Body mass index trajectories and adiposity rebound during the first 6 years in Korean children: based on the National Health Information Database, 2008-2015

Purpose We analyzed the nationwide longitudinal data to explore body mass index (BMI) growth trajectories and the time of adiposity rebound (AR). Methods Personal data of 84,005 subjects born between 2008 and 2012 were obtained from infant health check-ups which were performed at 5, 11, 21, 33, 45, 57, and 69 months. BMI 00trajectories of each subject were made according to sex and birth weight (Bwt) and the timing of AR was defined as the lowest BMI occurred. Subjects were divided according to Bwt and AR timing as follows: very low birth weight (VLBW), 0.5 kg ≤ Bwt ≤ 1.5 kg; low birth weight (LBW), 1.5 kg < Bwt ≤ 2.5 kg; non-LBW, 2.5 kg < Bwt ≤ 5.0 kg; early AR, before 45 months; moderate AR, at 57 months; and late AR, not until 69 months. Main results Median time point of minimum BMI was 45 months, and the prevalence rates of early, moderate, and late AR were 63.0%, 16.6%, and 20.4%, respectively. BMI at the age of 57 months showed a strong correlation with AR timing after controlling for Bwt (P < 0.001). Sugar-sweetened beverage intake at 21 months (P = 0.02) and no-exercise habit at 57 months (P < 0.001) showed correlations with early AR. When VLBW and LBW subjects were analyzed, BMI at 57 months and breastfeeding at 11 months were correlated with rapid weight gain during the first 5 months (both P < 0.001). Conclusions Based on this first longitudinal study, the majority of children showed AR before 57 months and the degree of obesity at the age of 57 months had a close correlation with early AR or early weight during infancy.