Breastfeeding duration is associated with offspring’s adherence to prudent dietary pattern in adulthood: results from the Nutritionist’s Health Study

Determinants of obesity in Latin America

Obesity rates are increasing almost everywhere in the world, although the pace and timing for this increase differ when populations from developed and developing countries are compared. The sharp and more recent increase in obesity rates in many Latin American countries is an example of that and results from regional characteristics that emerge from interactions between multiple factors. Aware of the complexity of enumerating these factors, we highlight eight main determinants (the physical environment, food exposure, economic and political interest, social inequity, limited access to scientific knowledge, culture, contextual behaviour and genetics) and discuss how they impact obesity rates in Latin American countries. We propose that initiatives aimed at understanding obesity and hampering obesity growth in Latin America should involve multidisciplinary, global approaches that consider these determinants to build more effective public policy and strategies, accounting for regional differences and disease complexity at the individual and systemic levels.

Association of Infant Feeding Characteristics With Dietary Patterns and Obesity in Korean Childhood

OBJECTIVES

Young children's feeding characteristics can play an important role in eating habits and health during later childhood. This study was conducted to examine the associations of feeding characteristics with dietary patterns and obesity in children.

METHODS

This study utilized data from the Korea National Health and Nutrition Examination Survey conducted between 2013 and 2017. In total, 802 toddlers were included, with information on their demographic characteristics, feeding practices and duration, and 24-hour recall obtained from their parents. Feeding characteristics were categorized into feeding type, duration of total breastfeeding, duration of total formula feeding, duration of exclusive breastfeeding, and age when starting formula feeding. Dietary patterns were identified based on factor loadings for the food groups for 3 major factors, with "vegetables & traditional," "fish & carbohydrates," and "sweet & fat" patterns. Overweight/obesity was defined as ≥85th percentile in body mass index based on the 2017 Korean National Growth charts for children and adolescents. Multiple regression analysis was conducted to examine associations between feeding characteristics and dietary patterns. The association between dietary patterns and obesity was analyzed using multivariable logistic regression analysis.

RESULTS

The early introduction of formula feeding was inversely associated with the "vegetables & traditional" pattern (β=-0.18; 95% confidence interval [CI], -0.34 to -0.02). A higher "vegetables & traditional" intake was associated with a lower risk of obesity (odds ratio, 0.48; 95% CI, 0.24 to 0.95).

CONCLUSIONS

Feeding characteristics are associated with dietary patterns in later childhood, and dietary patterns were shown to have a potential protective association against obesity.

Parental body mass index and maternal gestational weight gain associations with offspring body composition in young women from the Nutritionists' Health Study

Objective

Intrauterine environment can induce fetal metabolic programming that predisposes to adiposity-related chronic diseases in its lifespan. We examined the associations of parental nutritional status and gestational weight gain with offspring body composition in early adulthood.

Methods

This is cross-sectional analysis of female participants of the NutriHS who were submitted to questionnaires, clinical examinations and body composition assessed by DXA. Association of preconception parental BMI and maternal gestational weight gain (exposures) with body composition measurements (outcomes) were analyzed using multiple linear models adjusted for Directed Acyclic Graphs-based covariables (maternal and paternal educational level, maternal age, and tobacco, alcohol and/or drugs use). The sample included 124 women (median 28 (24-31) years) with a mean BMI of 25.4 ± 4.7 kg/m².

Results

No association between previous paternal BMI and offspring's body composition was detected. In the fully adjusted linear regression model, maternal BMI was associated with offspring's total lean mass (β = 0.66, p = 0.001), appendicular skeletal muscle mass index (ASMI) (β = 0.11, p = 0.003) and fat mass index (FMI) (β = 0.03, p = 0.039). Gestational weight gain was associated with increased offspring's BMI (OR 1.12 [95% CI 1.02-1.20], p = 0.01). The linear regression model adjusted for maternal age and maternal and paternal education levels showed associations of gestational weight gain with offspring's ASMI (β = 0.42, p = 0.046), FMI (β = 0.22, p = 0.005) and android-to-gynoid fat ratio (β = 0.09, p = 0.035).

Conclusion

Our findings suggest that preconception maternal BMI could influence lean mass and general adiposity of young adult female offspring and that gestational weight gain could be useful for predicting centrally distributed adiposity.

Association between breast-feeding exposure and duration with offspring's dietary patterns over 1 year of age: a systematic review of observational studies

Some evidence suggests that breast-feeding may modify food preferences in the later years of life. The present study aimed to provide a systematic review of observational studies investigating the association between exposure to breast milk and its duration with data-driven or hypothesis-driven (or diet quality scores) dietary patterns over 1 year of age. The databases of PubMed, Scopus and Web of Science were searched for observational studies published from January 2010 until July 2021, which led to the identification of twenty-two eligible articles. There was considerable heterogeneity between studies in terms of assessment of exposure and outcome. Of the eleven studies that assessed data-driven dietary patterns, ten reported a significant association for at least one identified dietary pattern. Overall, being breast-fed and a longer duration of any/exclusive breast-feeding were associated with higher scores on healthy dietary patterns characterised mainly by high loadings of fruits, vegetables and whole grains. In comparison, a negative association was found for unhealthy dietary patterns rich in foods with high content of added sugar, salt and saturated fats. In terms of diet quality scores, nine out of eleven studies reported a significant positive association between the duration of any breast-feeding and adherence to recommended healthy diets or dietary guidelines. In conclusion, the evidence from this review was generally in support of the hypothesis indicating breast-feeding is associated with healthy dietary patterns at later ages. However, due to the methodological limitations in the available studies, further research is warranted to elucidate solid evidence on this topic.

Associations of Blautia Genus With Early-Life Events and Later Phenotype in the NutriHS

Introduction

Early-life events are associated with the risk of obesity and comorbidities later in life. The gut microbiota—whose composition is influenced by genetics and environmental factors—could be involved. Since the microbiota affects metabolism and fat storage, early-life insults could contribute to the occurrence of obesity driven, in part, by microbiota composition. We examined associations of gut bacteria with early-life events, nutritional status, and body composition in the Nutritionist’s Health Study (NutriHS).

Methods

A cross-sectional study of 114 female participants examining early-life data, body composition, and biological samples was conducted. Fecal microbiota structure was determined targeting the V4 region of the 16S rRNA gene. Principal coordinates analysis (PCoA) and permutational multivariate analysis of variance (PERMANOVA) were used to test the impact of variables on microbial diversity. Profiles were identified using the Jensen-Shannon divergence matrix and Calinski–Harabasz index. Differential abundance between the categories of exclusive breastfeeding duration and nutritional status was tested using DESeq2.

Results

In the sample [median age 28 years and body mass index (BMI) 24.5 kg/m²], 2 microbiota profiles driven by the Blautia or Prevotella genus were identified. An estimated 9.1% of the variation was explained by the profiles (p < 0.001), 2.1% by nutritional status (p = 0.004), and 1.8% by exclusive breastfeeding (p = 0.012). The proportion of participants with BMI <25 kg/m² and who were breastfed for at least 6 months was higher in the Blautia profile (p < 0.05).

Conclusion

Findings in a Blautia-driven profile of healthy women reinforce that early-life events play a role in defining gut microbiota composition, confirming the importance of exclusive breastfeeding for infant gut colonization in establishing a protective profile against adiposity-related outcomes in adulthood.

Childhood eating practices are relevant to ultra-processed food consumption in adulthood: results from the Nutritionists' Health Study

Studies on childhood feeding and current food consumption, according to the NOVA classification, in adults are scarce. The objective of this study was to evaluate the relationship between childhood dietary practices and the current consumption of different categories of processed foods in young adults using data from the Nutritionists' Health Study (NutriHS) cohort. A cross-sectional analysis was performed using data of 392 on nutrition undergraduate students or nutritionists aged ≥18 years. Current food consumption was assessed using a food frequency questionnaire and the NOVA classification. The investigated childhood eating practices included fruit and vegetable intake, exclusive breastfeeding, and other breastfeeding practices. Participants breastfed with introduction of solid, semi-solid or soft foods before 6 months had higher current consumption of processed foods than those who were not breastfed (β = 4.30; 95% confidence interval [CI] = 0.56-8.04) and those who did not have the habits of eating fruits and vegetables during childhood consumed less unprocessed and minimally processed foods in adulthood than those who ate fruits and vegetables during infancy (β = -3.76; 95% CI = -0.82 to -6.70). Further, later introduction of infant formula or other types of milk between 3 and 5 months of age had a lower current consumption of ultra-processed foods than those fed infant formula or other types of milk before 1 month age of life (β = -3.09; 95% CI = -6.12 to -0.06). In conclusion, childhood feeding practices were linked to food consumption in adult life in NutriHS cohort, highlighting that the first 1000 days of life seems to impact on food choices during adulthood, with potential to protect against nutrition-related diseases later in life.

Pre-pregnancy BMI is associated with offspring body composition in adulthood before adiposity-related disorders: a retrospective cohort

OBJECTIVE

To investigate the association between maternal pre-pregnancy BMI and offspring body composition in adulthood.

DESIGN

Retrospective cohort. Undergraduates of nutrition or nutritionists were recruited at the baseline of the Nutritionists' Health Study between 2014 and 2017. Maternal pre-pregnancy BMI and current life aspects were self-reported through online questionnaires. Three body compartments were dual-energy x-ray absorptiometry-determined. The following variables were obtained: body fat (%), fat mass index (FMI) (kg/m2), android-to-gynoid fat ratio, visceral adipose tissue (VAT) (cm3), appendicular skeletal muscle mass index (ASMI) (kg/m2), total bone and femur mineral content (g) and density (g/cm2). Linear regression adjusted according to directed acyclic graphs recommendation was performed.

SETTING

São Paulo, Brazil.

PARTICIPANTS

Healthy non-pregnant women (aged 20-45 years) (n 150).

RESULTS

Median age and BMI were 22 years (IQR = 20, 29) and 22·3 kg/m2 (IQR = 20·4, 25·3), respectively. Pre-pregnancy BMI ≥ 25 kg/m2 was reported by 14·7 % of mothers. In fully adjusted models, maternal pre-pregnancy BMI was associated with their daughters' body fat % (β = 0·31; 95 % CI 0·0004, 0·63), FMI (β = 0·17; 95 % CI 0·03, 0·30), android-to-gynoid ratio (β = 0·01; 95 % CI 0·004, 0·02) and VAT (β = 0·09; 95 % CI 0·02, 0·16), but not with total bone density (β = 0·001; 95 % CI -0·003, 0·006) and content (β = 7·13; 95 % CI -4·19, 18·46). Direct association with ASMI was also detected, but lost statistical significance when participants whose mothers were underweight were excluded.

CONCLUSIONS

Maternal pre-pregnancy BMI was directly associated with offspring general and visceral adiposity but seems not to be associated with bone mass. Results reinforce importance of avoiding excess of maternal adiposity, as an attempt to break the vicious cycle of obesity transmission.

Maternal and paternal obesity are associated with offspring obestatin levels in the Nutritionists' Health Study

OBJECTIVES

The aim of this study was to examine whether paternal and maternal body mass indexes (BMIs) were independently associated with obestatin and visfatin levels in adult offspring.

METHODS

This cross-sectional analysis included 124 women who participated in the Nutritionists' Health Study (NutriHS) at baseline. Early life events, anthropometry, dual-energy x-ray absorptiometry-determined body composition and blood sample were obtained. Associations of parental BMI with outcomes (obestatin and visfatin) were tested by multiple linear regression, using minimal sufficient adjustments recommended by Directed Acyclic Graph. Participants' mean BMI was 25 ± 5 kg/m² and 74% were metabolically healthy. Median obestatin and visfatin levels were 56.4 pg/mL (42-72) and 17.7 ng/mL (14-21.8), respectively. Eleven percent of mothers and 39% of fathers were overweight/obese.

RESULTS

Daughters born from overweight/obese mothers had higher BMI than those born from normal weight women (P = 0.003). In adjusted regression model, offspring obestatin levels were associated with maternal BMI (β = -0.03; P = 0.045) and paternal BMI (β = -0.02; P = 0.048) independently of maternal and paternal education, maternal age, and maternal use of tobacco, alcohol, and/or drugs. No association was detected with visfatin levels.

CONCLUSION

Inverse associations of maternal and paternal BMIs with offspring obestatin concentrations in women could suggest a utility of this biomarker of energy regulation determined in early adulthood. Whether obestatin could be an indicator of protection against obesity-related disorders in the life course requires investigation in studies designed to test such hypothesis.

Early life feeding and current dietary patterns are associated with biomarkers of glucose and lipid metabolism in young women from the Nutritionist's Health Study

BACKGROUND/OBJECTIVES

We investigated if breastfeeding duration and current dietary patterns (DP) were associated with glucose and lipid metabolism biomarkers in women from the Nutritionist's Health Study.

SUBJECTS/METHODS

This is a cross-sectional analysis of 200 healthy undergraduates and nutrition graduates aged ≤45 years. Total [<6; ≥6 months] and predominant [<3; ≥3 months] breastfeeding were recalled using questionnaires. Diet were assessed using a food frequency questionnaire. DP obtained by factor analysis by principal component were categorized into tertiles of adherence (T1 = reference). Glucose and lipid biomarkers were categorized into tertiles (T1 + T2 = reference). Logistic regression was applied considering minimal sufficient adjustment recommended by directed acyclic graphs.

RESULTS

Median (interquartile range) age and BMI were 23.0 (20.0; 28.5) years and 22.6 (20.7; 25.4) kg/m², respectively. Mean ± SD values of glucose, LDL-c and HDL-c were 82.0 ± 9.0, 101.1 ± 29.6 and 54.4 ± 12.4 mg/dL, respectively. Women breastfed for <6 months had higher chance of being classified into T3 of insulin (OR = 2.87; 95%CI = 1.28-6.40). Predominant breastfeeding < 3 months was associated with insulin levels (OR = 2.27; 95%CI = 1.02-5.02) and HOMA-IR (OR = 2.36; 95%CI = 1.06-5.26). Breastfeeding was not associated with lipids. The Processed pattern was directly associated with LDL-c (T3: OR 6.08; 95%CI 1.80-20.58; P-trend = 0.004), while the Prudent pattern was inversely associated with LDL-c (T3: OR 0.26; 95%CI 0.08-0.87; P-trend = 0.029) and LDL-c/HDL-c ratio (T3: OR 0.28; 95%CI 0.08-0.97; P-trend = 0.046).

CONCLUSION

Early feeding could be a protective factor against insulin resistance development, while current DP were associated with lipid profile. This evidence indicates that from early life until early adulthood, dietary habits might influence women's cardiometabolic risk profile.