(12-10-10) Nutrition in infancy and long-term risk of obesity: evidence from 2 randomized controlled trials.

Singhal A, Kennedy K, Lanigan J, Fewtrell M, Cole TJ, Stephenson T, Elias-
Jones A, Weaver LT, Ibhanesebhor S, Macdonald PD, Bindels J, Lucas A.

Medical Research Council Childhood Nutrition Research Centre, University
College London, Institute of Child Health, London, United Kingdom.
Abstract
BACKGROUND: Growth acceleration as a consequence of relative overnutrition in
infancy has been suggested to increase the risk of later obesity. However, few
studies have investigated this association by using an experimental study
design.

OBJECTIVE: We investigated the effect of early growth promotion on later body
composition in 2 studies of infants born small for gestational age (weight
<10th percentile in study 1 and <20th percentile in study 2).

DESIGN: We reviewed a subset of children (n = 153 of 299 in study 1 and 90 of
246 in study 2) randomly assigned at birth to receive either a control formula
or a nutrient-enriched formula (which contained 28-43% more protein and 6-12%
more energy than the control formula) at 5-8 y of age. Fat mass was measured by
using bioelectric impedance analysis in study 1 and deuterium dilution in study
2.

RESULTS: Fat mass was lower in children assigned to receive the control
formula than in children assigned to receive the nutrient-enriched formula in
both trials [mean (95% CI) difference for fat mass after adjustment for sex:
study 1: -38% (-67%, -10%), P = 0.009; study 2: -18% (-36%, -0.3%), P = 0.04].
In nonrandomized analyses, faster weight gain in infancy was associated with
greater fat mass in childhood.

CONCLUSIONS: In 2 prospective randomized trials, we showed that a nutrient-
enriched diet in infancy increased fat mass later in childhood. These
experimental data support a causal link between faster early weight gain and a
later risk of obesity, have important implications for the management of
infants born small for gestational age, and suggest that the primary prevention
of obesity could begin in infancy.

Source: Am J Clin Nutr. 2010 Sep 29. [Epub ahead of print]

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