Journal Mobile Options
Table of Contents
Vol. 65, Suppl. 3, 2006
Issue release date: April 2006
Horm Res 2006;65:65–69

Size at Birth, Postnatal Growth and Risk of Obesity

Ong K.K.
aMRC Epidemiology Unit, Strangeways Research Laboratory, Cambridge, and bDepartment of Paediatrics, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK

Individual Users: Register with Karger Login Information

Please create your User ID & Password

Contact Information

I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in


Epidemiological studies over the last 15 years have shown that size at birth, early postnatal catch-up growth and excess childhood weight gain are associated with an increased risk of adult cardiovascular disease and type 2 diabetes. At the same time, rising rates of obesity and overweight in children, even at pre-school ages, have shifted efforts towards the identification of very early factors that predict risk of subsequent obesity, which may allow early targeted interventions. Overall, higher birth weight is positively associated with subsequent greater body mass index in childhood and later life; however, the relationship is complex. Higher birth weight is associated with greater subsequent lean mass, rather than fat mass. In contrast, lower birth weight is associated with a subsequent higher ratio of fat mass to lean mass, and greater central fat and insulin resistance. This paradoxical effect of lower birth weight is at least partly explained by the observation that infants who have been growth restrained in utero tend to gain weight more rapidly, or ‘catch up’, during the early postnatal period, which leads to increased central fat deposition. There is still debate as to whether there are critical early periods for obesity: does excess weight gain during infancy, childhood or even very early neonatal life have a greater impact on long-term fat deposition and insulin resistance? Early identification of childhood obesity risk will be aided by identification of maternal and fetal genes that regulate fetal nutrition and growth, and postnatal genes that regulate appetite, energy expenditure and the partitioning of energy intake into fat or lean tissue growth.

Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.


  1. Department of Health 2005 Health Survey for England: Obesity among children under 11, London, UK.
  2. Dietz WH: Overweight in childhood and adolescence. N Engl J Med 2004;350:855–857.
  3. Loos RJ, Beunen G, Fagard R, Derom C, Vlietinck R: Birth weight and body composition in young adult men – a prospective twin study. Int J Obes Relat Metab Disord 2001;25:1537–1545.
  4. Loos RJ, Beunen G, Fagard R, Derom C, Vlietinck R: Birth weight and body composition in young women: a prospective twin study. Am J Clin Nutr 2002;75:676–682.
  5. Hediger ML, Overpeck MD, Kuczmarski RJ, McGlynn A, Maurer KR, Davis WW: Muscularity and fatness of infants and young children born small- or large-for-gestational-age. Pediatrics 1998;102:E60.

    External Resources

  6. Gale CR, Martyn CN, Kellingray S, Eastell R, Cooper C: Intrauterine programming of adult body composition. J Clin Endocrinol Metab 2001;86:267–272.
  7. Law CM, Barker DJ, Osmond C, Fall CH, Simmonds SJ: Early growth and abdominal fatness in adult life. J Epidemiol Community Health 1992;46:184–186.
  8. Barker M, Robinson S, Osmond C, Barker DJ: Birth weight and body fat distribution in adolescent girls. Arch Dis Child 1997;77:381–383.
  9. Yajnik C: Interactions of perturbations in intrauterine growth and growth during childhood on the risk of adult-onset disease. Proc Nutr Soc 2000;59:257–265.
  10. de Zegher F, Ong K, Dunger D, Ibáñez L: Along the path from fetal growth restraint to later diabetes: fat excess emerges by age 3 year. Horm Res 2005;64(suppl 1):183.
  11. Ong KK, Preece MA, Emmett PM, Ahmed ML, Dunger DB: Size at birth and early childhood growth in relation to maternal smoking, parity and infant breast-feeding: longitudinal birth cohort study and analysis. Pediatr Res 2002;52:863–867.
  12. Monteiro PO, Victora CG: Rapid growth in infancy and childhood and obesity in later life–a systematic review. Obes Rev 2005;6:143–154.
  13. Singhal A, Cole TJ, Lucas A: Early nutrition in preterm infants and later blood pressure: two cohorts after randomised trials. Lancet 2001;357:413–419.
  14. Singhal A, Fewtrell M, Cole TJ, Lucas A: Low nutrient intake and early growth for later insulin resistance in adolescents born preterm. Lancet 2003;361:1089–1097.
  15. Stunkard AJ, Berkowitz RI, Schoeller D, Maislin G, Stallings VA: Predictors of body size in the first 2 y of life: a high-risk study of human obesity. Int J Obes Relat Metab Disord 2004;28:503–513.
  16. Ong KK, Emmett PM, Noble S, Ness A, Dunger DB, the ALSPAC Study Team: Dietary energy intake at the age of 4 months predicts postnatal weight gain and childhood body mass index. Pediatrics 2006;117:e503–e508.

    External Resources

  17. Martin RM, Ness AR, Gunnell D, Emmett P, Davey Smith G: Does breast-feeding in infancy lower blood pressure in childhood? The Avon Longitudinal Study of Parents and Children (ALSPAC). Circulation 2004;109:1259–1266.
  18. Reilly JJ, Armstrong J, Dorosty AR, Emmett PM, Ness A, Rogers I, Steer C, Sherriff A: Early life risk factors for obesity in childhood: cohort study. BMJ 2005;330:1357.
  19. Vickers MH, Gluckman PD, Coveny AH, Hofman PL, Cutfield WS, Gertler A, Breier BH, Harris M: Neonatal leptin treatment reverses developmental programming. Endocrinology 2005;146:4211–4216.
  20. Yura S, Itoh H, Sagawa N, Yamamoto H, Masuzaki H, Nakao K, Kawamura M, Takemura M, Kakui K, Ogawa Y, Fujii S: Role of premature leptin surge in obesity resulting from intrauterine undernutrition. Cell Metab 2005;1:371–378.
  21. Farooqi IS, O’Rahilly S: New advances in the genetics of early onset obesity. Int J Obes (Lond) 2005;29:1149–1152.
  22. Stettler N, Stallings VA, Troxel AB, Zhao J, Schinnar R, Nelson SE, Ziegler EE, Strom BL: Weight gain in the first week of life and overweight in adulthood: a cohort study of European American subjects fed infant formula. Circulation 2005;111:1897–1903.
  23. Bhargava SK, Sachdev HS, Fall CH, Osmond C, Lakshmy R, Barker DJ, Biswas SK, Ramji S, Prabhakaran D, Reddy KS: Relation of serial changes in childhood body-mass index to impaired glucose tolerance in young adulthood. N Engl J Med 2004;350:865–875.
  24. Ekelund U, Ong K, Linné Y, Neovius M, Brage S, Dunger DB, Wareham NJ, Rössner S: Upward weight percentile crossing in infancy and early childhood independently predicts fat mass in young adults: the Stockholm Weight Development Study (SWEDES). Am J Clin Nutr 2006;83:324–330.
  25. Wells JC, Hallal PC, Wright A, Singhal A, Victora CG: Fetal, infant and childhood growth: relationships with body composition in Brazilian boys aged 9 years. Int J Obes (Lond) 2005;29:1192–1198.
  26. Berkowitz RI, Stallings VA, Maislin G, Stunkard AJ: Growth of children at high risk of obesity during the first 6 y of life: implications for prevention. Am J Clin Nutr 2005;81:140–146.
  27. Forsen T, Eriksson JG, Tuomilehto J, Teramo K, Osmond C, Barker DJ: Mother’s weight in pregnancy and coronary heart disease in a cohort of Finnish men: follow up study. BMJ 1997;315:837–840.
  28. Catalano PM, Kirwan JP, Haugel-de Mouzon S, King J: Gestational diabetes and insulin resistance: role in short- and long-term implications for mother and fetus. J Nutr 2003;133:1674S–1683S.
  29. Sobngwi E, Boudou P, Mauvais-Jarvis F, Leblanc H, Velho G, Vexiau P, Porcher R, Hadjadj S, Pratley R, Tataranni PA, Calvo F, Gautier JF: Effect of a diabetic environment in utero on predisposition to type 2 diabetes. Lancet 2003;361:1861–1865.
  30. Hunter WA, Cundy T, Rabone D, Hofman PL, Harris M, Regan F, Robinson E, Cutfield WS: Insulin sensitivity in the offspring of women with type 1 and type 2 diabetes. Diabetes Care 2004;27:1148–1152.
  31. McCance DR, Pettitt DJ, Hanson RL, Jacobsson LT, Knowler WC, Bennett PH: Birth weight and non-insulin dependent diabetes: thrifty genotype, thrifty phenotype, or surviving small baby genotype? BMJ 1994;308:942–945.
  32. Victora CG, Barros FC, Horta BL, Martorell R: Short-term benefits of catch-up growth for small-for-gestational-age infants. Int J Epidemiol 2001;30:1325–1330.

Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50