Early infancy - a critical period for development of obesity

Abstract

Abundant epidemiologic evidence from the developed world now shows that more rapid weight gain during the first half of infancy predicts later obesity and cardio-metabolic risk. In countries in transition, in which stunting is still prevalent, distinguishing the effects of gain in weight from linear growth remains a challenge. Moreover, very few studies to date have incorporated body composition measures during infancy, which is key to understanding determinants of infant weight gain that also predict later obesity. In addition to infant feeding type, potential determinants include the perinatal endocrine milieu. Animal and emerging human data raise the possibility that ensuring adequate leptin exposure to the growing fetus may regulate energy balance as the infant grows. Understanding these pathways, as well as examining the balance between cardiovascular and cognitive effects in both term and preterm infants, will point the way toward effective interventions to alter infant growth to prevent later obesity.

Fig. 1

Changes in percent fat mass (%FM) during the first 2 years of life Adapted from Butre et al..

Fig 2

Lifelong lower trajectory of weight gain programmed by a reduction in energy reduction during the lactation period in the rat. Adapted from Widdowson and McCance.

Fig 3

Mean z (SD) scores for height, weight and body mass index (BMI) in the first 11 years after birth among boys who had coronary heart disease as adults. The mean values for all boys are set at zero, with deviations from the mean expressed as standard deviations (z-scores). Reproduced with permission from Barker et al..

Fig. 4

Adjusted mean SD (z) scores foe later body mass index (BMI) fat mass index (FMI), fat-free mass index (FFMI) and waist circumference (WC), suatified according to change in weight SD scores quartiles from 0 to 3 months and 3 to 6 months of age. Error bars indicate 95% CIs. Data from general linear models adjusted for birth weight SDS, sex, puberty physical activity, socioeconomic class ethnicity and parental BMI Reproduced with permission from Chomtho et al..

Fig. 5

Predicted difference in systolic blood pressure (BP) at age 3 years according to quartile of weight-for-length z-score at birth and age 6 months adjusted for child age, sex, height and blood pressure measurement conditions, and maternal income, education, race ethnicity and smoking status. Reproduced with permission from Belfort et al..

Fig. 6

Prevalence of obesity at age 5 years (body mass index greater than 95th percentile) predicted by crossing upwards two major percentile lines on the CDC growth charts 21 from 1 to 6, 6 to 12, 12 to 18 and 18 to 24 months of age Taveras et al. unpublished data.

Fig 7

Weight-far-age z-score in the first year of life in experimental ν control trial groups and three observational groups Data from a PROBIT randomized controlled trial of breastfeeding promotion in the Republic of Belarus. Reproduced with permission from Kramer et al.

Fig 8

Peabody Picture Vocabulary Test III (PPVT-III) score (standard error) within deciles of infant weight z-score at 6 months. Estimates adjusted for child birth weight z-score sex, age at cognitive assessment, gestational age, breastfeeding duration race/ethnicity and English as second language status; maternal age, parity, smoking status and PPVT-III score; parental educational levels; and annual household income. Reproduced with permission from Belfort et al..