Long-term anthropometric outcomes in patients treated in the growth and nutrition program
Park, So Hyeon
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OBJECTIVE: Prior studies suggested rapid weight gain in infancy as a risk factor for the development of obesity. Our aim was to determine if early-childhood treatment for malnutrition is associated with the development of obesity in later-childhood. METHODS: This was a retrospective chart review of 194 children who had been treated and discharged from the Growth and Nutrition Program (GNP) from 1/1/2000 to 7/30/2014, with at least one height and weight recorded after discharge. Subjects predisposed to obesity due to medical conditions or medications were excluded. Obesity was defined using WHO and CDC growth charts, body mass index ≥95th percentile for age and sex, and compared to published prevalence rates. Potential predictors of obesity prevalence were also examined. RESULTS: None of the 194 subjects were obese at time of discharge from GNP. Over the 20-year follow-up period, 7% became obese (well below the national obesity prevalence of 18.5%1. 3 of 11 (27.3%) patients prescribed preterm infant formula became obese in contrast to 10 of 173 (5.8%) who were not prescribed (p=0.007). 6 of 27 (22.2%) subjects identified as African American became obese in contrast to 7 of 157 (4.5%) who did not identify (p=0.001). CONCLUSION: While overall prevalence of obesity was lower than that of the general population, children requiring preterm infant formula and/or identified as African American were more likely to develop obesity in childhood. Findings support the need for more anticipatory guidance regarding preterm infant formula and aggressive weight management and planning prior to GNP discharge.