Associations of Infant Feeding and Timing of Weight Gain and Linear Growth during Early Life with Childhood Blood Pressure: Findings from a Prospective Population Based Cohort Study

Abstract

ObjectiveSmall birth size and rapid postnatal growth have been associated with higher future blood pressure. The timing of these effects, the relative importance of weight gain and linear growth and the role of infant feeding need to be clarified.MethodsWe assessed how blood pressure relates to birth weight, infant and childhood growth and infant feeding (duration of exclusive breastfeeding and timing of introduction of complementary feeding) in 2227 children aged 5 years from a prospective cohort study (Amsterdam Born Children and their Development). Postnatal growth was represented by statistically independent measures of relative weight gain (weight gain independent of height) and linear growth in four age periods during infancy (0–1 month; 1–3 months; 3–6 months; 6–12 months) and from 12 months to 5 years.ResultsLower birth weight was associated with higher childhood diastolic blood pressure (-0.38 mm Hg.SD-1; P = 0.007). Faster relative weight gain and linear growth after 1 month were positively associated with systolic and diastolic blood pressure. Associations of linear growth with systolic blood pressure ranged from 0.47 to 1.49 mm Hg.SD-1; P<0.01 for all. Coefficients were similar for different periods of infancy and also for relative weight gain and linear growth. Compared to breastfeeding <1 month, breastfeeding >1 month was associated with lower blood pressure (e.g. >6 months -1.56 mm Hg systolic blood pressure; P<0.001). Compared to >6 months, introduction of complementary feeding <6 months was associated with higher blood pressure (e.g. 4–6 months 0.91 mm Hg systolic blood pressure; P = 0.004).ConclusionsAfter the age of one month faster growth in either weight or height is associated with higher childhood blood pressure. It is unknown whether faster weight gain and linear growth carry the same risk for adult hypertension and cardiovascular morbidity. Longer breastfeeding and delayed introduction of complementary feeding may be associated with lower adult blood pressure.

Excess early postnatal weight gain and blood pressure in healthy young children

“…[56][57][58][59] Our estimates of the association of interest were higher when BP was measured in sitting rather than supine posture. Our results with regard to SBP are in line with the results found by De Beer et al 27 They also found an association with DBP, but we could not confirm this. Furthermore, the results of our study are in line with our previous study of healthy young children, where we showed that higher VAT resulted in higher sitting SBP values.…”

“…25,26 The results of two studies suggested that there is also an association between WLG during the first 3 months of life and BP. 27,28 It is important to reveal the origin of BP variations in population to prevent hypertension and CVD. Deeper understanding of the impact of growth patterns early in life may contribute to better cardiovascular health from early life onward.…”

Complementary Feeding in Developed Countries: The 3 Ws (When, What, and Why?)

“…The PROBIT study that followed children up to the age of 6.5 years showed that EBF duration had no effect on blood pressure [2]. In contrast, other studies broadly support that longer breastfeeding, but < 24 months, and subsequent delayed introduction of CF were related to lower waist circumference and blood pressure in early life [74,75]. Recent studies have also evaluated the specific role of LC-PUFA and fat intake during CF in later cardiometabolic health.…”

Effect of early postnatal nutrition on chronic kidney disease and arterial hypertension in adulthood: a narrative review

“…In total, five studies found a significant association between increased weight gain in different periods between birth and 4 years of age, and lower BP in adolescence and adulthood (Table 1). 29,[33][34][35][36] However, the vast majority of studies, including a meta-analysis of five cohort studies reports that postnatal weight gain is associated with higher BP later in life, especially when early and excessive 24,31,[37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53] (Table 1).…”