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First-Borns Carry a Higher Metabolic Risk in Early Adulthood: Evidence from a Prospective Cohort Study

Siervo, M; Horta, BL; Stephan, BCM; Victora, CG; Wells, JCK; (2010) First-Borns Carry a Higher Metabolic Risk in Early Adulthood: Evidence from a Prospective Cohort Study. PLOS ONE , 5 (11) , Article e13907. 10.1371/journal.pone.0013907. Green open access

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Abstract

Background: Birth order has been associated with early growth variability and subsequent increased adiposity, but the consequent effects of increased fat mass on metabolic risk during adulthood have not been assessed. We aimed to quantify the metabolic risk in young adulthood of being first-born relative to those born second or subsequently.Methodology and Principal Findings: Body composition and metabolic risk were assessed in 2,249 men, aged 17-19 years, from a birth cohort in southern Brazil. Metabolic risk was assessed using a composite z-score integrating standardized measurements of blood pressure, total cholesterol, high density lipoprotein, triglycerides and fat mass. First-borns had lower birth weight z-score (Delta = -0.25, 95%CI -0.35, -0.15, p<0.001) but showed greater weight gain during infancy (change in weight z-score from birth to 20 months: Delta = 0.39, 95%CI 0.28-0.50, P<0.0001) and had greater mean height (Delta = 1.2 cm, 95%CI: 0.7-1.6, p<0.0001) and weight (Delta = 0.34 kg, 95%CI: 0.13-0.55, p<0.002) at 43 months. This greater weight and height tracked into early adulthood, with first-borns being significantly taller, heavier and with significantly higher fat mass than later-borns. The metabolic risk z-score was significantly higher in first-borns.Conclusions/Significance: First-born status is associated with significantly elevated adiposity and metabolic risk in young adult men in Brazil. Our results, linking cardiovascular risk with life history variables, suggest that metabolic risk may be associated with the worldwide trend to smaller family size and it may interact with changes in behavioural or environmental risk factors.

Type: Article
Title: First-Borns Carry a Higher Metabolic Risk in Early Adulthood: Evidence from a Prospective Cohort Study
Open access status: An open access version is available from UCL Discovery
DOI: 10.1371/journal.pone.0013907
Publisher version: http://dx.doi.org/10.1371/journal.pone.0013907
Language: English
Additional information: © 2010 Siervo et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Earlier phases of the 1982 cohort study were funded by the International Development research Center (Canada), the World Health Organization (Department of Child and Adolescent Health and Development, and Human Reproduction Programme), the Overseas Development Administration (United Kingdom), the United Nations Development Fund for Women, the National Program for Centers of Excellence (Brazil), the National Research Council (Brazil) and the Ministry of Health (Brazil). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Keywords: BIRTH-WEIGHT, PSYCHOLOGICAL STRESS, CHILDHOOD GROWTH, BODY-COMPOSITION, ENERGY-BALANCE, PREGNANCY, FETAL, CORTISOL, OBESITY, ASSOCIATION
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept
URI: https://discovery.ucl.ac.uk/id/eprint/762811
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