In children, WHtR continued to decrease after BMI adiposity rebound at age 6, suggesting rebound is an epiphenomenon rather than a physiological norm.
Waist-to-height ratio trajectories suggest that the widely accepted BMI-based 'adiposity rebound' in early childhood is an epiphenomenon likely driven by fat-free mass anabolism rather than true adiposity.
Absolute Event Rate: 0% vs 0%
Rolland-Cachera and colleagues introduced the concept of “adiposity rebound” in a paper published in the American Journal of Clinical Nutrition in 1984. They observed that body mass index (BMI)-increased during the first year of life and then decreased with a renewed rise at about 6 years of age, which they termed “adiposity rebound”, concluding that early rebound increased the risk of excess adiposity in later years. Although this concept has been vigorously criticised, an alternative explanation for this phenomenon has been lacking for 42 years. In this study, 2410 children and adolescents' data aged 2 – 19 years from the US National Health and Nutrition Examination Survey (NHANES) 2021–2023 cycle were analysed using a more accurate adiposity-specific marker, waist circumference-to-height ratio (WHtR). The mean value of BMI at age 2 years (17.1 kg/m 2 ) was regained by age 6 years after a significant decrease (adiposity rebound), but the WHtR mean value at age 2 years (0.54) was never regained throughout childhood and adolescence. While BMI-adiposity rebound seems to be completed by age 6 years, WHtR, which specifically assesses fat mass, continued decreasing. A body composition reset at the intersection of BMI and WHtR trajectories at age 4 years until WHtR nadir at age 7 years was observed. The body composition reset is a post-infancy BMI increase after an initial decline that simultaneously corresponds to a continued WHtR adiposity physiological decrease, culminating at the lowest WHtR trajectory before a subsequent WHtR increase. These novel findings establish that “adiposity rebound” is not physiologic but an epiphenomenon. I posit that “adiposity rebound” is a BMI-induced false discovery similar to the “obesity paradox” in adults. Therefore, fat-free mass or skeletal muscle mass anabolism is likely the accurate physiologic explanation for the body composition reset effect that occurs in early childhood.
Andrew O. Agbaje (Sun,) reported a other. In children, WHtR continued to decrease after BMI adiposity rebound at age 6, suggesting rebound is an epiphenomenon rather than a physiological norm.