometabolic risk at young adulthood, the age interval 2-6y being the most predictive. Monitoring and stabilizing the BMI SDS of children as young as 2-6y may not only reverse the progression towards adult overweight, but it may also safeguard cardiometabolic status.