The contribution of feeding mode to obesogenic growth trajectories in American Samoan infants

Abstract

Background Samoans are recognized for their particularly high body mass index and prevalent adult obesity but infants are understudied. Objective To examine the prevalence of overweight and obesity and determine the contribution of feeding mode to obesogenic growth trajectories in American Samoan infants. Methods Data were extracted from the well baby records of 795 (n=417 male) Samoan infants aged 0-15 months. Mixed-effects growth models were used to produce individual weight and length curves. Further mixed-effects models were fitted with feeding mode (breastfed, formula- or mixed-fed) as a single observation at age four (±2) months. Weight and length values were converted to Z-scores according to the CDC 2000 reference. Results At 15 months, 23.3% of boys and 16.7% of girls were obese (weight-for-length > 95th percentile). Feeding mode had a significant effect on weight and length trajectories. Formula-fed infants gained weight and length faster than breastfed infants. Formula-fed boys were significantly more likely to be obese at 15 months (38.6%) than breastfed boys (23.4%), χ2=8.4, P<0.01, odds ratio=2.05, 95% CI [1.04, 4.05]. Conclusion Obesity in American Samoans is not confined to adults. Obesity prevention efforts should be targeted at early life and promotion of breastfeeding may be a suitable intervention target.

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