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Associations of early-life growth with health using an allostatic load score in young, urban African adults: Birth to Twenty Plus Cohort

Published online by Cambridge University Press:  29 October 2019

Craig J. McGowan*
SAMRC Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa
Shane A. Norris
SAMRC Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa
Address for correspondence: Craig J. McGowan, SAMRC Developmental Pathways for Health Research Unit, 7 York Rd, Parktown, Johannesburg 2193, South Africa. Email:


Growth in early life is associated with various individual health outcomes in adulthood, but limited research has been done on associations with a more comprehensive measure of health. Combining information from multiple biological systems, allostatic load (AL) provides such a quantitative measure of overall physiological health. We used longitudinal data from the Birth to Twenty Plus cohort in South Africa to calculate an AL score at age 22 years and examined associations with birth weight and linear growth and weight gain from age 0 to 2 years and 2 to 5 years, as attenuated by trajectories of body mass index and pubertal development in later childhood and adolescence. Differences in total AL score between males and females were small, though levels of individual biological factors contributing to AL differed by sex. Increased weight gain from age 2 to 5 years among males was associated with an increased risk of high AL, but no other early-life measures were associated with AL. Increased adiposity through childhood and adolescence in females was associated with higher AL in early adulthood. These results illustrate that patterns of early-life growth are not consistently associated with higher AL. While more research is needed to link AL in young adulthood to later health outcomes, these results also suggest increased adiposity during childhood and adolescence represents a potential early sign of later physiological risk.

Original Article
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2019

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