Artikel
Rapid weight gain amongst term children whose birth weight is appropriate-for-gestational-age and dietary factors during infancy and early childhood
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Veröffentlicht: | 6. September 2007 |
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Background: It is not clear whether the adverse effects of rapid weight gain in infancy, a risk factor for later obesity, are modified by nutrition in the first two years of life in term children whose birth weight is appropriate-for-gestational age (AGA).
Objective: To examine the interaction between rapid weight gain and nutrition in infancy and early childhood, and their effect on body fat percentage (BF%) trajectories between 2 and 5 years of age.
Methods: This analysis includes 249 (51.4% female) term AGA participants of the DOrtmund Nutritional and Anthropometric Longitudinally Designed (DONALD) Study, with repeated anthropometric measurements until 5 years of age, and information on breastfeeding status, as well as on diet at 12 and 18-24 months.
Results: Overall, 28.5% (71/249) of the children gained weight rapidly between birth and 24 months. Multilevel model analyses showed that rapid growers who had been fully breastfed for at least 4 months had a lower BF% at age 2 years than those who had not been fully breastfed for at least 4 months [β (±SE) -1.53 (±0.59%), p=0.005]. In addition, rapid growers with a consistently high fat intake at both 12 and 18-24 months did not display the physiological decrease in BF% between 2 and 5 years that would normally be expected (+0.73 (±0.26%)/year, p=0.0007).
Conclusions: Nutritional factors in early life influence the degree to which rapid weight gain between birth and 24 months modifies later body composition development: full breastfeeding for at least 4 months protects against high BF% among rapid growers, whilst a consistently high fat intake in the second year of life ‘inhibits’ the physiological decrease in BF% between 2 and 5 years. Whereas breastfeeding promotion must occur before a child’s growth pattern can be established, dietary fat intake in the second year of life may be appropriately adjusted.