To what extent do weight gain and eating avidity during infancy predict later adiposity?

OBJECTIVE: To determine the extent to which weight gain and eating behaviours in infancy predict later adiposity. DESIGN: Population-based, prospective, longitudinal birth cohort study. Weights collected in infancy were used to calculate Z-scores for weight gain to age 1 year conditional on birth weight (CWG). To avoid multiple significance tests, variables from the parent questionnaire completed at age 1 year describing eating avidity were combined using general linear modelling to create an infancy avidity score. Anthropometry, skinfold thicknesses and bioelectrical impedance data collected at age 7-8 years were combined using factor analysis, to create an adiposity index. SETTING: Gateshead, UK. SUBJECTS: Members of the Gateshead Millennium Study cohort with data at both time points (n 561). RESULTS: CWG in infancy significantly predicted adiposity at age 7 years, but related more strongly to length and lean mass. High adiposity (> 90th internal percentile) at age 7 years was significantly associated with high CWG (relative risk 2·76; 95% CI 1·5, 5·1) in infancy, but less so with raised (> 74th internal percentile) eating avidity in infancy (relative risk 1·87; 95% CI 0·9, 3·7). However, the majority of children with high weight gain (77·6%) or avidity (85·5%) in infancy did not go on to have high adiposity at age 7 years. CONCLUSIONS: Rapid weight gain in infancy and the eating behaviours which relate to it do predict later adiposity, but are more strongly predictive of later stature and lean mass.

How does infant behaviour relate to weight gain and adiposity?

An understanding of how infant eating behaviour relates to later obesity is required if interventions in infancy are to be attempted. The aim of this paper is to review findings from the Gateshead Millennium Study to describe (i) what we have already established about the relationship between infant feeding transitions, infancy weight gain and eating behaviour and (ii) describe new analyses that examine how infant eating behaviour and temperament relate to infancy weight gain and childhood adiposity. The Gateshead Millennium Study recruited 1029 infants at birth and parents completed questionnaires five times in the first year. We have already described how starting solids and ceasing breast-feeding seems to be a response to rapid early weight gain, rather than a cause, and that parents identify and respond to the individual appetite characteristics of their child. A number of questions about eating behaviour at 12 months were used to construct an infancy eating avidity score that was positively associated with height at age 7-8 years, but not with an adiposity index constructed using bioelectrical impedance, waist and skinfolds. Infancy eating avidity score was associated with greater fussiness and lower satiety responsivity on the Child Eating Behaviour Questionnaire at age 6-8 years. Temperament measured at age 6 weeks and 8 months showed no consistent associations with either infancy weight gain or adiposity at 6-8 years. While infancy may seem a logical time to intervene with children at risk of future obesity, the collective findings from this substantial population-based study largely suggest otherwise.