Abstract
We aimed to study growth patterns according to rapid weight gain (RWG) and infant feeding practices during the first 120 days and whether infant feeding practices mediated the association between RWG in the first semester of life and subsequent body mass index (BMI) z-score in children from age 1 to 6. (1) Methods: 862 children from the Growth and Feeding during Lactation and Early Childhood in Children of Aragon study (CALINA in Spanish) were examined. Repeated-measures ANOVA analyses were conducted to assess growth trajectories according to RWG and type of feeding practice. The product of coefficients mediation method was used to assess the potential contribution of infant feeding practices to the association between RWG and BMI z-score. Mediation models were conducted using IBM SPSS-PROCESS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp. (2) Results: BMI and weight z-score trajectories were significantly higher in the RWG group and the formula-fed group. No significant differences were found regarding height. Infant feeding practices did not mediate the association between RWG and BMI z-score but were associated with BMI at 6 years. (3) Conclusions: Infant feeding practices and RWG determine different growth trajectories of BMI and weight during childhood. Although infant feeding practices did not mediate the association between early RWG and BMI later in life, formula feeding is independently related to higher BMI growth patterns later in childhood.
Highlights
Obesity prevalence has increased by 100% in the last 40 years worldwide and it does affect adults, and children; over 40 million children under 5 are already overweight and are predisposed to later overweight or obesity during adulthood [1]
In order to try and explain whether type of feeding mediates the established association between rapid weight gain (RWG) and body weight and body mass index (BMI), the aim of this study is to describe growth patterns according to RWG and type of infant feeding during the first 120 days and to assess the mediation effect of the type of feeding during the first 4 months of life on the association between RWG and BMI z-score from 1 to 6 years of age
Mean of birth weight was significantly higher in the non-rapid weight gainers group (p < 0.001), but from 6 months onward, children in the RWG group presented significantly higher BMI-for-age z-score (BAz) at 6, 12, 24, 36, 60, and 72 months (p < 0.01 in all cases)
Summary
Obesity prevalence has increased by 100% in the last 40 years worldwide and it does affect adults, and children; over 40 million children under 5 are already overweight and are predisposed to later overweight or obesity during adulthood [1]. According to the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative (COSI). Study, overweight and obesity prevalence in European children from 6 to 9 years old oscillates among countries between 19.3–49.0% of boys and 18.4–42.5% of girls when following the 2007 WHO growth. Obesity, defined by the WHO as an abnormal or excessive fat accumulation presenting a risk to health [3], has a multifactorial origin, involving mainly genetic and environmental factors [4]. Early-life environmental factors during the perinatal period are recognized as major factors in shaping obesity risk, both in childhood and even later in adulthood [5,6]. Parental exposures such as higher pre-pregnancy body mass index (BMI), prenatal tobacco exposure, excessive gestational weight gain, high birth weight, and infant rapid weight gain (RWG) are factors strongly associated with future childhood obesity [5,7].
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