Associations between children's dietary patterns, excessive weight gain, and obesity risk: cohort study nested to a randomized field trial.

Abstract

Objective: To identify the critical period of excessive weight gain (EWG) in childhood and the dietary patterns associated with it.

Methods: A cohort study nested to a randomized field trial with mother-child pairs interviewed by home visits at ages six months, 12 months, three years, and six years. We selected 715 pregnant women from 20 healthcare centers in southern Brazil. EWG was considered as a change in body mass index-for-age (BMI-for-age) z-score >0.67. Two 24-hour recalls were used to determine the dietary patterns by exploratory factor analysis. The effect of dietary patterns on EWG was assessed by logistic regressions using Generalized Estimating Equations.

Results: The critical period for EWG was from six to 12 months (46.5% BMI variation >0.67; n=228; p≤0.001). Dietary patterns at six months associated with EWG were baby bottles of cow´s milk added to baby cereal flours and added sugar (relative risk - RR 1.43; 95% confidence interval - 95%CI 1.15-1.79; p≤0.001 and RR 1.59; 95%CI 1.28-1.97, p≤0.001); fruit juice and creamy dessert (RR 1.39; 95%CI 1.08-1.33; p≤0.001) and sweet beverages (RR 1.19; 95%CI 1.02-1.38; p=0.024).

Conclusions: The second semester of life was the most critical period for EWG in childhood, influenced mostly by the consumption of cow's milk added with baby cereal flour and sugar, fruit juice, creamy desserts, and sweet beverages. These findings emphasize the importance of early dietary interventions to promote healthier food choices and prevent EWG during infancy.