Article Text

Download PDFPDF
Racial differences in crossing major growth percentiles in infancy
  1. Summer Sherburne Hawkins1,
  2. Sheryl L Rifas-Shiman2,
  3. Matthew W Gillman2,
  4. Elsie M Taveras3,4
  1. 1 School of Social Work, Boston College, Chestnut Hill, Massachusetts, USA
  2. 2 Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
  3. 3 Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, Massachusetts, USA
  4. 4 Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
  1. Correspondence to Dr Summer Hawkins, Boston College, School of Social Work, McGuinn Hall, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, USA; summer.hawkins{at}


Background/aims We examined associations of ever crossing upwards ≥2 (vs <2) major weight-for-length (WFL) percentiles in the first 24 months with obesity at 5 years among white and black children.

Methods We included 10 979 white and 1245 black children from the Linked CENTURY Study with percentile crossing data in all four 6-month periods in the first 24 months and obesity (age-specific and sex-specific body mass index ≥95th percentile) at 5 years. We used adjusted logistic regression models and stratified by race.

Results 64% of children crossed upwards ≥2 major WFL percentiles in the first 2 years. Among white children, 12% were obese vs 7% for <2 crossings, while among black children the frequencies were 23% vs 9%. Black children (adjusted OR 2.94, 2.04 to 4.23) who had ever crossed upwards ≥2 major WFL percentiles had a higher odds of obesity at age 5 than white children (adjusted OR 1.89, 1.64 to 2.18) (interaction p=0.02).

Conclusions Our results suggest that rapid weight gain in infancy is more deleterious among black than white children for later obesity.

  • Growth
  • health disparities
  • pediatric obesity

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors SSH conceptualised and designed the study, participated in data collection and interpretation of the results, drafted the initial manuscript. SRL-S participated in data collection, analysis and interpretation, critically reviewed and revised the manuscript. MWG participated in data interpretation, critically reviewed and revised the manuscript. EMT conceptualised and designed the study, participated in data interpretation, critically reviewed and revised the manuscript. All authors approved the final manuscript. SRL-S had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

  • Funding This work was partially funded by grants from the NIH (R00 HD068506) to Dr Hawkins and the National Center for Chronic Disease Prevention and Health Promotion (contract no. 200-2008-M-26882) to Dr Taveras. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funders.

  • Competing interests None declared.

  • Ethics approval The Institutional Review Boards at Boston College and Harvard Pilgrim Health Care reviewed this study and considered it exempt.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No data from the Linked Collecting Electronic Nutrition Trajectory Data Using e-Records of Youth Study are publicly available.