Academic journal article Childhood Obesity

Age at Introduction to Solid Foods and Child Obesity at 6 Years

Academic journal article Childhood Obesity

Age at Introduction to Solid Foods and Child Obesity at 6 Years

Article excerpt

[Author Affiliation]

Chloe M. Barrera. Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA.

Cria G. Perrine. Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA.

Ruowei Li. Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA.

Kelley S. Scanlon. Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA.

Address correspondence to, Chloe M. Barrera, MPH, Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, 4770 Buford Highway Northeast, Mailstop F-77, Atlanta, GA 30341, E-mail: kri3@cdc.gov

Introduction

In the United States, more than 8% of 2- to 5-year-olds and 17% of 6- to 11-year-olds have obesity.1 Children with obesity are more likely to have elevated cholesterol and blood pressure levels, breathing and joint problems, and are more likely to become adults with obesity.2,3 Multiple factors contribute to development of childhood obesity,3 and though no single factor explains all obesity, understanding which factors may play a role has important public health implications.

Early infancy, particularly early nutrition, has been identified as a critical period for preventive strategies aimed at decreasing rates of obesity.4 One strategy that has been identified is increasing adherence to guidelines regarding timing of the introduction of solid foods. In previous analyses of the Infant Feeding Practices Study II (IFPS II), we found that 40% of infants in our sample were introduced to solid foods before 4 months of age.5 Although there has been inconsistency in recent years regarding recommendations on whether complementary foods should be introduced between 4 and 6 months,6,7 or not until 6 months,8-10 most groups agree that introduction to solid foods before 4 months is too early.6-8,10

A review of 26 studies concluded that introduction of solids ≤4 months is associated with obesity, particularly among formula-fed infants.11 However, of the studies reviewed, the researchers concluded that few were large, good-quality studies. Additionally, some studies suggest that the association may differ for breastfed versus formula-fed infants.11,12 Thus, our aim, using data from a cohort of US children followed longitudinally throughout the first year of life, and contacted again at 6 years, was to assess how early introduction of solid foods (before 4 months) was associated with obesity at 6 years of age, and test for an interaction with breastfeeding status, controlling for multiple potential infant, child, and maternal confounders.

Methods

The IFPS II, conducted from 2005 to 2007, followed mothers from their third trimester of pregnancy through their infant's first year. Infants born before 35 weeks, weighing less than 5 pounds (lbs), who were a nonsingleton, or with medical conditions that would affect feeding were not eligible to participate. A cross-sectional Year 6 Follow Up study (Y6FU) was conducted in 2012 when infants from the original study were approximately 6 years old. Among eligible IFPS II participants (completed the neonatal questionnaire and not subsequently disqualified from IFPS II),13 1542 completed the Y6FU (response rate of 52%). Detailed methodology of Y6FU, including comparison of respondents to nonrespondents and to a nationally representative sample, are presented in a previously published methods article.13 Generally, participants of Y6FU were more likely to be white, higher educated, and married compared to a national sample.13

Child Obesity

With the Y6FU questionnaire, mothers were sent a measuring tape and instructions on how to measure their child's height. …

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