Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore.
Am J Clin Nutr. 2023 Jan;117(1):83-92. doi: 10.1016/j.ajcnut.2022.10.021. Epub 2022 Dec 21.
The timing of introduction of complementary foods and the duration of breastfeeding (BF) have been independently associated with child overweight and obesity; however, their combined influence on body fat partitioning and cardiometabolic risk is unclear.
We investigated the associations of the timing of introduction of complementary foods, the duration of BF, and their interaction with child adiposity and cardiometabolic risk markers.
We analyzed data from 839 children in the prospective Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort. Mothers reported the age at which infants were first fed complementary foods and BF duration, classified as early (≤4 mo) versus typical (>4 mo) complementary feeding (CF) and short (≤4 mo) versus long (>4 mo) duration of any BF, respectively. We measured adiposity and cardiometabolic risk markers at the age of 6 y and examined their associations with infant feeding patterns using multiple regression, adjusting for sociodemographics, parents' body mass index (BMI), maternal factors, birth weight for gestational age, and infant weight gain.
Of 839 children, 18% experienced early CF, whereas 54% experienced short BF. Short (vs. long) BF and early (vs. typical) CF were independently associated with higher z-scores of BMI [β (95% confidence interval), short BF, 0.18 standard deviation score (SDS) (-0.01, 0.38); early CF, 0.34 SDS (0.11, 0.57)] and sum of skinfolds [short BF, 1.83 mm (0.05, 3.61); early CF, 2.73 mm (0.55, 4.91)]. Children who experienced both early CF and short BF (vs. typical CF-long BF) had synergistically higher diastolic blood pressure [1.41 mmHg (-0.15, 2.97), P-interaction = 0.023] and metabolic syndrome score [0.81 (0.16, 1.47), P-interaction = 0.081]. Early CF-long BF (vs. early CF-short BF) was associated with a lower systolic blood pressure [-3.74 mmHg (-7.01, -0.48)], diastolic blood pressure [-2.29 mmHg (-4.47, -0.11)], and metabolic syndrome score [-0.90 (-1.80, 0.00)].
A combination of early CF and short BF was associated with elevated child adiposity and cardiometabolic markers. Longer BF duration may protect against cardiometabolic risk associated with early CF. This trial was registered at clinicaltrials.gov as NCT01174875.
辅食添加时间和母乳喂养（BF）时间与儿童超重和肥胖有关；然而，它们对体脂分布和心血管代谢风险的综合影响尚不清楚。
我们研究了辅食添加时间、BF 时间及其相互作用与儿童肥胖和心血管代谢风险标志物的关系。
我们分析了前瞻性新加坡儿童生长到健康结果（GUSTO）队列中的 839 名儿童的数据。母亲报告婴儿首次喂食辅食和 BF 时间，分别归类为早期（≤4 个月）与典型（>4 个月）辅食喂养（CF）和短期（≤4 个月）与长期（>4 个月）任何 BF。我们在 6 岁时测量了肥胖和心血管代谢风险标志物，并使用多元回归分析了它们与婴儿喂养模式的关系，调整了社会人口统计学、父母的体重指数（BMI）、母亲因素、胎龄出生体重和婴儿体重增长。
在 839 名儿童中，18%经历了早期 CF，而 54%经历了短期 BF。与长期 BF 相比，短期 BF 和早期 CF 与 BMI 得分较高有关[β（95%置信区间），短期 BF，0.18 个标准差评分（SDS）（-0.01，0.38）；早期 CF，0.34 SDS（0.11，0.57）]和皮褶厚度总和[短期 BF，1.83 毫米（0.05，3.61）；早期 CF，2.73 毫米（0.55，4.91）]。与典型 CF-长期 BF 相比，经历早期 CF 和短期 BF 的儿童（vs. 早期 CF-短期 BF）的舒张压[1.41mmHg（-0.15，2.97），P 交互=0.023]和代谢综合征评分[0.81（0.16，1.47），P 交互=0.081]更高。与早期 CF-短期 BF 相比，早期 CF-长期 BF 与收缩压[3.74mmHg（-7.01，-0.48）]、舒张压[-2.29mmHg（-4.47，-0.11）]和代谢综合征评分[-0.90（-1.80，0.00）]较低有关。
早期 CF 和短期 BF 的结合与儿童肥胖和心血管代谢标志物升高有关。较长的 BF 时间可能有助于预防与早期 CF 相关的心血管代谢风险。本试验在 clinicaltrials.gov 上注册为 NCT01174875。
