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Title: Risk of being overweight at 5 years of age is associated with weight gain and energy intake during infancy in formula-fed children

Author
item ANDRES, ALINE - Arkansas Children'S Nutrition Research Center (ACNC)
item FAWCETT, KINDANN - University Arkansas For Medical Sciences (UAMS)
item CASEY, PATRICK - Arkansas Children'S Hospital
item Badger, Thomas
item CLEVES, MARIO - Arkansas Children'S Nutrition Research Center (ACNC)

Submitted to: Annals of Pediatric Research
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 12/30/2019
Publication Date: 1/11/2020
Citation: Andres, A., Fawcett, K., Casey, P., Badger, T.M., Cleves, M. 2020. Risk of being overweight at 5 years of age is associated with weight gain and energy intake during infancy in formula-fed children. Annals of Pediatric Research. 4(1):1029.

Interpretive Summary: The aim of this study was to determine the relationship between weight gain and energy intake during infancy and childhood adiposity at 5 years of age. Growth, body composition, and dietary intake were monitored during the first year of life and at age 5 years in 152 healthy formula-fed infants. Results suggested that body weight gain during the first year of life are important determinant of body mass index (BMI) at 5 years of age even after considering other important variables such as maternal BMI and infancy energy intake. These findings suggests that other factors such as energy expenditure and/or the efficiency of nutrient utilization may be different in these children.

Technical Abstract: Although rapid weight gain during infancy has been associated with overweight and obese status in children and adults, no published studies have investigated the role of infant weight gain during infancy on later adiposity while controlling for dietary intake. To determine the relationship between weight gain (g/kg/d at 3 months intervals) and energy intake during infancy and childhood adiposity at 5 years of age; A cohort of healthy term infants was prospectively followed from 3 to 60 months of age. Anthropometrics, body composition (nuclear magnetic resonance [Echo-MRI AH]), and dietary intake (3 day food records) were assessed at 3, 6, 9, 12, 24, 36, 48 and 60 months. Formula-fed infants (n=152) from the central Arkansas region in the United States were recruited between 2002 and 2011. BMI-for-age Z-score, body fat (%) and energy intake (kcal). Linear and logistic regression models were used while adjusting for maternal body mass index (BMI), gestational age, sex, birth weight, birth length, and energy intake. Higher weight gain (g/kg/d) between 3 and 12 months of age was significantly associated with higher BMI-for-age Z-score (BMIZ) and higher percent body fat at 5 years of age after controlling for infant sex, gestational age, birth length, birth weight, maternal BMI and energy intake. Infants who had a BMIZ >1 at 6, 9 and 12 months had greater probabilities to have a BMIZ > 1 at age 5 years (adjusted odds ratio = 1.9 [95% CI: 1.1-3.0], 2.9 [95%CI: 1.6-5.2] and 3.4 [95%CI: 1.8-6.1], respectively, P<0.02) after adjusting for the covariates. Energy intake was significantly greater by 64 kcal/d on average between birth and 12 months of age for children who were overweight at 5 years compared to their counterparts (P<0.03). Higher weight gain (g/kg/d) during infancy was associated with higher BMIZ and percent body fat at 5 years of age after adjusting for important covariates such as maternal BMI and energy intake. To prevent high BMIZ later in life, infants with high weight gain and their family may benefit from early lifestyle interventions on adequate intake and feeding cues.