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Norris SA, Nyati LH, Murphy-Alford A, Lucas N, Santos IS, Costa CS, Kuriyan R, Wickranasinghe VP, Ariff S, Jayasinghe S, Kurpad AV, Ismail LC, Hills AP. Infant growth and body composition from birth to 24 months: are infants developing the same? Eur J Clin Nutr 2024:10.1038/s41430-023-01386-5. [PMID: 38172346 DOI: 10.1038/s41430-023-01386-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 11/18/2023] [Accepted: 12/01/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Given the importance of infancy for establishing growth trajectories, with later-life health consequences, we investigated longitudinal body composition among infants from six economically and ethnically diverse countries. METHODS We recruited mother-infant dyads using the WHO Multicenter Growth Reference Study criteria. We measured fat-free mass (FFM) in 1393 (49% female) infants from birth to 6 months of age (Australia, India, and South Africa; n = 468), 3-24 months of age (Brazil, Pakistan, South Africa, and Sri Lanka; n = 925), and derived fat mass (FM), fat mass index (FMI), and fat-free mass index (FFMI). Height-for-age (HAZ), weight-for-age (WAZ), and weight-for-length (WHZ) Z-scores were computed. Sex differences were assessed using a t-test, and country differences using a one-way analysis of covariance. We further compared subsamples of children with average (-0.25 > HAZ < +0.25), below-average (≤-0.25) and above-average (≥+0.25) HAZ. RESULTS HAZ performed well between 0 and 6 months, but less so between 3 and 24 months. The stunting prevalence peaked at 10.3% for boys and 7.8% for girls, at 24 months. By 24 months, girls had greater FMI (10%) than boys. There were significant differences in FFM (both sexes in all countries) and FM (Brazilian boys, Pakistani and South African girls) by 24 months of age between infants with average, above-average, and below-average HAZ. CONCLUSION In a multi-country sample representing more ideal maternal conditions, body composition was heterogeneous even among infants who exhibited ideal length. Having a mean HAZ close to the median of the WHO standard for length reduced FFM between-country heterogeneity but not FM, suggesting that other factors may influence adiposity.
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Affiliation(s)
- Shane A Norris
- SAMRC Developmental Pathways for Health Research Unit, Department of Pediatrics, University of the Witwatersrand, Johannesburg, South Africa
- School of Human Development and Health, University of Southampton, Southampton, UK
| | - Lukhanyo H Nyati
- SAMRC Developmental Pathways for Health Research Unit, Department of Pediatrics, University of the Witwatersrand, Johannesburg, South Africa.
- Interprofessional Education Unit, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa.
| | | | - Nishani Lucas
- Department of Paediatrics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | | | | | - Rebecca Kuriyan
- Division of Nutrition, St John's Research Institute, Bengaluru, India
| | | | - Shabina Ariff
- Dept Pediatrics & Child Health, The Aga Khan University, Karachi, Pakistan
| | | | - Anura V Kurpad
- Division of Nutrition, St John's Research Institute, Bengaluru, India
| | - Leila Cheikh Ismail
- University of Sharjah, Sharjah, United Arab Emirates
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK
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