Effect of birth weight, exclusive breastfeeding and growth in infancy on fat mass and fat free mass indices in early adolescence: an analysis of the Entebbe Mother and Baby Study (EMaBs) cohort

Abstract

Background: There is limited data from Africa on the effect of pre- and post-natal growth and infant feeding on later body composition. This study's aim was to investigate the effect of birth weight, exclusive breastfeeding and infant growth on adolescent body composition, using data from a Ugandan birth cohort. Methods: Data was collected prenatally from pregnant women and prospectively from their resulting live offspring. Data on body composition (fat mass index [FMI] and fat free mass index [FFMI]) was collected from 10- and 11-year olds. Linear regression was used to assess the effect of birth weight, exclusive breastfeeding and infant growth on FMI and FFMI, adjusting for confounders. Results: 177 adolescents with a median age of 10.1 years were included in analysis, with mean FMI 2.9 kg/m2 (standard deviation (SD) 1.2), mean FFMI 12.8 kg/m2 (SD 1.4) and mean birth weight 3.2 kg (SD 0.5). 90 (50.9%) were male and 110 (63.2%) were exclusively breastfeeding at six weeks of age. Birth weight was associated with FMI in adolescence (regression coefficient β= 0.66 per kg increase in birth weight, 95% confidence interval (CI) (0.04, 1.29), P=0.02), while exclusive breastfeeding (β= -0.43, 95% CI (-1.06, 0.19), P=0.12), growth 0-6 months (β= 0.24 95% CI (-0.43, 0.92), P=0.48) and growth 6-12 months (β= 0.61, 95% CI (-0.23, 1.46), P=0.11) were not associated with FMI among adolescents. Birth weight (β= 0.91, 95% CI (0.17, 1.65), P=0.01) was associated with FFMI in adolescence. Exclusive breastfeeding (β= 0.17, 95% CI (-0.60, 0.94), P=0.62), growth 0-6 months (β= 0.56, 95% CI (-0.20, 1.33), P= 0.10), and growth 6-12 months (β= -0.02, 95% CI (-1.02, 0.99), P=0.97) were not associated with FFMI. Conclusions: Birth weight predicted body composition parameters in Ugandan early adolescents, however, exclusive breastfeeding at six weeks of age and growth in infancy did not.

Body composition of type 2 diabetes patients in Uganda: A case-control study

“…Differences in the medians of clinical and body composition parameters were further assessed using the Mann-Whitney U test. Fat-Free and Fat Mass Indices were derived (kilograms/height in metres 2 ) 12 to offer a precise estimation of body composition parameters adjusted for height differences among study participants.…”

Insulin dependent diabetes and anthropometric assessment: Understanding the rationale for body composition measurement

“…Increased fat adiposity among IDDM patients contributes to a biological embodiment that relates to how factors that are experienced at different life stages alter the body's biological functioning, thus increasing the risk of later disease outcomes. 23 Scientific evidence shows that weight gain has short term benefits to most patients because they are usually lean. 8,10 Unfortunately, excess weight gain can lead to an increase in fat mass which is strongly associated with insulin resistance.…”

Body Composition Characteristics of Type 1 Diabetes Children and Adolescents: A Hospital-Based Case-Control Study in Uganda

“…Body composition measurements can inform the clinical diagnosis of disease, improve prognosis, and facilitate the early assessment of adverse metabolic outcomes [ 8 ]. Understanding the body composition of diabetic children is vital for monitoring response to treatment and managing resulting weight changes [ 9 ].…”