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Megersa BS, Andersen GS, Abera M, Abdissa A, Zinab B, Ali R, Admassu B, Kedir E, Nitsch D, Filteau S, Girma T, Yilma D, Wells JC, Friis H, Wibaek R. Associations of early childhood body mass index trajectories with body composition and cardiometabolic markers at age 10 years: the Ethiopian infant anthropometry and body composition (iABC) birth cohort study. Am J Clin Nutr 2024; 119:1248-1258. [PMID: 38458400 DOI: 10.1016/j.ajcnut.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 02/17/2024] [Accepted: 03/05/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Variability in body mass index (BMI) (kg/m2) trajectories is associated with body composition and cardiometabolic markers in early childhood, but it is unknown how these associations track to later childhood. OBJECTIVES We aimed to assess associations of BMI trajectories from 0 to 5 y with body composition and cardiometabolic markers at 10 y. METHODS In the Ethiopian infant anthropometry and body composition (iABC) birth cohort, we previously identified 4 distinct BMI trajectories from 0 to 5 y: stable low BMI (19.2%), normal BMI (48.8%), rapid growth to high BMI (17.9%), and slow growth to high BMI (14.1%). At 10 y, we obtained data from 320 children on anthropometry, body composition, abdominal subcutaneous and visceral fat, and cardiometabolic markers. Associations of BMI trajectories and 10-y outcomes were analyzed using multiple linear regression. RESULTS Compared with children with the normal BMI trajectory, those with rapid growth to high BMI had 1.7 cm (95% CI: 0.1, 3.3) larger waist circumference and those with slow growth to high had 0.63 kg/m2 (95% CI: 0.09, 1.17) greater fat mass index and 0.19 cm (95% CI: 0.02, 0.37) greater abdominal subcutaneous fat, whereas those with stable low BMI had -0.28 kg/m2 (95% CI: -0.59, 0.03) lower fat-free mass at 10 y. Although the confidence bands were wide and included the null value, children with rapid growth to high BMI trajectory had 48.6% (95% CI: -1.4, 123.8) higher C-peptide concentration and those with slow growth to high BMI had 29.8% (95% CI: -0.8, 69.8) higher insulin and 30.3% (95% CI: -1.1, 71.6) higher homeostasis model assessment of insulin resistance, whereas those with rapid growth to high BMI had -0.23 mmol/L (95% CI: -0.47, 0.02) lower total cholesterol concentration. The trajectories were not associated with abdominal visceral fat, blood pressure, glucose, and other lipids at 10 y. CONCLUSIONS Children with rapid and slow growth to high BMI trajectories before 5 y tend to show higher measures of adiposity and higher concentrations of markers related to glucose metabolism at 10 y. CLINICAL TRIAL REGISTRY ISRCTN46718296 (https://www.isrctn.com/ISRCTN46718296).
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Affiliation(s)
- Bikila S Megersa
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark.
| | | | - Mubarek Abera
- Department of Psychiatry, Faculty of Medical Sciences, Jimma University, Jimma, Ethiopia
| | | | - Beakal Zinab
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark; Department of Nutrition and Dietetics, Faculty of Public Health, Jimma University, Jimma, Ethiopia
| | - Rahma Ali
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark; Department of Population and Family Health, Jimma University, Jimma, Ethiopia
| | - Bitiya Admassu
- Department of Population and Family Health, Jimma University, Jimma, Ethiopia
| | - Elias Kedir
- Department of Radiology, Faculty of Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Dorothea Nitsch
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Suzanne Filteau
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Tsinuel Girma
- Department of Pediatrics and Child Health, Faculty of Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Daniel Yilma
- Department of Internal Medicine, Faculty of Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Jonathan Ck Wells
- Childhood Nutrition Research Center, Population Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Henrik Friis
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Rasmus Wibaek
- Clinical Research, Steno Diabetes Center Copenhagen, Herlev, Denmark
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Huang Y, Zhang L, Ainiwan D, Alifu X, Cheng H, Qiu Y, Zhou H, Liu H, Yu Y. Breastfeeding, Gestational Diabetes Mellitus, Size at Birth and Overweight/Obesity in Early Childhood. Nutrients 2024; 16:1351. [PMID: 38732598 PMCID: PMC11085597 DOI: 10.3390/nu16091351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 04/24/2024] [Accepted: 04/28/2024] [Indexed: 05/13/2024] Open
Abstract
Background: Breastfeeding appears to reduce the risk of childhood overweight/obesity. However, it remains unclear whether this protective effect persists among high-risk populations. This study aims to investigate the association of breastfeeding with the risk of overweight/obesity in early childhood and whether this association is altered by gestational diabetes mellitus (GDM) or size at birth. Methods: Feeding practices during the first 12 months of age and weight and length at 12-36 months of age were collected. Full breastfeeding includes exclusive and predominant breastfeeding. Children with body mass index (BMI) values greater than 1 standard deviation from the mean of sex- and age-specific BMI were classified as overweight/obese. Multiple generalized estimating equations models were applied to analyze the associations of full breastfeeding duration with overweight/obesity risk. Results: Among all participants (n = 9329), infants with a longer full-breastfeeding duration had a reduced risk of overweight/obesity in early childhood compared with those breastfed for less than one month. Infants exposed to GDM and those born large for gestational age (LGA) had a higher risk of overweight/obesity in early childhood. Among infants of mothers with GDM (n = 1748), infants with full breastfeeding for greater than 6 months (aOR: 0.58; 95% CI: 0.44, 0.78) showed a decreased risk of overweight/obesity in early childhood compared with those breastfed for less than one month. Among LGA infants (n = 1279), infants with full breastfeeding for 3-5 months (aOR: 0.66; 95% CI: 0.57, 0.76) and greater than 6 months (aOR: 0.70; 95% CI: 0.56, 0.88) showed a decreased risk of overweight/obesity in early childhood. Similar results were observed among LGA infants of mothers with GDM. Conclusions: Initiating and prolonging breastfeeding would reduce the risk of overweight/obesity in early childhood, and LGA infants and infants born to mothers with GDM would experience greater benefits.
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Affiliation(s)
- Ye Huang
- Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (Y.H.); (L.Z.); (D.A.); (X.A.); (H.C.); (Y.Q.); (H.Z.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Libi Zhang
- Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (Y.H.); (L.Z.); (D.A.); (X.A.); (H.C.); (Y.Q.); (H.Z.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Diliyaer Ainiwan
- Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (Y.H.); (L.Z.); (D.A.); (X.A.); (H.C.); (Y.Q.); (H.Z.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Xialidan Alifu
- Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (Y.H.); (L.Z.); (D.A.); (X.A.); (H.C.); (Y.Q.); (H.Z.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Haoyue Cheng
- Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (Y.H.); (L.Z.); (D.A.); (X.A.); (H.C.); (Y.Q.); (H.Z.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Yiwen Qiu
- Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (Y.H.); (L.Z.); (D.A.); (X.A.); (H.C.); (Y.Q.); (H.Z.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Haibo Zhou
- Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (Y.H.); (L.Z.); (D.A.); (X.A.); (H.C.); (Y.Q.); (H.Z.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Hui Liu
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China;
| | - Yunxian Yu
- Department of Public Health and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; (Y.H.); (L.Z.); (D.A.); (X.A.); (H.C.); (Y.Q.); (H.Z.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
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Camier A, Cissé AH, Heude B, Nicklaus S, Chabanet C, Bernard JY, Lioret S, Charles MA, de Lauzon-Guillain B. Infant feeding practices and body mass index up to 7.5 years in the French nationwide ELFE study. Pediatr Obes 2024:e13121. [PMID: 38622765 DOI: 10.1111/ijpo.13121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 03/08/2024] [Accepted: 03/26/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND/OBJECTIVES The infant diet represents one of the main modifiable determinants of early growth. This study aimed to investigate the associations of infant feeding practices with body mass index (BMI) until 7.5 years. SUBJECTS/METHODS Analyses were based on data from the French nationwide ELFE birth cohort. Data on breastfeeding (BF) and complementary feeding (CF) were collected monthly from 2 to 10 months. Infant feeding practices were characterized using principal component analyses (PCA) and hierarchical ascendant classification. BMI z-score was computed at 1, 2, 3, 5 and 7.5 years, from data collected in the child's health booklet; 7.5-year overweight was defined according to IOTF references. Associations between infant feeding practices and BMI were investigated by linear regression models adjusted for main confounders. RESULTS Ever breastfeeding was not associated with BMI up to 7.5 years. Compared to intermediate breastfeeding duration (1 to <3 months), longer breastfeeding duration (≥6 months) was related to lower 1-year BMI, but not at older ages. Compared to the recommended age at CF introduction (4-6 months), early CF (<4 months) was related to higher BMI up to 5 years with a similar trend at 7.5 years, but not to the risk of overweight. The PCA patterns characterized by early baby cereal introduction and late food pieces introduction or by frequent intake of main food groups were related to a lower BMI up to 7.5 years. CONCLUSION Breastfeeding was related with a lower BMI in infancy but not thereafter, whereas an early CF initiation (<4 months) was associated with a higher BMI in childhood.
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Affiliation(s)
- Aurore Camier
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Aminata Hallimat Cissé
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Barbara Heude
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Sophie Nicklaus
- Centre des Sciences du Goût et de l'Alimentation, CNRS, INRAE, Institut Agro, Université de Bourgogne, Dijon, France
| | - Claire Chabanet
- Centre des Sciences du Goût et de l'Alimentation, CNRS, INRAE, Institut Agro, Université de Bourgogne, Dijon, France
| | - Jonathan Y Bernard
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Sandrine Lioret
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | - Marie Aline Charles
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
- Unité mixte Inserm-Ined-EFS ELFE, Ined, Aubervilliers, France
| | - Blandine de Lauzon-Guillain
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Paris, France
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Aagaard KM, Barkin SL, Burant CF, Carnell S, Demerath E, Donovan SM, Eneli I, Francis LA, Gilbert-Diamond D, Hivert MF, LeBourgeois MK, Loos RJF, Lumeng JC, Miller AL, Okely AD, Osganian SK, Ramirez AG, Trasande L, Van Horn LV, Wake M, Wright RJ, Yanovski SZ. Understanding risk and causal mechanisms for developing obesity in infants and young children: A National Institutes of Health workshop. Obes Rev 2024; 25:e13690. [PMID: 38204366 DOI: 10.1111/obr.13690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 10/02/2023] [Accepted: 11/21/2023] [Indexed: 01/12/2024]
Abstract
Obesity in children remains a major public health problem, with the current prevalence in youth ages 2-19 years estimated to be 19.7%. Despite progress in identifying risk factors, current models do not accurately predict development of obesity in early childhood. There is also substantial individual variability in response to a given intervention that is not well understood. On April 29-30, 2021, the National Institutes of Health convened a virtual workshop on "Understanding Risk and Causal Mechanisms for Developing Obesity in Infants and Young Children." The workshop brought together scientists from diverse disciplines to discuss (1) what is known regarding epidemiology and underlying biological and behavioral mechanisms for rapid weight gain and development of obesity and (2) what new approaches can improve risk prediction and gain novel insights into causes of obesity in early life. Participants identified gaps and opportunities for future research to advance understanding of risk and underlying mechanisms for development of obesity in early life. It was emphasized that future studies will require multi-disciplinary efforts across basic, behavioral, and clinical sciences. An exposome framework is needed to elucidate how behavioral, biological, and environmental risk factors interact. Use of novel statistical methods may provide greater insights into causal mechanisms.
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Affiliation(s)
- Kjersti M Aagaard
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, Houston, Texas, USA
- Department of Molecular and Cell Biology, Baylor College of Medicine, Houston, Texas, USA
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | - Shari L Barkin
- Department of Pediatrics, Children's Hospital of Richmond, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Charles F Burant
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Susan Carnell
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Ellen Demerath
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Sharon M Donovan
- Division of Nutritional Sciences, University of Illinois, Urbana-Champaign, Illinois, USA
- Department of Food Science and Human Nutrition, University of Illinois, Urbana-Champaign, Illinois, USA
| | - Ihuoma Eneli
- Center for Healthy Weight and Nutrition, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA
- Center of Nutrition, Department of Pediatrics, University of Colorado, Aurora, Colorado, USA
| | - Lori A Francis
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Diane Gilbert-Diamond
- Department of Epidemiology, Medicine and Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
- Diabetes Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Monique K LeBourgeois
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Ruth J F Loos
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Julie C Lumeng
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Alison L Miller
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Anthony D Okely
- School of Health and Society, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia
- llawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
- Department of Sport, Food, and Natural Sciences, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Stavroula K Osganian
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Amelie G Ramirez
- Department of Population Health Sciences, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Leonardo Trasande
- Department of Pediatrics, New York University (NYU) School of Medicine, New York, New York, USA
- Department of Environmental Medicine, New York University (NYU) School of Medicine, New York, New York, USA
- Department of Population Health, New York University (NYU) School of Medicine, New York, New York, USA
| | - Linda V Van Horn
- Department of Preventive Medicine, Northwestern University, Chicago, Illinois, USA
| | - Melissa Wake
- Population Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Rosalind J Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, Kravis Children's Hospital, New York, New York, USA
| | - Susan Z Yanovski
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
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Clayton PK, Putnick DL, Trees IR, Ghassabian A, Tyris JN, Lin TC, Yeung EH. Early Infant Feeding Practices and Associations with Growth in Childhood. Nutrients 2024; 16:714. [PMID: 38474842 DOI: 10.3390/nu16050714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 02/25/2024] [Accepted: 02/26/2024] [Indexed: 03/14/2024] Open
Abstract
Early infant growth trajectories have been linked to obesity risk. The aim of this study was to examine early infant feeding practices in association with anthropometric measures and risk of overweight/obesity in childhood. A total of 2492 children from Upstate KIDS, a population-based longitudinal cohort, were included for the analysis. Parents reported breastfeeding and complementary food introduction from 4 to 12 months on questionnaires. Weight and height were reported at 2-3 years of age and during later follow-up at 7-9 years of age. Age and sex z-scores were calculated. Linear mixed models were conducted, adjusting for maternal and child sociodemographic factors. Approximately 54% of infants were formula-fed at <5 months of age. Compared to those formula-fed, BMI- (adjusted B, -0.23; 95% CI: -0.42, -0.05) and weight-for-age z-scores (adjusted B, -0.16; -0.28, -0.03) were lower for those exclusively breastfed. Infants breastfed for ≥12 months had a lower risk of being overweight (aRR, 0.33; 0.18, 0.59) at 2-3 years, relative to formula-fed infants. Compared to introduction at <5 months, the introduction of fruits and vegetables between 5 and 8 months was associated with lower risk of obesity at 7-9 years (aRR, 0.45; 0.22, 0.93). The type and duration of breastfeeding and delayed introduction of certain complementary foods was associated with lower childhood BMI.
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Affiliation(s)
- Priscilla K Clayton
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6710B Rockledge Dr, Bethesda, MD 20817, USA
| | - Diane L Putnick
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6710B Rockledge Dr, Bethesda, MD 20817, USA
| | - Ian R Trees
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6710B Rockledge Dr, Bethesda, MD 20817, USA
| | - Akhgar Ghassabian
- Department of Pediatrics and Population Health, NYU Grossman School of Medicine, 550 First Avenue, New York, NY 10016, USA
| | - Jordan N Tyris
- Division of Hospital Medicine, Children's National Hospital, 111 Michigan Avenue NW, Washington, DC 20010, USA
| | - Tzu-Chun Lin
- Glotech Inc., 1801 Research Blvd Ste 605, Rockville, MD 20850, USA
| | - Edwina H Yeung
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6710B Rockledge Dr, Bethesda, MD 20817, USA
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Zheng M, D'Souza NJ, Atkins L, Ghobadi S, Laws R, Szymlek-Gay EA, Grimes C, Baker P, He QQ, Campbell KJ. Breastfeeding and the Longitudinal Changes of Body Mass Index in Childhood and Adulthood: A Systematic Review. Adv Nutr 2024; 15:100152. [PMID: 37977327 PMCID: PMC10714232 DOI: 10.1016/j.advnut.2023.100152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 11/01/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023] Open
Abstract
Mounting evidence supports the beneficial role of breastfeeding in lowering obesity risk, but the enduring impact of breastfeeding on longitudinal changes in body mass index (BMI) (i.e., BMI trajectories) remains unclear. This systematic review summarized evidence on how breastfeeding influenced the longitudinal trajectories of BMI later in life. Literature searches were conducted in Medline, Embase, Web of Science, and ScienceDirect to identify studies that assessed how breastfeeding (versus other feeding types or duration) was associated with longitudinal trajectories of BMI or BMI z-score. Three randomized controlled trials (RCTs) and 24 longitudinal cohort studies were included. Two-thirds (18/27) of studies were rated as acceptable or high quality. Most cohort studies (9/11) showed that children who continued to breastfeed at 3 to 12 mo of age had a lower BMI trajectory or lower odds of following a high BMI trajectory than those who were formula-fed or mixed-fed. The BMI differences between breastfeeding and other feeding groups were evident from age 7 mo and remained up to 8 y, and the magnitude of between-group BMI differences increased with age. For breastfeeding duration, 12 out of 15 cohort studies found that longer breastfeeding duration was associated with lower BMI trajectories up to age 18 y. Moreover, beneficial associations were observed for both exclusive and any breastfeeding with BMI trajectory. In contrast, mixed findings were reported from 3 RCTs that compared BMI trajectories from birth to ages 12 to 24 mo between breastfeeding promotion versus control or breastfeeding versus formula-feeding groups. The current review provides further longitudinal evidence from cohort studies that breastfeeding versus formula/mixed feeding or longer breastfeeding duration was associated with lower BMI trajectories. Such associations initiated in early childhood became more apparent with age and were sustained into early adulthood. The existing evidence substantiates the importance of breastfeeding promotion and continuation to support obesity prevention.
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Affiliation(s)
- Miaobing Zheng
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia.
| | - Ninoshka J D'Souza
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Linda Atkins
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Saeed Ghobadi
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Rachel Laws
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Ewa A Szymlek-Gay
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Carley Grimes
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Philip Baker
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Qi-Qiang He
- School of Public Health, Wuhan University, Wuhan, Republic of China
| | - Karen J Campbell
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
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7
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Gong T, Zhong Y, Ding Y, Wu Q, Yao M, Yin J, Shao Y, Liu J. Growth and development of syphilis-exposed and -unexposed uninfected children during their first 18 months of life in Suzhou, China: a nested case-control study with propensity score matching. Front Public Health 2023; 11:1263324. [PMID: 38145074 PMCID: PMC10748380 DOI: 10.3389/fpubh.2023.1263324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 11/17/2023] [Indexed: 12/26/2023] Open
Abstract
Background With the successful implementation of Prevention of Mother-to-Child Transmission (PMTCT) policies, the proportion of infants with exposure to both syphilis and antibiotic medication in utero has increased in China, but there is limited evidence about the early growth and development of such infants. Methods We conducted a retrospective nested case-control study based on data from the China PMTCT program conducted in Suzhou from 2016 to 2021. Propensity score matching (PSM) was employed to extract 826 syphilis-exposed but uninfected (SEU) infants and 1,652 syphilis-unexposed uninfected (SUU) infants from a total of 712,653 infants. Maternal characteristics were collected through questionnaires, such as parity, age, education level, smoking and drinking habits during pregnancy. Infantile characteristics were retrieved from medical records or via questionnaires, such as gestational age, gender, mode of delivery, Apgar scores, birth weight and length, outdoor time, vitamin D intake, and feed pattern. Mixed effects models, adjusting for potential influencing factors, were used to investigate the early infantile growth pattern of SEU and SUU infants. All statistical analysis were conducted using R (version 4.2.0). Results Length and weight were slightly higher in SEU infants than in the SUU infants at some time points (months 0 and 18 for length, p-values <0.05; months 0, 6, and 18 for weight, p < 0.05). In the mixed effects model, SEU group was found to be associated with higher weight [exponentiated beta exp.(β) = 1.15, 95% Confidence Interval (CI) = 1.06, 1.25], length [exp(β) = 1.42, 95% CI = 1.14, 1.77], and BMI z-score [exp(β) = 1.09, 95% CI = 1.00, 1.19]. Conclusion With the effective prevention of congenital syphilis under the PMTCT program, SEU infants have non-inferior growth patterns during their first 18 months of life compared with SUU controls in Suzhou, China.
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Affiliation(s)
- Tian Gong
- Suzhou Maternal and Child Healthcare Center, Suzhou Municipal Hospital, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Yi Zhong
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Yaling Ding
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Qianlan Wu
- Suzhou Maternal and Child Healthcare Center, Suzhou Municipal Hospital, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Mengxin Yao
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Jieyun Yin
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Yan Shao
- Suzhou Maternal and Child Healthcare Center, Suzhou Municipal Hospital, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Juning Liu
- Suzhou Maternal and Child Healthcare Center, Suzhou Municipal Hospital, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
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8
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Warkentin S, Santos AC, Oliveira A. Weight trajectories from birth to 5 years and child appetitive traits at 7 years of age: a prospective birth cohort study. Br J Nutr 2023; 130:1278-1288. [PMID: 36690498 DOI: 10.1017/s0007114523000272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Rapid prenatal and postnatal weight gain seem to alter appetite regulation and hypothalamic functions through different pathways; however, little is known on how early life growth trajectories may influence appetitive traits in school-age. We aimed to explore the associations between weight trajectories from birth to 5 years and appetitive traits at 7. Participants were from the Generation XXI birth cohort (n 3855). Four weight trajectories were investigated: 'normal weight gain' (closely overlaps the 50th percentile in the weight-for-age curve), 'weight gain during infancy' (low birth weight and weight gain mainly during infancy), 'weight gain during childhood' (continuous weight gain since birth) and 'persistent weight gain' (always showing higher weight than the average). Appetitive traits were assessed through the Children's Eating Behaviour Questionnaire. Associations were tested using generalised linear models, adjusted for maternal and child characteristics. Compared with 'normal weight gain', those in the other growth trajectories showed greater enjoyment of food and eating in response to food stimuli (i.e. Food Responsiveness) but were less able to compensate for prior food intake and ate faster at 7 (i.e. less Satiety Responsiveness and Slowness in Eating). Also, those with 'weight gain during infancy' showed to have greater Emotional Overeating and less Emotional Undereating and were fussier. Associations were stronger if greater weight gain occurred during infancy. Early infancy seems to be a sensitive period in the development of later appetitive traits. The control of rapid growth during infancy, besides strategies focused on the overall environment where children are living, is necessary.
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Affiliation(s)
- Sarah Warkentin
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto (Institute of Public Health of the University of Porto), Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Ana Cristina Santos
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto (Institute of Public Health of the University of Porto), Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
- Department of Public Health and Forensic Sciences and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Andreia Oliveira
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto (Institute of Public Health of the University of Porto), Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
- Department of Public Health and Forensic Sciences and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
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9
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Bakshi S, Paswan VK, Yadav SP, Bhinchhar BK, Kharkwal S, Rose H, Kanetkar P, Kumar V, Al-Zamani ZAS, Bunkar DS. A comprehensive review on infant formula: nutritional and functional constituents, recent trends in processing and its impact on infants' gut microbiota. Front Nutr 2023; 10:1194679. [PMID: 37415910 PMCID: PMC10320619 DOI: 10.3389/fnut.2023.1194679] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/30/2023] [Indexed: 07/08/2023] Open
Abstract
Human milk is considered the most valuable form of nutrition for infants for their growth, development and function. So far, there are still some cases where feeding human milk is not feasible. As a result, the market for infant formula is widely increasing, and formula feeding become an alternative or substitute for breastfeeding. The nutritional value of the formula can be improved by adding functional bioactive compounds like probiotics, prebiotics, human milk oligosaccharides, vitamins, minerals, taurine, inositol, osteopontin, lactoferrin, gangliosides, carnitine etc. For processing of infant formula, diverse thermal and non-thermal technologies have been employed. Infant formula can be either in powdered form, which requires reconstitution with water or in ready-to-feed liquid form, among which powder form is readily available, shelf-stable and vastly marketed. Infants' gut microbiota is a complex ecosystem and the nutrient composition of infant formula is recognized to have a lasting effect on it. Likewise, the gut microbiota establishment closely parallels with host immune development and growth. Therefore, it must be contemplated as an important factor for consideration while developing formulas. In this review, we have focused on the formulation and manufacturing of safe and nutritious infant formula equivalent to human milk or aligning with the infant's needs and its ultimate impact on infants' gut microbiota.
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Affiliation(s)
- Shiva Bakshi
- Department of Dairy Science and Food Technology, Institute of Agricultural Sciences, Banaras Hindu University, Varanasi, India
| | - Vinod Kumar Paswan
- Department of Dairy Science and Food Technology, Institute of Agricultural Sciences, Banaras Hindu University, Varanasi, India
| | - Satya Prakash Yadav
- Department of Dairy Science and Food Technology, Institute of Agricultural Sciences, Banaras Hindu University, Varanasi, India
| | - Basant Kumar Bhinchhar
- Department of Livestock Production Management, Sri Karan Narendra Agriculture University, Jobner, India
| | - Sheela Kharkwal
- Department of Agriculture Economics, Sri Karan Narendra Agriculture University, Jobner, India
| | - Hency Rose
- Division of Dairy Technology, ICAR—National Dairy Research Institute, Karnal, India
| | - Prajasattak Kanetkar
- Department of Dairy Science and Food Technology, Institute of Agricultural Sciences, Banaras Hindu University, Varanasi, India
| | - Vishal Kumar
- Department of Dairy Science and Food Technology, Institute of Agricultural Sciences, Banaras Hindu University, Varanasi, India
| | - Zakarya Ali Saleh Al-Zamani
- Department of Dairy Science and Food Technology, Institute of Agricultural Sciences, Banaras Hindu University, Varanasi, India
- Department of Food Technology and Science, Faculty of Agriculture and Veterinary Medicine, Ibb University, Ibb, Yemen
| | - Durga Shankar Bunkar
- Department of Dairy Science and Food Technology, Institute of Agricultural Sciences, Banaras Hindu University, Varanasi, India
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10
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Gupta M, Phan TLT, Lê-Scherban F, Eckrich D, Bunnell HT, Beheshti R. Associations of longitudinal BMI percentile classification patterns in early childhood with neighborhood-level social determinants of health. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.06.08.23291145. [PMID: 37398451 PMCID: PMC10312866 DOI: 10.1101/2023.06.08.23291145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Background Understanding social determinants of health (SDOH) that may be risk factors for childhood obesity is important to developing targeted interventions to prevent obesity. Prior studies have examined these risk factors, mostly examining obesity as a static outcome variable. Objectives This study aimed to identify distinct subpopulations based on BMI percentile classification or changes in BMI percentile classifications over time and explore these longitudinal associations with neighborhood-level SDOH factors in children from 0 to 7 years of age. Methods Using Latent Class Growth (Mixture) Modelling (LCGMM) we identify distinct BMI% classification groups in children from 0 to 7 years of age. We used multinomial logistic regression to study associations between SDOH factors with each BMI% classification group. Results From the study cohort of 36,910 children, five distinct BMI% classification groups emerged: always having obesity (n=429; 1.16%), overweight most of the time (n=15,006; 40.65%), increasing BMI% (n=9,060; 24.54%), decreasing BMI% (n=5,058; 13.70%), and always normal weight (n=7,357; 19.89%). Compared to children in the decreasing BMI% and always normal weight groups, children in the other three groups were more likely to live in neighborhoods with higher rates of poverty, unemployment, crowded households, and single-parent households, and lower rates of preschool enrollment. Conclusions Neighborhood-level SDOH factors have significant associations with children's BMI% classification and changes in classification over time. This highlights the need to develop tailored obesity interventions for different groups to address the barriers faced by communities that can impact the weight and health of the children living within them.
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Affiliation(s)
- Mehak Gupta
- Computer & Info. Sciences, University of Delaware, Newark, DE 19716, USA
| | | | - Félice Lê-Scherban
- Epidemiology & Biostatistics, and Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA 19104, USA
| | | | | | - Rahmatollah Beheshti
- Computer & Info. Sciences, and Epidemiology, University of Delaware, Newark, DE 19716, USA
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11
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Zeng X, Chen T, Cui Y, Zhao J, Chen Q, Yu Z, Zhang Y, Han L, Chen Y, Zhang J. In utero exposure to perfluoroalkyl substances and early childhood BMI trajectories: A mediation analysis with neonatal metabolic profiles. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 867:161504. [PMID: 36634772 DOI: 10.1016/j.scitotenv.2023.161504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/30/2022] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND In utero perfluoroalkyl substances (PFAS) exposure has been associated with childhood adiposity, but the mechanisms are poorly known. OBJECTIVE To investigate the potential mediating role of neonatal metabolites in the relationship between prenatal PFAS exposure and childhood adiposity trajectories in the first four years of life. METHODS We analyzed the data for 1671 mother-child pairs from the Shanghai Birth Cohort study. We included those with PFAS exposure information in early pregnancy, neonatal metabolites data and at least three child anthropometric measurements at 6, 12, 24 and/or 48 months. Body mass index (BMI) z-score trajectories were identified using latent class growth mixture modeling. The associations between PFAS concentrations and trajectory classes were assessed using multinomial logistic regression. Screening and penalization-based selection was used to identify neonatal amino acids and acylcarnitines with significant mediation effects. RESULTS Three BMI z-score trajectories in early childhood were identified: a persistent increase trajectory (Class 1, 2.2 %), a stable trajectory (Class 2, 66 %), and a transient increase trajectory (Class 3, 32 %). Increased odds of being in Class 1 were observed in association with one log-unit increase in concentrations of perfluorooctane sulfonate (odds ratio [OR], 1.76 [95 % CI, 0.96-3.23], Class 2 as reference; OR, 2.36 [95 % CI, 1.27-4.40], Class 3 as reference), perfluorononanoic acid (OR, 1.90 [95 % CI, 0.97-3.72], Class 2 as reference; OR, 2.23 [95 % CI, 1.12-4.42], Class 3 as reference) and perfluorodecanoic acid (OR, 1.95 [95 % CI, 1.12-3.38], Class 2 as reference; OR, 2.14 [95 % CI, 1.22-3.76], Class 3 as reference). The effect of prenatal PFAS exposure on being in Class 1 was significantly but partly mediated by octanoylcarnitine (2.64 % for perfluorononanoic acid and 3.70 % for sum of 10 PFAS). CONCLUSIONS In utero PFAS exposure is a risk factor for persistent growth in BMI z-score in early childhood. The alteration of neonatal acylcarnitines suggests a potential molecular pathway.
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Affiliation(s)
- Xiaojing Zeng
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Ting Chen
- Department of Pediatric Endocrinology and Genetic Metabolism, Shanghai Institute for Pediatric Research, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Yidan Cui
- Department of Bioinformatics and Biostatistics, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Jian Zhao
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Qian Chen
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Zhangsheng Yu
- Clinical Research Institute, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; Department of Bioinformatics and Biostatistics, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Yongjun Zhang
- Department of Neonatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Lianshu Han
- Department of Pediatric Endocrinology and Genetic Metabolism, Shanghai Institute for Pediatric Research, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Yan Chen
- Department of Neonatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
| | - Jun Zhang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
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12
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Abrams SA, Bergner EM. Is It Time to Revise the Current Nutrient Requirements for Infant Formulas Principally Established in 1980? Adv Nutr 2023; 14:426-431. [PMID: 36878358 DOI: 10.1016/j.advnut.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 02/23/2023] [Accepted: 02/27/2023] [Indexed: 03/07/2023] Open
Abstract
Because of the production of nutrient-deficient infant formulas (IFs), the United States Congress passed regulations on the composition and production of IF, referred to as the Infant Formula Act (IFA), in 1980, which was amended in 1986. More detailed FDA rules have been created since then, specifying the ranges or minimum intakes of nutrients and providing details for the safe production and evaluation of infant formulas. Although generally effective in ensuring safe IF, recent events have made it clear that a re-evaluation of aspects of all the nutrient composition regulations for IF is needed, including consideration of adding requirements related to bioactive nutrients not mentioned in the IFA. We propose that, as principal examples, the requirement for iron content needs to be re-evaluated and that DHA and AA should be considered for addition to the nutrient requirements after scientific review by a panel such as those established by the National Academies of Sciences, Engineering, and Medicine. Additionally, there is no specific requirement in current FDA regulations for the energy density of IF, and this should be added alongside potential revisions of the protein requirement. It would also be ideal to have specific FDA rules on nutrient intakes for premature infants as these are exempted from the specific nutrient regulations of the amended IFA.
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Affiliation(s)
- Steven A Abrams
- Department of Pediatrics, Dell Medical School at the University of Texas, Austin, TX, United States.
| | - Erynn M Bergner
- Department of Pediatrics, University of Oklahoma College of Medicine, Oklahoma City, OK, United States
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13
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Ong YY, Pang WW, Michael N, Aris IM, Sadananthan SA, Tint MT, Liang Choo JT, Ling LH, Karnani N, Velan SS, Fortier MV, Tan KH, Gluckman PD, Yap F, Chong YS, Godfrey KM, Chan SY, Eriksson JG, Chong MFF, Wlodek ME, Lee YS. Timing of introduction of complementary foods, breastfeeding, and child cardiometabolic risk: a prospective multiethnic Asian cohort study. Am J Clin Nutr 2023; 117:83-92. [PMID: 36789947 DOI: 10.1016/j.ajcnut.2022.10.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/22/2022] [Accepted: 10/28/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The timing of introduction of complementary foods and the duration of breastfeeding (BF) have been independently associated with child overweight and obesity; however, their combined influence on body fat partitioning and cardiometabolic risk is unclear. OBJECTIVE We investigated the associations of the timing of introduction of complementary foods, the duration of BF, and their interaction with child adiposity and cardiometabolic risk markers. METHODS We analyzed data from 839 children in the prospective Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort. Mothers reported the age at which infants were first fed complementary foods and BF duration, classified as early (≤4 mo) versus typical (>4 mo) complementary feeding (CF) and short (≤4 mo) versus long (>4 mo) duration of any BF, respectively. We measured adiposity and cardiometabolic risk markers at the age of 6 y and examined their associations with infant feeding patterns using multiple regression, adjusting for sociodemographics, parents' body mass index (BMI), maternal factors, birth weight for gestational age, and infant weight gain. RESULTS Of 839 children, 18% experienced early CF, whereas 54% experienced short BF. Short (vs. long) BF and early (vs. typical) CF were independently associated with higher z-scores of BMI [β (95% confidence interval), short BF, 0.18 standard deviation score (SDS) (-0.01, 0.38); early CF, 0.34 SDS (0.11, 0.57)] and sum of skinfolds [short BF, 1.83 mm (0.05, 3.61); early CF, 2.73 mm (0.55, 4.91)]. Children who experienced both early CF and short BF (vs. typical CF-long BF) had synergistically higher diastolic blood pressure [1.41 mmHg (-0.15, 2.97), P-interaction = 0.023] and metabolic syndrome score [0.81 (0.16, 1.47), P-interaction = 0.081]. Early CF-long BF (vs. early CF-short BF) was associated with a lower systolic blood pressure [-3.74 mmHg (-7.01, -0.48)], diastolic blood pressure [-2.29 mmHg (-4.47, -0.11)], and metabolic syndrome score [-0.90 (-1.80, 0.00)]. CONCLUSIONS A combination of early CF and short BF was associated with elevated child adiposity and cardiometabolic markers. Longer BF duration may protect against cardiometabolic risk associated with early CF. This trial was registered at clinicaltrials.gov as NCT01174875.
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Affiliation(s)
- Yi Ying Ong
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Wei Wei Pang
- Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
| | - Navin Michael
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore, Republic of Singapore
| | - Izzuddin M Aris
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Suresh Anand Sadananthan
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore, Republic of Singapore
| | - Mya-Thway Tint
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore, Republic of Singapore
| | | | - Lieng Hsi Ling
- Department of Cardiology, National University Heart Centre, National University Hospital, Singapore, Republic of Singapore
| | - Neerja Karnani
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore, Republic of Singapore
| | - S Sendhil Velan
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore, Republic of Singapore
| | - Marielle V Fortier
- Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, Singapore, Republic of Singapore
| | - Kok Hian Tan
- Duke-NUS Medical School, Singapore, Republic of Singapore; Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, Republic of Singapore
| | - Peter D Gluckman
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore, Republic of Singapore; Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Fabian Yap
- KK Women's and Children's Hospital, Singapore, Republic of Singapore; Duke-NUS Medical School, Singapore, Republic of Singapore
| | - Yap-Seng Chong
- Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore; Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore, Republic of Singapore
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Centre and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Shiao-Yng Chan
- Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore; Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore, Republic of Singapore
| | - Johan G Eriksson
- Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore; Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore, Republic of Singapore; Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland; Folkhälsan Research Center, Helsinki, Finland
| | - Mary F-F Chong
- Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore, Republic of Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Republic of Singapore
| | - Mary E Wlodek
- Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore; Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore, Republic of Singapore; Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia
| | - Yung Seng Lee
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore; Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, Singapore, Republic of Singapore; Division of Paediatric Endocrinology, Department of Paediatrics, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Republic of Singapore.
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14
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Yoshinaga M, Takahashi H, Ito Y, Aoki M, Miyazaki A, Kubo T, Shinomiya M, Horigome H, Tokuda M, Lin L, Ogata H, Nagashima M. Developmental trajectories at a high risk for childhood overweight/obesity. Pediatr Int 2023; 65:e15425. [PMID: 36416571 DOI: 10.1111/ped.15425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 08/24/2022] [Accepted: 10/12/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND The associations between developmental patterns (trajectories) in children and maternal factors have been widely investigated, but paternal effects on these trajectories are unclear. This study aimed to determine child and parental factors involved in developmental trajectories at high risk for causing adverse cardiovascular (CV) profiles in children. METHODS We analyzed longitudinal anthropometric data from birth to the present and CV profiles of 1,832 healthy volunteers (51% girls) aged 3-15 years who participated in a nationwide study between July 2012 and January 2014. Six trajectory latent class growth models were developed using body mass index z- scores. Predictors for being in developmental trajectories at high risk for causing adverse CV profiles were determined by multivariate regression analysis. RESULTS The mean±standard deviation number of anthropometric data points was 12±3 for both boys and girls. Among the six trajectories, the infantile onset and continual increase groups had significantly worse levels of many CV profiles than those in the remaining groups. Paternal overweight/obesity was an independent predictor for boys being in the infantile onset group and for girls being in the continual increase group. Additionally, maternal pre-pregnancy overweight/obesity in boys and maternal excessive gestational weight gain in girls were independent predictors for being in the infantile onset group. Having no sibling in boys and an older maternal age were independent predictors for being in the continual increase group. CONCLUSIONS Interventions to prevent childhood obesity should include strategies that focus on fathers and mothers as well as those that focus on children with certain types of familial background.
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Affiliation(s)
- Masao Yoshinaga
- Department of Pediatrics, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan.,Orange Medical and Welfare Center for Severe Motor and Intellectual Disabilities, Kirishima, Japan
| | | | - Yoshiya Ito
- Clinical Medicine Area, Japanese Red Cross Hokkaido College of Nursing, Kitami, Japan
| | - Machiko Aoki
- Department of Pediatrics, Aoki Internal Medicine and Cardiovascular and Pediatrics Clinic, Fukuoka, Japan
| | - Ayumi Miyazaki
- Department of Pediatrics, Japan Community Health Care Organization Takaoka Fushiki Hospital, Takaoka, Japan
| | - Toshihide Kubo
- Department of Pediatrics, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Masaki Shinomiya
- Department of Internal Medicine, Nishifuna Naika, Funabashi, Japan
| | - Hitoshi Horigome
- Department of Child Health, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | | | - Lisheng Lin
- Department of Child Health, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Hiromitsu Ogata
- Epidemiology and Biostatistics, Kagawa Nutrition University, Sakado, Japan
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15
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Demmelmair H, Fleddermann M, Koletzko B. Infant Feeding Choices during the First Post-Natal Months and Anthropometry at Age Seven Years: Follow-Up of a Randomized Clinical Trial. Nutrients 2022; 14:nu14193900. [PMID: 36235553 PMCID: PMC9572598 DOI: 10.3390/nu14193900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/10/2022] [Accepted: 09/13/2022] [Indexed: 11/16/2022] Open
Abstract
The Belgrade–Munich Infant Milk Trial (BeMIM) randomized healthy term infants into either a protein-reduced intervention infant formula (IF) group, with an α-lactalbumin-enriched whey and long-chain polyunsaturated fatty acids, or a control infant formula (CF) group. A non-randomized breastfed group (BF) was studied for reference. We assessed the long-term effects of these infant feeding choices on growth measures until the age of seven years. Weight, standing height, head circumference, and percent body fat (using skinfolds and bioelectrical impedance) were determined with standardized methods. A total of 161 children out of the 256 completers of the initial study (63%) participated in the seven-year follow-up. Children in the three study groups did not differ in their anthropometric measures, including body mass index (IF 16.1 ± 2.6, CF: 15.6 ± 1.7, BF: 15.6 ± 2.5 kg/m2, mean ± SD). IGF-1 serum concentrations determined at the age of 4 months contributed to explaining the variances in weight (p = 0.001), height (p = 0.001) and BMI (p = 0.035) z-scores at the age of seven years, whereas insulin levels at four months did not. Different feeding choices during the first four months of life leading to higher energy efficiency and increased growth with IF did not affect later growth outcomes at an early school age. Diet-induced modulation of IGF-1 in the first months of life may have lasting programming effects on later growth.
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Affiliation(s)
- Hans Demmelmair
- Dr. Von Hauner Children’s Hospital, University of Munich Medical Centre, Ludwig-Maximilians-Universiät München, 80337 Munich, Germany
- Correspondence: (H.D.); (B.K.)
| | | | - Berthold Koletzko
- Dr. Von Hauner Children’s Hospital, University of Munich Medical Centre, Ludwig-Maximilians-Universiät München, 80337 Munich, Germany
- Correspondence: (H.D.); (B.K.)
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16
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Khalsa AS, Li R, Rausch J, Klebanoff MA, Ingol TT, Boone KM, Keim SA. Early childhood growth trajectories in a Medicaid population. Pediatr Obes 2022; 17:e12918. [PMID: 35307980 PMCID: PMC9357091 DOI: 10.1111/ijpo.12918] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 02/07/2022] [Accepted: 02/28/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Evidence on the role of early growth trajectories and later obesity risk is primarily based on privately insured or universally insured samples. OBJECTIVES We aimed to characterize and determine factors associated with early growth trajectories and estimate associations with overweight/obesity risk in a Medicaid-insured and uninsured cohort. METHODS Infants seen at a large pediatric academic centre in 2010-2016 were included. Weight and length/height measurements were converted to age and sex-specific BMI z-scores (BMIz) based on the World Health Organization (WHO) Growth Standards. Group-based trajectories were modelled using BMIz created groups. Logistic and log-binomial regression models estimated associations between membership in trajectories and maternal/child factors and overweight or obesity at 36, 48, and 60 months, separately. Analyses were performed between 2019 and 2021. RESULTS The best-fitting model identified five BMIz trajectories among 30 189 children and 310 113 clinical encounters; two trajectories showed rapid rise in BMIz. Lower maternal education, pre-pregnancy maternal overweight/obese status, and maternal smoking were positively associated with both rapid-rising BMIz trajectories. Children in either of the two rapid-rising trajectories were 3.00 (95% CI: 2.85, 3.25), 2.97 (95% CI: 2.77, 3.18) and 2.76 (95% CI: 2.53, 3.01) times more likely to have overweight or obesity at 36, 48, and 60 months, respectively compared to children in the stable trajectory groups. CONCLUSIONS Among Medicaid insured and uninsured children, several maternal and child characteristics were associated with early rapid-rise in BMIz. Clinical monitoring of early rapidly rising BMI may be important to address modifiable risk factors for obesity in families from low-income households.
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Affiliation(s)
- Amrik Singh Khalsa
- Division of Primary Care Pediatrics, Nationwide Children’s Hospital 700 Children’s Drive Columbus, OH 43205
- Center for Child Health Equity and Outcomes Research, The Abigail Wexner Research Institute, Nationwide Children’s Hospital 700 Children’s Drive, Columbus, OH 43205
- Department of Pediatrics, College of Medicine, The Ohio State University 370 W. 9th Ave. Columbus, OH 43210
| | - Rui Li
- Department of Hematology, James Cancer Hospital & Solove Research Institute, The Ohio State University Wexner Medical Center 460 W 10th Ave, Columbus, OH 43210
| | - Joseph Rausch
- Department of Pediatrics, College of Medicine, The Ohio State University 370 W. 9th Ave. Columbus, OH 43210
- Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children’s Hospital 700 Children’s Drive Columbus, OH 43205
| | - Mark A. Klebanoff
- Department of Pediatrics, College of Medicine, The Ohio State University 370 W. 9th Ave. Columbus, OH 43210
- Center for Perinatal Research, The Abigail Wexner Research Institute, Nationwide Children’s Hospital 700 Children’s Drive Columbus, OH 43205
- Division of Epidemiology, College of Public Health, The Ohio State University 370 W. 9 Ave. Columbus, OH 43210
| | - Taniqua T. Ingol
- Division of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC 27599
| | - Kelly M. Boone
- Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children’s Hospital 700 Children’s Drive Columbus, OH 43205
| | - Sarah A. Keim
- Department of Pediatrics, College of Medicine, The Ohio State University 370 W. 9th Ave. Columbus, OH 43210
- Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children’s Hospital 700 Children’s Drive Columbus, OH 43205
- Division of Epidemiology, College of Public Health, The Ohio State University 370 W. 9 Ave. Columbus, OH 43210
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17
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Antibiotics prior to age 2 years have limited association with preschool growth trajectory. Int J Obes (Lond) 2022; 46:843-850. [PMID: 34999718 PMCID: PMC8967797 DOI: 10.1038/s41366-021-01023-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 07/20/2021] [Accepted: 11/05/2021] [Indexed: 11/18/2022]
Abstract
Background: Prior studies of early antibiotic use and growth have shown mixed results, primarily on cross-sectional outcomes. This study examined the effect of oral antibiotics before age 24 months on growth trajectory at age 2–5 years. Methods: We captured oral antibiotic prescriptions and anthropometrics from electronic health records through PCORnet, for children with ≥1 height and weight at 0–12 months of age, ≥1 at 12–30 months, and ≥2 between 25 and 72 months. Prescriptions were grouped into episodes by time and by antimicrobial spectrum. Longitudinal rate regression was used to assess differences in growth rate from 25 to 72 months of age. Models were adjusted for sex, race/ethnicity, steroid use, diagnosed asthma, complex chronic conditions, and infections. Results: 430,376 children from 29 health U.S. systems were included, with 58% receiving antibiotics before 24 months. Exposure to any antibiotic was associated with an average 0.7% (95% CI 0.5, 0.9, p < 0.0001) greater rate of weight gain, corresponding to 0.05 kg additional weight. The estimated effect was slightly greater for narrow-spectrum (0.8% [0.6, 1.1]) than broad-spectrum (0.6% [0.3, 0.8], p < 0.0001) drugs. There was a small dose response relationship between the number of antibiotic episodes and weight gain. Conclusion: Oral antibiotic use prior to 24 months of age was associated with very small changes in average growth rate at ages 2–5 years. The small effect size is unlikely to affect individual prescribing decisions, though it may reflect a biologic effect that can combine with others.
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18
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FERREIRA RDMM, SANTOS DCD, VILELA LBF, OLIVEIRA TLD, EGEA MB. Early introduction of complementary foods in infants under six months: a case study from Rio Verde, Brazil. FOOD SCIENCE AND TECHNOLOGY 2022. [DOI: 10.1590/fst.55522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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19
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The importance of sleep and parity in understanding changes in weight and breastfeeding behavior among postpartum women. Appetite 2021; 170:105889. [PMID: 34954303 DOI: 10.1016/j.appet.2021.105889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 12/16/2021] [Accepted: 12/20/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Breastfeeding duration has been linked with the health of both women and their children, but research that considers women's weight change postpartum and practical factors that may impact their quality of life (i.e., sleep quantity, number of children) is limited. METHOD A survey was administered to 568 women (M age = 31.32 years; SD = 4.21) who had given birth within the past year. The survey included assessments of pre- and post-pregnancy weight and height, breastfeeding practices, current sleep quantity, presence of breastfeeding-specific support, and other demographics including their total number of children. RESULTS Greater pre-pregnancy to postpartum weight increase was related to shorter duration of breastfeeding. Mothers who exclusively breastfed for the first six months had less postpartum weight increase (i.e., the discrepancy between their pre-pregnancy and post-pregnancy weight was smaller) than those who did not. Fewer children and greater hours of sleep were significantly associated with longer duration of breastfeeding. Sleep partially accounted for the relationship between body mass index change and breastfeeding duration. Breastfeeding-specific support did not impact the effect of low sleep on shorter breastfeeding duration. CONCLUSIONS Duration of breastfeeding may suffer due to fatigue. Sleep plays a key role in understanding the ways in which weight change impact breastfeeding behavior. Greater holistic support for mothers in the postpartum period is needed to foster an environment that encourages breastfeeding.
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20
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Zheng M, Campbell KJ, Baur L, Rissel C, Wen LM. Infant feeding and growth trajectories in early childhood: the application and comparison of two longitudinal modelling approaches. Int J Obes (Lond) 2021; 45:2230-2237. [PMID: 34230577 DOI: 10.1038/s41366-021-00892-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 05/11/2021] [Accepted: 06/24/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND/OBJECTIVES The role of infant feeding practices in longitudinal growth trajectories in children remains equivocal. This study utilised two longitudinal approaches to examine the associations of infant feeding mode (breastfeeding, mixed feeding, formula feeding), breastfeeding duration, and the timing of solid foods introduction with body mass index (BMI) z-score in early childhood. SUBJECTS/METHODS Secondary analyses of data from the Healthy Beginnings Trial were conducted. Infant feeding practices were reported by mothers at 6, 12, and 24 months of child age. Child weight and length were measured at birth, 12, 24, 42, and 60 months. Two longitudinal approaches: linear spline multilevel model (LSMM) and group-based trajectory modelling (GBTM) were used to describe BMI z-score trajectories and assess its associations with infant feeding practices. RESULTS The LSMM approach demonstrated that the breastfeeding group showed lower BMI z-scores from ages 12 to 60 months than the mixed feeding and formula feeding groups. Children who were breastfed for ≥ 6 versus < 6 months exhibited a lower BMI z-score trajectory from ages 12 to 60 months. Results from the GBTM approach revealed that the mixed feeding (OR: 1.83, 95%CI 1.04, 3.21) and the formula feeding group (OR: 2.00, 95%CI 0.67, 5.92) showed a tendency for higher odds of following the "High BMIz" trajectory than the breastfeeding group. Breastfeeding duration ≥6 versus < 6 months was linked with lower odds of following the "High BMIz" trajectory (OR 0.65, 95%CI 0.43, 0.98). Both approaches revealed no evidence of an association between the timing of solid foods introduction and BMI z-score trajectory. CONCLUSIONS The two longitudinal approaches revealed similar findings that infant feeding mode and breastfeeding duration, but not the timing of solid foods introduction, were associated with BMI z-score trajectory in early childhood. The findings provide robust longitudinal evidence to encourage and support extended breastfeeding for childhood obesity prevention.
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Affiliation(s)
- Miaobing Zheng
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
| | - Karen J Campbell
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Louise Baur
- School of Public Health and Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Chris Rissel
- School of Public Health and Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Li Ming Wen
- School of Public Health and Sydney Medical School, The University of Sydney, Sydney, Australia.,Health Promotion Unit, Population Health Research and Evaluation Hub, Sydney Local Health District, NSW, Sydney, Australia
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21
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Norris T, Mansukoski L, Gilthorpe MS, Hamer M, Hardy R, Howe LD, Li L, Ong KK, Ploubidis GB, Viner RM, Johnson W. Early childhood weight gain: Latent patterns and body composition outcomes. Paediatr Perinat Epidemiol 2021; 35:557-568. [PMID: 33960515 DOI: 10.1111/ppe.12754] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/26/2020] [Accepted: 01/03/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Despite early childhood weight gain being a key indicator of obesity risk, we do not have a good understanding of the different patterns that exist. OBJECTIVES To identify and characterise distinct groups of children displaying similar early-life weight trajectories. METHODS A growth mixture model captured heterogeneity in weight trajectories between 0 and 60 months in 1390 children in the Avon Longitudinal Study of Parents and Children. Differences between the classes in characteristics and body size/composition at 9 years were investigated. RESULTS The best model had five classes. The "Normal" (45%) and "Normal after initial catch-down" (24%) classes were close to the 50th centile of a growth standard between 24 and 60 months. The "High-decreasing" (21%) and "Stable-high" (7%) classes peaked at the ~91st centile at 12-18 months, but while the former declined to the ~75th centile and comprised constitutionally big children, the latter did not. The "Rapidly increasing" (3%) class gained weight from below the 50th centile at 4 months to above the 91st centile at 60 months. By 9 years, their mean body mass index (BMI) placed them at the 98th centile. This class was characterised by the highest maternal BMI; highest parity; highest levels of gestational hypertension and diabetes; and the lowest socio-economic position. At 9 years, the "Rapidly increasing" class was estimated to have 68.2% (95% confidence interval [CI] 48.3, 88.1) more fat mass than the "Normal" class, but only 14.0% (95% CI 9.1, 18.9) more lean mass. CONCLUSIONS Criteria used in growth monitoring practice are unlikely to consistently distinguish between the different patterns of weight gain reported here.
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Affiliation(s)
- Tom Norris
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Liina Mansukoski
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Mark S Gilthorpe
- Leeds Institute for Data Analytics, University of Leeds, Leeds, UK.,Faculty of Medicine and Health, University of Leeds, Leeds, UK.,Alan Turing Institute, British Library, London, UK
| | - Mark Hamer
- Division of Surgery and Interventional Sciences, Faculty Medical Sciences, University College London, London, UK
| | - Rebecca Hardy
- CLOSER, Department of Social Science, University College London, London, UK
| | - Laura D Howe
- MRC Integrative Epidemiology Unit at the University of Bristol, Population Health Sciences, University of Bristol, Bristol, UK
| | - Leah Li
- Population, Policy and Practice Programme, Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Ken K Ong
- MRC Epidemiology Unit and Department of Paediatrics, University of Cambridge, Cambridge, UK
| | - George B Ploubidis
- Centre for Longitudinal Studies, Department of Social Science, University College London, London, UK
| | - Russell M Viner
- Population, Policy and Practice Programme, Great Ormond Street Institute of Child Health, University College London, London, UK
| | - William Johnson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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22
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Extensive Study of Breast Milk and Infant Growth: Protocol of the Cambridge Baby Growth and Breastfeeding Study (CBGS-BF). Nutrients 2021; 13:nu13082879. [PMID: 34445039 PMCID: PMC8400677 DOI: 10.3390/nu13082879] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 08/13/2021] [Accepted: 08/19/2021] [Indexed: 12/14/2022] Open
Abstract
Growth and nutrition during early life have been strongly linked to future health and metabolic risks. The Cambridge Baby Growth Study (CBGS), a longitudinal birth cohort of 2229 mother-infant pairs, was set up in 2001 to investigate early life determinant factors of infant growth and body composition in the UK setting. To carry out extensive profiling of breastmilk intakes and composition in relation to infancy growth, the Cambridge Baby Growth and Breastfeeding Study (CBGS-BF) was established upon the original CBGS. The strict inclusion criteria were applied, focusing on a normal birth weight vaginally delivered infant cohort born of healthy and non-obese mothers. Crucially, only infants who were exclusively breastfed for the first 6 weeks of life were retained in the analysed study sample. At each visit from birth, 2 weeks, 6 weeks, and then at 3, 6, 12, 24, and 36 months, longitudinal anthropometric measurements and blood spot collections were conducted. Infant body composition was assessed using air displacement plethysmography (ADP) at 6 weeks and 3 months of age. Breast milk was collected for macronutrients and human milk oligosaccharides (HMO) measurements. Breast milk intake volume was also estimated, as well as sterile breastmilk and infant stool collection for microbiome study.
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23
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Evaluation of an Infant Formula with Large, Milk-Phospholipid Coated Lipid Droplets on Long-Term Growth and Development of Singaporean Infants: Randomized Controlled Trial Protocol. Nutrients 2021; 13:nu13082865. [PMID: 34445029 PMCID: PMC8401090 DOI: 10.3390/nu13082865] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/16/2021] [Accepted: 08/19/2021] [Indexed: 11/24/2022] Open
Abstract
A concept infant formula (IF) was developed with physical properties of lipid droplets mimicking more closely those in human milk. This paper describes the unique design of a randomised controlled trial evaluating the impact of the concept IF on infant growth and body composition development whilst applying a cohort-like recruitment approach that fully supports breastfeeding practices of the study population. Subjects entered the study between birth and 1 months of age, and whenever parents decided to introduce formula were randomised to one of three study formulas; the concept IF comprising large lipid droplets coated by milk phospholipids and containing a specific mixture of prebiotics, a standard IF with the specific prebiotic mixture or a standard IF without the prebiotic mixture. The primary objective was to evaluate the impact of the concept IF on growth and body composition outcomes during the first year of life with a follow-up at 2, 3, 4 and 5 years of age. In addition, stool, saliva and buccal smear samples and parameters assessing safety, gastrointestinal tolerance and cognitive outcomes were collected. The applied cohort-like enrolment approach is distinctly different from standard clinical safety or efficacy studies and may provide valuable insights on trial design for the evaluation of IF while carefully considering breastfeeding practices.
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24
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Liang J, Zheng S, Li X, Xiao D, Wang P. Associations of community, famliy and early individual factors with body mass index z-scores trajectories among Chinese children and adolescents. Sci Rep 2021; 11:14535. [PMID: 34267304 PMCID: PMC8282779 DOI: 10.1038/s41598-021-93949-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 05/06/2021] [Indexed: 11/09/2022] Open
Abstract
The prevalence of childhood overweight and obesity is increasing. This study aimed to examine trajectories of BMI z-scores among Chinese children and the potential determinants including early individual, family and community factors. Group-based trajectory modeling was employed to identify BMI z-scores trajectories of children aged 2-18 years using the five waves data (2010, 2012, 2014, 2016, and 2018) of the China Family Panel Studies (CFPS). Multivariate logistic regression was conducted to determine the association between early individual, family, community factors and BMI z-scores trajectories of children. We identified three trajectories for boys and girls, named Class 1 as "not-overweight", Class 2 as "persistent rapid descending but overweight during pre-school age", and Class 3 as "rapid rising up to school age and then become-overweight" class. Macrosomia (OR 1.772; 95% CI 1.188-2.644) and being a single child (OR 2.038; 95% CI 1.453-2.859) were more likely to belong in Class 3 among boys. Girls living in the advantaged communities (OR 1.539; 95% CI 1.052-2.252), rural-living (OR 1.558; 95% CI 1.133-2.142) and with none social integration (OR 1.496; 95% CI 1.07-2.091) were more likely to belong in Class 2. There are heterogeneous BMI z-scores trajectories of children aged 2-18, and pre-school age is a critical window that could predict the long-term growth patterns. BMI z-scores trends need to be monitored during pre-school age, focusing on those at higher risk of later overweight obesity status, and targeted interventions at the early individual, family, community levels are essential.
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Affiliation(s)
- Jing Liang
- School of Health Sciences, Wuhan University, Wuhan, 430071, China
| | - Si Zheng
- School of Health Sciences, Wuhan University, Wuhan, 430071, China
| | - Xuyang Li
- School of Health Sciences, Wuhan University, Wuhan, 430071, China
| | - Dianmin Xiao
- Gannan Medical University, Ganzhou, 341000, China
| | - Peigang Wang
- School of Health Sciences, Wuhan University, Wuhan, 430071, China. .,Wuhan University Center for Population and Health Research, Wuhan, 430071, China.
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25
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Infant Feeding and Ethnic Differences in Body Mass Index during Childhood: A Prospective Study. Nutrients 2021; 13:nu13072291. [PMID: 34371801 PMCID: PMC8308235 DOI: 10.3390/nu13072291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 06/28/2021] [Accepted: 06/30/2021] [Indexed: 12/16/2022] Open
Abstract
This study investigated ethnic differences in childhood body mass index (BMI) in children from Dutch and Turkish descent and the role of infant feeding factors (breastfeeding duration, milk feeding frequency, as well as the timing, frequency and variety of complementary feeding (CF)). We used data from 244 children (116 Dutch and 128 Turkish) participating in a prospective study in the Netherlands. BMI was measured at 2, 3 and 5 years and standard deviation scores (sds) were derived using WHO references. Using linear mixed regression analyses, we examined ethnic differences in BMI-sds between 2 and 5 years, and the role of infant feeding in separate models including milk or CF factors, or both (full model). Relative to Dutch children, Turkish children had higher BMI-sds at age 3 (mean difference: 0.26; 95%CI: 0.04, 0.48) and 5 (0.63; 0.39, 0.88), but not at 2 years (0.08; -0.16, 0.31). Ethnic differences in BMI-sds were somewhat attenuated by CF factors at age 3 (0.16; -0.07, 0.40) and 5 years (0.50; 0.24, 0.77), whereas milk feeding had a minor impact. Of all factors, only CF variety was associated with BMI-sds in the full model. CF factors, particularly CF variety, explain a small fraction of the BMI-sds differences between Dutch and Turkish children. The role of CF variety on childhood BMI requires further investigation.
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26
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Sobik S, Sims CR, McCorkle G, Bellando J, Sorensen ST, Badger TM, Casey PH, Williams DK, Andres A. Early infant feeding effect on growth and body composition during the first 6 years and neurodevelopment at age 72 months. Pediatr Res 2021; 90:140-147. [PMID: 32961547 DOI: 10.1038/s41390-020-01157-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 08/11/2020] [Accepted: 09/01/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND This study longitudinally characterized the developmental status, growth, and body composition of children who were fed human milk (breastfed, BF), cow's milk-based (MF), or soy protein-based (SF) infant formula from 3 to 12 months. METHODS Standardized anthropometrics and dual-energy X-ray absorptiometry were used to characterize growth and body composition at 3, 6, 9, 12, 24, 36, 48, 60, and 72 months (NCT00616395). Preschool Language Scale-3, Children's Memory Scale Index (CMS), and Wechsler Preschool and Primary Scale of Intelligence were administered at age 72 months. Mixed-effects models adjusting for gestational age, birth weight, child race and sex, parental education, and maternal IQ were performed. RESULTS Body Mass index (BMI) was significantly lower between 24 and 72 months in BF children compared to SF children. At 3 and 6 months, BF infants had significantly higher fat mass (FM) than SF infants, whereas BF children had significantly lower FM at 36 and 48 months than SF children. Delayed Recognition Index of the CMS was higher for SF than for MF participants (p = 0.009). There was no other significant difference in developmental outcomes between groups. CONCLUSIONS In conclusion, BF, MF, and SF support adequate growth and development up to age 6 years. IMPACT Although soy protein-based infant formula is reported to support normal infant growth and development compared to cow's milk-based formula and human milk, there are limited data on the effect of these feeding methods in school-aged children. This study suggests a significant difference in body composition, specifically BMI, after 24 months between infant feeding methods during the first year of life and in early childhood; however, all diets provide adequate nutrients to maintain normal development up to 72 months.
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Affiliation(s)
- Sarah Sobik
- Arkansas Children's Nutrition Center, Little Rock, AR, USA.,Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.,Arkansas Children's Research Institute, Little Rock, AR, USA
| | - Clark R Sims
- Arkansas Children's Nutrition Center, Little Rock, AR, USA
| | | | - Jayne Bellando
- Arkansas Children's Nutrition Center, Little Rock, AR, USA.,Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.,Arkansas Children's Research Institute, Little Rock, AR, USA
| | - Seth T Sorensen
- Arkansas Children's Nutrition Center, Little Rock, AR, USA.,Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.,Arkansas Children's Research Institute, Little Rock, AR, USA
| | - Thomas M Badger
- Arkansas Children's Nutrition Center, Little Rock, AR, USA.,Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.,Arkansas Children's Research Institute, Little Rock, AR, USA
| | - Patrick H Casey
- Arkansas Children's Nutrition Center, Little Rock, AR, USA.,Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.,Arkansas Children's Research Institute, Little Rock, AR, USA
| | | | - Aline Andres
- Arkansas Children's Nutrition Center, Little Rock, AR, USA. .,Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA. .,Arkansas Children's Research Institute, Little Rock, AR, USA.
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27
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Picó C, Reis F, Egas C, Mathias P, Matafome P. Lactation as a programming window for metabolic syndrome. Eur J Clin Invest 2021; 51:e13482. [PMID: 33350459 DOI: 10.1111/eci.13482] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 12/14/2020] [Accepted: 12/15/2020] [Indexed: 12/12/2022]
Abstract
The concept of developmental origins of health and disease (DOHaD) was initially supported by the low birth weight and higher risk of developing cardiovascular disease in adult life, caused by nutrition restriction during foetal development. However, other programming windows have been recognized in the last years, namely lactation, infancy, adolescence and even preconception. Although the concept has been developed in order to study the impact of foetal calorie restriction in adult life, it is now recognized that maternal overweight during programming windows is also harmful to the offspring. This article explores and summarizes the current knowledge about the impact of maternal obesity and obesogenic diets during lactation in the metabolic programming towards the development of metabolic syndrome in the adult life. The impact of maternal obesity and obesogenic diets in milk quality is discussed, including the alterations in specific micro and macronutrients, as well as the impact of such alterations in the development of metabolic syndrome-associated features in the newborn, such as insulin resistance and adiposity. Moreover, the impact of milk quality and formula feeding in infants' gut microbiota, immune system maturation and in the nutrient-sensing mechanisms, namely those related to gut hormones and leptin, are also discussed under the current knowledge.
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Affiliation(s)
- Catalina Picó
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Nutrigenomics and Obesity), University of the Balearic Islands, Palma (Mallorca), Spain.,Instituto de Investigación Sanitaria Illes Balears (IdISBa), Palma (Mallorca), Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Palma (Mallorca), Spain
| | - Flávio Reis
- Faculty of Medicine, Institute of Pharmacology & Experimental Therapeutics and Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal.,Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
| | - Conceição Egas
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal.,Center of Neuroscience and Cell Biology (CNC), University of Coimbra, Coimbra, Portugal
| | | | - Paulo Matafome
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal.,Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal.,Faculty of Medicine, Institute of Physiology and Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal.,Department of Complementary Sciences, Instituto Politécnico de Coimbra, Coimbra Health School (ESTeSC), Coimbra, Portugal
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28
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Breastfeeding and growth trajectory from birth to 5 years among children exposed and unexposed to gestational diabetes mellitus in utero. J Perinatol 2021; 41:1033-1042. [PMID: 33510423 DOI: 10.1038/s41372-021-00932-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 11/09/2020] [Accepted: 01/15/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVES This study aims to evaluate the association between exposure to gestational diabetes mellitus and growth trajectory from birth to 5 years and to test whether breastfeeding influences this association among children exposed and unexposed to gestational diabetes. STUDY DESIGN Weight at 0, 6, 12, and 18 months and 2, 3, 4, and 5 years were retrospectively collected for 103 children exposed and 63 children unexposed to gestational diabetes. Weight-for-age z-score was calculated. Mixed linear model for repeated measurements were computed to test whether breastfeeding was associated differently with weight-for-age z-score of children exposed or unexposed to diabetes. RESULTS Children exposed to gestational diabetes had greater z-score values at 6 months and 4 and 5 years (p < 0.10). Breastfeeding duration was not associated with weight-for-age z-score trajectory in any children. CONCLUSION Children exposed to gestational diabetes had a different growth trajectory in early life, but breastfeeding duration did not seem to influence this association.
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Millward DJ. Interactions between Growth of Muscle and Stature: Mechanisms Involved and Their Nutritional Sensitivity to Dietary Protein: The Protein-Stat Revisited. Nutrients 2021; 13:729. [PMID: 33668846 PMCID: PMC7996181 DOI: 10.3390/nu13030729] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 02/15/2021] [Accepted: 02/22/2021] [Indexed: 02/07/2023] Open
Abstract
Childhood growth and its sensitivity to dietary protein is reviewed within a Protein-Stat model of growth regulation. The coordination of growth of muscle and stature is a combination of genetic programming, and of two-way mechanical interactions involving the mechanotransduction of muscle growth through stretching by bone length growth, the core Protein-Stat feature, and the strengthening of bone through muscle contraction via the mechanostat. Thus, growth in bone length is the initiating event and this is always observed. Endocrine and cellular mechanisms of growth in stature are reviewed in terms of the growth hormone-insulin like growth factor-1 (GH-IGF-1) and thyroid axes and the sex hormones, which together mediate endochondral ossification in the growth plate and bone lengthening. Cellular mechanisms of muscle growth during development are then reviewed identifying (a) the difficulties posed by the need to maintain its ultrastructure during myofibre hypertrophy within the extracellular matrix and the concept of muscle as concentric "bags" allowing growth to be conceived as bag enlargement and filling, (b) the cellular and molecular mechanisms involved in the mechanotransduction of satellite and mesenchymal stromal cells, to enable both connective tissue remodelling and provision of new myonuclei to aid myofibre hypertrophy and (c) the implications of myofibre hypertrophy for protein turnover within the myonuclear domain. Experimental data from rodent and avian animal models illustrate likely changes in DNA domain size and protein turnover during developmental and stretch-induced muscle growth and between different muscle fibre types. Growth of muscle in male rats during adulthood suggests that "bag enlargement" is achieved mainly through the action of mesenchymal stromal cells. Current understanding of the nutritional regulation of protein deposition in muscle, deriving from experimental studies in animals and human adults, is reviewed, identifying regulation by amino acids, insulin and myofibre volume changes acting to increase both ribosomal capacity and efficiency of muscle protein synthesis via the mechanistic target of rapamycin complex 1 (mTORC1) and the phenomenon of a "bag-full" inhibitory signal has been identified in human skeletal muscle. The final section deals with the nutritional sensitivity of growth of muscle and stature to dietary protein in children. Growth in length/height as a function of dietary protein intake is described in the context of the breastfed child as the normative growth model, and the "Early Protein Hypothesis" linking high protein intakes in infancy to later adiposity. The extensive paediatric studies on serum IGF-1 and child growth are reviewed but their clinical relevance is of limited value for understanding growth regulation; a role in energy metabolism and homeostasis, acting with insulin to mediate adiposity, is probably more important. Information on the influence of dietary protein on muscle mass per se as opposed to lean body mass is limited but suggests that increased protein intake in children is unable to promote muscle growth in excess of that linked to genotypic growth in length/height. One possible exception is milk protein intake, which cohort and cross-cultural studies suggest can increase height and associated muscle growth, although such effects have yet to be demonstrated by randomised controlled trials.
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Affiliation(s)
- D Joe Millward
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK
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30
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Ratsika A, Codagnone MC, O’Mahony S, Stanton C, Cryan JF. Priming for Life: Early Life Nutrition and the Microbiota-Gut-Brain Axis. Nutrients 2021; 13:423. [PMID: 33525617 PMCID: PMC7912058 DOI: 10.3390/nu13020423] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 01/21/2021] [Accepted: 01/24/2021] [Indexed: 12/18/2022] Open
Abstract
Microbes colonize the human body during the first moments of life and coexist with the host throughout the lifespan. Intestinal microbiota and their metabolites aid in the programming of important bodily systems such as the immune and the central nervous system during critical temporal windows of development, with possible structural and functional implications throughout the lifespan. These critical developmental windows perinatally (during the first 1000 days) are susceptible timepoints for insults that can endure long lasting effects on the microbiota-gut-brain axis. Environmental and parental factors like host genetics, mental health, nutrition, delivery and feeding mode, exposure to antibiotics, immune activation and microbiota composition antenatally, are all factors that are able to modulate the microbiota composition of mother and infant and may thus regulate important bodily functions. Among all these factors, early life nutrition plays a pivotal role in perinatal programming and in the modulation of offspring microbiota from birth throughout lifespan. This review aims to present current data on the impact of early life nutrition and microbiota priming of important bodily systems and all the factors influencing the microbial coexistence with the host during early life development.
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Affiliation(s)
- Anna Ratsika
- APC Microbiome Ireland, Biosciences Institute, University College Cork, Cork T12 YT20, Ireland; (A.R.); (M.C.C.); (S.O.); (C.S.)
- Department of Anatomy and Neuroscience, University College Cork, Cork T12 YT20, Ireland
| | - Martin C. Codagnone
- APC Microbiome Ireland, Biosciences Institute, University College Cork, Cork T12 YT20, Ireland; (A.R.); (M.C.C.); (S.O.); (C.S.)
- Department of Anatomy and Neuroscience, University College Cork, Cork T12 YT20, Ireland
| | - Siobhain O’Mahony
- APC Microbiome Ireland, Biosciences Institute, University College Cork, Cork T12 YT20, Ireland; (A.R.); (M.C.C.); (S.O.); (C.S.)
- Department of Anatomy and Neuroscience, University College Cork, Cork T12 YT20, Ireland
| | - Catherine Stanton
- APC Microbiome Ireland, Biosciences Institute, University College Cork, Cork T12 YT20, Ireland; (A.R.); (M.C.C.); (S.O.); (C.S.)
- Department of Psychiatry and Neurobehavioural Science, University College Cork, Cork T12 YT20, Ireland
- Teagasc Food Research Centre, Moorepark, Fermoy P61 C996, Ireland
| | - John F. Cryan
- APC Microbiome Ireland, Biosciences Institute, University College Cork, Cork T12 YT20, Ireland; (A.R.); (M.C.C.); (S.O.); (C.S.)
- Department of Anatomy and Neuroscience, University College Cork, Cork T12 YT20, Ireland
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Sirkka O, Hof MH, Vrijkotte T, Abrahamse-Berkeveld M, Halberstadt J, Seidell JC, Olthof MR. Feeding patterns and BMI trajectories during infancy: a multi-ethnic, prospective birth cohort. BMC Pediatr 2021; 21:34. [PMID: 33441111 PMCID: PMC7805191 DOI: 10.1186/s12887-020-02456-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 12/01/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Milk feeding type (exclusive breastfeeding [EBF], formula feeding or mixed feeding) and timing of complementary feeding (CF) have been associated with infant growth. However, studies evaluating their combined role, and the role of ethnicity, are scarce. We examined associations of feeding patterns (milk feeding type combined with timing of CF) with infant body mass index (BMI) trajectories and potential ethnic-specific associations. METHODS Infant feeding and BMI data during the 1st year of life from 3524 children (Dutch n = 2880, Moroccan n = 404 and Turkish n = 240) from the Amsterdam Born Children and their Development (ABCD) cohort were used. Six feeding patterns were defined: EBF/earlyCF, EBF/lateCF (reference), formula/earlyCF, formula/lateCF, mixed/earlyCF and mixed/lateCF. A covariate adjusted latent class mixed model was applied to simultaneously model BMI trajectories and associations with feeding patterns. Potential ethnic differences in the associations were studied in a separate model where interactions between ethnicity and feeding patterns were included. RESULTS Four distinct BMI trajectories (low, mid-low, mid-high and high) were identified. Feeding pattern of formula/earlyCF was associated with lower odds for low (OR: 0.43; 95% CI: 0.25, 0.76) or mid-high (0.28; 0.16, 0.51) (ref: high) trajectory compared with EBF/lateCF pattern (ref). An ethnic-specific model revealed that among Dutch infants, formula/earlyCF pattern was associated with lower odds for low trajectory (0.46; 0.24, 0.87), whereas among Turkish/Moroccan infants almost all feeding patterns were associated with lower odds for the low trajectory (ref: high). CONCLUSION Infant feeding patterns are associated with early BMI trajectories with specific ethnic differences. Future studies should take the role of ethnicity into account in the associations between infant feeding and growth.
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Affiliation(s)
- Outi Sirkka
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1085, 1081 HV, Amsterdam, the Netherlands. .,Danone Nutricia Research, Utrecht, the Netherlands.
| | - Michel H Hof
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Public Health Research institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Tanja Vrijkotte
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | | | - Jutka Halberstadt
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1085, 1081 HV, Amsterdam, the Netherlands
| | - Jacob C Seidell
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1085, 1081 HV, Amsterdam, the Netherlands
| | - Margreet R Olthof
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1085, 1081 HV, Amsterdam, the Netherlands
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32
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Zhang T, Song Y, Teng H, Zhang Y, Lu J, Tao L, Jin Y, Yin J, Zhou D. BMI Trajectories During the First 2 Years, and Their Associations With Infant Overweight/Obesity: A Registered Based Cohort Study in Taizhou, China. Front Pediatr 2021; 9:665655. [PMID: 34055698 PMCID: PMC8149948 DOI: 10.3389/fped.2021.665655] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 04/13/2021] [Indexed: 01/04/2023] Open
Abstract
Objective: The purpose of this study was to identify trajectories of body mass index (BMI) in toddlers from birth to 2 years old and examine their association with infantile overweight/obesity. Methods: Data were collected from 19,054 children born in any hospital or community healthcare center in Taizhou, China from 2018 to 2019 with at least three BMI measurements after birth. The Latent Class Growth Mixture Model was used to identify distinct BMI trajectories during the first 2 years of infants. Multiple logistic regression models were conducted to explore the associated factors of different BMI trajectories, and log-binomial regression was performed to assess the association between the trajectories and overweight/obesity. Results: Three heterogeneous BMI trajectories were identified and labeled as "lower" (36.21%, n = 6,899), "middle" (53.15%, n = 10,128) and "upper" (10.64%, n = 2,027), respectively. Several characteristics of infants and their corresponding mothers were found to be correlated with infant BMI trajectories, including infant sex, mode of delivery and weight at birth, as well as maternal parity, early pregnancy BMI and status of gestational diabetes mellitus. Furthermore, compared with those in the lower trajectory, infants in the middle [prevalence ratio (PR) = 2.63, 95% confidence interval (95%CI) = 2.17-2.63] or upper (PR = 2.98, 95%CI = 1.51-2.98) trajectory groups were prone to be overweight/obesity at their final observation. Conclusion: Heterogeneous BMI trajectories were observed in our study. Characteristics of both infants and their corresponding mothers could be potential determinants of infant growth. Moreover, infants in the middle and upper trajectory groups were more likely to suffer overweight/obesity.
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Affiliation(s)
- Tian Zhang
- Department of Epidemiology and Biostatics, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Ying Song
- Department of Epidemiology and Biostatics, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Haoyue Teng
- Department of Epidemiology and Biostatics, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Yue Zhang
- Department of Epidemiology and Biostatics, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Jianan Lu
- Department of Epidemiology and Biostatics, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Linghua Tao
- Department of Gynaecology and Obstetrics, Taizhou Woman and Children's Hospital, Taizhou, China
| | - Yanjie Jin
- Department of Gynaecology and Obstetrics, Taizhou Woman and Children's Hospital, Taizhou, China.,Beijing Longtengxinyang Information Technology Company, Beijing, China
| | - Jieyun Yin
- Department of Epidemiology and Biostatics, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Danhong Zhou
- Department of Gynaecology and Obstetrics, Taizhou Woman and Children's Hospital, Taizhou, China
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de Fluiter KS, van Beijsterveldt IALP, Breij LM, Acton D, Hokken-Koelega ACS. Association Between Fat Mass in Early Life and Later Fat Mass Trajectories. JAMA Pediatr 2020; 174:1141-1148. [PMID: 32804197 PMCID: PMC7432277 DOI: 10.1001/jamapediatrics.2020.2673] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
IMPORTANCE A rapid increase in weight in early life is associated with an increased risk for adiposity and cardiovascular diseases at age 21 years and beyond. However, data on associations of early change in measured fat mass percentage (FM%) with adiposity development are lacking. OBJECTIVE To investigate whether a rapid increase in FM% in the first months of life is associated with higher trajectories of body fat mass during the first 2 years of life. DESIGN, SETTING, AND PARTICIPANTS A birth cohort consisting of 401 healthy, term-born infants of the Sophia Pluto Cohort Study was analyzed. Participants were born between January 7, 2013, and October 13, 2017. Data were analyzed from February 1, 2020, to May 20, 2020. INTERVENTIONS Longitudinal measurements of FM% by air-displacement plethysmography and dual-energy x-ray absorptiometry, and abdominal subcutaneous and visceral fat mass (FM) by ultrasonography in infants at ages 1, 3, 6, 9, 12, 18, and 24 months. A rapid increase in FM% was defined as a change in FM% of greater than 0.67 standard deviation scores (SDS). MAIN OUTCOMES AND MEASURES Associations between change in FM% SDS in the first and second 6-month period of life with body composition at age 2 years and whether a rapid increase in FM% SDS during the first 6 months leads to higher body FM and abdominal FM trajectories during the first 2 years of life. RESULTS Of the 401 participants, 228 infants (57%) were male. Change in FM% SDS from age 1 to 6 months was positively associated with FM% (β, 0.044; 95% CI, 0.017-0.068), FMI (β, 0.061; 95% CI, 0.032-0.091), and abdominal subcutaneous FM (β, 0.064; 95% CI, 0.036-0.092) at age 2 years, but not with visceral FM. In contrast, no associations were found within the 6- to 12-month period. Infants with a rapid increase in FM% of greater than 0.67 SDS in the first 6 months of life had higher trajectories of FM%, FM index, and subcutaneous FM during the first 2 years of life (all P≤.001), but visceral FM index was not significantly different compared with infants without a rapid increase (P = .12). CONCLUSIONS AND RELEVANCE In this study, only the change in FM% in the first 6 months of life was associated with more adiposity at age 2 years. Infants with a rapid increase in FM% had higher trajectories of FM% and FM index during the first 2 years of life. These findings appear to support a critical window for adiposity programming in early life.
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Affiliation(s)
- Kirsten S. de Fluiter
- Department of Pediatrics, Subdivision of Endocrinology, Erasmus University Medical Center, Sophia Children’s Hospital, Rotterdam, the Netherlands
| | - Inge A. L. P. van Beijsterveldt
- Department of Pediatrics, Subdivision of Endocrinology, Erasmus University Medical Center, Sophia Children’s Hospital, Rotterdam, the Netherlands
| | - Laura M. Breij
- Department of Pediatrics, Subdivision of Endocrinology, Erasmus University Medical Center, Sophia Children’s Hospital, Rotterdam, the Netherlands
| | - Dennis Acton
- Danone Nutricia Research, Utrecht, the Netherlands
| | - Anita C. S. Hokken-Koelega
- Department of Pediatrics, Subdivision of Endocrinology, Erasmus University Medical Center, Sophia Children’s Hospital, Rotterdam, the Netherlands,Dutch Growth Research Foundation, Rotterdam, the Netherlands
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de Fluiter KS, Kerkhof GF, van Beijsterveldt IALP, Breij LM, van de Heijning BJM, Abrahamse-Berkeveld M, Hokken-Koelega ACS. Longitudinal human milk macronutrients, body composition and infant appetite during early life. Clin Nutr 2020; 40:3401-3408. [PMID: 33309161 DOI: 10.1016/j.clnu.2020.11.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/15/2020] [Accepted: 11/15/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND & AIMS Breastfeeding is the gold standard infant feeding. Data on macronutrients in relation to longitudinal body composition and appetite are very scarce. The aim of this study was to investigate longitudinal human milk macronutrients at 1 and 3 months in association with body composition and appetite during early life in healthy, term-born infants. We hypothesized that infants receiving higher caloric human milk would have more body fat mass and satiate earlier. METHODS In 133 exclusively breastfed infants (Sophia Pluto Cohort), human milk samples at 1 and 3 months were analyzed for macronutrients (fat, protein, carbohydrate) by MIRIS Human Milk Analyzer, with appetite assessment by Baby Eating Behavior Questionnaires. Fat mass (FM) and fat-free mass (FFM) were measured by PEA POD and DXA, and abdominal FM by ultrasound. RESULTS Milk samples showed large differences in macronutrients, particularly in fat content. Protein and energy content decreased significantly from 1 to 3 months. Fat and carbohydrate content tended to decrease (p = 0.066 and 0.081). Fat (g/100 ml) and energy (kcal/100 ml) content at 3 months were associated with FM% at 6 months (β 0.387 and 0.040, resp.) and gain in FM% from 1 to 6 months (β 0.088 and 0.009, resp.), but not with FM% at 2 years. Carbohydrate content at 3 months tended to associate with visceral FM at 2 years (β 0.290, p = 0.06). Infants receiving higher caloric milk were earlier satiated and finished feeding faster. CONCLUSIONS Our longitudinal data show decreasing milk protein and energy content from age 1 to 3 months, while fat and carbohydrate tended to decrease. Macronutrient composition, particularly fat content, differed considerably between mothers. Milk fat and energy content at 3 months associated with gain in FM% from age 1 to 6 months, indicating that higher fat and energy content associate with higher gain in FM% during the critical window for adiposity programming. As infants receiving higher caloric breastfeeding were earlier satiated, this self-regulatory mechanism might prevent intake of excessive macronutrients. ONLINE TRIAL REGISTRY NTR, NL7833.
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Affiliation(s)
- Kirsten S de Fluiter
- Department of Pediatrics, Subdivision of Endocrinology, Erasmus University Medical Center - Sophia Children's Hospital, Rotterdam, the Netherlands.
| | - Gerthe F Kerkhof
- Department of Pediatrics, Subdivision of Endocrinology, Erasmus University Medical Center - Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Inge A L P van Beijsterveldt
- Department of Pediatrics, Subdivision of Endocrinology, Erasmus University Medical Center - Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Laura M Breij
- Department of Pediatrics, Subdivision of Endocrinology, Erasmus University Medical Center - Sophia Children's Hospital, Rotterdam, the Netherlands
| | | | | | - Anita C S Hokken-Koelega
- Department of Pediatrics, Subdivision of Endocrinology, Erasmus University Medical Center - Sophia Children's Hospital, Rotterdam, the Netherlands; Dutch Growth Research Foundation, Rotterdam, the Netherlands
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35
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Childhood obesity: Is it related to feeding type of the infant? JOURNAL OF SURGERY AND MEDICINE 2020. [DOI: 10.28982/josam.810439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Trabulsi JC, Smethers AD, Eosso JR, Papas MA, Stallings VA, Mennella JA. Impact of early rapid weight gain on odds for overweight at one year differs between breastfed and formula-fed infants. Pediatr Obes 2020; 15:e12688. [PMID: 32705816 PMCID: PMC7773222 DOI: 10.1111/ijpo.12688] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 05/22/2020] [Accepted: 05/26/2020] [Indexed: 01/24/2023]
Abstract
BACKGROUND Early rapid weight gain (RWG) increases, whereas longer durations of breastfeeding decreases, odds for later obesity. OBJECTIVES To determine the independent and interactive effects of early weight gain and diet on infant weight status trajectories and odds for overweight at 1 year. METHODS We conducted secondary analysis on data from two longitudinal trials with repeated anthropometric measures. One trial consisted of predominantly or exclusively breastfed (BF, n = 97) infants, whereas the other consisted of exclusively formula-fed (FF, n = 113) infants. Weight-for-length z-score (WLZ) change from 0.5 to 4.5 months was used to categorize early weight gain as slow (<-0.67; SWG), normal (-0.67 to 0.67; NWG) or rapid (>0.67; RWG). Linear-mixed effects models were fit to examine the independent effects and interaction of early diet (BF, FF) and weight gain (SWG, NWG, RWG) groups on WLZ trajectories; logistic regression was used to assess odds for overweight at 1 year. RESULTS While similar percentages (41%) of BF and FF infants experienced RWG, we found a significant diet × early weight gain group interaction (P < .001) on weight status. At 1 year, the WLZ of FF infants with RWG (1.57 ± 0.99) was twice that of BF infants with RWG (0.83 ± 0.92). Using BF infants with NWG as the reference group, FF infants with RWG had increased odds [OR: 25.3 (95% CI: 3.21, 199.7)] for overweight at 1 year, whereas BF infants with RWG did not. CONCLUSIONS Early diet interacts with early weight gain and influences weight status trajectories and overweight risk at 1 year.
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Affiliation(s)
- Jillian C. Trabulsi
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware
| | | | - Jessica R. Eosso
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware
| | - Mia A. Papas
- The Value Institute, Christiana Care Health System, Newark, Delaware
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Moore BF, Harrall KK, Sauder KA, Glueck DH, Dabelea D. Neonatal Adiposity and Childhood Obesity. Pediatrics 2020; 146:peds.2020-0737. [PMID: 32796097 PMCID: PMC7461209 DOI: 10.1542/peds.2020-0737] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/24/2020] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES To explore the longitudinal association of neonatal adiposity (fat mass percentage) with BMI trajectories and childhood overweight and obesity from ages 2 to 6 years. METHODS We studied 979 children from the Healthy Start cohort. Air displacement plethysmography was used to estimate fat mass percentage. Child weight and recumbent length or standing height were abstracted from medical records. Overweight and obesity were defined as BMI levels ≥85th percentile for age and sex. Mixed-effects models were used to examine the association between neonatal fat mass percentage and BMI trajectories from age 2 to 6 years. We tested for effect modification by sex, race and/or ethnicity, and breastfeeding duration. We estimated the proportion of children classified as overweight or obese at specific levels of neonatal fat mass percentage (mean ± SD). RESULTS The mean neonatal adiposity level was 9.1% ± 4.0%. Child BMI levels differed by neonatal adiposity. Each SD increase in neonatal adiposity resulted in a 0.12 higher overall BMI level between ages 2 to 6 years (95% confidence interval: 0.03 to 0.20; P < .01), and this association was not modified by offspring sex, race and/or ethnicity, or breastfeeding duration. Increasing neonatal adiposity was associated with an increasing proportion of childhood overweight and obesity by age 5 years (P = .02). CONCLUSIONS We provide novel evidence that higher neonatal adiposity is significantly associated with higher overall BMI levels and an increased likelihood of overweight or obesity from ages 2 to 6 years. Because various prenatal exposures may specifically influence offspring fat accretion, neonatal adiposity may be a useful surrogate end point for prenatal interventions aimed at reducing future childhood overweight and obesity.
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Affiliation(s)
- Brianna F. Moore
- Department of Epidemiology, Human Genetics, and
Environmental Sciences, School of Public Health, The University of Texas Health
Science Center at Houston, Austin Regional Campus, Austin, Texas;,Lifecourse Epidemiology of Adiposity and Diabetes
Center and
| | | | - Katherine A. Sauder
- Lifecourse Epidemiology of Adiposity and Diabetes
Center and,Department of Pediatrics, School of Medicine,
University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Deborah H. Glueck
- Department of Pediatrics, School of Medicine,
University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes Center and .,Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado.,Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado; and
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Anderson CE, Whaley SE, Crespi CM, Wang MC, Chaparro MP. Every month matters: longitudinal associations between exclusive breastfeeding duration, child growth and obesity among WIC-participating children. J Epidemiol Community Health 2020; 74:785-791. [PMID: 32611693 DOI: 10.1136/jech-2019-213574] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 04/27/2020] [Accepted: 06/08/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND Research has found breastfeeding to be protective of obesity; however, this link remains contentious. We examined longitudinal associations between exclusive breastfeeding duration, growth trajectories and obesity at 4 years among children participating in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), and whether these associations differed in the context of the 2009 WIC food package change, implemented to improve alignment with dietary guidelines and promote breastfeeding. METHODS Longitudinal data from 260 935 WIC-participating children in Los Angeles County, California, 2003-2016, were used to assess the relationship between duration of receipt of the fully breastfeeding package (an exclusive breastfeeding proxy) with childhood growth and obesity using mixed effects and Poisson regression models. RESULTS Children exclusively breastfed for longer duration had healthier growth trajectories and lower obesity risk at age 4. Compared with infants with no fully breastfeeding package receipt, any receipt (a breastfeeding initiation proxy) was associated with reduced obesity risk. Obesity risk was lowest for boys and girls exclusively breastfed for 7 (risk ratio (RR)=0.73, 95% CI=0.64 to 0.82) and 13 months (RR=0.63, 95% CI=0.58 to 0.69), respectively. Exclusive breastfeeding duration increased, but associations between exclusive breastfeeding duration and growth and obesity were not modified, following the 2009 WIC food package change. CONCLUSION Increased duration of exclusive breastfeeding was associated with reduced obesity risk. The greatest incremental benefit was observed going from none to any exclusive breastfeeding, and the maximum cumulative benefit was among children receiving the fully breastfeeding package for more than 6 months. Breastfeeding promotion in WIC remains important for obesity prevention.
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Affiliation(s)
- Christopher E Anderson
- Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA.,Public Health Foundation Enterprises-Special Supplemental Nutrition Program for Women, Infants and Children (PHFE-WIC), Irwindale, California, USA
| | - Shannon E Whaley
- Public Health Foundation Enterprises-Special Supplemental Nutrition Program for Women, Infants and Children (PHFE-WIC), Irwindale, California, USA
| | - Catherine M Crespi
- Biostatistics, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - May C Wang
- Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - M Pia Chaparro
- Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, California, USA
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Gestational Diabetes Mellitus Is Associated with Age-Specific Alterations in Markers of Adiposity in Offspring: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093187. [PMID: 32375312 PMCID: PMC7246521 DOI: 10.3390/ijerph17093187] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 04/24/2020] [Accepted: 04/27/2020] [Indexed: 12/14/2022]
Abstract
Maternal hyperglycemia alters an offspring’s metabolic health outcomes, as demonstrated by the increased risk for obesity, impaired glucose handling and diabetes from early childhood onwards. Infant growth patterns are associated with childhood adiposity and metabolic health outcomes and, as such, can be used as potential markers to detect suboptimal metabolic development at an early age. Hence, we aimed to assess whether gestational diabetes mellitus (GDM) has an impact on offspring growth trajectories. Outcomes included weight gain (WG), body mass index (BMI), and skin fold thickness (SFT) measured at least at two time points from birth to later childhood. In addition, we explored the role of early life pre- and post-natal nutritional modifiable factors on longitudinal growth in infants of mother with GDM (GDM–F1). Despite the large heterogeneity of the studies, we can still conclude that GDM seems to be associated with altered growth outcomes in the offspring. More specifically, these alterations in growth outcomes seem to be rather time-specific. Increased SFT were reported particularly at birth, with limited information on reporting SFT between 2–5 y, and increased adiposity, measured via SFT and BMI, appeared mainly in later childhood (5–10 y). Studies evaluating longitudinal growth outcomes suggested a potential role of early life nutritional modifiable factors including maternal nutrition and breastfeeding. These may impact the cycle of adverse metabolic health by attenuating growth outcome alterations among GDM–F1. Conclusions: Timely diagnoses of growth deviations in infancy are crucial for early identification of GDM–F1 who are at risk for childhood overweight and metabolic disease development.
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Prevention of Childhood Obesity: A Position Paper of the Global Federation of International Societies of Paediatric Gastroenterology, Hepatology and Nutrition (FISPGHAN). J Pediatr Gastroenterol Nutr 2020; 70:702-710. [PMID: 32205768 DOI: 10.1097/mpg.0000000000002708] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Global childhood obesity increased more than 8-fold over 40 years, inducing a very large personal, societal, and economic burden. Effects of available treatments are less than satisfactory; therefore, effective prevention is of high priority. In this narrative review, we explore preventive opportunities. The available evidence indicates large benefits of improving nutrition and lifestyle during early life, such as promoting breast-feeding and improving the quality of infant and early childhood feeding. Promoting healthy eating patterns and limiting sugar-containing beverage consumption from early childhood onwards are of great benefit. Regular physical activity and limited sedentary lifestyle and screen time alone have limited effects but are valuable elements in effective multicomponent strategies. The home environment is important, particularly for young children, and can be improved by educating and empowering families. School- and community-based interventions can be effective, such as installing water fountains, improving cafeteria menus, and facilitating regular physical activity. Reducing obesogenic risk factors through societal standards is essential for effective prevention and limiting socioeconomic disparity; these may comprise food, drink, and physical activity standards for day cares and schools, general food quality standards, front-of-pack food labeling, taxation of unhealthy foods, restriction of food advertisements to children, and others. Effective prevention of childhood obesity is not achieved by single interventions but by integrated multicomponent approaches involving multiple stakeholders that address children, families, and societal standards. Pediatricians and their organizations should be proactive in supporting and empowering families to support their children's health, and in promoting societal measures that protect children.
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Association of Cesarean Birth with Body Mass Index Trajectories in Adolescence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17062003. [PMID: 32197392 PMCID: PMC7142989 DOI: 10.3390/ijerph17062003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 03/12/2020] [Accepted: 03/17/2020] [Indexed: 12/19/2022]
Abstract
Background: This study aimed to identify patterns of body mass index (BMI) changes in adolescence and to assess whether delivery mode (Cesarean and vaginal delivery) was associated with BMI trajectories. Methods: This study was conducted among 569 adolescents aged 10–15 years that resided in the city of Zibo, China. The height and weight of each participant were repeatedly measured at 10, 11, 12, 13, 14 and 15 years. Group based trajectory modeling (GBTM) was used to estimate BMI change trajectories, and multinomial logistic regression was conducted to evaluate the independent association of delivery mode and BMI trajectory classes. Results: Of the 569 participants, 407 (71.5%) were vaginal deliveries and 162 (28.5%) were Cesarean deliveries. Five distinct long-term BMI trajectories were identified: “persistent healthy weight” (57.5%), “persistent underweight” (6.5%), “obesity to healthy weight” (7.8%), “progressive overweight” (10.6%), “progressive obesity” (17.6%). Adjusted multinomial logistic models revealed a twofold increase in risks between ages 10–15 years of “progressive obesity” trajectory (OR = 2.50, 95% CI: 1.42, 4.41) for children born through Cesarean section compared with vaginal birth. Conclusions: Five distinct long-term BMI trajectories were identified during adolescence in our research, and we confirmed that Cesarean birth was significantly increased the risk of “progressive obesity” trajectory but not the “obesity to healthy weight” trajectory.
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Nutrition status in adult Chilean population: economic, ethnic and sex inequalities in a post-transitional country. Public Health Nutr 2020; 23:s39-s50. [PMID: 32131930 DOI: 10.1017/s1368980019004439] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To assess the relationship between malnutrition, socioeconomic status (SES) and ethnicity in Chilean adult population. DESIGN Nationally representative survey (ENS) conducted in 2016-2017. Sociodemographic information, weight, height and hemoglobin (Hb) were measured (2003 ENS). Excess weight was defined as BMI ≥25 kg/m2. Undernutrition included underweight (BMI <18·5 kg/m2), short stature (height <1·49 m in women and <1·62 m in men) or anaemia (Hb <12 g/l). Education and household income level were used as indicators of SES; ethnicity was self-reported. We applied linear combinations of estimators to compare the prevalence of excess weight and undernutrition by SES and ethnicity. SETTING Chile. PARTICIPANTS In total, 5082 adults ≥20 years (64 % women) and 1739 women ≥20 years for anaemia analyses. RESULTS Overall, >75 % of women and men had excess weight. Low SES women either by income or education had higher excess weight ((82·0 (77·1, 86·1) v. 65·0 (54·8, 74·1)) by income; (85·3 (80·6, 89·0) v. 68·2 (61·6, 74·1) %) by education) and short stature (20-49 years; 31(17·9, 48·2) v. 5·2 (2·2,11·4) by education); obesity was also more frequent among indigenous women (20-49 years; 55·8 (44·4, 66·6) v. 37·2 (32·7, 42·0) %) than non-indigenous women. In men, excess weight did not significantly differ by SES or ethnicity, but short stature concentrated in low SES (20-49 years; 47·6 (24·6, 71·6) v. 4·5 (2·1, 9·5) by education) and indigenous men (21·5 (11·9, 5·5, 11·9) v. 8·2 (5·5, 11·9)) (P < 0·05 for all). CONCLUSIONS In Chile, malnutrition is disproportionately concentrated among women of low SES and indigenous origin; these inequalities should be considered when implementing prevention policies.
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Wang X, Martinez MP, Chow T, Xiang AH. BMI growth trajectory from ages 2 to 6 years and its association with maternal obesity, diabetes during pregnancy, gestational weight gain, and breastfeeding. Pediatr Obes 2020; 15:e12579. [PMID: 31691508 DOI: 10.1111/ijpo.12579] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 09/08/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To identify latent BMI growth trajectories from ages 2 to 6 years and examine their independent associations with maternal prepregnancy obesity or overweight, pre-existing type 1 (T1D) or type 2 diabetes (T2D) or gestational diabetes (GDM) with or without requiring antidiabetic medications during pregnancy, excessive gestational weight gain (EGWG), and breastfeeding ≤ 6 months. RESEARCH DESIGN AND METHOD Data included 71 892 children born at Kaiser Permanente Southern California hospitals in 2007 to 2011 with complete information on maternal risk factors. Group-based trajectory modelling was used to identify latent BMI trajectory groups. Logistic regression was used to assess independent associations adjusted for covariates. RESULTS Three distinct BMI trajectory groups were identified: Group 1 (59% of the cohort) had stable low BMI, Group 2 (35% of the cohort) had stable median BMI, and Group 3 (6% of the cohort) had high and increasing BMI over time. Relative to Groups 1 and 2 combined, the adjusted odds ratio (OR) (95% CI) of being in Group 3 associated with maternal exposures were 5.6 (5.1-6.2) for prepregnancy obesity, 2.4 (2.2-2.7) for prepregnancy overweight, 2.1 (1.2-3.7) for T1D, 1.6 (1.4-1.8) for T2D, 1.4 (1.3-1.6) for GDM requiring medication treatment, 1.1 (1.0-1.3) for GDM not requiring medication, 1.3 (1.2-1.4) for EGWG, and 1.2 (1.2-1.3) for breastfeeding ≤ 6 months. CONCLUSION Child's high and increasing BMI trajectory was strongly associated with maternal prepregnancy obesity and overweight, modestly associated with maternal T1D, T2D, and GDM requiring medication treatment and EGWG, and slightly associated with breastfeeding ≤ 6 months. GDM not requiring medication treatment during pregnancy had little association.
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Affiliation(s)
- Xinhui Wang
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Mayra P Martinez
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Ting Chow
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Anny H Xiang
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
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Malekzadeh JM, Synaii S, Ebrahimzadeh Koor B, Falsafian G, Nakhaie MR. Growth Indices of Exclusively Breastfed Until 6 Months Age and Formula-Fed Infants in Southwest of Iran. Int J Prev Med 2020; 10:207. [PMID: 31921399 PMCID: PMC6941303 DOI: 10.4103/ijpvm.ijpvm_36_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 07/07/2018] [Indexed: 12/18/2022] Open
Abstract
Background: Formula milk is prepared as a nutritional substitution for human breast milk, but because of biologic and constituent differences, it might cause obesity and growth disorders in infants. In this study, we compared the growth pattern of formula-fed and breastfed infants living in Yasuj, southwest of Iran. Methods: Infants 7–14 months of age in southwest of Iran were classified as exclusively breastfed (n = 200) and formula-fed (n = 200) in their first 6 months of life. Growth velocity and Z-scores of weight for age, length for age, weight for length, and head circumference were estimated using WHO Anthro Plus software (2010) and SPSS Version 19 (SPSS Inc., Chicago, IL, USA) using World Health Organization reference for growth data. Results: The study showed that Z-score of length for age and head circumference for age at the birth were significantly lower in formula-fed group than exclusively breastfed group (P < 0.05), but the Z-score of weight for length did not differ significantly. At the sixth month of age, Z-score of weight for length was significantly higher in formula-fed group (P < 0.05), but Z-score of length for age had no significant difference and Z-score of head circumference was higher in exclusively breastfed group yet (P < 0.05). Growth velocity, prevalence of obesity, wasting, underweight, and stunting did not differ between two groups. Conclusions: Our findings suggest that formula feeding can lead to greater weight gain and may help the catch up of length, but evidences are not convincing enough to suggest the formula as an obesogenic feeding in the studied area. To make a conclusion, we suggest comparing the privileged and unprivileged areas and controlling for confounding variables including family hygiene and infant feeding practices between formula-fed and breastfed infants.
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Affiliation(s)
- Jan-Mohamad Malekzadeh
- Department of Nutrition, Yasuj School of Health, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Saiid Synaii
- Department of Nutrition, Yasuj School of Health, Yasuj University of Medical Sciences, Yasuj, Iran
| | | | - Ghasem Falsafian
- Department of Nutrition, Yasuj School of Health, Yasuj University of Medical Sciences, Yasuj, Iran
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Kansra AR, Lakkunarajah S, Jay MS. Childhood and Adolescent Obesity: A Review. Front Pediatr 2020; 8:581461. [PMID: 33511092 PMCID: PMC7835259 DOI: 10.3389/fped.2020.581461] [Citation(s) in RCA: 144] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 11/23/2020] [Indexed: 12/12/2022] Open
Abstract
Obesity is a complex condition that interweaves biological, developmental, environmental, behavioral, and genetic factors; it is a significant public health problem. The most common cause of obesity throughout childhood and adolescence is an inequity in energy balance; that is, excess caloric intake without appropriate caloric expenditure. Adiposity rebound (AR) in early childhood is a risk factor for obesity in adolescence and adulthood. The increasing prevalence of childhood and adolescent obesity is associated with a rise in comorbidities previously identified in the adult population, such as Type 2 Diabetes Mellitus, Hypertension, Non-alcoholic Fatty Liver disease (NAFLD), Obstructive Sleep Apnea (OSA), and Dyslipidemia. Due to the lack of a single treatment option to address obesity, clinicians have generally relied on counseling dietary changes and exercise. Due to psychosocial issues that may accompany adolescence regarding body habitus, this approach can have negative results. Teens can develop unhealthy eating habits that result in Bulimia Nervosa (BN), Binge- Eating Disorder (BED), or Night eating syndrome (NES). Others can develop Anorexia Nervosa (AN) as they attempt to restrict their diet and overshoot their goal of "being healthy." To date, lifestyle interventions have shown only modest effects on weight loss. Emerging findings from basic science as well as interventional drug trials utilizing GLP-1 agonists have demonstrated success in effective weight loss in obese adults, adolescents, and pediatric patients. However, there is limited data on the efficacy and safety of other weight-loss medications in children and adolescents. Nearly 6% of adolescents in the United States are severely obese and bariatric surgery as a treatment consideration will be discussed. In summary, this paper will overview the pathophysiology, clinical, and psychological implications, and treatment options available for obese pediatric and adolescent patients.
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Affiliation(s)
- Alvina R Kansra
- Division of Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Sinduja Lakkunarajah
- Division of Adolescent Medicine, Department of Pediatrics, Medical College of Wisconsin Affiliated Hospitals, Milwaukee, WI, United States
| | - M Susan Jay
- Division of Adolescent Medicine, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, United States
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Koletzko B, Demmelmair H, Grote V, Totzauer M. Optimized protein intakes in term infants support physiological growth and promote long-term health. Semin Perinatol 2019; 43:151153. [PMID: 31466703 DOI: 10.1053/j.semperi.2019.06.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Breastfeeding is associated with a reduced later obesity risk, relative to feeding convention infant formula. Breastfeeding induces less weight gain during the first two years of life, which predicts less obesity up to adulthood. We tested the hypothesis that a high infant protein supply promotes weight gain and obesity risk, mediated by increased plasma amino acids and growth factors, insulin and insulin like growth factor 1 (IGF-1). A large multi-centre double blind trial randomized formula-fed infants to conventional bottle milk with a high protein content, or an intervention formula with a reduced protein content more similar to levels provided with human milk. Protein-reduced formula normalized weight, body mass index and body fatness up to 6 years, relative to a breastfed reference group, and reduced the adjusted odds for obesity 2.6-fold. Available data indicate potential underlying mechanisms. We conclude that infant feeding has very marked long-term programming effects on later BMI, obesity and adiposity, with major public health implications. Breastfeeding lowers the risk for later obesity and adiposity. This provides additional motivation for proactively and enthusiastically promoting, protecting and supporting breastfeeding. A high milk protein intake in infancy increases the long-term risk for obesity and adiposity. Infants not or not fully breastfed should receive infant formula delivering protein in amounts more similar to human milk contents, with high protein quality. Other sources of very high infant protein intakes, particular drinking unmodified cows' milk, should be avoided in infancy.
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Affiliation(s)
- Berthold Koletzko
- Div. Metabolic and Nutritional Medicine, Dept. of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU - Ludwig-Maximilians-Universität Munich, Lindwurmstr. 4, D-80337 München, Germany.
| | - Hans Demmelmair
- Div. Metabolic and Nutritional Medicine, Dept. of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU - Ludwig-Maximilians-Universität Munich, Lindwurmstr. 4, D-80337 München, Germany
| | - Veit Grote
- Div. Metabolic and Nutritional Medicine, Dept. of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU - Ludwig-Maximilians-Universität Munich, Lindwurmstr. 4, D-80337 München, Germany
| | - Martina Totzauer
- Div. Metabolic and Nutritional Medicine, Dept. of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU - Ludwig-Maximilians-Universität Munich, Lindwurmstr. 4, D-80337 München, Germany
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Palou M, Picó C, Palou A. Leptin as a breast milk component for the prevention of obesity. Nutr Rev 2019; 76:875-892. [PMID: 30285146 DOI: 10.1093/nutrit/nuy046] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Leptin ingested as a component of breast milk is increasingly recognized to play a role in the postnatal programming of a healthy phenotype in adulthood. Besides its primary function in controlling body weight, leptin may be an essential nutrient required during lactation to ensure that the system controlling fat accumulation and body composition is well organized from the early stages of development. This review delves into the following topics: (1) the imprinted protective function of adequate leptin intake during lactation in future metabolic health; (2) the consequences of a lack of leptin intake or of alterations in leptin levels; and (3) the mechanisms described for the effects of leptin on postnatal programming. Furthermore, it highlights the importance of breastfeeding and the need to establish optimal or reference intake values for leptin during lactation to design patterns of personalized nutrition from early childhood.
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Affiliation(s)
- Mariona Palou
- Alimentómica SL, Palma de Mallorca, Spain.,Nutrigenomics and Obesity Group, Laboratory of Molecular Biology, Nutrition and Biotechnology, University of the Balearic Islands, Palma de Mallorca, Spain.,Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Catalina Picó
- Nutrigenomics and Obesity Group, Laboratory of Molecular Biology, Nutrition and Biotechnology, University of the Balearic Islands, Palma de Mallorca, Spain.,Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain.,Instituto de Investigación Sanitaria Illes Balears, Palma de Mallorca, Spain
| | - Andreu Palou
- Nutrigenomics and Obesity Group, Laboratory of Molecular Biology, Nutrition and Biotechnology, University of the Balearic Islands, Palma de Mallorca, Spain.,Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain.,Instituto de Investigación Sanitaria Illes Balears, Palma de Mallorca, Spain
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48
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Leptin in Human Milk and Child Body Mass Index: Results of the Ulm Birth Cohort Studies. Nutrients 2019; 11:nu11081883. [PMID: 31412610 PMCID: PMC6723424 DOI: 10.3390/nu11081883] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 08/08/2019] [Accepted: 08/09/2019] [Indexed: 12/27/2022] Open
Abstract
The objective of the study was to investigate the potential association of human milk leptin concentrations with child body mass index (BMI) and BMI trajectory patterns up to two years of age among children in the Ulm SPATZ Health Study. Leptin concentration was measured in skimmed human milk by ELISA (R&D System). Child BMI was determined at two to three days, three to four weeks, four to five months, one year, and two years of age. In SPATZ, leptin concentration at six weeks was inversely associated with child BMI at four to five weeks [beta –0.13, 95%CI –0.21;–0.05)] and at three to four months –0.12 –0.21;–0.03)]. Among infants of average BMI shortly after delivery, six week leptin was positively associated with greater increase in BMI from four to five weeks up to two years of age [0.16 (0.04;0.27)]. No associations were observed for six month leptin. Direction of association was the same in the Ulm Birth Cohort Study (UBCS), but statistically insignificant as the point estimate included the null effect value. Our results from SPATZ suggest human milk leptin may play a role in early infant growth. However, it is plausible that the lack of associations in UBCS suggest that these differences of human milk leptin composition between populations could have an impact in infant growth and development in a given population.
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Mattsson M, Maher GM, Boland F, Fitzgerald AP, Murray DM, Biesma R. Group-based trajectory modelling for BMI trajectories in childhood: A systematic review. Obes Rev 2019; 20:998-1015. [PMID: 30942535 DOI: 10.1111/obr.12842] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 01/19/2019] [Accepted: 01/20/2019] [Indexed: 12/24/2022]
Abstract
Childhood obesity is an important public health issue. We aimed to systematically review studies that used group-based trajectory modelling approaches to investigate body mass index (BMI) trajectories in early childhood, explore associated determinants, and the association with body composition outcomes. Five databases were searched systematically for studies using group-based trajectory modelling approaches to track BMI trajectories from birth. Fourteen studies using latent class growth analysis or growth mixture modelling to track BMI trajectories were identified. Three or four trajectories were identified in most studies. High maternal pre-pregnancy BMI was the most frequently identified risk factor for membership of a rapid gain trajectory. Significant associations between rapid weight gain and stable high trajectories and body measures at follow-up were identified by several studies. Relatively similar trajectories were identified across studies. Trajectories characterized by rapid weight gain were associated with several predictors, as well as body measures at follow-up, however not with great consistency. Similar associations with body measure outcomes were found for stable high and rapid gain trajectories, suggesting that long-term outcomes do not differ greatly between children with consistently high BMI and children with rapid increases in BMI. As the shape and timing of the trajectories differed between studies, it is difficult to draw conclusions.
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Affiliation(s)
- Molly Mattsson
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Gillian M Maher
- School of Public Health, University College Cork, Cork, Ireland
| | - Fiona Boland
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Deirdre M Murray
- Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - Regien Biesma
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
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50
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Koletzko B. Interindividual variation of human milk metabolome. Am J Clin Nutr 2019; 110:1-3. [PMID: 31051515 DOI: 10.1093/ajcn/nqz063] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 03/27/2019] [Indexed: 12/18/2022] Open
Affiliation(s)
- Berthold Koletzko
- LMU-Ludwig-Maximilians-Universität Munich, Dr von Hauner Children's Hospital, Munich, Germany
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