Role of growth at different age intervals, early life nutrition, and adulthood factors on the development of adult body composition in individuals from low and middle-income countries Restricted; Files & ToC

Abstract

Low and middle-income countries (LMICs) have witnessed an increased prevalence of cardiometabolic risk factors such as diabetes, hypertension, and excess weight in the adult population. Body mass index (BMI) is generally used to characterize adult weight status at the individual and population levels. However, the study of body composition compartments (FFMI: fat mass index, and FFMI: fat-free mass index) beyond body size is more relevant to understand the obesity burden. The objective of this dissertation was to investigate the role of growth at different age intervals, early life nutrition, and adult environment on the development of adult body composition in individuals from LMICs. We conducted three separate secondary data analyses of large and long-lasting birth cohorts and a cross-sectional nationally representative dataset. In aim 1, we found that prenatal and postnatal relative weight gains were associated with higher FFMI, FMI, BMI and waist circumference (WC) in young and mid-adulthood. Conditional height in infancy was a significant but weak predictor of adult adiposity and did not predict FFMI. In aim 2, we identified sex-specific latent class trajectories of body composition from adolescence to mid-adulthood. Intercepts were different and slopes did not overlap across time. Some parental characteristics and self’s schooling attainment were significantly associated with body composition class membership. Exposure to a nutrition supplement in the first 1,000 days of life did not predict class membership. In aim 3, we observed that most of BMI and WC variability in adult life was attributed to between-individual and between-household differences. Individual and household factors showed the strongest associations with BMI and WC, and explained 2.1-17.4% of the observed variability at these levels. Results from this dissertation suggest that early life factors like parental characteristics and growth in the first 1,000 days of life have a small but long-lasting role on adult body composition. Early/mid-childhood and adolescence are key periods to prevent relative excess weight gain given the strongest associations with adult body composition. The large and rapid increase in adiposity in young and mid-adulthood might be largely influenced by the adult environment with factors operating at individual and household levels.

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About this Dissertation

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School	Laney Graduate School
Department	Nutrition and Health Sciences
Degree	Ph.D.
Submission	Dissertation
Language	English
Research Field	Health Sciences, Epidemiology Health Sciences, Public Health Health Sciences, Nutrition
Keyword	LMICs Latent class growth analysis National survey Early life Cohort studies Multilevel analysis Body composition Child nutrition Adolescence Child growth Obesity
Committee Chair / Thesis Advisor	Stein, Aryeh D, Emory University
Committee Members	Martorell, Reynaldo, Emory University Adair, Linda S, University of North Carolina – Chapel Hill Patel, Shivani A, Emory University Ramirez-Zea, Manuel, Institute of Nutrition of Central America and Panama (INCAP)

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