Associations Between Birthweight and Appetite Traits: Appetite Traits Partially Mediate the Link Between Birthweight and Later Child Weight in Low-Income Hispanic Families

Abstract

ObjectivesTo examine whether: 1) birthweight was associated with child appetite traits (AT) at age 2 years; and 2) ATs mediated the link between birthweight and weight at age 3 years among Hispanic children. MethodsThis study is a secondary longitudinal analysis of data collected from the “Starting Early Program” randomized controlled obesity prevention trial of low-income, Hispanic mother-child pairs (n = 533). Birthweight-for-gestational-age z-scores (BWGAz) were determined using Fenton growth curves; weight-for-age z-scores (WFAz) were determined using World Health Organization growth charts. Four ATs, including Food Responsiveness (FR), Enjoyment of Food (EF), Satiety Responsiveness (SR), and Slowness in Eating (SE), were assessed using the Child Eating Behavior Questionnaire at age 2 years. Simple linear regression analysis was used to assess direct associations between BWGAz and each AT. Bootstrapping analyses were used to assess whether ATs were significantly associated with BWGAz, and mediated the relationship between BWGAz and later child WFAz. ResultsOf the 401 children with both BWGAz and AT measures, 49% were male with mean birthweight of 3.4 kg. After adjusting for covariates related to child weight, infants with higher BWGAz had lower SR scores at age 2 years (B = –0.11, 95%CI = –0.18 to – 0.04, P < 0.01) and higher WFAz at age 3 years (B = 0.39, 95%CI = 0.26 to 0.53; P < 0.001). Lower SR was also associated with higher WFAz at age 3 years (B = –0.42, 95%CI = –0.62 to –0.22, P < 0.001). A significant indirect effect of BWGAz on WFAz at age 3 years through SR at age 2 years was detected (B = 0.04, 95%CI = 0.01 to 0.08; P < 0.01 [indirect effect]); however, only 10% of the total effect was mediated by this indirect pathway. Therefore, SR partially mediated the positive relationship between BWGAz and child WFAz at age 3 years. BWGAz was not associated with other ATs. ConclusionsHigher BWGAz was associated with lower SR scores at age 2 years and higher WFAz at age 3 years. SR partially mediated the link between BWGAz and child WFAz. Our findings warrant exploring additional pathways through which birthweight effects appetite traits, as well as later child weight. Funding SourcesUSDA AFRI.