RESUMO
OBJECTIVE: To investigate the early postnatal growth-chronic disease hypothesis, we decided to trace two total community cohorts of Jamaican children (Studies A & B). DESIGN AND METHODS: Prenatal and postnatal under-nutrition were widespread in the Caribbean in the early-mid 20th century. Current rates of some chronic diseases (high blood pressure (BP), diabetes) may reflect recent lifestyle and body mass index (BMI) changes, superimposed on these early constraints on childhood growth. Study A comprised children born between 1962 and 1963 and their recalled birth weight, weight at 1 month and height from 3 months were noted and other details were measured 1-3 monthly for 5 years, with re-measures at age 10-11 years (n=177). In study B (n=417), similar parameters were noted for all children <5 years, until 5 years of age. If traced, we took lifestyle enquiries, standardised measures of current height, weight, BP and fasting blood glucose. RESULTS: In Study A, 130 children (73 percent) were traced: 35 had migrated overseas (26 with whereabouts known), 3 died, 5 were ill/pregnant, leaving 87 available and known locally. Of 65 invited, 61 (28 men, 33 women) were seen. Of 205 initially sampled in Study B, 24 had migrated, 5 died, and 2 were ill so that 174 (85 percent) were still known locally but not yet followed. Study A: Univariate correlations between growth in height from 3 months to 5 years and current systolic BP (SBP) of adults aged 35+ years were inverse, at -0.21. Adjusted for current BMI, these changed to -0.25; further adjusting for initial 3-month height reduced the co-relation to -0.17 (p<0.02). Earlier height increments (to 2, 3 or 4 years) were more weakly inversely related to adult SBP, as was growth in weight, univariate -0.10, and after adjusting for current BMI and weight, -0.15 (p<0.05). Adjusted correlations with diastolic BP were prominent (-0.37) from 3 months to 4 years but not up to 5 years. Height and weight had tracked markedly from 0 to 5 years, those who grew the least having higher adult BP. CONCLUSION: Tracing adult cohorts from these earlier childhood studies in modern Jamaica is practical, worthwhile sample sizes can be achieved (>70 percent) and from this previously relatively undernourished community, those who grew least from 0 to 5 years had higher BP, even after accounting for initial size.(Au)
