Nutrition in infancy and long-term risk of obesity: evidence from 2 randomized controlled trials

Singhal, Atul; Kennedy, Kathy; Lanigan, Julie; Fewtrell, Mary; Cole, Tim J.; Stephenson, Terence; Elias-Jones, A C; Weaver, Lawrence T.; Ibhanesebhor, Samuel; Macdonald, P. D. M.; Bindels, Jacques; Lucas, Alan

doi:10.3945/ajcn.2010.29302

Cited by 172 publications

(144 citation statements)

References 48 publications

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“…The timing of infancy weight gain is another issue that may impact future overweight. Singhal et al (35) have demonstrated a causal link between rapid early weight gain and the future risk for obesity. Finally, breast-feeding compared with formula-feeding positively impacts the digestive tract, leading to immediate and long-term health effects.…”

Section: Discussionmentioning

confidence: 99%

Infant feeding practices and prevalence of obesity in eight European countries – the IDEFICS study

Hunsberger¹,

Lanfer²,

Reeske³

et al. 2012

Public Health Nutr.

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Objective: To assess the association between exclusive breast-feeding and childhood overweight. Design: Cross-sectional data are from the baseline survey of the longitudinal cohort study IDEFICS. Exclusive rather than partial breast-feeding is the focus of the study due to the theoretical relationship between exclusive breast-feeding and development of dietary self-regulation. Children's measured heights and weights were used to calculate weight status, while waist-to-height ratio (WtHR) and skinfold measures were examined as alternative indicators of adiposity and fat patterning. Setting: Examination centres in eight European countries (Italy, Estonia, Cyprus, Belgium, Sweden, Hungary, Germany and Spain). Subjects: The analysis included 14 726 children aged 2-9 years for whom early feeding practices were reported by parents in standardized questionnaires. Results: After controlling for education, income and other potential confounders, breast-feeding exclusively for 4-6 months was protective of overweight (including obesity) when compared with children never exclusively breast-fed (OR 5 0?73; 95 % CI 0?63, 0?85) across all measures of overweight. Exclusively breast-feeding for 6 months offered slightly more protection than for 4 and 5 months combined (OR 5 0?71; 95 % CI 0?58, 0?85). The associations could not be explained by socio-economic characteristics or maternal overweight. Conclusions: This multi-country investigation indicated that exclusive breastfeeding for 4-6 months may confer protection against overweight in addition to other known benefits. There was no demonstrated benefit of exclusive breastfeeding for more than 6 months or combination feeding for any duration across all measures of overweight examined.

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Section: Discussionmentioning

confidence: 99%

Infant feeding practices and prevalence of obesity in eight European countries – the IDEFICS study

Hunsberger¹,

Lanfer²,

Reeske³

et al. 2012

Public Health Nutr.

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“…This difference in weight for length at 2 years is of major benefit as it predicts a 13 % lower obesity risk at age 14-16 years with lower protein infant formula (14) . Longterm follow-up of a subset of children assigned in other trials to nutrient-dense or less nutrient-dense infant formulae found that those infants who received the growth promoting formulae had increased body fat mass 5-8 years later (41) . Moreover, in several non-randomised analyses, faster weight gain in infancy was associated with greater fat mass in childhood (30,32,33,40) .…”

Section: Accelerated Postnatal Growth Hypothesismentioning

confidence: 99%

Early nutrition programming of long-term health

et al. 2012

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Increasing evidence from the EU Project EARNEST and many other investigators demonstrates that early nutrition and lifestyle have long-term effects on later health and the risk of common non-communicable diseases (known as 'developmental programming'). Because of the increasing public health importance and the transgenerational nature of the problem, obesity and associated disorders are the focus of the new EU funded project 'EarlyNutrition'. Currently, three key hypotheses have been defined: the fuel mediated 'in utero' hypothesis suggests that intrauterine exposure to an excess of fuels, most notably glucose, causes permanent changes of the fetus that lead to obesity in postnatal life; the accelerated postnatal weight gain hypothesis proposes an association between rapid weight gain in infancy and an increased risk of later obesity and adverse outcomes; and the mismatch hypothesis suggests that experiencing a developmental 'mismatch' between a sub-optimal perinatal and an obesogenic childhood environment is related to a particular predisposition to obesity and corresponding co-morbidities. Using existing cohort studies, ongoing and novel intervention studies and a basic science programme to investigate those key hypotheses, project EarlyNutrition will provide the scientific foundations for evidence-based recommendations for optimal nutrition considering long-term health outcomes, with a focus on obesity and related disorders. Scientific and technical expertise in placental biology, epigenetics and metabolomics will provide understanding at the cellular and molecular level of the relationships between early life nutritional status and the risk of later adiposity. This will help refine strategies for intervention in early life to prevent obesity.Early nutrition: Developmental programming: Obesity and related disorders:

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“…Thus, early nutritional practices have not been backed by rigorous experimental evidence of efficacy and safety, which is expected in other areas of public health; and have the potential to cause harm. For example, 'intuitive' attempts to promote growth in small, growth-retarded newborns could significantly increase later CVD and obesity (3)(4)(5)(8)(9)(10)(11)(12)(13)(14) . This lack of a sound evidence-base has prevented changes to nutritional and public health practice in infancy in order to prevent later NCD.…”

Section: Proceedings Of the Nutrition Societymentioning

confidence: 99%

The role of infant nutrition in the global epidemic of non-communicable disease

Singhal

2016

Proc. Nutr. Soc.

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Non-communicable diseases (NCD) and atherosclerotic CVD in particular, are the most important health problems of the 21st century. Already in every world region except Africa, NCD account for greater mortality than communicable, maternal, perinatal and nutritional conditions combined. Although modifiable lifestyle factors in adults are the main determinants, substantial evidence now suggests that factors in early life also have a major role in the development of NCD; commonly referred to as the Developmental Origins of Health and Disease hypothesis. Factors in utero, early postnatal life and throughout childhood, have been shown to affect NCD by influencing risk factors for CVD such as obesity, diabetes, hypertension and dyslipidaemia. Infant nutrition (e.g. breastfeeding rather than bottle feeding) and a slower pattern of infant weight gain have been shown to be particularly protective against later risk of obesity and CVD in both low-and high-income countries. The mechanisms involved are poorly understood, but include epigenetic changes; effects on endocrine systems regulating body weight, food intake and fat deposition; and changes in appetite regulation. As a consequence, strategies to optimise early life nutrition could make a major contribution to stemming the current global epidemic of NCD. This review will consider the role of early life factors in the development of NCD, focusing on the impact of infant nutrition/growth on obesity and CVD. The review will highlight the experimental (randomised) evidence where available, briefly summarise the underlying mechanisms involved and consider the implications for public health.

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Nutrition in infancy and long-term risk of obesity: evidence from 2 randomized controlled trials

Cited by 172 publications

References 48 publications

Infant feeding practices and prevalence of obesity in eight European countries – the IDEFICS study

Infant feeding practices and prevalence of obesity in eight European countries – the IDEFICS study

Early nutrition programming of long-term health

The role of infant nutrition in the global epidemic of non-communicable disease

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