Background: Childhood obesity is a serious public health challenge today. Obese children are more likely to become obese adults and develop associated cardiovascular and metabolic diseases including hypertension, stroke and type 2 diabetes. Early identification of infants at risk of obesity may allow timely intervention to reduce later cardiometabolic risk. While low birth weight is associated with poor health in later life, early body composition (fat mass [FM] and lean mass [LM]) may be a better predictor.
Aims: This study aimed to determine: (1) whether infant body composition is a better predictor of childhood obesity than birth weight, and if so, (2) which infant body composition factors predict childhood obesity and (3) what other early life factors predict childhood obesity.
Methods: This was an observational follow-up study of 130 children recruited as newborns at the Royal Brisbane and Women’s Hospital in 2007-2010. Body composition was measured by air displacement plethysmography using the PEA POD® during infancy (at birth, 6 weeks, 3 months and 4.5 months old) and the BOD POD® at 8-11 years old. Maternal risk factors (e.g. maternal pre-pregnancy body mass index [BMI]) and infant feeding information were also recorded. Backward stepwise multiple regression analysis was used to identify significant predictors of childhood obesity.
Results: Childhood percentage fat (%Fat) was not associated with either birth weight or birth weight z-score. Increased %Fat at 6 weeks old was a significant predictor of increased childhood %Fat as were higher maternal pre-pregnancy BMI and earlier exposure to formula feeding.
Conclusions: Adiposity at 6 weeks old may be a better predictor of childhood obesity than birth weight. This may help identify at-risk infants and enable early targeted intervention to prevent obesity before it develops. Interventions aimed at reducing maternal BMI before pregnancy and facilitating continued breastfeeding may also help reduce childhood obesity risk.