To what extent do weight gain and eating avidity during infancy predict later adiposity?

Abstract

Objective: To determine the extent to which weight gain and eating behaviours in infancy predict later adiposity. Design: Population-based, prospective, longitudinal birth cohort study. Weights collected in infancy were used to calculate Z-scores for weight gain to age 1 year conditional on birth weight (CWG). To avoid multiple significance tests, variables from the parent questionnaire completed at age 1 year describing eating avidity were combined using general linear modelling to create an infancy avidity score. Anthropometry, skinfold thicknesses and bioelectrical impedance data collected at age 7-8 years were combined using factor analysis, to create an adiposity index. Setting: Gateshead, UK. Subjects: Members of the Gateshead Millennium Study cohort with data at both time points (n 561). Results: CWG in infancy significantly predicted adiposity at age 7 years, but related more strongly to length and lean mass. High adiposity (. 90th internal percentile) at age 7 years was significantly associated with high CWG (relative risk 2?76; 95 % CI 1?5, 5?1) in infancy, but less so with raised (. 74th internal percentile) eating avidity in infancy (relative risk 1?87; 95 % CI 0?9, 3?7). However, the majority of children with high weight gain (77?6 %) or avidity (85?5 %) in infancy did not go on to have high adiposity at age 7 years. Conclusions: Rapid weight gain in infancy and the eating behaviours which relate to it do predict later adiposity, but are more strongly predictive of later stature and lean mass. Keywords Obesity Weight velocity Feeding behaviour InfancyA number of studies have found significant associations between rapid infancy weight gain and later overweight (1) , leading to the suggestion that prevention (2,3) and even treatment of childhood obesity (4,5) should begin as early as the first year of life. However, weight gain in infancy reflects growth in bone and muscle as well as fat and some infants will be showing rapid gain in height or lean mass rather than adiposity (6) . Thus while on average rapid weight gain may predict later adiposity, what is not clear is how well it would prospectively identify individual children at risk. There is also recent research that suggests there are distinctive childhood eating behaviours related to overweight which may reflect an inherent tendency to overeat (7) , so eating behaviour in infancy could predispose to, or protect against, later obesity (7,8) .Apart from studies examining how the type and style of milk feeding relates to later obesity (9-11) , we currently know little about eating behaviour in infancy and even less about how it tracks on to later adiposity or eating style. We hypothesised that eating avidity, a global term to denote enthusiasm and hunger for food, might be a useful predictor of gain in fat. The Gateshead Millennium Study was set up in order to examine infant growth and weight gain and how this relates to eating behaviour, prospectively measured from birth (12) . These children have now been followed into childhood where me...

Pathways into and out of overweight and obesity from infancy to mid‐childhood

“…This apparent paradox reflects the fact that, while there undoubtedly is an association between infant weight and later overweight, it is not clear how important that association really is. Thus, a German study found that while weight change over the first 2 years of life was the best predictor of a body mass index (BMI) in the obese range at school entry, still only one in five children with rapid weight gain went on to have obesity (4) and we made a similar observation in a UK cohort (10).…”

“…Routine weights measured at school entry (age 4–5) were retrieved from routine data records (mean age 4.9). Data were further collected from 585 children at age 6–8 years at school and/or home visits (mean age 7.5) .…”

How does infant behaviour relate to weight gain and adiposity?

“…This revealed that CWG generally showed a stronger association with measures of height, BMI and lean mass than with adiposity at age 7 years (37) .…”

Interaction Effects on Prediction of Children Weight at School Entry Using Model Averaging

“…The children were studied prospectively using parent report questionnaire shortly after birth at 6 weeks and at 4, 8, 12 months. The cohort has since been re-traced at school entry, parent report questionnaires completed at 5-8 years, and a range of anthropometric and body composition measures collected at age 7-8 years [8,15].…”