(08-11-10) Nutrition in infancy and long-term risk of obesity: evidence from 2 randomized controlled trials1,2,3

Atul Singhal, Kathy Kennedy, Julie Lanigan, Mary Fewtrell, Tim J Cole, Terence Stephenson, Alun Elias-Jones, Lawrence T Weaver, Samuel Ibhanesebhor, Peter D MacDonald, Jacques Bindels and Alan Lucas
1 From the Medical Research Council Childhood Nutrition Research Centre (AS, KK, JL, MF, and AL), and the Medical Research Council Centre of Epidemiology for Child Health (TJC), University College London, Institute of Child Health, London, United Kingdom; the Academic Division of Child Health, University Hospital, Nottingham, United Kingdom (TS); the Leicester General Hospital, National Health Service Trust, Leicester, United Kingdom (AE-J); the University Department of Child Health, Royal Hospital for Sick Children, Glasgow, United Kingdom (LTW); the Wishaw General Hospital, Wishaw, United Kingdom (SI); the Southern General Hospital, Glasgow, United Kingdom; and the Danone Research Centre for Specialized Nutrition, Wageningen/Amsterdam, Netherlands (JB).
2 Supported by the Medical Research Council (United Kingdom) with a contribution toward the follow-up of children in study 2 from the Early Nutrition Programming Long-Term Follow-Up of Efficacy and Safety Trials and Integrated Epidemiological, Genetic, Animal, Consumer and Economic Research as part of Sixth Framework Programme (FP6-FOOD-CT-2005-007036). Farley's Health Products, a division of HJ Heinz Company Ltd (Uxbridge, United Kingdom), supplied trial formulas for study 1; and Nutricia Ltd (Trowbridge, Wiltshire, United Kingdom) provided formulas for study 2. Farley's Health Products and Nutricia Ltd made charitable contributions for the conduct of the original randomized trials.
3 Address correspondence to A Singhal, University College London, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, United Kingdom. E-mail: [email protected] .
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:
Vol. 92, No. 5, 1133-1144, November 2010 American Journal of Clinical Nutrition

News

---

In evidenza

"L'informazione presente nel sito serve a migliorare, e non a sostituire, il rapporto medico-paziente."

Per coloro che hanno problemi di salute si consiglia di consultare sempre il proprio medico curante.