publication

Infant breastfeeding and childhood fat measures assessed by magnetic resonance imaging

Title: Infant breastfeeding and childhood general, visceral, liver, and pericardial fat measures assessed by magnetic resonance imaging

Authors: Suzanne Vogelezang, Susana Santos, Eline M van der Beek, Marieke Abrahamse-Berkeveld, Liesbeth Duijts, Aad van der Lugt, Janine F Felix and Vincent WV Jaddoe
Published: August 1, 2018
Journal:

Am J Clin Nutr 2018;108:1–8.

It is known that childhood overweight and obesity are associated with several adverse health consequences in later life, including type 2 diabetes, hypertension and cardiovascular diseases1. Particularly, abdominal visceral and organ fat have shown to be strongly associated with an adverse metabolic risk profile, even after accounting for differences in BMI or waist circumference 2,3,4.

The first 1000 days present a unique window of opportunity to influence both short- and long-term health outcomes. Early life nutrition lays the foundation for health in later life.

Human milk is tailor-made for infants, providing balanced nutrition that matches the needs of the infant at each developmental stage.

Breastfeeding seems to be associated with a lower risk of overweight in later life 5,6,7. This association may be explained by the differences in composition and functionality between human milk and infant formula 8,9, 10. In addition to nutritional factors, lifestyle and behavioral factors, may play a role in the development of overweight and obesity 9,11.

In this study, the associations of breastfeeding duration and exclusiveness and of age at introduction of solid foods with measures of general, visceral, and organ adiposity at 10 y were studied.

Information on infant feeding was obtained from 4444 children from a population-based prospective cohort study. At the mean age of 9.8 y, MRI scans were performed in a subgroup of 2646 children. Body mass index, fat mass index, fat-free mass index, visceral fat index, pericardial fat index and liver fat fraction were estimated.

After adjustment for age and sex, a shorter duration of breastfeeding, nonexclusive breastfeeding during the first 4 months and early introduction of solids were associated with more unfavorable general, visceral, and organ fat outcomes, except for pericardial fat index at the age of 10y. After further adjustments, only the associations of shorter breastfeeding duration and nonexclusive breastfeeding with a lower fat-free mass index remained significant (P<0.05). The associations of infant feeding with visceral fat index and liver fat fraction were attenuated to nonsignificant. Maternal education was found to be the strongest confounder.

These results suggest that the associations of duration and exclusiveness of breastfeeding, and age at the introduction of solid foods with general, visceral, and organ fat measures at the age of 10y are largely explained by family-based sociodemographic factors.

Rather than nutrition only in early infancy, nutrition and lifestyle during childhood may be critical in relation to the development of adiposity.

1.
Reilly J, Kelly J. Long-term impact of overweight and obesity in childhood and adolescence on morbidity and premature mortality in adulthood: systematic review. Int J Obes (Lond). 2011;35(7):891–8.
2.
Fox C, Massaro J, Hoffmann U, et al. Abdominal visceral and subcutaneous adipose tissue compartments: association with metabolic risk factors in the Framingham Heart Study. Circulation. 2007;116(1):39-48.
3.
Després J. Body fat distribution and risk of cardiovascular disease: an update. Circulation. 2012;126(10):1301-1313.
4.
Gishti O, Gaillard R, Durmus B, et al. BMI, total and abdominal fat distribution, and cardiovascular risk factors in school-age children. Pediatr Res. 2015;77(5):710-718.
5.
Mitra S, Fernandez-Del-Valle M, Hill J. The role of MRI in understanding the underlying mechanisms in obesity associated diseases. Biochim Biophys Acta Mol Basis Dis. 2017;1863(5):1115-1131.
6.
Owen C, Martin R, Whincup P, Smith G, Cook D. Effect of infant feeding on the risk of obesity across the life course: a quantitative review of published evidence. Pediatrics. 2005;115(5):1367-1377.
7.
Horta B, Victora C. Long-Term Effects of Breastfeeding: A Systematic Review. Geneva (Switzerland): WHO; 2013:.
8.
Savino F, Fissore M, Liguori S, Oggero R. Can hormones contained in mothers’ milk account for the beneficial effect of breast-feeding on obesity in children? Clin Endocrinol (Oxf). 2009;71(6):757-765.
9.
Bartok C, Ventura A. Mechanisms underlying the association between breastfeeding and obesity. Int J Pediatr Obes. 2009;4(4):196-204.
10.
Houseknecht K, McGuire M, Portocarrero C, McGuire M, Beerman K. Leptin is present in human milk and is related to maternal plasma leptin concentration and adiposity. Biochem Biophys Res Commun. 1997;240(3):742-747.
11.
Disantis K, Collins B, Fisher J, Davey A. Do infants fed directly from the breast have improved appetite regulation and slower growth during early childhood compared with infants fed from a bottle? Int J Behav Nutr Phys Act. 2011;8:89.