Unadjusted bz Outcome Systolic blood pressure (mm Hg) 0e6 mo 1.38 0.35 6e12 mo 0.05 0.35 12e48 mo 1.47 0.34 BMI (kg/m2) 0e6 mo 1.01 0.13 6e12 mo 0.60 0.16 12e48 mo 1.80 0.17 Sum of triceps and subscapular skin folds (mm) 0e6 mo 2.72 0.43 6e12 mo 1.61 0.53 12e48 mo 4.83 0.57 Subscapular/triceps ratio*102 0e6 mo 1.29 0.90 6e12 mo 2.08 0.91 12e48 mo 0.14 0.94 <0.01 0.88 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 <0.01 0.15 0.02 0.89 0.21 0.26 <0.01 0.04 0.06 <0.01 <0.01 <0.01 <0.01 0.02 0.05 0.28 Unadjusted bz Outcome Systolic blood pressure (mm Hg) 0e6 mo 0.42 0.33 6e12 mo 0.39 0.34 12e48 mo 1.61 0.38 BMI (kg/m2) 0e6 mo 0.30 0.14 6e12 mo 0.28 0.15 12e48 mo 0.73 0.16 Sum of triceps and subscapular skin folds (mm) 0e6 mo 1.29 0.45 6e12 mo 1.31 0.44 12e48 mo 1.89 0.52 Subscapular/triciptal ratio*102 0e6 mo 2.37 1.00 6e12 mo 1.84 0.92 12e48 mo 1.11 1.02 SE p Value Maternal, child and adolescent health Table 3 Association between conditional weight gain in infancy and childhood and outcomes at age 14e15 years SE p Value 1993 Pelotas Birth Cohort, Brazil, 2008. *Model 1: adjustment for sex, skin colour, puberty status, socioeconomic level, pre-gestational body mass index (BMI) and smoking during pregnancy. yModel 2: adjustment for variables included in model 1 plus adolescent (14e15 years) BMI (except when the outcome was BMI) and height. zChange in outcome per SD increase in conditional weight or length/height. b, beta coefﬁcient; BMI, body mass index; mo, months. Both BMIdwhich comprises fat and lean massdand the sum of skin foldsdwhich represents fat mass onlydwere positively associated with early weight gain. The regression coefﬁcients suggest that weight gain from 12e48 months had a larger effect than earlier gains. It is reassuring that results on BMI and sum of skin folds are very consistent as these are two independent measures of obesity. A previous analysis of a subsample of 9-year-olds from our cohort showed that while early weight gain was related to lean mass assessed through isotope dilution, later weight gain was associated with fat mass.27 Also using BMI and skin folds, Stettler and colleagues found that rapid weight gain during early infancy was associated with obesity in older chil- dren and young adults,12 and suggested that the ﬁrst week of life was critical for BMI development.13 These studies did not report on the effects of height gain nor used conditional growth modelling. Length gain from 0e6 months, when adjusted for weight gain in the same period, did not appear to increase blood pressuredif anything it was associated with a borderline reduction (p¼0.05) in systolic pressure. It was also associated with lower BMI and possibly with reduced skin folds. Length/height gains from 6e12 and 12e48 months were not associated with blood pressure, but showed negative associations with BMI and skin folds (not all of which were statistically signiﬁcant), which suggest that putting on length/height without excessive weight gain is beneﬁcial for body composition development. Central deposition of fat can be measured both as waist circumference (alone or as a ratio to hip/thigh circumference) and as subscapular-to-triceps skin fold ratios. Both measures have been linked to glucose intolerance, hypertension and coronary heart disease.28e32 In our adjusted analyses, the skin fold ratio was not associated with early weight or height gains. This Table 4 Association between conditional length/height gain in infancy and childhood and outcomes at age 14e15 years Model 1* bz 1.39 0.09 1.06 1.05 0.61 1.62 2.86 1.56 4.35 0.87 0.78 0.06 Model 1* bz 0.26 0.35 1.23 0.18 0.27 0.75 0.87 1.19 1.90 1.71 1.29 0.45 SE 0.32 0.32 0.32 0.16 0.18 0.18 0.47 0.56 0.62 0.99 1.02 0.93 SE 0.31 0.32 0.37 0.16 0.16 0.18 0.51 0.47 0.61 1.09 1.03 1.14 1993 Pelotas Birth Cohort, Brazil, 2008. *Model 1: adjustment for sex, skin colour, puberty status, socioeconomic level, pre-gestational BMI and smoking during pregnancy. yModel 2: adjustment for variables included in model 1 plus BMI (except when the outcome was BMI) and height at 14e15 years. zChange in outcome per SD increase in conditional weight or length/height. b, beta coefﬁcient; BMI, body mass index; mo, months. 152 J Epidemiol Community Health 2012;66:149e154. doi:10.1136/jech.2010.124842 Model 2y bz 0.49 0.73 0.27 1.03 0.63 1.83 0.11 0.07 0.19 1.29 0.99 0.00 Model 2y bz 0.55 0.33 0.13 0.04 0.20 0.93 0.46 0.57 0.03 2.24 1.51 0.54 SE 0.33 0.31 0.35 0.17 0.17 0.19 0.28 0.29 0.40 1.05 1.03 1.04 SE 0.34 0.35 0.45 0.18 0.17 0.20 0.30 0.25 0.33 1.24 1.08 1.27 p Value <0.01 0.79 <0.01 <0.01 <0.01 <0.01 <0.01 0.01 <0.01 0.38 0.44 0.95 p Value 0.41 0.28 <0.01 0.26 0.10 <0.01 0.09 0.01 <0.01 0.12 0.21 0.69 p Value 0.14 0.02 0.44 <0.01 <0.01 <0.01 0.70 0.80 0.63 0.22 0.34 1.00 p Value 0.10 0.34 0.78 0.81 0.25 <0.01 0.13 0.03 0.93 0.07 0.16 0.67