Abstract
Understanding the role in pediatric obesity of early life feeding practices and dietary intake at school age is essential for early prevention. The study aimed to examine associations of early life feeding practices, environmental and health-related exposures, and dietary intake at school age as determinants of obesity in children aged 10–12 years. In an earlier study of 233 healthy infants in two Arab towns in northern Israel, neonatal history, feeding practices, and health information were obtained up to age 18 months. This follow-up study assessed dietary intake and anthropometric measurements at age 10–12 years using the 24 h recall method. Overall, 174 children participated in this study. Almost all (98%) the children were breastfed. The prevalence of obesity at school age was 42%. A multivariable model adjusted for energy intake and socioeconomic status showed positive associations of total fat intake and of weight-for-height z score, but not feeding practices in infancy, with obesity. Higher gestational age at birth was associated with lower odds of obesity at age 10–12 years. In conclusion, in a population with near universal breastfeeding, gestational age at birth, weight indicators but not feeding practices in infancy, and total fat intake at school age were associated with increased likelihood of obesity.
Highlights
Achieving optimal physical growth in children is essential to reduce health inequalities throughout the lifecycle
No significant differences in other sociodemographic data or in early life health factors were found between children who were enrolled in the study and those who were not (Table 1)
Feeding practices in infancy were not associated with obesity among school age children
Summary
Achieving optimal physical growth in children is essential to reduce health inequalities throughout the lifecycle. Life and school age environmental and dietary exposures are the main determinants of children’s physical growth [1,2,3,4,5,6]. Birth weight and weight gain during early life were shown to be related to high body mass index (BMI) and obesity during childhood and adolescence [3,4,5,6], and to cardiovascular and metabolic risks in adulthood [7], as well as trajectories in BMI in childhood and obesity in adolescence [7,8,9]. Understanding early determinants of obesity in children is warranted. Diet and feeding practices in infancy were shown to have long-term influence on children’s growth, including adiposity [10,11,12,13,14,15].
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