To identify BMI trajectories utilizing methods and graphing tools that maintain and visualize variability of BMIs ≥95 percentile, and to investigate individual differences in early sociodemographic risk, infant growth and feeding patterns, and maternal weight status on these trajectories.
Participants included 1,041 predominantly rural, poor families from the Family Life Project, a longitudinal birth cohort. Youth anthropometrics were measured 8 times between ages 2 months and 12 years; at 2 months, mothers reported sociodemographics, youth birthweight, infant feeding, and self-reported child weight and height (at 2 months and 12 y). At 6 months, mothers reported breastfeeding. At 2 years maternal weight and height were measured.
Three BMI trajectories were identified: “maintained non-overweight,” “developed obesity,” and “developed severe obesity.” Compared with the non-overweight trajectory, the children with heavier trajectories were breastfed for a shorter duration and had heavier mothers at all assessments. The children with “developed obesity” trajectory were not heavier at birth than those with non-overweight trajectory, yet, they displayed greater change in weight-for-length percentile during infancy; additionally, their mothers had the highest change in BMIs between 2 months and 12y. Children with the “developed severe obesity” trajectory was heavier at birth, and more likely to be heavy during infancy and fed solid foods early.
Using informed analytical and graphing approaches, we described patterns of growth, and identified early predictors of obesity and severe obesity trajectories among a diverse sample of poor, rural youth. Researchers are urged to consider these approaches in future work, and to focus on identifying protective factors in youth with obesity and severe obesity.

Copyright © 2020. Published by Elsevier Inc.