Skip to main content
    • Aa
    • Aa

Impact of growth patterns and early diet on obesity and cardiovascular risk factors in young children from developing countries: Plenary Lecture

  • Camila Corvalán (a1), Juliana Kain (a2), Gerardo Weisstaub (a2) and Ricardo Uauy (a2) (a3)

Non-communicable chronic diseases are now a worldwide epidemic. Diet and physical activity throughout life are among its main determinants. In countries undergoing the early stages of the nutrition transition weight gain from birth to 2 years of life is related to lean mass gain, while ponderal gain after age 2 years is related to adiposity and later diabetes and CVD risk. Evidence from developing countries undergoing the more advanced stages of the nutrition transition is limited. The early growth patterns of a cohort of Chilean children born in 2002 with normal birth weight who at 4 years had a high prevalence of obesity and CVD risk factors have been assessed. Results indicate that BMI gain in early life, particularly from 6 months to 24 months, is positively associated with adiposity and CVD risk status at 4 years. These results together with existing evidence suggest that actions to prevent obesity and nutrition-related chronic diseases in developing countries should start early in life, possibly after 6 months of age. This approach should consider assessing the effect of mode of feeding and the amount and type of energy fed, as well as the resulting growth patterns. The challenge for researchers addressing the nutrition transition is to define the optimal nutrition in early life, considering not only the short- and long-term health consequences but also taking into account the stage of the nutritional transition for the given population of interest. The latter will probably require redefining optimal postnatal growth based on the context of maternal size and fetal growth.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

      Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Impact of growth patterns and early diet on obesity and cardiovascular risk factors in young children from developing countries
      Available formats
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about sending content to Dropbox.

      Impact of growth patterns and early diet on obesity and cardiovascular risk factors in young children from developing countries
      Available formats
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about sending content to Google Drive.

      Impact of growth patterns and early diet on obesity and cardiovascular risk factors in young children from developing countries
      Available formats
Corresponding author
*Corresponding author: Professor Ricardo Uauy, fax +44 20 7958 8111, email
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

3.G Fanjiang & RE Kleinman (2007) Nutrition and performance in children. Curr Opin Clin Nutr Metab Care 10, 342347.

4.PD Gluckman , MA Hanson & AS Beedle (2007) Early life events and their consequences for later disease: a life history and evolutionary perspective. Am J Hum Biol 19, 119.

5.KM Godfrey , KA Lillycrop , GC Burdge (2007) Epigenetic mechanisms and the mismatch concept of the developmental origins of health and disease. Pediatr Res 61, 5R–10R.

7.R Hardy , U Sovio , VJ King (2006) Birthweight and blood pressure in five European birth cohort studies: an investigation of confounding factors. Eur J Public Health 16, 2130.

8.CA Newsome , AW Shiell , CH Fall (2003) Is birth weight related to later glucose and insulin metabolism? – A systematic review. Diabet Med 20, 339348.

9.E Oken & MW Gillman (2003) Fetal origins of obesity. Obes Res 11, 496506.

10.AL Sawaya & S Roberts (2003) Stunting and future risk of obesity: principal physiological mechanisms. Cad Saude Publica 19, Suppl. 1, S21S28.

11.P Duran , B Caballero & M de Onis (2006) The association between stunting and overweight in Latin American and Caribbean preschool children. Food Nutr Bull 27, 300305.

12.C Doak , L Adair , M Bentley (2002) The underweight/overweight household: an exploration of household sociodemographic and dietary factors in China. Public Health Nutr 5, 215221.

13.JL Garrett & MT Ruel (2005) Stunted child-overweight mother pairs: prevalence and association with economic development and urbanization. Food Nutr Bull 26, 209221.

14.AL Sawaya , P Martins , D Hoffman (2003) The link between childhood undernutrition and risk of chronic diseases in adulthood: a case study of Brazil. Nutr Rev 61, 168175.

15.DG Schroeder , R Martorell & R Flores (1999) Infant and child growth and fatness and fat distribution in Guatemalan adults. Am J Epidemiol 149, 177185.

16.CS Yajnik , CH Fall , KJ Coyaji (2003) Neonatal anthropometry: the thin-fat Indian baby. The Pune Maternal Nutrition Study. Int J Obes Relat Metab Disord 27, 173180.

17.CS Yajnik , HG Lubree , SS Rege (2002) Adiposity and hyperinsulinemia in Indians are present at birth. J Clin Endocrinol Metab 87, 55755580.

21.CG Victora , D Sibbritt , BL Horta (2007) Weight gain in childhood and body composition at 18 years of age in Brazilian males. Acta Paediatr 96, 296300.

22.CG Victora , L Adair , C Fall (2008) Maternal and child undernutrition: consequences for adult health and human capital. Lancet 371, 340357.

23.AD Stein , AM Thompson & A Waters (2005) Childhood growth and chronic disease: evidence from countries undergoing the nutrition transition. Matern Child Nutr 1, 177184.

24.NJ Crowther , N Cameron , J Trusler (1998) Association between poor glucose tolerance and rapid post natal weight gain in seven-year-old children. Diabetologia 41, 11631167.

25.NS Levitt , EV Lambert , D Woods (2000) Impaired glucose tolerance and elevated blood pressure in low birth weight, nonobese, young South African adults: early programming of cortisol axis. J Clin Endocrinol Metab 85, 46114618.

27.A Nazmi , SR Huttly , CG Victora (2007) Hb A1c in relation to intrauterine growth among male adolescents in southern Brazil. Eur J Clin Nutr 61, 434437.

29.NS Levitt , K Steyn , T De Wet (1999) An inverse relation between blood pressure and birth weight among 5 year old children from Soweto, South Africa. J Epidemiol Community Health 53, 264268.

30.AM Menezes , PC Hallal , BL Horta (2007) Size at birth and blood pressure in early adolescence: a prospective birth cohort study. Am J Epidemiol 165, 611616.

31.CE Stein , CH Fall , K Kumaran (1996) Fetal growth and coronary heart disease in south India. Lancet 348, 12691273.

33.DA Lawlor , P Juni , S Ebrahim (2003) Systematic review of the epidemiologic and trial evidence of an association between antidepressant medication and breast cancer. J Clin Epidemiol 56, 155163.

34.G Leguizamon & F von Stecher (2003) Third trimester glycemic profiles and fetal growth. Curr Diab Rep 3, 323326.

36.G Davey Smith , C Steer , S Leary (2007) Is there an intrauterine influence on obesity? Evidence from parent child associations in the Avon Longitudinal Study of Parents and Children (ALSPAC). Arch Dis Child 92, 876880.

37.A Plagemann (2008) A matter of insulin: developmental programming of body weight regulation. J Matern Fetal Neonatal Med 21, 143148.

39.CB Ebbeling , DB Pawlak & DS Ludwig (2002) Childhood obesity: public-health crisis, common sense cure. Lancet 360, 473482.

40.A Lucas , MS Fewtrell & TJ Cole (1999) Fetal origins of adult disease – the hypothesis revisited. Br Med J 319, 245249.

42.L Ibanez , K Ong , DB Dunger (2006) Early development of adiposity and insulin resistance after catch-up weight gain in small-for-gestational-age children. J Clin Endocrinol Metab 91, 21532158.

43.C Corvalan , CO Gregory , M Ramirez-Zea (2007) Size at birth, infant, early and later childhood growth and adult body composition: a prospective study in a stunted population. Int J Epidemiol 36, 550557.

44.NJ Crowther , N Cameron , J Trusler (2008) Influence of catch-up growth on glucose tolerance and beta-cell function in 7-year-old children: results from the birth to twenty study. Pediatrics 121, e1715e1722.

45.SK Bhargava , HS Sachdev , CH Fall (2004) Relation of serial changes in childhood body-mass index to impaired glucose tolerance in young adulthood. N Engl J Med 350, 865875.

47.J Baird , D Fisher , P Lucas (2005) Being big or growing fast: systematic review of size and growth in infancy and later obesity. Br Med J 331, 929.

48.KK Ong & RJ Loos (2006) Rapid infancy weight gain and subsequent obesity: systematic reviews and hopeful suggestions. Acta Paediatr 95, 904908.

49.PO Monteiro & CG Victora (2005) Rapid growth in infancy and childhood and obesity in later life – a systematic review. Obes Rev 6, 143154.

50.D Fisher , J Baird , L Payne (2006) Are infant size and growth related to burden of disease in adulthood? A systematic review of literature. Int J Epidemiol 35, 11961210.

51.N Stettler (2007) Nature and strength of epidemiological evidence for origins of childhood and adulthood obesity in the first year of life. Int J Obes (Lond) 31, 10351043.

52.N Cameron , J Pettifor , T De Wet (2003) The relationship of rapid weight gain in infancy to obesity and skeletal maturity in childhood. Obes Res 11, 457460.

55.BA Dennison , LS Edmunds , HH Stratton (2006) Rapid infant weight gain predicts childhood overweight. Obesity (Silver Spring) 14, 491499.

56.N Stettler , BS Zemel , S Kumanyika (2002) Infant weight gain and childhood overweight status in a multicenter, cohort study. Pediatrics 109, 194199.

59.JC Wells , PC Hallal , A Wright (2005) Fetal, infant and childhood growth: relationships with body composition in Brazilian boys aged 9 years. Int J Obes (Lond) 29, 11921198.

60.BL Horta , FC Barros , CG Victora (2003) Early and late growth and blood pressure in adolescence. J Epidemiol Community Health 57, 226230.

62.Y Ben-Shlomo (2007) Rising to the challenges and opportunities of life course epidemiology. Int J Epidemiol 36, 481483.

65.SP Walker , SM Chang & CA Powell (2007) The association between early childhood stunting and weight status in late adolescence. Int J Obes (Lond) 31, 347352.

66.PO Monteiro , CG Victora , FC Barros (2003) Birth size, early childhood growth, and adolescent obesity in a Brazilian birth cohort. Int J Obes Relat Metab Disord 27, 12741282.

67.R Uauy , J Kain , V Mericq (2008) Nutrition, child growth, and chronic disease prevention. Ann Med 40, 1120.

68.ZA Bhutta , T Ahmed , RE Black (2008) What works? Interventions for maternal and child undernutrition and survival. Lancet 371, 417440.

69.R Gonzalez , M Merialdi , O Lincetto (2006) Reduction in neonatal mortality in Chile between 1990 and 2000. Pediatrics 117, e949e954.

70.P Zimmet , KG Alberti , F Kaufman (2007) The metabolic syndrome in children and adolescents – an IDF consensus report. Pediatr Diabetes 8, 299306.

72.TB Hickman , RR Briefel , MD Carroll (1998) Distributions and trends of serum lipid levels among United States children and adolescents ages 4–19 years: data from the Third National Health and Nutrition Examination Survey. Prev Med 27, 879890.

73.CG Owen , RM Martin , PH Whincup (2005) Effect of infant feeding on the risk of obesity across the life course: a quantitative review of published evidence. Pediatrics 115, 13671377.

75.T Harder , R Bergmann , G Kallischnigg (2005) Duration of breastfeeding and risk of overweight: a meta-analysis. Am J Epidemiol 162, 397403.

76.AE Buyken , N Karaolis-Danckert , T Remer (2008) Effects of breastfeeding on trajectories of body fat and BMI throughout childhood. Obesity (Silver Spring) 16, 389395.

78.CG Owen , PH Whincup , JA Gilg (2003) Effect of breast feeding in infancy on blood pressure in later life: systematic review and meta-analysis. Br Med J 327, 11891195.

79.CG Owen , PH Whincup , K Odoki (2002) Infant feeding and blood cholesterol: a study in adolescents and a systematic review. Pediatrics 110, 597608.

80.DA Lawlor , CJ Riddoch , AS Page (2005) Infant feeding and components of the metabolic syndrome: findings from the European Youth Heart Study. Arch Dis Child 90, 582588.

81.J Cohen (1977) Statistical Power Analysis for the Behavioral Sciences, revised ed.New York: Academic Press.

84.K Macé , Y Shahkhalili , O Aprikian (2006) Dietary fat and fat types as early determinants of childhood obesity: a reappraisal. Int J Obes (Lond) 30, S50S57.

85.O Miralles , J Sanchez , A Palou (2006) A physiological role of breast milk leptin in body weight control in developing infants. Obesity (Silver Spring) 14, 13711377.

88.A Singhal & J Lanigan (2007) Breastfeeding, early growth and later obesity. Obes Rev 8, Suppl. 1, 5154.

89.A Singhal & A Lucas (2004) Early origins of cardiovascular disease: is there a unifying hypothesis? Lancet 363, 16421645.

90.KK Ong , PM Emmett , S Noble (2006) Dietary energy intake at the age of 4 months predicts postnatal weight gain and childhood body mass index. Pediatrics 117, e503e508.

91.I Thorsdottir , I Gunnarsdottir & GI Palsson (2003) Birth weight, growth and feeding in infancy: relation to serum lipid concentration in 12-month-old infants. Eur J Clin Nutr 57, 14791485.

92.DB Allison , SK Egan , LM Barraj (1999) Estimated intakes of trans fatty and other fatty acids in the US population. J Am Diet Assoc 99, 166174.

95.I Ohlund , A Hornell , T Lind (2008) Dietary fat in infancy should be more focused on quality than on quantity. Eur J Clin Nutr 62, 10581064.

96.BM Popkin & P Gordon-Larsen (2004) The nutrition transition: worldwide obesity dynamics and their determinants. Int J Obes Relat Metab Disord 28, Suppl. 3, S2S9.

97.DJ Barker (1998) In utero programming of chronic disease. Clin Sci (Lond) 95, 115128.

98.DJ Barker (2006) Adult consequences of fetal growth restriction. Clin Obstet Gynecol 49, 270283.

99.CN Hales & DJ Barker (2001) The thrifty phenotype hypothesis. Br Med Bull 60, 5–20.

104.M de Onis (2004) The use of anthropometry in the prevention of childhood overweight and obesity. Int J Obes Relat Metab Disord 28, Suppl. 3, S81S85.

106.M de Onis , C Garza , CG Victora (2004) The WHO Multicentre Growth Reference Study: planning, study design, and methodology. Food Nutr Bull 25, Suppl., S15S26.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Proceedings of the Nutrition Society
  • ISSN: 0029-6651
  • EISSN: 1475-2719
  • URL: /core/journals/proceedings-of-the-nutrition-society
Please enter your name
Please enter a valid email address
Who would you like to send this to? *