Weight following birth and childhood dietary intake: A prospective cohort study

Highlights

• Both intrauterine and postnatal growth played a major role in dietary intake at age 4.

• Higher-birth-weight children ate less energy-dense food and dairy.

• Children with lower newborn weight loss ate less fruit.

• Children who caught up in growth in the first year of life ate more dairy products.

• Children with higher weight had a dietary pattern rich in energy-dense food and dairy.

Abstract

Objectives

Unhealthy childhood dietary habits track through life and are independent and modifiable risk factors for disease. Therefore, it is essential to understand the factors involved. We aimed to evaluate the associations of birthweight (BW) and newborn weight change (NWC) during the first 96 h of life and childhood longitudinal weight trajectories with dietary intake at age 4.

Methods

As part of the Generation XXI birth cohort (G21), children were recruited in 2005 and 2006 at all public units providing obstetrical and neonatal care in Porto, Portugal. Information was collected by face-to-face interview and abstracted from clinical records. At age 4, weight measurements recorded from birth to current age were abstracted and weight trajectories estimated. Food frequency questionnaires were applied, and three dietary patterns (DPs) were identified: “Energy-dense food (EDF)+Dairy,” “Lower in Healthy Food,” and “Healthier.” Logistic regression models were used to compute the odds ratio (OR) and 95% confidence intervals (CIs) (OR [95% CI]) in a sample of 775 children.

Results

Children with higher BW were less frequently in the “EDF+Dairy” DP (0.94 [0.89–0.98] per 100 g increase in BW). Children with higher NWC had lower odds of eating fruit ≥3/d (0.93 [0.87–0.99] per 1% increase in NWC). Children with higher weight during childhood had higher odds of belonging to the “EDF+Dairy” DP (1.90 [1.04–3.47]) and lower odds of eating vegetable soup ≥2/d (0.56 [0.34–0.91]). Children showing catch-up grow in the first year of life had higher odds of eating dairy products ≥3/d (3.76 [1.31–10.80]).

Conclusions

The way that children grow during childhood played a major role on dietary intake at age 4.

Introduction

The prevention of adverse lifestyles such as unhealthy dietary habits in early childhood has become increasingly important, mainly due to the increasing prevalence of overweight among preschool children [1]. Moreover, unhealthy dietary habits track into later ages and are also considered independent and modifiable risk factors for cardiovascular disease and type 2 diabetes [2]. Therefore, it is essential to understand the determinants of childhood dietary habits.

Previous studies have suggested that a period of inadequate nutrition and growth can “program” an individual's food preferences later in life [3], [4], [5], [6], [7], [8]. A classic example of this so-called “programming” is the preference for fatty foods later in life in children whose mothers were exposed to the Dutch famine during pregnancy [6]. In a more recent study, poor fetal growth was positively correlated with hedonic response to a sweet solution in the first day of life [3]. Even in young adults, intrauterine growth restriction was associated with preference for carbohydrates over protein in regular diets [4]. However, programming is not limited to gestation; evidence shows that it extends from the periconception period throughout the postnatal period, adding to the importance of studying growth in a longitudinal way [9].

In addition to programming appetite, early inadequate nutrition and growth can affect childhood dietary habits by influencing parental beliefs and feeding practices [10]. In addition, it may cause problems in feeding, such as swallowing, vomiting, refusal to eat, or neophobia [11], [12], and eating disorders such as anorexia and bulimia nervosa [13].

Although the relation between fetal growth and dietary habits has been addressed previously [3], [4], [5], [6], [7], [8], to the best of our knowledge, there have been no studies of the impact of growth during early postnatal life on later dietary intake. The use of longitudinal weight trajectories to evaluate this association is also novel.

Therefore, we aimed to evaluate the association of birth weight (BW), newborn weight change (NWC), and childhood weight trajectories with dietary intake at age 4, including specific food groups and items, and a posteriori-defined dietary patterns (DPs).