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The Effects of Diet on Regional Adiposity Measured via Ultrasound in Full-Term Infants: A Systematic Review
Kinzie L Matzeller1, Michelle Kubicki2, Dominikus R Atmaka1
1Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO 80521, United States.
Insights
Infant diet impacts regional fat distribution, with breastfeeding linked to more subcutaneous fat. Ultrasound is a key tool for assessing infant adiposity and metabolic health risks.
Area of Science:
- Pediatric Nutrition
- Infant Growth and Development
- Metabolic Health
Background:
- Regional adiposity is a better predictor of infant metabolic health risk than total body fat.
- Assessing infant regional adiposity is challenging but crucial for understanding growth.
- Ultrasonography offers a non-invasive method to study infant fat distribution and diet effects.
Purpose of the Study:
- To systematically review evidence on ultrasound's use in assessing infant diet's impact on regional adiposity.
- To synthesize findings for infants aged 0-24 months.
Main Methods:
- Comprehensive literature search across PubMed, Web of Science, and CINAHL.
- Data extraction by three independent reviewers, assessing study quality.
- Inclusion of 10 studies (9 cohort, 1 RCT) with 1833 infants.
Main Results:
- Studies focused on liquid diets (breast milk, formula) and measured abdominal or limb fat.
- Breastfeeding frequency and human milk intake correlated with increased subcutaneous fat.
- Macronutrient effects on regional adiposity showed conflicting results.
Conclusions:
- Infant dietary exposures have varied effects on regional adiposity (subcutaneous vs. visceral fat).
- Heterogeneity in study age and location may explain varied findings.
- Future research should explore complementary feeding's role in infant regional adiposity.
Context:
While total body fat is an important metric of infant growth, regional adiposity may provide more clinically relevant information for predicting metabolic health risk compared with total body fat alone. Regional adiposity assessment in infants remains limited, in part due to historical challenges in accurately and safely assessing adiposity in early life. Ultrasonography has emerged as a practical and non-invasive assessment method to examine the impact of infant diet on fat distribution.
Objective:
The objective of this study was to systematically review the existing evidence on the use of ultrasound to synthesize the impacts of infant diet on regional adiposity in infants of between 0 and 24 months.
Data Sources:
A comprehensive literature search was conducted in PubMed, Web of Science, and CINAHL, identifying 530 articles.
Data Extraction:
Three reviewers independently extracted data, including study design, sample size, infant age, dietary exposure, site of fat measurement, and adipose tissue thickness. Quality was assessed using ROBINS-I (non-randomized) and ROB-2 (randomized trial).
Data Analysis:
Ten studies involving 1833 infants met the inclusion criteria (9 prospective cohort studies and 1 randomized controlled trial). All studies focused on the liquid diet phase (breast milk, infant formula) and used the same technique to measure the abdominal (visceral fat, subcutaneous fat, and/or preperitoneal fat) or limb areas (triceps, biceps, arms, subscapular, suprailiac, and/or thighs). Three studies reported differences in subcutaneous and visceral fat deposition between breastfed and formula-fed infants. Breastfeeding frequency and total human milk intake were associated with increased subcutaneous fat, while macronutrients in human milk had conflicting associations with regional adiposity.
Conclusions:
The effects of dietary exposures during infancy on regional adiposity identified in this review, including subcutaneous vs visceral fat, vary, possibly due to the heterogeneity in study characteristics, including age and geographic location. Future research should examine how early feeding practices, including complementary food introduction and composition, influence regional adiposity.
Systematic Review Registration:
PROSPERO registration No. CRD420251180472.
