The Association Between Rapid Growth in Children Under the Age of Five and Adolescent Obesity

Abstract

Early-life nutrition is a critical predictor of long-term health, yet the association between rapid early-childhood growth and adolescent obesity, particularly in relation to the “double burden of malnutrition,” remains under-researched in Indonesia. This study aimed to analyze the association between rapid growth and adolescent obesity. Data were obtained from the 1997, 2000, and 2014 waves of the Indonesian Family Life Survey (IFLS). This study included 641 children (aged 0–23 months at baseline) with complete anthropometric measurements across all three waves. Rapid growth was defined as an increase in z-scores of >0.67 in weight-for-age (WAZ), height-for-age (HAZ), or weight-for-height (WHZ) between 1997 and 2000. Multivariable logistic regression, stratified by baseline nutritional status, was used to estimate adjusted risk ratios (aRRs). The adolescent obesity prevalence was 4.5%. Rapid WAZ growth was significantly associated with adolescent obesity (aRR = 4.49; 95% CI: 1.32–15.25), whereas rapid WHZ growth showed a borderline association (aRR = 2.90; 95% CI: 0.87–9.47). Stratified analysis showed that the association between rapid weight gain and adolescent obesity was markedly stronger among children with a history of undernutrition (aRR = 14.99 for WAZ; aRR = 9.52 for WHZ) than among those without. Rapid weight gain during early childhood, particularly in children with a history of undernutrition, is a strong predictor of adolescent obesity. These findings emphasize the importance of integrating longitudinal growth-trajectory monitoring into routine child health assessments to promote healthy growth while minimizing future metabolic risks.