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Nyasordzi J, Conrad J, Goletzke J, Ludwig-Walz H, Herder C, Roden M, Wudy SA, Hua Y, Remer T, Buyken AE. Early life factors and their relevance for markers of cardiometabolic risk in early adulthood. Nutr Metab Cardiovasc Dis 2021; 31:2109-2121. [PMID: 34023180 DOI: 10.1016/j.numecd.2021.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 03/09/2021] [Accepted: 03/25/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND AIMS Early life exposures could be pertinent risk factors of cardiometabolic diseases in adulthood. We assessed the prospective associations of early life factors with markers of cardiometabolic risk among healthy German adults. METHODS AND RESULTS We examined 348 term-born DONALD Study participants with measurement of fasting blood at the age of 18-24 years to assess metabolic indices: fatty liver index (FLI), hepatic steatosis index (HSI), pro-inflammatory score and insulin sensitivity (HOMA2-%S). Early life factors (maternal weight in early pregnancy, maternal early pregnancy BMI, gestational weight gain (GWG), maternal age, birth weight and full breastfeeding (>17 weeks)) were assessed at enrolment of the offspring into the study. Multivariable linear regression models were used to analyze associations between early life factors and markers of cardiometabolic risk in early adulthood with adjustment for potential confounders. A higher early pregnancy BMI was related to notably higher levels of offspring FLI, HSI, pro-inflammatory score and a lower HOMA2-%S (all p < 0.0001). Similarly, a higher gestational weight gain was associated with a higher FLI (p = 0.044), HSI (p = 0.016), pro-inflammatory score (p = 0.032) and a lower HOMA2-%S among females (p = 0.034). Full breastfeeding was associated with a lower adult FLI (p = 0.037). A casual mediation analysis showed that these associations were mediated by offspring adult waist circumference (WC). CONCLUSION This study suggests that early pregnancy BMI, gestational weight gain, and full breastfeeding are relevant for offspring markers of cardiometabolic risk which seems to be mediated by body composition in young adulthood.
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Affiliation(s)
- Juliana Nyasordzi
- Department of Sports and Health, Institute of Nutrition, Consumption and Health, Paderborn University, Germany; University of Health and Allied Sciences, Ho, Volta Region, Ghana.
| | - Johanna Conrad
- Institute of Nutritional and Food Sciences, Nutritional Epidemiology, University of Bonn, Bonn, Germany.
| | - Janina Goletzke
- Department of Sports and Health, Institute of Nutrition, Consumption and Health, Paderborn University, Germany.
| | - Helena Ludwig-Walz
- DONALD Study Dortmund, Department of Nutrition and Food Sciences (IEL), Nutritional Epidemiology, University of Bonn, Dortmund, Germany; Department of Nutritional, Food and Consumer Sciences, Fulda University of Applied Sciences, Germany.
| | - Christian Herder
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; Pediatric Endocrinology and Diabetology, Laboratory for Translational Hormone Analytics, Peptide Hormone Research Unit, Center of Child and Adolescent Medicine, Justus Liebig University Giessen, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, Germany; Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
| | - Michael Roden
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; Pediatric Endocrinology and Diabetology, Laboratory for Translational Hormone Analytics, Peptide Hormone Research Unit, Center of Child and Adolescent Medicine, Justus Liebig University Giessen, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, Germany; Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
| | - Stefan A Wudy
- Pediatric Endocrinology and Diabetology, Laboratory for Translational Hormone Analytics, Peptide Hormone Research Unit, Center of Child and Adolescent Medicine, Justus Liebig University Giessen, Germany.
| | - Yifan Hua
- DONALD Study Dortmund, Department of Nutrition and Food Sciences (IEL), Nutritional Epidemiology, University of Bonn, Dortmund, Germany; Department of Nutritional, Food and Consumer Sciences, Fulda University of Applied Sciences, Germany.
| | - Thomas Remer
- DONALD Study Dortmund, Department of Nutrition and Food Sciences (IEL), Nutritional Epidemiology, University of Bonn, Dortmund, Germany; Department of Nutritional, Food and Consumer Sciences, Fulda University of Applied Sciences, Germany.
| | - Anette E Buyken
- Department of Sports and Health, Institute of Nutrition, Consumption and Health, Paderborn University, Germany.
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Horta BL, Victora CG, França GVA, Hartwig FP, Ong KK, Rolfe EDL, Magalhães EIS, Lima NP, Barros FC. Breastfeeding moderates FTO related adiposity: a birth cohort study with 30 years of follow-up. Sci Rep 2018; 8:2530. [PMID: 29416098 PMCID: PMC5803210 DOI: 10.1038/s41598-018-20939-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 01/26/2018] [Indexed: 12/20/2022] Open
Abstract
This study assessed the association of breastfeeding with body composition at 30 years, among subjects who have been prospectively followed since birth in a southern Brazilian city. We also evaluated whether breastfeeding moderated the association between the rs9939609 variant in the FTO gene and adiposity. At 30 years, total and predominant breastfeeding were positively associated with lean mass index and inversely with visceral fat thickness. Among subjects breastfed for <1 month, all outcomes showed monotonically increasing values with additional copies of the A allele in the FTO genotype (rs9939609). Associations among subjects breastfed for one month or longer tended to be in the same direction but showed lower magnitude and were less consistent; for all outcomes. Interactions had p values ≤ 0.05 for body mass index, fat mass index and waist circumference. Even among young adults, breastfeeding moderates the association between the FTO variant rs9939609 and body composition.
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Affiliation(s)
- Bernardo Lessa Horta
- Postgradute Programme in Epidemiology, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil.
| | - Cesar G Victora
- Postgradute Programme in Epidemiology, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | | | - Fernando P Hartwig
- Postgradute Programme in Epidemiology, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Ken K Ong
- Medical Research Council (MRC) Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, England
| | - Emanuella de Lucia Rolfe
- Medical Research Council (MRC) Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, England
| | - Elma I S Magalhães
- Postgradute Programme in Epidemiology, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Natalia P Lima
- Postgradute Programme in Epidemiology, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Fernando C Barros
- Universidade Católica de Pelotas, Pelotas, Rio Grande do Sul, Brazil
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Early rapid weight gain and subsequent overweight and obesity in middle childhood in Peru. BMC OBESITY 2016; 3:55. [PMID: 27999679 PMCID: PMC5155392 DOI: 10.1186/s40608-016-0135-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 12/02/2016] [Indexed: 12/17/2022]
Abstract
Background Rapid postnatal weight gain is associated with risk of overweight and obesity, but it’s unclear whether this holds in populations exposed to concurrent obesogenic risk factors and for children who have been extensively breastfed. This study investigates whether an increase in weight for age from birth to 1 year (infancy) and from 1 to 5 years (early childhood) predicts overweight and obesity, and waist circumference at 8 years, using data from a longitudinal cohort study in Peru. Methods Generalized estimating equations (GEE) models were constructed for overweight and obesity, obesity alone and waist circumference at 8 years versus rapid weight gain in infancy, and early childhood including adjusted models to account for confounders. Results Rapid weight gain in both periods was associated with double the risk of overweight and obesity, obesity alone at 8 years and increased waist circumference even after controlling for maternal BMI and education level, sex of child, height-for-age at 8 years, consumption of “fast food” and number of days of active exercise. The association was significant, with some differences, for children in both rural and urban environments. Conclusions Rapid weight gain in infancy and in early childhood in Peru is associated with overweight and obesity at age 8 years even when considering other determinants of childhood obesity. Electronic supplementary material The online version of this article (doi:10.1186/s40608-016-0135-z) contains supplementary material, which is available to authorized users.
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Jonas W, Woodside B. Physiological mechanisms, behavioral and psychological factors influencing the transfer of milk from mothers to their young. Horm Behav 2016; 77:167-81. [PMID: 26232032 DOI: 10.1016/j.yhbeh.2015.07.018] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Revised: 07/12/2015] [Accepted: 07/23/2015] [Indexed: 12/13/2022]
Abstract
This article is part of a Special Issue "Parental Care".Producing milk to support the growth of their young is a central element of maternal care in mammals. In spite of the facts that ecological constraints influence nursing frequency, length of time until weaning and the composition of milk, there is considerable similarity in the anatomy and physiology of milk production and delivery across mammalian species. Here we provide an overview of cross species variation in nursing patterns and milk composition as well as the mechanisms underlying mammary gland development, milk production and letdown. Not all women breastfeed their infants, thus in later sections we review studies of factors that facilitate or impede the initiation and duration of breastfeeding. The results of these investigations suggest that the decisions to initiate and maintain breastfeeding are influenced by an array of personal, social and biological factors. Finally, studies comparing the development of breastfed and formula fed infants as well as those investigating associations between breastfeeding, maternal health and mother/infant interaction are reviewed. Leading health agencies including the World Health Organization and CDC advocate breastfeeding for at least the first 6months postpartum. To achieve these rates will require not only institutional support but also a focus on individual mother/infant dyads and their experience.
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Affiliation(s)
- Wibke Jonas
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Fraser Mustard Institute of Human Development, University of Toronto, Toronto, Canada
| | - Barbara Woodside
- Center for Studies in Behavioral Neurobiology, Concordia University, Montreal, QC, Canada.
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Walz H, Bohn B, Sander J, Eberle C, Alisch M, Oswald B, Kroke A. Access to Difficult-to-reach Population Subgroups: A Family Midwife Based Home Visiting Service for Implementing Nutrition-related Preventive Activities - A Mixed Methods Explorative Study. AIMS Public Health 2015; 2:516-536. [PMID: 29546123 PMCID: PMC5690248 DOI: 10.3934/publichealth.2015.3.516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Accepted: 08/10/2015] [Indexed: 11/18/2022] Open
Abstract
Health and social inequality are tightly linked and still pose an important public health problem. However, vulnerable and disadvantaged populations are difficult to reach for health-related interventions. Given the long-lasting effects of an adverse, particular nutrition-related, intrauterine and neonatal environment on health development (perinatal programming), an early and easy access is essential for sustainable interventions. The goal of this explorative study was therefore to elucidate whether an existing access of family midwives (FMs) to families in need of support could be an option to implement effective public health and nutrition interventions. To that end three research objectives were formulated: (1) to determine whether a discernible impact of home visits by FMs can be described; (2) to identify subgroups among these families in need of more specific interventions; (3) to determine how relevant nutrition-related topics are for both FMs and the supported families. For addressing these objectives a mixed methods design was used: Routine documentation data from 295 families visited by a family midwife (FM) were analyzed (secondary analysis), and structured expert interviews with FMs were conducted and analyzed. Study reporting followed the STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) statement. Based on the FMs reports, a significant improvement (p < 0.001) regarding psycho-social variables could be determined after the home visits. Single mothers, however, seemed to benefit less from the FMs service compared to their counterparts (p = 0.015). Nutritional counseling was demanded by 89% of the families during the home visits. In addition, nutrition-related topics were reported in the interviews to be of high interest to both families and the FMs. Based on the obtained results it is concluded that FMs home visits offer a promising access to vulnerable and disadvantaged families for implementing nutrition-related preventive activities.
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Affiliation(s)
- Helena Walz
- Fulda University of Applied Sciences, Department of Nutritional, Food and Consumer Sciences, Fulda, Germany
| | - Barbara Bohn
- formerly: Fulda University of Applied Sciences, Department of Nutritional, Food and Consumer Sciences, Fulda, Germany; currently: University of Ulm, Institute of Epidemiology and Medical Biometry, ZIBMT, Ulm, Germany
| | - Jessica Sander
- Fulda University of Applied Sciences, Department of Nutritional, Food and Consumer Sciences, Fulda, Germany
| | - Claudia Eberle
- Fulda University of Applied Sciences, Department of Nursing and Health Sciences, Fulda, Germany
| | - Monika Alisch
- Fulda University of Applied Sciences, Department of Social Work, Fulda, Germany
| | - Bernhard Oswald
- Youth Welfare Office, Quality Management / Early Prevention, Fulda, Germany
| | - Anja Kroke
- Fulda University of Applied Sciences, Department of Nutritional, Food and Consumer Sciences, Fulda, Germany
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Ramokolo V, Lombard C, Chhagan M, Engebretsen IMS, Doherty T, Goga AE, Fadnes LT, Zembe W, Jackson DJ, Van den Broeck J. Effects of early feeding on growth velocity and overweight/obesity in a cohort of HIV unexposed South African infants and children. Int Breastfeed J 2015; 10:14. [PMID: 25873986 PMCID: PMC4396061 DOI: 10.1186/s13006-015-0041-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 03/15/2015] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND South Africa has the highest prevalence of overweight/obesity in Sub-Saharan Africa. Assessing the effect of modifiable factors such as early infant feeding on growth velocity and overweight/obesity is therefore important. This paper aimed to assess the effect of infant feeding in the transitional period (12 weeks) on 12-24 week growth velocity amongst HIV unexposed children using WHO growth velocity standards and on the age and sex adjusted body mass index (BMI) Z-score distribution at 2 years. METHODS Data were from 3 sites in South Africa participating in the PROMISE-EBF trial. We calculated growth velocity Z-scores using the WHO growth standards and assessed feeding practices using 24-hour and 7-day recall data. We used quantile regression to study the associations between 12 week infant feeding and 12-24 week weight velocity (WVZ) with BMI-for-age Z-score at 2 years. We included the internal sample quantiles (70th and 90th centiles) that approximated the reference cut-offs of +2 (corresponding to overweight) and +3 (corresponding to obesity) of the 2 year BMI-for-age Z-scores. RESULTS At the 2-year visit, 641 children were analysed (median age 22 months, IQR: 17-26 months). Thirty percent were overweight while 8.7% were obese. Children not breastfed at 12 weeks had higher 12-24 week mean WVZ and were more overweight and obese at 2 years. In the quantile regression, children not breastfed at 12 weeks had a 0.37 (95% CI 0.07, 0.66) increment in BMI-for-age Z-score at the 50th sample quantile compared to breast-fed children. This difference in BMI-for-age Z-score increased to 0.46 (95% CI 0.18, 0.74) at the 70th quantile and 0.68 (95% CI 0.41, 0.94) at the 90th quantile . The 12-24 week WVZ had a uniform independent effect across the same quantiles. CONCLUSIONS This study demonstrates that the first 6 months of life is a critical period in the development of childhood overweight and obesity. Interventions targeted at modifiable factors such as early infant feeding practices may reduce the risks of rapid weight gain and subsequent childhood overweight/obesity.
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Affiliation(s)
- Vundli Ramokolo
- />Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
- />Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Carl Lombard
- />Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa
| | - Meera Chhagan
- />Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- />School of Public Health, University of the Western Cape, Cape Town, South Africa
- />Department of Pediatrics, University of KwaZulu Natal, KwaZulu Natal, South Africa
| | - Ingunn MS Engebretsen
- />Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Tanya Doherty
- />Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
- />School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - Ameena E Goga
- />Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
- />Department of Paediatrics and Child Health, Kalafong Hospital, University of Pretoria, Pretoria, South Africa
| | - Lars Thore Fadnes
- />Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- />Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Wanga Zembe
- />Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Debra J Jackson
- />School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - Jan Van den Broeck
- />Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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Bradbury KE, Balkwill A, Tipper SJ, Crowe FL, Reeves GK, Green J, Beral V, Key TJ. The association of plasma IGF-I with dietary, lifestyle, anthropometric, and early life factors in postmenopausal women. Growth Horm IGF Res 2015; 25:90-5. [PMID: 25641638 DOI: 10.1016/j.ghir.2015.01.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Revised: 09/01/2014] [Accepted: 01/06/2015] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Higher circulating concentrations of insulin like growth factor (IGF-I) are associated with an increased risk of breast cancer. The objective of this study was to investigate associations between circulating IGF-I concentrations and dietary factors (intakes of protein, dairy protein, and alcohol), lifestyle factors (smoking and HT use), anthropometric indices (height and adiposity) and factors in early life (birth weight, having been breastfed, body size at age 10, and at age 20) in postmenopausal women in the UK. DESIGN An analysis of plasma IGF-I concentrations (measured by immunoassay) in 1883 postmenopausal women. Multivariate analysis was used to examine correlates of plasma IGF-I concentrations. RESULTS Women in the highest quintile of total protein and dairy protein intakes had, respectively, 7.6% and 5.5% higher plasma IGF-I concentrations than women in the lowest quintile (p trend <0.05 for both). Other factors significantly (p<0.05) associated with reduced IGF-I concentrations were: consuming 14 or more vs 3-7 alcoholic drinks per week (8.8% lower IGF-I); current vs non-current HT users (9.9% lower IGF-I); current use of oestrogen alone vs oestrogen+progestagen (16.9% lower IGF-I); obese vs overweight (6.8% lower IGF-I); and women who reported wearing larger vs smaller clothes sizes at age 20 (4.9% lower IGF-I). CONCLUSIONS This study in post-menopausal women identified several potentially modifiable determinants of circulating IGF-I concentrations. There is now strong evidence from this and other studies that IGF-I concentrations are associated with dietary protein intakes.
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Affiliation(s)
- Kathryn E Bradbury
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK.
| | - Angela Balkwill
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Sarah J Tipper
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Francesca L Crowe
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Gillian K Reeves
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Jane Green
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Valerie Beral
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
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Cheng G, Bolzenius K, Joslowski G, Günther ALB, Kroke A, Heinrich J, Buyken AE. Velocities of weight, height and fat mass gain during potentially critical periods of growth are decisive for adult body composition. Eur J Clin Nutr 2014; 69:262-8. [PMID: 25005675 DOI: 10.1038/ejcn.2014.131] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Revised: 05/03/2014] [Accepted: 06/01/2014] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To examine whether maximal velocities of weight, height and fat mass during potentially critical periods of growth were associated with body composition in young adulthood. SUBJECTS/METHODS Analyses were performed on 277 female and 271 male participants of the DOrtmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study with anthropometric measurements in young adulthood (18-25 years) as well as early life (0-2 years), mid-childhood (3-8 years) or puberty (9-15 years). Maximum growth velocities were calculated using the SuperImposition by Translation And Rotation (SITAR) routine or polynomial functions and related to adult fat mass index (FMI) and fat-free mass index (FFMI). RESULTS In early life, faster weight gain was associated with a moderately higher FMI and FFMI in young adulthood in women only (Ptrend=0.01). In mid-childhood and puberty, weight and fat mass velocities were related to adult FMI and FFMI in both sexes (Ptrend⩽0.002): relative differences between the highest and lowest tertiles of these growth velocities ranged 33-69% for adult FMI and 6-12% for adult FFMI. A higher mid-childhood height velocity was related to a modestly higher adult FMI in women only (Ptrend=0.0005). CONCLUSIONS Faster gain in weight and body fat during mid-childhood and puberty appear to be particularly relevant for adult fat mass.
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Affiliation(s)
- G Cheng
- 1] West China School of Public Health, Sichuan University, Chengdu, China [2] IEL-Nutritional Epidemiology, University of Bonn, DONALD Study at the Research Institute of Child Nutrition, Dortmund, Germany [3] Department of Nutritional, Food and Consumer Sciences, Fulda University of Applied Sciences, Fulda, Germany
| | - K Bolzenius
- IEL-Nutritional Epidemiology, University of Bonn, DONALD Study at the Research Institute of Child Nutrition, Dortmund, Germany
| | - G Joslowski
- IEL-Nutritional Epidemiology, University of Bonn, DONALD Study at the Research Institute of Child Nutrition, Dortmund, Germany
| | - A L B Günther
- Department of Nutritional, Food and Consumer Sciences, Fulda University of Applied Sciences, Fulda, Germany
| | - A Kroke
- Department of Nutritional, Food and Consumer Sciences, Fulda University of Applied Sciences, Fulda, Germany
| | - J Heinrich
- Institute of Epidemiology I, Helmholtz Zentrum Muenchen-German Research Center for Environmental Health, Neuherberg, Germany
| | - A E Buyken
- IEL-Nutritional Epidemiology, University of Bonn, DONALD Study at the Research Institute of Child Nutrition, Dortmund, Germany
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