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      The adiposity rebound in the 21st century children: meaning for what?

      review-article
      , MD, PhD
      Korean Journal of Pediatrics
      Korean Pediatric Society
      Body mass index, Adiposity rebound, Obesity

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          Abstract

          With the increase in the prevalence of overweight and obesity worldwide, early adiposity rebound, which is known to have a strong association with obesity, has recently been a focus of research. Early adiposity rebound is conventionally known to have a close relationship with non-communicable diseases. However, novel insights into early adiposity rebound have implied an acceleration of growth and puberty, which is directly reflected in the trends in the timing of adiposity rebound, in the 21st century compared with in the past. Furthermore, the observation that lean mass changes rather than fat mass changes show a more similar pattern to body mass index trajectories is interesting. In this article, the later outcomes and risk factors of early adiposity rebound are briefly summarized, and the current trends in the timing of adiposity rebound and novel insights into its relationship with body composition are reviewed.

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          Most cited references44

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          Fetal and infant growth and impaired glucose tolerance at age 64.

          To discover whether reduced fetal and infant growth is associated with non-insulin dependent diabetes and impaired glucose tolerance in adult life. Follow up study of men born during 1920-30 whose birth weights and weights at 1 year were known. Hertfordshire, England. 468 men born in east Hertfordshire and still living there. Fasting plasma glucose, insulin, proinsulin, and 32-33 split pro-insulin concentrations and plasma glucose and insulin concentrations 30 and 120 minutes after a 75 g glucose drink. 93 men had impaired glucose tolerance or hitherto undiagnosed diabetes. They had had a lower mean birth weight and a lower weight at 1 year. The proportion of men with impaired glucose tolerance fell progressively from 26% (6/23) among those who had weighted 18 lb (8.16 kg) or less at 1 year to 13% (3/24) among those who had weighed 27 lb (12.25 kg) or more. Corresponding figures for diabetes were 17% (4/23) and nil (0/24). Plasma glucose concentrations at 30 and 120 minutes fell with increasing birth weight and weight at 1 year. Plasma 32-33 split proinsulin concentration fell with increasing weight at 1 year. All these trends were significant and independent of current body mass. Blood pressure was inversely related to birth weight and strongly related to plasma glucose and 32-33 split proinsulin concentrations. Reduced growth in early life is strongly linked with impaired glucose tolerance and non-insulin dependent diabetes. Reduced early growth is also related to a raised plasma concentration of 32-33 split proinsulin, which is interpreted as a sign of beta cell dysfunction. Reduced intrauterine growth is linked with high blood pressure, which may explain the association between hypertension and impaired glucose tolerance.
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            Early adiposity rebound in childhood and risk of Type 2 diabetes in adult life.

            Type 2 diabetes is associated with a small body size at birth and a high BMI in adult life. The aim of our study was to assess the associations between Type 2 diabetes and birth size, infant growth and age at adiposity rebound. We carried out a longitudinal study of 8760 subjects born in Helsinki during 1934 to 1944. On average, they had 18 measurements of height and weight between birth and 12 years of age. In western countries BMI usually decreases after the age of 2 years and rises again at around 6 years--the so-called adiposity rebound. We defined age at adiposity rebound by the age of lowest BMI between one and 12 years. We identified people with Type 2 diabetes using a national register. A total of 290 individuals developed Type 2 diabetes in adult life. The cumulative incidence of Type 2 diabetes decreased progressively from 8.6% in persons whose adiposity rebound occurred before the age of 5 years to 1.8% in those in whom it occurred after 7 years ( p<0.001). Early adiposity rebound was preceded by low weight gain between birth and 1 year ( p<0.001). Large differences in the incidence of Type 2 diabetes are associated with growth rates in utero, weight gain in infancy and age at adiposity rebound.
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              Influence of macronutrients on adiposity development: a follow up study of nutrition and growth from 10 months to 8 years of age.

              To investigate the relationship between early nutrient intake and adiposity development. A follow up study of nutrition and growth carried out in a sample of 112 French children from 10 months to 8 years of age. Nutritional intakes at the age of 2 years and anthropometric measurements: Body Mass Index (BMI), subscapular and triceps skinfolds at the age of 8 years, and age at adiposity rebound assessed on the basis of BMI development. The BMI at the age of 8 years is positively correlated with energy intake at the age of 2 years, but this correlation becomes non significant after adjustment for BMI at 2 years. Protein (% of energy) intake at the age of 2 years is positively correlated with BMI and subscapular skinfold at 8 years after adjustment for energy intake at 2 years and parental BMI. The percentage of protein at 2 years is negatively associated with age at adiposity rebound, i.e. the higher the protein intake at 2 years, the earlier the adiposity rebound and the higher the subsequent BMI level. Protein at the age of 2 years is the only nutrient intake associated with fatness development pattern. A high protein intake increases body fatness at 8 years of age, via an early adiposity rebound. The association between protein intake and obesity is consistent with the increased stature and accelerated growth of obese children. A high fat low protein diet (such as human milk) is adapted to high energy demand for growth in early childhood. Our results suggest that high protein diet early in life could increase the risk of obesity and other pathologies later in life.
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                Author and article information

                Journal
                Korean J Pediatr
                Korean J Pediatr
                KJP
                Korean Journal of Pediatrics
                Korean Pediatric Society
                1738-1061
                2092-7258
                December 2018
                6 December 2018
                : 61
                : 12
                : 375-380
                Affiliations
                Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
                Author notes
                Corresponding author: Min Jae Kang, MD, PhD Department of Pediatrics, Hallym University Sacred Heart Hospital, 22, Gwanpyeong-ro 170beon-gil, Dongan-gu, Anyang 14068, Korea Tel: +82-31-380-3730 Fax: +82-31-380-1900 E-mail: mjkang@ 123456hallym.or.kr
                Author information
                http://orcid.org/0000-0003-3080-0941
                Article
                kjp-2018-07227
                10.3345/kjp.2018.07227
                6313085
                30585060
                c2fa1e05-0faa-4f6d-be13-98ae78e4f269
                Copyright © 2018 by The Korean Pediatric Society

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 6 November 2018
                : 4 December 2018
                : 6 December 2018
                Categories
                Review Article

                Pediatrics
                body mass index,adiposity rebound,obesity
                Pediatrics
                body mass index, adiposity rebound, obesity

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