Dietary Energy Intake at the Age of 4 Months Predicts Postnatal Weight Gain and Childhood Body Mass Index

Abstract

OBJECTIVE. Rapid infant weight gain has been shown to predict later obesity risk; however, it is unclear which factors influence infant diet and weight gain. The objective of this study was to determine whether different feeding patterns and energy intakes that are provided to infants affect body weight and BMI later in childhood.METHODS. This representative birth cohort study was conducted in the United Kingdom. Energy intake at age 4 months was estimated from 1-day unweighed dietary records in 881 infants and related to their childhood weight gain and BMI.RESULTS. Among formula-or mixed-fed infants (N ϭ 582), energy intake was higher in first-born infants (mean Ϯ SE: 2730 Ϯ 29.4 kJ/day; n ϭ 263) than in subsequent-born infants (2620.8 Ϯ 25.2 kJ/day; n ϭ 296). Energy intake at 4 months was also higher in infants who were given solid foods earlier (1-2 months: 2805.6 Ϯ 50.4 kJ/day, n ϭ 89; 2-3 months: 2658.6 Ϯ 25.2 kJ/day, n ϭ 339; 4ϩ months: 2587.2 Ϯ 46.2 kJ/day, n ϭ 111). Higher energy intake at 4 months predicted greater weight gain between birth to age 1, 2, or 3 years and larger body weight and BMI at ages 1 to 5 years. No significant associations were seen in breastfed infants (N ϭ 299).CONCLUSIONS. Among formula-or mixed-fed infants, dietary energy intake at age 4 months predicted postnatal weight gain and childhood obesity risk. Both prenatal and postnatal factors may influence infant energy intake and postnatal weight gain. T HE WORK OF Hales and Barker 1 originally highlighted the possible link between early life influences and adult cardiovascular and metabolic disease. However, there is still much controversy as to whether prenatal rather than early postnatal nutrition influences later risks for obesity. Several recent population studies have reported that rapid weight gain during the first 2 to 3 years of life predicts increased obesity risk. We reported in the geographically based Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort that faster rates of weight gain between birth and 2 years predicted larger BMI, waist circumference, and body fat mass at 5 years of age. 2 Subsequent larger studies have confirmed that rapid weight gain during the first 4 to 12 months predicts larger BMI in later childhood 3,4 and also in young adults. 5,6 The first 2 to 3 years of postnatal life represents a hypervariable period of weight gain, as many infants show relatively rapid weight gain in apparent compensation for in utero growth restraint. 2,7,8 For example, first-born infants are thinner at birth and show subsequent rapid "catch-up" postnatal weight gain compared with a mother's subsequent offspring. 9 Infancy growth is largely regulated by nutrition, 10 and it is proposed that early postnatal catch-up and catch-down growth may be regulated by differences in appetite and satiety. 11 In the ALSPAC cohort, we therefore identified factors that influence early infancy dietary energy intake and hypothesized that greater energy intake at 4 months of age could predict subsequent faster chi...

Dietary assessment in the Avon Longitudinal Study of Parents and Children

“…Applying this to the nutrient information at 4 months allowed an assessment of energy intake in breast-and formula-fed infants related to age of first solid foods and weight gain up to 5 years of age. In formula-fed, but not breast-fed, children energy intake at 4 months was associated with greater weight gain at 5 years and the early feeding of solids (Ong et al, 2006).…”

Delayed introduction of solid feeding reduces child overweight and obesity at 10 years

“…Total dietary energy intake at 4 Delayed introduction of solid feeding reduces child overweight and obesity KA Seach et al months predicts continued postnatal weight gain and childhood BMI. 18 Strengths of our study include frequent prospective data collection of feeding practices, information on many important potential confounders and measurement of outcomes using a standardized tool with clinical relevance, at an age beyond early childhood, and, therefore, after the time of adiposity rebound. We have also assessed dose-response relationships, including the possibility of non-linear associations, between the duration of feeding practices and risk of above healthy BMI.…”

Macrosomia is associated with high weight-for-height in children aged 1–3 years in Shanghai, China

“…It has also been reported that early introduction to solid foods is associated with increased BMI and percentage of body fat in infants of a prospective study in the UK. 17 Study by Ong and colleagues 18 reported that energy intake is significantly higher among infants who were given weaning foods earlier. These infants have higher body weight compared with those who were fed weaning foods later.…”