Associations of infant feeding practices with abdominal and hepatic fat measures in childhood in the longitudinal Healthy Start Study

Background: Infant feeding patterns have been linked with obesity risk in childhood, but associations with precise measures of body fat distribution are unclear.

Objective: We examined associations of infant feeding practices with abdominal fat and hepatic fat trajectories in childhood.

Methods: This study included 356 children in the Healthy Start Study, a prospective prebirth cohort in Colorado. Infant feeding practices were assessed by postnatal interviews and categorized as any human milk <6 mo compared with ≥6 mo; complementary foods introduced ≤4 mo compared with >4 mo; soda introduced ≤18 mo compared with >18 mo. Abdominal subcutaneous (SAT) and visceral adipose tissue (VAT) areas and hepatic fat (%) were assessed by magnetic resonance imaging in early and middle childhood (median 5 and 9 y old, respectively). We examined associations of infant feeding with adiposity trajectories across childhood using linear mixed models.

Results: In the sample of children, 67% consumed human milk ≥6 mo, 75% were introduced to complementary foods at >4 mo, and 81% were introduced to soda at >18 mo. We did not find any associations between duration of any human milk consumption and childhood adiposity trajectories. Early introduction to complementary foods (≤4 mo) was associated with faster rates of change for SAT and VAT during childhood (Slope [95% CI]: 15.1 [10.7,19.4] cm²/y for SAT; 2.5 [1.9,2.9] cm²/y for VAT), compared with introduction at >4 mo (5.5 [3.0,8.0] cm²/y and 1.6 [1.3,1.9] cm²/y, respectively). Similarly, early introduction to soda (≤18 mo) was associated with faster rates of change for all 3 outcomes during childhood (Slope [95% CI]: 20.6 [15.0,26.1] cm²/y for SAT, 2.7 [2.0,3.3] cm²/y for VAT, 0.3 [0.1,0.5] %/year for hepatic fat) compared with delayed introduction (5.4 [2.8,8.0] cm²/y, 1.7 [1.3, 2.0] cm²/y, -0.1 [-0.2,0.0] %/y, respectively).

Conclusions: The timing of introduction and quality of complementary foods in infancy was associated with rates of abdominal and hepatic fat accrual during childhood. Experimental studies are needed to assess underlying mechanisms.