Age of introduction of complementary feeding and overweight in adolescence and adulthood: A systematic review

Araújo, Cybele Sodré; Costa, Priscila Ribas de Farias; Queiroz, Valterlinda Alves de Oliveira; Santana, Mônica Leila Portela de; Miranda, Emile Pereira; Pitangueira, Jacqueline Costa Dias; Assis, Ana Marlúcia de Oliveira

doi:10.1111/mcn.12796

Cited by 10 publications

(7 citation statements)

References 28 publications

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“…Timing of CF introduction could contribute to childhood obesity, although previous studies showed inconsistent associations. [12][13][14][15] Systematic reviews suggested no clear association between CF introduction with children's obesity risk, with the exception of solid food introduction before 4 months, 14,16 which has been associated with greater obesity risk. Limitations of studies thus far include small sample sizes, a lack of inclusion of important confounders (eg, breastfeeding or formula feeding and maternal and paternal BMI), and the lack of longitudinal assessment of outcomes, especially up to adolescence.…”

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confidence: 99%

Timing of Complementary Feeding Introduction and Adiposity Throughout Childhood

et al. 2019

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This study examines associations of timing of CF introduction with adiposity throughout childhood and adolescence in the US Project Viva prospective cohort study. OBJECTIVES: To examine associations of the timing of complementary feeding (CF) introduction with adiposity throughout childhood. METHODS: We studied 1013 children from Project Viva. Our exposure was CF introduction, categorized as ,4 months (19%), 4 to ,6 months (68%; reference group), and $6 months of age (14%). Our outcomes included adiposity measures in midchildhood (mean: 7.9 years; SD 0.8; n = 896) and early adolescence (mean: 13.2 years; SD 0.9; n = 850). We used linear regression models adjusted for potential confounders and ran separate models for infants who were breastfed at least partly for $4 months (categorized as breastfed; 69%) and infants who were never breastfed or stopped breastfeeding at ,4 months (categorized as formula fed; 31%). RESULTS: CF initiated at ,4 months was associated with higher adiposity in midchildhood in breastfed children; associations persisted into adolescence for waist circumference, truncal fat mass, and the sum of subscapular and triceps skinfolds (eg, waist circumference: confounderadjusted b 2.97 [95% confidence interval (CI) 0.47 to 5.47] cm). The effect estimates were larger in formula-fed children, with more associations persisting into adolescence (eg, waist circumference: adjusted b 3.42 [95% CI 0.12 to 6.71] cm). CF initiated at $6 months was associated with a higher subscapular/triceps skinfold ratio in midchildhood and adolescence (adjusted b 0.13 [95% CI 0.02 to 0.25]) in formula-fed children. CONCLUSIONS: We found associations of early CF introduction with higher adiposity measurements in breastfed and formula-fed children and associations of late introduction of CF with higher adiposity in formula-fed children. WHAT'S KNOWN ON THIS SUBJECT: The timing of complementary feeding (CF) introduction could possibly contribute to childhood obesity, although the evidence is inconsistent. Previous findings suggest that early introduction of complementary foods might be associated with an increased risk of obesity in early childhood.

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confidence: 99%

Timing of Complementary Feeding Introduction and Adiposity Throughout Childhood

et al. 2019

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“…Feeding plays a fundamental role in adequate growth and development in early childhood 1 . Given the impact of feeding on infant morbidity and mortality 2 and the influence of childhood feeding practices on health in adulthood 3,4 , complementary feeding is an undeniably relevant theme for the public health agenda. This highlights the need for policies to promote healthy feeding in childhood to support and protect breastfeeding and adequate complementary feeding [5][6][7] .…”

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confidence: 99%

Relative validity and reproducibility of WHO indicators for assessment of feeding practices in children under two years of age

Oliveira

Silva

Moraes

et al. 2023

Ciênc. saúde coletiva

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The study aimed to evaluate relative validity and reproducibility of seven WHO indicators of dietary practices in children aged 6-23.9 months. Data from probabilistic sample of children who used primary healthcare services in Rio de Janeiro, Brazil were collected using a 24h dietary recall (24HR) and a closed questionnaire (Q1) on feeding in the day before the study. The last one was reapplied (Q2) around 16 days later. Validity was assessed by comparing the prevalence rates estimated by 24HR and Q1 and calculating the positive (PPV) and negative (NPV) predictive values, sensitivity (Se), specificity (Sp), and accuracy index (AI) for the resulting indicators. For reproducibility, estimated prevalence rates based on Q1 and Q2 were compared and the kappa index and prevalence-adjusted bias-adjusted kappa were estimated. Of the seven estimated indicators, the prevalence of two was overestimated (Continued breastfeeding: 50.0% vs 40.0%; Sweet beverage consumption: 65.1% vs 52.7%) and the prevalence of one was underestimated (Zero vegetable or fruit consumption: 6.5% vs 18.1%). For most indicators, Se and PPV were higher than Sp and NPV. The prevalence rates determined with Q1 and Q2 were similar for 6 indicators. More than half showed good, very good or excellent agreement.

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“…9,10 Although studies have investigated the relationships between early CF introduction at age < 4 months and excessive weight gain in children, these studies have yielded inconsistent results. For example, several studies have documented meaningful links between early CF introduction and excess weight gain, 6,[11][12][13] whereas others have found no association between the time of CF introduction and excessive weight gain in children. [13][14][15][16] Moreover, studies assessing these associations have had important limitations, including small sample sizes, failure to account for important confounders by methodological issues and lack of longitudinal assessment.…”

Section: Introductionmentioning

confidence: 99%

“…[13][14][15][16] Moreover, studies assessing these associations have had important limitations, including small sample sizes, failure to account for important confounders by methodological issues and lack of longitudinal assessment. 12,13,15,17 The present study evaluated the potential associations between timing of CF introduction and childhood body mass index (BMI) by analysing a large-scale, population-based nationwide cohort dataset in Korea. Data were derived from a nationwide cohort study that included all Korean children born in 2008 and 2009.…”

Section: Introductionmentioning

confidence: 99%

“…For example, several studies have documented meaningful links between early CF introduction and excess weight gain, 6,11–13 whereas others have found no association between the time of CF introduction and excessive weight gain in children 13–16 . Moreover, studies assessing these associations have had important limitations, including small sample sizes, failure to account for important confounders by methodological issues and lack of longitudinal assessment 12,13,15,17 …”

Section: Introductionmentioning

confidence: 99%

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Association between complementary food introduction before age 4 months and body mass index at age 5–7 years: A retrospective population‐based longitudinal cohort study

Hee

Baek

et al. 2022

J Human Nutrition Diet

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Background The optimal time of starting complementary foods (CFs) in infants remains a subject of debate. This population‐based longitudinal cohort study evaluated the association between early CF introduction and body mass index (BMI) in children aged 5–7 years. Methods The present study included 917,707 children born in Korea during 2008–2009. Initial timing of CF introduction was obtained by questionnaires administered between 4 and 6 months and 9 and 12 months of age. The cohort consisted of 154,565 eligible individuals who properly completed the screening programme, including structured questionnaires, anthropometric measurements and physical examinations. To balance baseline characteristics, children were subjected to propensity score matching based on 95 covariates, including indicators of baseline health such as perinatal condition, birth weight, economic status, clinical disease and drug exposure. Exposure was defined as introduction to CF at age < 4 months, and outcomes were overweight (BMI z‐score > 85th percentile) and obesity (BMI z‐score > 95th percentile) at ages 5–7 years. Results Of the 154,565 eligible children in the observed cohort, 10,499 (6.8%) were introduced to CF at age < 4 months and 144,066 (93.2%) at age ≥ 4 months. Propensity score matching yielded 9680 children introduced to CF at age < 4 months and 35,396 at age ≥ 4 months. The risk for being overweight or obese at age 5–7 years was slightly higher among those who started CF at age < 4 months than at age ≥4 months (adjusted relative risk = 1.06; 95% confidence interval = 1.02–1.09). A similar but stronger association was observed for being obese at age 5–7 years (adjusted relative risk = 1.12; 95% confidence interval = 1.05–1.19). Conclusions Early CF introduction before age 4 months was associated with increased BMI at age 5–7 years.

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Age of introduction of complementary feeding and overweight in adolescence and adulthood: A systematic review

Cited by 10 publications

References 28 publications

Timing of Complementary Feeding Introduction and Adiposity Throughout Childhood

Timing of Complementary Feeding Introduction and Adiposity Throughout Childhood

Relative validity and reproducibility of WHO indicators for assessment of feeding practices in children under two years of age

Association between complementary food introduction before age 4 months and body mass index at age 5–7 years: A retrospective population‐based longitudinal cohort study

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