First-year “critical window” to establishing anti-obesity habits, flag researchers

03 Jun 2021 --- A study has shown the roots for obesity start in the first year of life but after mothers stop breastfeeding. Consequently, the first year of a child’s life is a critical window of opportunity for parents to promote healthy eating habits.

Researchers at Columbia University Mailman School of Public Health, US, and Universidade Federal de Ciências da Saúde de Porto Alegre, Brazil, found that children consumed fewer fats and carbohydrates and had lower measures of body fats when their mothers had healthy infant feeding habits.

Márcia Vitolo, head researcher at Universidade Federal de Ciências da Saúde de Porto Alegre, tells NutritionInsight: “Childhood obesity tracks to adulthood and the prevention must start in the first two to three years of life, where the food preferences are established.”

Big impacts from early practices
The researchers conducted a randomized trial in Porto Alegre, Brazil, in 31 centers that provide prenatal, infant and other primary care services to low-income families.

“What this study suggests is that we might have to think even earlier. Feeding practices early in life can already have a significant impact on the body size of preschool children,” says co-senior author Dr. L.H. Lumey, professor of epidemiology at Columbia University Mailman School of Public Health.The Brazilian dietary guideline details ten steps for healthy eating practices from birth to two years old.

The intervention was based on births from May 2008 to February 2009. It consisted of a training program to increase the knowledge of primary healthcare workers centered on Brazilian dietary guidelines.

“During the health workers’ training, we updated them about the current feeding practices and prevalence of obesity among children in early ages. The intervention proposed to prevent families from offering unhealthy foods to babies and toddlers,” Vitolo notes.

Infant nutrition re-education
All families in the trial were informed about complementary foods that should not be offered to children under two years of age through posters in waiting rooms.

Trained interviewers measured children’s growth and other outcomes at ages six months, one year, three years and six years at subsequent home visits. Details about food types, amounts and preparation methods were also recorded.

The findings were “particularly striking” concerning calories from cookies and powdered chocolate, essential carbohydrates and fats.

“Most surprising was that the mothers in our randomized trial offered ultra-processed foods that are high in sugar and fat as early as six months of age,” said Vitolo.

“This behavior can be explained by cultural influences and strong marketing of processed baby foods, which continues globally,” she added.

During the health workers’ training, sugar, sweets, soft drinks, salty snacks, cookies and ultra-processed foods were emphasized as foods for mothers to avoid for their babies until two years of age.

Results of the trial
Energy intake at all ages was lower in the intervention group compared to the control group, with a statistically significant difference at three years.

Also, children from the intervention group aged 3 had lower carbohydrate and total fat consumption than the control group and at six years of age had accumulated less body fat as measured by a smaller waist circumference and thinner skin folds.

“We found that the energy intake in both study groups was above the requirement across all age waves. However, the excess energy intake was less in the intervention group,” observed Caroline Sangalli, who analyzed the study results with Lumey.Early-life feeding patterns can have a substantial impact on preschool children’s body size.

“Although the disparity was slight at the onset, in the long term, the reduced intake of 92 kcal per day adds up to 33,000 kcal per year. Changes of this magnitude could explain changes in weight gain during childhood.”

At six years of age, the intervention group had lower body fat on several measures, but this difference was not reflected in BMI scores, a less sensitive measure of adiposity.

“However, with the prevalence of overweight in the intervention group at 7 percent lower than the control group at six years, this does suggest a valuable public health impact – especially since estimates indicate that the reduction in 1 percent of obesity prevalence among children up to age six years would save US$1.7 billion in medical costs,” says Vitolo.

Importance of healthy infant nutrition
Recently, industry has highlighted the significance of healthier feeding habits for infants. For example, probiotic drops and powders have emerged within the infant nutrition sector, which no longer solely includes formula.

Additionally, the development of a healthy infant microbiome has been shown to improve health prospects later in life.

Two maternal supplementation prototypes to boost children’s cognitive development during pregnancy and nursing have also been developed. NutritionInsight detailed the most recent trends in newborn nutrition.

UK organizations previously called for a “whole society” preventative approach to reduce childhood obesity.

By Nicole Kerr