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Early introduction of complementary foods and childhood overweight in breastfed and formula-fed infants in the Netherlands: the PIAMA birth cohort study.

ABSTRACT: To investigate whether early introduction of complementary foods (CF) is associated with an increased risk of overweight during childhood, and whether this association differs between formula-fed and breastfed infants.We included 2611 participants that were born at term from a Dutch population-based birth cohort (n?=?3963) designed to investigate the development of asthma and allergies. Parents kept records of their infant's age when CF were first introduced. Weight and height were parent reported yearly from age 1 to 8 years, and at ages 11, 14 and 17 years. We used multivariate generalized estimating equations analysis to investigate the association between timing of CF introduction (before 4 months vs at or after 4 months of age) and overweight at ages 1-17 years.Children with CF introduction before 4 months had higher odds of being overweight during childhood than children with CF introduction at or after 4 months (OR 1.32, 95% CI 1.19, 1.47). This association was observed in formula-fed infants (OR 1.51, 95% CI 1.17, 1.94) and breastfed infants (OR 1.32, 95% CI 1.19, 1.47). The duration of breastfeeding modified the association between CF introduction and overweight: children breastfed for shorter than 4 months, but not children breastfed for 4 months or longer with CF introduction before 4 months had higher odds of being overweight (OR 1.37, 95% CI 1.19, 1.57 and 1.07, 95% CI 0.87, 1.32, respectively), compared to those with CF introduction at or after 4 months.In children born at term, formula-fed infants and infants who were breastfed for shorter than 4 months, but not infants who were breastfed for 4 months or longer, had a higher risk of being overweight during childhood when being introduced to CF before 4 months of age.

SUBMITTER: Pluymen LPM

PROVIDER: S-EPMC6060808 | biostudies-other | 2018 Aug

REPOSITORIES: biostudies-other

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Early introduction of complementary foods and childhood overweight in breastfed and formula-fed infants in the Netherlands: the PIAMA birth cohort study.

Pluymen Linda P M LPM Wijga Alet H AH Gehring Ulrike U Koppelman Gerard H GH Smit Henriëtte A HA van Rossem L L

European journal of nutrition 20180222 5

<h4>Purpose</h4>To investigate whether early introduction of complementary foods (CF) is associated with an increased risk of overweight during childhood, and whether this association differs between formula-fed and breastfed infants.<h4>Methods</h4>We included 2611 participants that were born at term from a Dutch population-based birth cohort (n = 3963) designed to investigate the development of asthma and allergies. Parents kept records of their infant's age when CF were first introduced. Weig ...[more]

PMID: 29470690

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Project description:IntroductionUnderstanding which foods are introduced in the diet and when provides valuable information on complementary feeding. Fortified baby rice cereal is the most common first solid food given to infants, often followed by other baby cereals. The objective of this study was to examine food patterns among infants and toddlers consuming rice or non-rice baby cereals versus non-consumers.MethodsNHANES 2001-2014 data were used to assess dietary intake, nutrient adequacy, and food specific patterns of infants and toddlers. Groups were: baby cereal non-consumers (n = 3,910), non-rice baby cereal consumers (n = 711), and rice baby cereal consumers (n = 966). Those consuming both non-rice cereal and rice cereal were included in the rice cereal group (n = 9, 48, 61, and 10 for those 0-3, 4-6, 7-11, and 12-23 mos, respectively). Least-square means ± SEs were determined for nutrient intake and food group consumption by using covariate controlled regression analyses (p < 0.01).ResultsBaby cereal consumer groups, compared to non-consumers, had higher intakes of carbohydrates, iron, calcium, magnesium, zinc, and vitamin E, with lower percentage having intakes below the Estimated Average Requirement for iron, calcium, and vitamin E. Infants 0-3 mos and 4-6 mos in both baby cereal consumption groups consumed other solid foods, including baby foods and beverages, sweetened beverages, coffee and tea, 100% juice, vegetables (excluding potatoes), fruit, sugars, milk and yogurt, and mixed dishes. The baby cereal consumers and non-consumers groups had intakes aligned with the "American diet". Baby cereal non-consumers had a significantly higher percentage of exclusively breast fed at ages 0-3 mos and a lower percentage formula fed.ConclusionThis study provides detailed information on the introduction of baby cereals which was associated with better nutrient intakes and other complementary foods and intakes of nutrients that require special attention during early life. Further, cow's milk products and solid foods were introduced prior to the American Academy of Pediatrics' age recommendations.

Project description:Background:Protein intake from cow milk-based infant formula has been associated with rapid weight gain and increased adiposity, but the effect of protein from complementary foods has not been prospectively evaluated, and the effect of protein from sources other than formula during complementary feeding is not clear. Objective:The aim of this study was to directly compare the effect of protein from 2 common complementary food sources, meat and dairy, on infant growth and weight trajectory. Design:Healthy term, formula-fed infants were recruited from the metro Denver area, matched by sex and race/ethnicity and randomly assigned to a meat or a dairy complementary food group from 5 to 12 mo of age. Total protein intake during this 7-mo intervention was ?3 g ? kg-1 ? d-1 for both groups. Intakes of infant formula, cereal, fruit, and vegetables were ad libitum. Caregivers also completed 3-d diet records at 5, 10, and 12 mo of age. Anthropometric measures were obtained during monthly home visits, and blood samples were collected at 5 and 12 mo of age. Results:Sixty-four infants completed the intervention (meat: n = 32; dairy: n = 32). The average total protein intake (mean ± SD) increased from 2.01 ± 0.06 g ? kg-1 ? d-1 at 5 mo to 3.35 ±0.12 g ? kg-1 ? d-1 at 12 mo and did not differ between groups. Over time, weight and weight-for-age z score increased by 0.48 ± 0.07. However, there was a significant group-by-time interaction for both length-for-age z score (LAZ) and weight-for-length z score (WLZ). Post hoc analysis showed that LAZ increased in the meat group (+0.33 ± 0.09; P = 0.001 over time) and decreased in the dairy group (-0.30 ± 0.10; P = 0.0002 over time); WLZ significantly increased in the dairy group (0.76 ± 0.21; P = 0.000002 over time) compared with the meat group (0.30 ± 0.17; P = 0.55 over time). Insulin-like growth factor I and insulin-like growth factor-binding protein 3 both increased over time without group differences. Conclusions:Protein source may have an important role in regulating growth. In these formula-fed older infants, meat- and dairy-based complementary foods led to distinct growth patterns, especially for length. This trial was registered at www.clinicaltrials.gov as NCT02142647.

Dataset Information

Early introduction of complementary foods and childhood overweight in breastfed and formula-fed infants in the Netherlands: the PIAMA birth cohort study.

Publications

Early introduction of complementary foods and childhood overweight in breastfed and formula-fed infants in the Netherlands: the PIAMA birth cohort study.

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