1
|
Freire T, Clark X, Pulpitel T, Bell-Anderson K, Ribeiro R, Raubenheimer D, Crean AJ, Simpson SJ, Solon-Biet SM. Maternal macronutrient intake effects on offspring macronutrient targets and metabolism. Obesity (Silver Spring) 2024; 32:743-755. [PMID: 38328970 DOI: 10.1002/oby.23995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 12/04/2023] [Accepted: 12/21/2023] [Indexed: 02/09/2024]
Abstract
OBJECTIVE Exposure in utero to maternal diet can program offspring health and susceptibility to disease. Using C57BL6/JArc mice, we investigated how maternal dietary protein to carbohydrate balance influences male and female offspring appetite and metabolic health. METHODS Dams were placed on either a low-protein (LP) or high-protein (HP) diet. Male and female offspring were placed on a food choice experiment post weaning and were then constrained to either a standard diet or Western diet. Food intake, body weight, and composition were measured, and various metabolic tests were performed at different timepoints. RESULTS Offspring from mothers fed HP diets selected a higher protein intake and had increased body weight in early life relative to offspring from LP diet-fed dams. As predicted by protein leverage theory, higher protein intake targets led to increased food intake when offspring were placed on no-choice diets, resulting in greater body weight and fat mass. The combination of an HP maternal diet and a Western diet further exacerbated this obesity phenotype and led to long-term consequences for body composition and metabolism. CONCLUSIONS This work could help explain the association between elevated protein intake in humans during early life and increased risk of obesity in childhood and later life.
Collapse
Affiliation(s)
- Therese Freire
- Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Ximonie Clark
- Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Tamara Pulpitel
- Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
- School of Life and Environmental Sciences, Faculty of Science, The University of Sydney, Camperdown, New South Wales, Australia
| | - Kim Bell-Anderson
- Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Rosilene Ribeiro
- Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
- School of Life and Environmental Sciences, Faculty of Science, The University of Sydney, Camperdown, New South Wales, Australia
| | - David Raubenheimer
- Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
- School of Life and Environmental Sciences, Faculty of Science, The University of Sydney, Camperdown, New South Wales, Australia
| | - Angela J Crean
- Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
- School of Life and Environmental Sciences, Faculty of Science, The University of Sydney, Camperdown, New South Wales, Australia
| | - Stephen J Simpson
- Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
- School of Life and Environmental Sciences, Faculty of Science, The University of Sydney, Camperdown, New South Wales, Australia
| | - Samantha M Solon-Biet
- Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
- School of Life and Environmental Sciences, Faculty of Science, The University of Sydney, Camperdown, New South Wales, Australia
| |
Collapse
|
2
|
Zheng M, D'Souza NJ, Atkins L, Ghobadi S, Laws R, Szymlek-Gay EA, Grimes C, Baker P, He QQ, Campbell KJ. Breastfeeding and the Longitudinal Changes of Body Mass Index in Childhood and Adulthood: A Systematic Review. Adv Nutr 2024; 15:100152. [PMID: 37977327 PMCID: PMC10714232 DOI: 10.1016/j.advnut.2023.100152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 11/01/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023] Open
Abstract
Mounting evidence supports the beneficial role of breastfeeding in lowering obesity risk, but the enduring impact of breastfeeding on longitudinal changes in body mass index (BMI) (i.e., BMI trajectories) remains unclear. This systematic review summarized evidence on how breastfeeding influenced the longitudinal trajectories of BMI later in life. Literature searches were conducted in Medline, Embase, Web of Science, and ScienceDirect to identify studies that assessed how breastfeeding (versus other feeding types or duration) was associated with longitudinal trajectories of BMI or BMI z-score. Three randomized controlled trials (RCTs) and 24 longitudinal cohort studies were included. Two-thirds (18/27) of studies were rated as acceptable or high quality. Most cohort studies (9/11) showed that children who continued to breastfeed at 3 to 12 mo of age had a lower BMI trajectory or lower odds of following a high BMI trajectory than those who were formula-fed or mixed-fed. The BMI differences between breastfeeding and other feeding groups were evident from age 7 mo and remained up to 8 y, and the magnitude of between-group BMI differences increased with age. For breastfeeding duration, 12 out of 15 cohort studies found that longer breastfeeding duration was associated with lower BMI trajectories up to age 18 y. Moreover, beneficial associations were observed for both exclusive and any breastfeeding with BMI trajectory. In contrast, mixed findings were reported from 3 RCTs that compared BMI trajectories from birth to ages 12 to 24 mo between breastfeeding promotion versus control or breastfeeding versus formula-feeding groups. The current review provides further longitudinal evidence from cohort studies that breastfeeding versus formula/mixed feeding or longer breastfeeding duration was associated with lower BMI trajectories. Such associations initiated in early childhood became more apparent with age and were sustained into early adulthood. The existing evidence substantiates the importance of breastfeeding promotion and continuation to support obesity prevention.
Collapse
Affiliation(s)
- Miaobing Zheng
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia.
| | - Ninoshka J D'Souza
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Linda Atkins
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Saeed Ghobadi
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Rachel Laws
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Ewa A Szymlek-Gay
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Carley Grimes
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Philip Baker
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Qi-Qiang He
- School of Public Health, Wuhan University, Wuhan, Republic of China
| | - Karen J Campbell
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| |
Collapse
|
3
|
Raubenheimer D, Simpson SJ. Protein appetite as an integrator in the obesity system: the protein leverage hypothesis. Philos Trans R Soc Lond B Biol Sci 2023; 378:20220212. [PMID: 37661737 PMCID: PMC10475875 DOI: 10.1098/rstb.2022.0212] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/21/2023] [Indexed: 09/05/2023] Open
Abstract
Despite the large volume and extensive range of obesity research, there is substantial disagreement on the causes and effective preventative strategies. We suggest the field will benefit from greater emphasis on integrative approaches that examine how various potential contributors interact, rather than regarding them as competing explanations. We demonstrate the application of nutritional geometry, a multi-nutrient integrative framework developed in the ecological sciences, to obesity research. Such studies have shown that humans, like many other species, regulate protein intake more strongly than other dietary components, and consequently if dietary protein is diluted there is a compensatory increase in food intake-a process called protein leverage. The protein leverage hypothesis (PLH) proposes that the dilution of protein in modern food supplies by fat and carbohydrate-rich highly processed foods has resulted in increased energy intake through protein leverage. We present evidence for the PLH from a variety of sources (mechanistic, experimental and observational), and show that this mechanism is compatible with many other findings and theories in obesity research. This article is part of a discussion meeting issue 'Causes of obesity: theories, conjectures and evidence (Part II)'.
Collapse
Affiliation(s)
- David Raubenheimer
- Charles Perkins Centre and School of Life and Environmental Sciences, The University of Sydney, Sydney, New South Wales 2006, Australia
| | - Stephen J. Simpson
- Charles Perkins Centre and School of Life and Environmental Sciences, The University of Sydney, Sydney, New South Wales 2006, Australia
| |
Collapse
|
4
|
Kokkou S, Notara V, Kanellopoulou A, Lagiou A, Panagiotakos D. Protein Intake, Source and Effect on Children's Weight Status: An Epidemiological Study in Greece. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1606. [PMID: 37892269 PMCID: PMC10605076 DOI: 10.3390/children10101606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/24/2023] [Accepted: 09/25/2023] [Indexed: 10/29/2023]
Abstract
The development of overweight and obesity during late childhood and early adolescence is one of the most critical issues in public health. Additionally, over the past few years, the consumption of protein has tended to increase in both children and adults. The present study aimed to evaluate whether the protein type, either plant- or animal-sourced, as well as the quantity consumed, could potentially have a relationship with excess body weight in children. A total of 47 primary schools were selected, and 1728 students, aged 10-12 years, were enrolled for the purposes of this study, leading to our final sample of 712. Physical measurements, such as weight and height, were measured, and children were separated into two weight status categories according to their Body Mass Index, which was obtained through the International Obesity Task Force criteria. Students' diets were assessed through a questionnaire, and total, plant- and animal-derived protein intakes were calculated. Unadjusted analysis showed a statistically significant association between body weight and plant protein. After adjustment for overall energy intake, sex, age, and exercise, there was a statistically significant negative association between plant protein and excess body weight in children (OR: 0.964, 95% CI: 0.936; 0.992), but a lack of association for animal-sourced protein (OR: 1.002, 95% CI: 0.991; 1.013). Dietary plant-derived protein seems to have a positive effect on weight status in children, independently of total energy intake and physical activity; nevertheless, additional research is required in order to elucidate the underlying mechanisms.
Collapse
Affiliation(s)
- Stamatia Kokkou
- Department of Public and Community Health, Laboratory of Hygiene and Epidemiology, School of Public Health, University of West Attica, Alexandras Avenue 196, 115 21 Athens, Greece
| | - Venetia Notara
- Department of Public and Community Health, Laboratory of Hygiene and Epidemiology, School of Public Health, University of West Attica, Alexandras Avenue 196, 115 21 Athens, Greece
| | - Aikaterini Kanellopoulou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Thiseos 70, 176 76 Athens, Greece
| | - Areti Lagiou
- Department of Public and Community Health, Laboratory of Hygiene and Epidemiology, School of Public Health, University of West Attica, Alexandras Avenue 196, 115 21 Athens, Greece
| | - Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Thiseos 70, 176 76 Athens, Greece
| |
Collapse
|
5
|
Milani GP, Edefonti V, De Cosmi V, Bettocchi S, Mazzocchi A, Silano M, Pietrobelli A, Agostoni C. Protein and growth during the first year of life: a systematic review and meta-analysis. Pediatr Res 2023; 94:878-891. [PMID: 36941339 PMCID: PMC10444617 DOI: 10.1038/s41390-023-02531-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/23/2022] [Accepted: 02/06/2023] [Indexed: 03/23/2023]
Abstract
Dietary protein intake in the first year of life might influence later growth. We conducted a systematic review to investigate the growth effects of interventions based on infant formula composition providing different amounts of protein within the first year of life of healthy term infants; in the absence of other comparable information over the investigated period, a meta-analysis further compared weight or length gain at 120 days from high- (>2.0 g/100 kcal) and low-protein (≤2.0 g/100 kcal) content formula groups. Twelve papers (n = 2275) were included and five of them (n = 677) contributed to the meta-analysis. Most studies compared a high-protein formula, a low-protein formula, and breastfeeding. Evidence from the systematic review was inconclusive due to heterogeneity in design and treatments. In the presence of modest heterogeneity but in the absence of publication bias, the weighted mean difference for weight gain at 120 days was -0.02 g/day (95% CI: -1.41, 1.45); with higher heterogeneity, the weighted MD estimate of length gain at 120 days was 0.004 cm/month (95% CI: -0.26, 0.27). Although limited and underpowered, evidence from the meta-analysis does not support the assumption that high- vs. low-protein content formulas during exclusive milk-feeding lead to different growth outcomes in the first months of life. Prospero registration number: CRD42017058535. IMPACT: The optimal amount of dietary protein that should be given to healthy full-term infants early in life is still debated. Despite heterogeneity in study design, treatments, and outcomes, this systematic review showed that there is no clear-cut effect on the growth of different amounts of protein intake from formulas or complementary feeding. Evidence from the meta-analysis based on the five articles enrolling infants <1 month of life does not support the previous assumption that high- vs. low-protein content formulas during exclusive milk-feeding lead to different growth outcomes in the first 4 months of life.
Collapse
Affiliation(s)
- Gregorio P Milani
- Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Valeria Edefonti
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Valentina De Cosmi
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Silvia Bettocchi
- Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessandra Mazzocchi
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Marco Silano
- Unit of Human Nutrition and Health, Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Rome, Italy
| | - Angelo Pietrobelli
- Department of Surgical Science, Dentistry, Gynecology and Pediatrics, Pediatric Unit, Verona University Medical School, Verona, Italy
- Pennington Biomedical Research Center, LSU System, Baton Rouge, LA, USA
| | - Carlo Agostoni
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
- SC Pediatria-Immunoreumatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122, Milano, Italy.
| |
Collapse
|
6
|
Vieira Queiroz De Paula M, Grant M, Lanigan J, Singhal A. Does human milk composition predict later risk of obesity? A systematic review. BMC Nutr 2023; 9:89. [PMID: 37475022 DOI: 10.1186/s40795-023-00742-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 06/28/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Possible mechanisms behind the association of breastfeeding with a lower risk of later obesity are unknown but one possibility is the unique composition of human milk. Here, we systematically reviewed the evidence linking breast-milk macronutrient and hormonal composition with later obesity. METHODS We searched 7 databases for studies that included infants predominantly breast-fed for the first 3 months and which analysed associations between a measure of breast-milk composition and later (> 6 months) measures of obesity or body composition. RESULTS 47 publications were identified for full-text screening, of which 10 were eligible and only 3 found significant associations. Higher leptin concentration in breast milk at age 1 month was associated with lower infant BMI at 12, 18 and 24 months of age (1 study). Higher breast-milk adiponectin concentration at 6 weeks and 4 months were associated with adiposity at age 12 and 24 months (1 study). In 1 study, breast-milk carbohydrate content was positively associated, and fat content negatively associated, with adiposity at age 12 months. No significant associations were found between other hormones or macronutrients in human milk and later risk of obesity or body composition. CONCLUSIONS The evidence linking breast-milk composition with later obesity was inconsistent and confined to single, individual studies. Our review highlights the methodological limitations of previous studies and the need for further research in this area.
Collapse
Affiliation(s)
| | - Maude Grant
- Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health, London, UK
- Nestlé Nutrition, Société des Produits Nestlé, Vevey, Switzerland
| | - Julie Lanigan
- Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Atul Singhal
- Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health, London, UK
| |
Collapse
|
7
|
Describing the longitudinal breakfast quality index trajectories in early childhood: results from Melbourne InFANT program. Eur J Clin Nutr 2023; 77:363-369. [PMID: 36494475 DOI: 10.1038/s41430-022-01249-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 11/25/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Breakfast quality in early childhood remains understudied. This study describes the changes in breakfast quality index (BQI) (i.e. trajectory) in early childhood and assesses its associations with obesity outcomes. METHODS Data from children who participated in the Melbourne InFANT Program were used (n = 328). The Melbourne InFANT Program was a 15-month early obesity prevention intervention conducted from 2008 to 2013. Dietary intakes at ages 1.5, 3.5 and 5.0 years were assessed using three parent-proxy reported 24 h recalls. A revised nine-item BQI tool developed based on Australian dietary recommendations for young children was used to calculate BQI scores. Group-based trajectory modelling identified BQI trajectory groups. Multivariable linear and logistic regression examined the associations between identified BQI trajectory groups and obesity outcomes at age 5 years. RESULTS Mean BQI at ages 1.5, 3.5 and 5.0 years was 4.8, 4.8, 2.7 points, respectively. Two BQI trajectory groups were identified, and both showed a decline in BQI. The mean BQI of most children (74%) decreased from 5.0 to 4.0 points from ages 1.5 to 5.0 years (referred as "High BQI" group). The remaining children (26%) had a mean BQI of 4.8 and 1.2 points at age 1.5 and 5.0 years, respectively (referred as "Low BQI" group). The "Low BQI" group appeared to show higher risk of overweight (OR:1.30, 95% CI: 0.60, 2.81, P = 0.66) at age 5 years than the "High BQI" group. No difference in body mass index (BMI) z-score was found between the two groups. CONCLUSIONS Two BQI trajectory groups were identified. Both groups showed a decline in breakfast quality from ages 1.5 to 5.0 years. Our study highlights the need for early health promotion interventions and strategies to improve and maintain breakfast quality across early childhood.
Collapse
|
8
|
Endrinikapoulos A, Afifah DN, Mexitalia M, Andoyo R, Hatimah I, Nuryanto N. Study of the importance of protein needs for catch-up growth in Indonesian stunted children: a narrative review. SAGE Open Med 2023; 11:20503121231165562. [PMID: 37101818 PMCID: PMC10123915 DOI: 10.1177/20503121231165562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 03/02/2023] [Indexed: 04/28/2023] Open
Abstract
Stunting is a chronic nutritional deficiency due to various adverse cross-sectoral environmental conditions, including food intake. This influences the linear growth and development of children's brains and their cognitive function. Providing interventions to meet stunted children's protein needs tends to prevent the further abnormal development of cognitive functions. High-protein foods are supplied from various edible local commodities in Indonesia. Therefore, this study aims to demonstrate the importance of feeding stunted children with high-protein diets and provide insight that local food ingredients in the country have growth-promoting potential. Through Google Scholar, PubMed, Science Direct, and Nature, 107 articles were obtained with keywords related to stunting, such as protein intake, catch-up growth + stunting, and adverse effect + catch-up growth. The preferred citations randomized-controlled trials and systematic reviews relevant to the study question were compiled using Mendeley version 1.19.8. Based on the literature review results, stunting is hereditary and affects the quality of generations. The adequacy of protein needs is closely related to growth and development, hence, foods containing a high amount of the nutrient facilitate catch-up growth in stunted children. This conclusion is expected to provide information to policymakers and health agencies in the country concerning the education related to high nutritional local food, which can be reached by the community. Interventions with high-protein-containing local foods ought to be tailored to dietary needs and accompanied by monitoring for the presence or absence of unreasonable weight gain to prevent overweight or obesity.
Collapse
Affiliation(s)
- Ariana Endrinikapoulos
- Department of Nutrition, Faculty of Medicine, Diponegoro University, Semarang, Central Java, Indonesia
| | - Diana Nur Afifah
- Department of Nutrition, Faculty of Medicine, Diponegoro University, Semarang, Central Java, Indonesia
- Diana Nur Afifah, Nutrition Department, Medical Faculty, Diponegoro University, Prof. Sudarto, S.H Street, Tembalang, Semarang, Central Java ID 50275, Indonesia.
| | - Maria Mexitalia
- Department of Pediatric, Faculty of Medicine, Diponegoro University/Dr. Kariadi Hospital, Semarang, Central Java, Indonesia
| | - Robi Andoyo
- Department of Food Industrial Technology, Faculty of Agriculture Industrial Technology, Padjadjaran University, Bandung, West Java, Indonesia
| | - Ihat Hatimah
- Department of Public Education, Graduate School, Indonesia University of Education, Bandung, West Java, Indonesia
| | - Nuryanto Nuryanto
- Department of Nutrition, Faculty of Medicine, Diponegoro University, Semarang, Central Java, Indonesia
| |
Collapse
|
9
|
Zheng M, Hesketh KD, Vuillermin P, Dodd J, Wen LM, Baur LA, Taylor R, Byrne R, Mihrshahi S, Sly PD, Tang MLK, Campbell KJ. Determinants of rapid infant weight gain: A pooled analysis of seven cohorts. Pediatr Obes 2022; 17:e12928. [PMID: 35510714 PMCID: PMC9540679 DOI: 10.1111/ijpo.12928] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/15/2022] [Accepted: 04/13/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Rapid weight gain (RWG) in infancy is strongly associated with subsequent obesity risk, but little is known about the factors driving RWG. This study explored the child and maternal factors associated with infant RWG. METHODS Data from seven Australian and New Zealand cohorts were used (n = 4542). Infant RWG was defined as a change in weight z-score ≥0.67 from birth to age 1 year. Univariable and multivariable logistic regression assessed the association between child and maternal factors and infant RWG in each cohort. Meta-analysis was conducted to obtain pooled effect sizes. RESULTS Multivariable analyses revealed boys were more likely to experience RWG (OR 1.42 95% CI 1.22, 1.66) than girls. Higher birth weight in kg (OR 0.09, 95% CI 0.04, 0.20) and gestational age in weeks (OR 0.69, 95% CI 0.48, 0.98) were associated with lower RWG risk. Children who were breastfed for ≥6 months showed lower RWG risk (OR 0.45, 95% CI 0.38, 0.53). Children of native-born versus overseas-born women appeared to have higher RWG risk (OR 1.37, 95% CI 0.99, 1.90). Maternal smoking during pregnancy increased RWG risk (OR 1.60, 95% CI 1.28, 2.01), whereas children who started solids ≥6 months (OR 0.77, 95% CI 0.63, 0.93) and children with siblings (OR 0.68, 95% CI 0.57, 0.81) showed lower RWG risk in univariable analysis, but these associations were attenuated in multivariable analysis. No association was found for maternal age, education, marital status and pre-pregnancy BMI. CONCLUSION Maternal country of birth, smoking status, child sex, birth weight, gestational age, infant feeding and parity were potential determinants of infant RWG.
Collapse
Affiliation(s)
- Miaobing Zheng
- Deakin University, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition SciencesGeelongAustralia
| | - Kylie D. Hesketh
- Deakin University, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition SciencesGeelongAustralia
| | | | - Jodie Dodd
- Discipline of Obstetrics and GynaecologyThe Robinson Research Institute, The University of AdelaideAdelaideSouth AustraliaAustralia
| | - Li Ming Wen
- School of Public Health and Sydney Medical SchoolThe University of SydneySydneyAustralia
| | - Louise A. Baur
- School of Public Health and Sydney Medical SchoolThe University of SydneySydneyAustralia
| | - Rachael Taylor
- Department of MedicineUniversity of OtagoDunedinNew Zealand
| | - Rebecca Byrne
- School of Exercise and Nutrition Sciences, Faculty of HealthQueensland University of TechnologyKelvin GroveQueenslandAustralia
| | - Seema Mihrshahi
- Department of Health Sciences, Faculty of MedicineHealth and Human Sciences, Macquarie UniversitySydneyNew South WalesAustralia
| | - Peter D. Sly
- Children's Health and Environment ProgramThe University of QueenslandBrisbaneAustralia
| | | | - Karen J. Campbell
- Deakin University, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition SciencesGeelongAustralia
| |
Collapse
|
10
|
Abou-Dakn M, Alexy U, Beyer K, Cremer M, Ensenauer R, Flothkötter M, Geene R, Hellmers C, Joisten C, Koletzko B, Mata J, Schiffner U, Somm I, Speck M, Weißenborn A, Wöckel A. Ernährung und Bewegung im Kleinkindalter. Monatsschr Kinderheilkd 2022. [DOI: 10.1007/s00112-022-01519-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
|
11
|
Raubenheimer D, Senior AM, Mirth C, Cui Z, Hou R, Le Couteur DG, Solon-Biet SM, Léopold P, Simpson SJ. An integrative approach to dietary balance across the life course. iScience 2022; 25:104315. [PMID: 35602946 PMCID: PMC9117877 DOI: 10.1016/j.isci.2022.104315] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Animals require specific blends of nutrients that vary across the life course and with circumstances, e.g., health and activity levels. Underpinning and complicating these requirements is that individual traits may be optimized on different dietary compositions leading to nutrition-mediated trade-offs among outcomes. Additionally, the food environment may constrain which nutrient mixtures are achievable. Natural selection has equipped animals for solving such multi-dimensional, dynamic challenges of nutrition, but little is understood about the details and their theoretical and practical implications. We present an integrative framework, nutritional geometry, which models complex nutritional interactions in the context of multiple nutrients and across levels of biological organization (e.g., cellular, individual, and population) and levels of analysis (e.g., mechanistic, developmental, ecological, and evolutionary). The framework is generalizable across different situations and taxa. We illustrate this using examples spanning insects to primates and settings (laboratory, and the wild), and demonstrate its relevance for human health.
Collapse
Affiliation(s)
- David Raubenheimer
- The University of Sydney, Charles Perkins Centre and School of Life and Environmental Sciences, Sydney, Australia
- Zhengzhou University, Centre for Nutritional Ecology and Centre for Sport Nutrition and Health, Zhengzhou, China
- Corresponding author
| | - Alistair M. Senior
- The University of Sydney, Charles Perkins Centre and School of Life and Environmental Sciences, Sydney, Australia
- The University of Sydney, School of Mathematics and Statistics, Sydney, Australia
| | - Christen Mirth
- Monash University, School of Biological Science, Melbourne, Australia
| | - Zhenwei Cui
- Zhengzhou University, Centre for Nutritional Ecology and Centre for Sport Nutrition and Health, Zhengzhou, China
| | - Rong Hou
- Northwest University, Shaanxi Key Laboratory for Animal Conservation, College of Life Sciences, Xi’an, China
| | - David G. Le Couteur
- The University of Sydney, Charles Perkins Centre and Faculty of Medicine and Health, Concord Clinical School, ANZAC Research Institute, Centre for Education and Research on Ageing, Sydney, Australia
| | - Samantha M. Solon-Biet
- The University of Sydney, Charles Perkins Centre and School of Medical Sciences, Sydney, Australia
| | - Pierre Léopold
- Institut Curie, PSL Research University, CNRS UMR3215, INSERM U934, UPMC Paris-Sorbonne, Paris, France
| | - Stephen J. Simpson
- The University of Sydney, Charles Perkins Centre and School of Life and Environmental Sciences, Sydney, Australia
- Corresponding author
| |
Collapse
|
12
|
Jochum F, Abdellatif M, Adel A, Alhammadi A, Alnemri A, Alohali E, AlSarraf K, Al Said K, Elzalabany M, Isa HMA, Kalyanasundaram S, Reheim NA, Saadah O. Burden of Early Life Obesity and Its Relationship with Protein Intake in Infancy: The Middle East Expert Consensus. Pediatr Gastroenterol Hepatol Nutr 2022; 25:93-108. [PMID: 35360379 PMCID: PMC8958054 DOI: 10.5223/pghn.2022.25.2.93] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 12/13/2021] [Accepted: 02/20/2022] [Indexed: 02/06/2023] Open
Abstract
Adequate nutrition in early life is proposed to shape a child's future health by launching the growth trajectory in the proper direction, which helps to avoid negative metabolic programming effects. Protein intake during infancy and early childhood is of great importance, as it plays a key role in infant metabolic programming and the future risk of obesity. Breastfeeding provides the best nutrition in early life, with many benefits tailored for the baby, including the appropriate quantity and quality of proteins. Considering the high prevalence of childhood, and subsequent adult, obesity in the region, a virtual Middle East expert consensus meeting was held to discuss an effective approach for managing childhood obesity. Leading pediatric experts from Bahrain, Egypt, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates participated in the meeting. The experts discussed, debated, and agreed on certain directions, including the importance of educating parents, endorsing breastfeeding, and ensuring optimum quantity and quality intake of proteins in early life. This expert consensus may serve as the starting point for healthcare professionals in the region who are interested in shaping a healthy future for the generations to come.
Collapse
Affiliation(s)
- Frank Jochum
- Department of Pediatrics, Evangelisches Waldkrankenhaus Spandau, Berlin, Germany.,Pediatric Medicine, Brandenburg Medical School (MHB) Theodor Fontane, Neuruppin, Germany
| | | | - Ashraf Adel
- Department of General Pediatrics, Sidra Medicine, Doha, Qatar
| | - Ahmed Alhammadi
- Department of General Pediatrics, Sidra Medicine, Doha, Qatar
| | | | - Eman Alohali
- Dietetics Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Khaled AlSarraf
- Department of Pediatrics-Pediatric Gastroenterology, Amiri Hospital, Sharq, Kuwait
| | - Khoula Al Said
- Department of Child Health, Royal Hospital, Muscat, Oman
| | - Mahmoud Elzalabany
- Pediatrics Department, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Hasan M A Isa
- Pediatric Department, Salmaniya Medical Complex/Arabian Gulf University, Manama, Bahrain
| | | | | | - Omar Saadah
- Pediatrics Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| |
Collapse
|
13
|
Arnesen EK, Thorisdottir B, Lamberg-Allardt C, Bärebring L, Nwaru B, Dierkes J, Ramel A, Åkesson A. Protein intake in children and growth and risk of overweight or obesity: A systematic review and meta-analysis. Food Nutr Res 2022; 66:8242. [PMID: 35261578 PMCID: PMC8861858 DOI: 10.29219/fnr.v66.8242] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 12/20/2021] [Accepted: 01/05/2022] [Indexed: 11/28/2022] Open
Abstract
Objectives The aim of this study was to examine the evidence for an association between the dietary protein intake in children and the growth and risk of overweight or obesity up to 18 years of age in settings relevant for the Nordic countries. Methods We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Scopus up to February 26, 2021 for randomized controlled trials (RCTs) or prospective cohort studies assessing for protein intake from foods (total and from different sources) in children. The outcomes include weight, height/length, adiposity indices, and/or risk of overweight and/or obesity. The risk of bias was evaluated with instruments for each respective design (Cochrane’s Risk of Bias 2.0 and RoB-NObS). A meta-analysis of five cohort studies was performed. The evidence was classified according to the criteria of the World Cancer Research Fund. Results The literature search resulted in 9,132 abstracts, of which 55 papers were identified as potentially relevant. In total, 21 studies from 27 publications were included, of which five were RCTs and 16 were cohort studies. The RCTs found generally null effects of high-protein intake in infants on weight gain, nor that lower protein diets negatively affected growth. All included RCTs had some concern regarding the risk of bias and were limited by small sample sizes. Total protein intake and BMI were assessed in 12 cohorts, of which 11 found positive associations. The meta-analysis revealed a pooled effect estimate of 0.06 (95% CI 0.03, 0.1) kg/m2 BMI per one E% increment in total protein (I2 = 15.5). Therefore, the evidence for a positive relationship between total protein intake and BMI was considered probable. Furthermore, there was probable evidence for an association between higher intake of animal protein and increased BMI. There was limited, suggestive evidence for an effect of total protein intake and higher risk of overweight and/or obesity, while no conclusions could be made on the associations between animal vs. plant protein intake and risk of overweight and/or obesity. Discussion In healthy, well-nourished children of Western populations, there is probably a causal relationship between a high-protein intake in early childhood (≤ 18 months) – particularly protein of animal origin – and higher BMI later in childhood, with consistent findings across cohort studies. A lack of RCTs precluded a stronger grading of the evidence.
Collapse
Affiliation(s)
- Erik Kristoffer Arnesen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Erik Kristoffer Arnesen, Division of Clinical Nutrition, University of Oslo, Box 1046 Blindern, 0317 Oslo, Norway.
| | - Birna Thorisdottir
- Faculty of Sociology, Anthropology and Folkloristics and Health Science Institute, University of Iceland, Reykjavik, Iceland
| | | | - Linnea Bärebring
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Bright Nwaru
- Krefting Research Centre, Institute of Medicine, University of Gothenburg, Sweden
| | - Jutta Dierkes
- Centre for Nutrition, Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Alfons Ramel
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
| | - Agneta Åkesson
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|