Prematurity and reduced body fatness at 8-12 y of age
Mary S Fewtrell1, Alan Lucas, Tim J Cole
1Medical Research Council Childhood Nutrition Research Centre, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK. m.fewtrell@ich.ucl.ac.uk
Insights
Children born preterm have lower fat mass (FM) but not fat-free mass (FFM) when normalized for height. This may reduce their risk of adult obesity and related diseases.
Area of Science:
- Pediatric endocrinology
- Body composition analysis
- Growth and development
Background:
- Early life growth and nutrition influence adult morbidity and mortality.
- Preterm-born children are typically smaller than term-born peers.
- The association between preterm birth size differences and body composition is not well understood.
Purpose of the Study:
- To test if fat mass (FM) and fat-free mass (FFM) are proportionately lower in preterm-born children.
- To investigate body composition differences between preterm and term-born children at 8-12 years of age.
Main Methods:
- Studied 497 preterm and 95 term-born children aged 8-12 years.
- Assessed body composition using skinfold thicknesses and dual-energy X-ray absorptiometry.
- Normalized FM and FFM for height to calculate fat mass index (FMI) and fat-free mass index (FFMI).
Main Results:
- Preterm children had significantly lower body weight, FM, and FFM compared to term-born children.
- Preterm children exhibited a significantly lower FMI, but not FFMI.
- Lower FMI was observed in boys and more active children; no association found between neonatal factors and later FMI/FFMI.
Conclusions:
- Smaller size in preterm children is linked to lower height-normalized FM, but not FFM.
- This altered body composition in preterm individuals may decrease their risk of adult obesity and associated diseases.
Background:
Increasing evidence suggests that body composition, an important factor influencing morbidity and mortality in adult life, might be programmed by early growth and nutrition. Children born preterm remain shorter and lighter than their term-born peers during childhood, but it is unclear whether the size difference is associated with altered body composition.
Objective:
We tested the hypothesis that both fat mass (FM) and fat-free mass (FFM) are proportionately lower in children born preterm than in children born at term.
Design:
A total of 497 children born preterm and 95 children born at term were studied at 8-12 y of age. Body composition was determined with the use of skinfold thicknesses and dual-energy X-ray absorptiometry (in 200 preterm and 95 term children). FM and FFM were normalized for height to give fat mass index (FMI) and fat-free mass index (FFMI), respectively.
Results:
Children born preterm were significantly lighter than those born at term and had lower FM and FFM. However, FMI was significantly lower in preterm children, whereas FFMI was not. FMI was also significantly lower in boys than in girls and in children with higher activity levels. Additional data available for the preterm group showed no association between birth weight, gestational age, or neonatal diet and later FMI or FFMI.
Conclusions:
The smaller size of children born preterm than of children born at term is associated with lower FM but not FFM when normalized for height. We hypothesize that this could result in a reduction in the risk of obesity and related diseases during adult life.
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