No abstract

The determinants of childhood overweight and obesity are complex, but infant feeding and the early diet are important contributing factors. The complementary feeding period in particular, is a time during which children are nutritionally vulnerable, and a time where life-long eating habits may be established. We conducted a systematic review of the literature that investigated the relationship between the types of food consumed by infants during the complementary feeding period and overweight or obesity during childhood. Electronic databases were searched from inception until June 2012 using specified keywords. Following the application of strict inclusion/exclusion criteria, 10 studies were identified and reviewed by two independent reviewers. Data were extracted and aspects of quality were assessed using an adapted Newcastle-Ottawa scale. Studies were categorised into three groups: macronutrient intake, food type/group and adherence to dietary guidelines. Some association was found between high protein intakes at 2-12 months of age and higher body mass index (BMI) or body fatness in childhood, but was not the case in all studies. Higher energy intake during complementary feeding was associated with higher BMI in childhood. Adherence to dietary guidelines during weaning was associated with a higher lean mass, but consuming specific foods or food groups made no difference to children's BMI. We concluded that high intakes of energy and protein, particularly dairy protein, in infancy could be associated with an increase in BMI and body fatness, but further research is needed to establish the nature of the relationship. Adherence to dietary guidelines during weaning is recommended.

Our findings suggest that clinically diagnosed celiac disease and bone fractures co-occur and that celiac disease was associated with an increased risk of hip fractures as well as fractures in general. Further research would be needed to determine whether unrecognized celiac disease is associated with the risk of bone fractures.

Background A baby‐led approach to weaning (BLW) encompasses self‐feeding and self‐selecting graspable foods, offering an alternative to traditional weaning (TW). This cross‐sectional study explored adherence to characteristics of BLW and differences in food group exposure and nutrient intake between babies following either TW or BLW. Methods Nutritional data were collected via multiple‐pass 24‐h recall, following parental completion of an online survey. Results Infants were grouped according to age (6–8 months; TW [n = 36] and BLW [n = 24]) and (9–12 months; TW [n = 24] and BLW [n = 12]). BLW babies were more likely to be breast fed (p = 0.002), consumed a higher percentage of foods also consumed by their mother (p = 0.008) and were fed less purees (p < 0.001) at 6–8 months. TW babies were spoon fed more (p ≤ 0.001) at all ages. Amongst babies aged 6–8 months, total intake (from complementary food plus milk) of iron (p = 0.021), zinc (p = 0.048), iodine (p = 0.031), vitamin B12 (p = 0.002) and vitamin D (p = 0.042) and both vitamin B12 (p = 0.027) and vitamin D (p = 0.035) from complementary food alone was higher in babies following TW. Compared to TW, BLW babies aged 6–8 months had a higher percentage energy intake from fat (p = 0.043) and saturated fat (p = 0.026) from their milk. No differences in nutrient intake were observed amongst infants aged 9–12 months. Few differences were observed between groups in their number of exposures to specific food groups. Conclusions TW infants had higher intakes of key micronutrients at 6–8 months, although there were few differences in nutritional intake at 9–12 months or food group exposure between babies following TW or BLW. BLW appears to be socially desirable. Guidance for parents is required, along with larger, longer‐term studies, which explore the potential impact of BLW in later childhood.

The global prevalence of overweight and obesity in pregnancy is rising and this represents a significant challenge for the management of pregnancy and delivery. Women who have a pre‐pregnancy body mass index greater than 25 kg m–2 are more likely than those with a body mass index in the ideal range (20–24.99 kg m–2) to have problems conceiving a child and are at greater risk of miscarriage and stillbirth. All pregnancy complications are more likely with overweight, obesity and excessive gestational weight gain, including those that pose a significant threat to the lives of mothers and babies. Labour complications arise more often when pregnancies are complicated by overweight and obesity. Pregnancy is a stage of life when women have greater openness to messages about their lifestyle and health. It is also a time when they come into greater contact with health professionals. Currently management of pregnancy weight gain and the impact of overweight tends to be poor, although a number of research studies have demonstrated that appropriate interventions based around dietary change can be effective in controlling weight gain and reducing the risk of pregnancy complications. The development of individualised and flexible plans for avoiding adverse outcomes of obesity in pregnancy will require investment in training of health professionals and better integration into normal antenatal care.