Life course associations of height, weight, fatness, grip strength, and all-cause mortality for high socioeconomic status Guatemalans

Objectives: The objective of this study was to investigate the association between physical growth in pre-adult life with five outcomes at age 64-76: weight, body mass index, estimated body fat percentage, hand grip strength and mortality. Methods: Super-Imposition by Translation and Rotation (SITAR) growth curves of 40,484 Guatemalan individuals aged 3-19 years were modelled for the parameters of size, timing and intensity (peak growth velocity, e.g. cm/year) of height, weight, body mass index, and grip strength. Associations between the SITAR parameters and old age outcomes were tested using linear and binary logistic regression for a follow-up sample of high socioeconomic status (SES) Guatemalans, of whom 50 were aged 64-76 years old at re-measurement and 45 died prior to the year 2017. Results: SITAR models explained 69-98% of the variance in each outcome, with height the most precise. Individuals in the follow-up sample who had a higher BMI before age 20 years had higher estimated body fat (B=1.4 CI -0.02-2.8) and BMI (B=1.2, CI 0.2-2.2) at the ages 64-76 years. Those who grew slower in height but faster in weight and BMI before age 20 years, had higher BMI and body fat later in life. Conclusions: These findings highlight the importance of a life course perspective on health and mortality risk. Childhood exposures leading to variation in pre-adult growth may be key to better understanding health and mortality risks in old age.