Early-Life Factors and Body Mass Index Trajectories Among Children in the ECHO Cohort
Authors' conclusion
In this cohort study of children in the ECHO cohort, analyses identified children on the path to obesity as early as age 3.5 years. Modifiable factors could be targeted for early prevention and intervention programs aimed at reducing childhood obesity.
Study context
- Population
- Children aged 1 to 9 years with ≥4 weight and height assessments, ECHO cohort, data January 1997 to June 20244,925 boys [51.9%]
- Participants
- 9,483 children
- Exposure
- Atypical vs typical body mass index (BMI) trajectory
- Atypicaln = 1,006
- Typicaln = 8,477reference
- Outcome
- BMI trajectories (multiphase latent growth mixture model)
- Follow-up
- Ages 1 to 9 years
Methodological detailslongitudinal, multiphase latent growth mixture model, Analyses conducted January to June 2024
- Longitudinal
- Multiphase latent growth mixture model
- Analyses conducted January to June 2024
Main finding
As reported in the abstract
Two distinct 2-phase BMI trajectories
| Group | Value | b2 (BMI slope, phase 1) | Age at lowest BMI (95% CI) | Slope difference [b4 - b2] | Mean BMI at 9 years | b6 (BMI slope, ages 1 to 3.5 years) | Slope difference [b8 - b6] |
|---|---|---|---|---|---|---|---|
| Typical | 89.4% | −0.23 [95% CI, −0.24 to −0.22] | 6 years (5.94-6.11) | 0.81 [95% CI, 0.76-0.86] | 17.33 | ||
| Atypical | 10.6% | 26.2 | 0.06 [95% CI, −0.04 to 0.15] | 1.44 [95% CI, 1.34-1.55] |
Value
Typical89.4%
Atypical10.6%
b2 (BMI slope, phase 1)
Typical−0.23 [95% CI, −0.24 to −0.22]
Atypical— not stated in the abstract
Age at lowest BMI (95% CI)
Typical6 years (5.94-6.11)
Atypical— not stated in the abstract
Slope difference [b4 - b2]
Typical0.81 [95% CI, 0.76-0.86]
Atypical— not stated in the abstract
Mean BMI at 9 years
Typical17.33
Atypical26.2
b6 (BMI slope, ages 1 to 3.5 years)
Typical— not stated in the abstract
Atypical0.06 [95% CI, −0.04 to 0.15]
Slope difference [b8 - b6]
Typical— not stated in the abstract
Atypical1.44 [95% CI, 1.34-1.55]
Observational data: associations, not effects.
Further findings
- Prenatal smoking, high prepregnancy BMI, high gestational weight gain and high birth weight were key risk factors for the atypical trajectory
Original publication
Early-Life Factors and Body Mass Index Trajectories Among Children in the ECHO Cohort. JAMA Netw Open. Published 1 May 2025. doi:10.
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