Bell Katherine A, Wagner Carol L, Feldman Henry A, Shypailo Roman J, Belfort Mandy B
Division of Newborn Medicine and
Department of Pediatrics, Medical University of South Carolina, Charleston, SC.
Am J Clin Nutr. 2017 Aug;106(2):491-498. doi: 10.3945/ajcn.116.151126. Epub 2017 Jun 28.
The extent to which breastfeeding is protective against later-life obesity is controversial. Little is known about differences in infant body composition between breastfed and formula-fed infants, which may reflect future obesity risk. We aimed to assess associations of infant feeding with trajectories of growth and body composition from birth to 7 mo in healthy infants. We studied 276 participants from a previous study of maternal vitamin D supplementation during lactation. Mothers used monthly feeding diaries to report the extent of breastfeeding. We measured infants' anthropometrics and used dual-energy X-ray absorptiometry to assess body composition at 1, 4, and 7 mo. We compared changes in infant size ( scores for weight, length, and body mass index [BMI (in kg/m)]) and body composition (fat and lean mass, body fat percentage) between predominantly breastfed and formula-fed infants, adjusting in linear regression for sex, gestational age, race/ethnicity, maternal BMI, study site, and socioeconomic status. In this study, 214 infants (78%) were predominantly breastfed (median duration: 7 mo) and 62 were exclusively formula fed. Formula-fed infants had lower birth-weight scores than breastfed infants (-0.22 ± 0.86 and 0.16 ± 0.88, respectively; < 0.01) but gained more in weight and BMI through 7 mo of age (weight score difference: 0.37; 95% CI: 0.04, 0.71; BMI score difference: 0.35; 95% CI: 0, 0.69), with no difference in linear growth ( score difference: 0.05; 95% CI: -0.24, 0.34). Formula-fed infants gained more lean mass (difference: 303 g; 95% CI: 137, 469 g) than breastfed infants, but not fat mass (difference: -42 g; 95% CI: -299, 215 g). Formula-fed infants gained weight more rapidly and out of proportion to linear growth than did predominantly breastfed infants. These differences were attributable to greater accretion of lean mass, rather than fat mass. Any later obesity risk associated with infant feeding does not appear to be explained by differential adiposity gains in infancy.
母乳喂养对预防成年后肥胖的保护程度存在争议。关于母乳喂养婴儿和配方奶喂养婴儿在身体成分上的差异知之甚少,而这种差异可能反映未来肥胖风险。我们旨在评估健康婴儿从出生到7个月时婴儿喂养方式与生长轨迹和身体成分之间的关联。我们对先前一项关于哺乳期母亲补充维生素D的研究中的276名参与者进行了研究。母亲们使用每月喂养日记来报告母乳喂养的程度。我们测量了婴儿的人体测量指标,并使用双能X线吸收法评估婴儿在1个月、4个月和7个月时的身体成分。我们比较了主要母乳喂养婴儿和配方奶喂养婴儿在婴儿体型(体重、身长和体重指数[BMI(kg/m²)]得分)和身体成分(脂肪和瘦体重、体脂百分比)方面的变化,并在线性回归中对性别、胎龄、种族/族裔、母亲BMI、研究地点和社会经济地位进行了调整。在本研究中,214名婴儿(78%)主要进行母乳喂养(中位持续时间:7个月),62名婴儿完全采用配方奶喂养。配方奶喂养婴儿的出生体重得分低于母乳喂养婴儿(分别为-0.22±0.86和0.16±0.88;P<0.01),但在7个月龄前体重和BMI增加更多(体重得分差异:0.37;95%CI:0.04,0.71;BMI得分差异:0.35;95%CI:0,0.69),线性生长无差异(得分差异:0.05;95%CI:-0.24,0.34)。配方奶喂养婴儿比母乳喂养婴儿增加了更多的瘦体重(差异:303g;95%CI:137,469g),但脂肪量没有差异(差异:-42g;95%CI:-299,215g)。与主要母乳喂养婴儿相比,配方奶喂养婴儿体重增加更快,且与线性生长不成比例。这些差异归因于瘦体重的增加更多,而非脂肪量。婴儿喂养方式与后期肥胖风险之间的任何关联似乎无法用婴儿期脂肪量增加的差异来解释。