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Published on: February 2, 2017
Infant dietary patterns and early childhood weight outcomes: a secondary analysis from the Starting Early Program
Lauren Berube1, Christina Kim2, Andrea Deierlein
1New York University School of Global Public Health.
Insights
The Starting Early Program (StEP) promotes healthy infant diets, reducing child obesity risk. This healthy eating pattern mediated the program's positive effects on child weight outcomes.
Area of Science:
- Pediatric Nutrition
- Childhood Obesity Research
- Maternal and Infant Health
Background:
- Limited research exists on how infant dietary patterns influence child weight.
- The Starting Early Program (StEP) has shown success in promoting healthy infant nutrition and better child weight outcomes.
- The specific contribution of infant dietary patterns to weight or mediation of StEP's effects remains unstudied.
Purpose of the Study:
- To identify infant dietary patterns within the StEP program.
- To determine associations between these patterns and child weight outcomes.
- To examine if dietary patterns mediate the relationship between StEP participation and child weight.
Main Methods:
- Secondary analysis of 377 mother-infant dyads from a randomized trial of StEP.
- Infant diet assessed at 10 months via 24-hour recall; dietary patterns identified using latent class analysis.
- Child weight-for-age z-scores (WFAz) and overweight status analyzed using regression models; mediation analyses performed.
Main Results:
- Four infant dietary patterns were identified: Breastfed-High variety, Formula fed-High variety, Formula fed-Low variety, and Mixed fed-Low variety.
- Infants in the Formula fed-Low variety pattern had higher WFAz and increased odds of being overweight at 24 and 36 months compared to the Breastfed-High variety group.
- StEP participation increased adherence to the Breastfed-High variety pattern, which mediated lower WFAz at 24 months.
Conclusions:
- Distinct infant dietary patterns are associated with varying risks of child obesity.
- StEP effectively promotes an infant dietary pattern aligned with feeding guidelines.
- This promoted dietary pattern acts as a mediator for the intervention's positive impact on child weight.
Background:
Limited studies assess how infant dietary patterns impact child weight. The Starting Early Program (StEP) promotes healthy nutrition during pregnancy and infancy and leads to healthier child weight, but whether dietary patterns contribute to weight or mediate StEP weight outcomes has not been studied.
Objectives:
This secondary analysis identified infant dietary patterns in StEP, determined associations between dietary patterns and child weight outcomes, and examined whether dietary patterns mediated the relationship between StEP and child weight.
Methods:
Data were from 377 mother-infant dyads enrolled in a randomized trial testing the efficacy of StEP. Infant diet was assessed at 10 months using an interviewer-administered 24-hour recall, and dietary patterns were identified using latent class analysis. Child weights were abstracted from medical records at 12, 24, and 36 months. Associations between infant dietary patterns and weight-for-age z-score (WFAz) and likelihood of being classified as overweight (WFA ≥85th percentile) were assessed using multivariable linear and logistic regression models. Mediation analyses were used to assess intervention effects on WFAz via impacts on infant dietary patterns.
Results:
Four classes of infant dietary patterns were identified, characterized by differences in milk feeding and complementary food type and variety: Breastfed-High variety; Formula fed-High variety; Formula fed-Low variety; and Mixed fed-Low variety. Compared to the Breastfed-High variety class, infants in the Formula fed-Low variety class had higher WFAz and were more likely to be classified as overweight at 24 and 36 months. Participation in StEP increased membership in Breastfed-High variety, which mediated the association between StEP and lower WFAz at 24 months.
Conclusions:
Infant dietary patterns were identified and associated with child obesity risk. StEP promoted an infant dietary pattern that was most consistent with infant feeding guidelines, which mediated intervention effects on child weight.
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