Infant Feeding and Ethnic Differences in Body Mass Index during Childhood: A Prospective Study.

Outi Sirkka,Margreet R Olthof,Lieke Van Houtum,Jutka Halberstadt,Tanja Vrijkotte,Marieke Abrahamse-Berkeveld,Jacob C Seidell

doi:10.3390/nu13072291

Abstract

This study investigated ethnic differences in childhood body mass index (BMI) in children from Dutch and Turkish descent and the role of infant feeding factors (breastfeeding duration, milk feeding frequency, as well as the timing, frequency and variety of complementary feeding (CF)). We used data from 244 children (116 Dutch and 128 Turkish) participating in a prospective study in the Netherlands. BMI was measured at 2, 3 and 5 years and standard deviation scores (sds) were derived using WHO references. Using linear mixed regression analyses, we examined ethnic differences in BMI-sds between 2 and 5 years, and the role of infant feeding in separate models including milk or CF factors, or both (full model). Relative to Dutch children, Turkish children had higher BMI-sds at age 3 (mean difference: 0.26; 95%CI: 0.04, 0.48) and 5 (0.63; 0.39, 0.88), but not at 2 years (0.08; −0.16, 0.31). Ethnic differences in BMI-sds were somewhat attenuated by CF factors at age 3 (0.16; −0.07, 0.40) and 5 years (0.50; 0.24, 0.77), whereas milk feeding had a minor impact. Of all factors, only CF variety was associated with BMI-sds in the full model. CF factors, particularly CF variety, explain a small fraction of the BMI-sds differences between Dutch and Turkish children. The role of CF variety on childhood BMI requires further investigation.

Highlights

We found that relative to Dutch children, Turkish children had a higher body mass index (BMI)-sds at age 3 and 5 years, but not at 2 years
A small fraction of the ethnic differences in BMI-sds were explained by complementary feeding (CF) factors, CF variety, whereas milk feeding factors had a minor impact
Previous studies in the Netherlands reported higher overweight prevalence at 2 years among children from Turkish descent compared to children from Dutch descent [26,27], we did not observe ethnic differences in BMI at this age

Summary

Introduction

Childhood overweight (and obesity) remains an important and growing global public health issue [1]. In the Netherlands, overweight rates have slightly declined during recent years among children from Dutch descent, while remaining high among children from. Infants of Turkish descent have been reported to have a higher body mass index (BMI) already during the first year of life [5], and by 2 years of age, one out of five children of Turkish descent has developed overweight [3]. Infant feeding has been suggested as one of the most important modifiable risk factors for long-term growth outcomes [6,7,8]. A better understanding of the role of infant feeding in explaining ethnic differences in childhood BMI is pivotal

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