Catch-up growth, metabolic and cardiovascular risk in post-institutionalized Romanian adolescents

BACKGROUND: Reduced prenatal growth followed by rapid postnatal weight gain are risk factors for developing metabolic and cardiovascular disease. Children reared in institutions experience a similar pattern of growth restriction followed by catch-up growth after removal. We explored whether patterns of catch-up growth affect metabolic and cardiovascular outcomes in previously institutionalized adolescents. METHOD: A longitudinal study of institutionalized infants randomized to care as usual (n=68) or foster care intervention (n=68), and never institutionalized controls (n=127). Body mass index (BMI) was measured at baseline (20 months), 30-, 42-months, and ages 8, 12, 16. At age 16, metabolic and pro-inflammatory markers were derived from blood samples. RESULTS: Four BMI trajectories were derived (i.e., average-stable, low-stable, elevated, and accelerated). The accelerated trajectory was comprised predominately of children randomized to foster care, who also exhibited higher levels of glycosylated hemoglobin and C-reactive protein than the other three trajectories. Also, children placed in foster care at younger ages were more likely to be on the accelerated rather than average-stable trajectory. CONCLUSIONS: Although catch-up growth is viewed as a positive improvement among post-institutionalized children, rapid/continuous increases in body size pose a health concern. Attention should be given to monitoring weight gain, diet, and physical activity.