Nutrition during the lifecycle: infancy and childhood
Food choices in the early years influence not only body composition and growth rate, but also the establishment of eating patterns that can continue throughout life. Dietary intakes during childhood and adolescence are critical in setting the scene for health in the future. Several studies have looked at growth in infancy as a risk factor for lifetime obesity. In a recent systematic review, there was good evidence that infants in the highest part of the size distribution for weight or body mass index were at increased risk of adult and childhood obesity . In several other studies, however, it has been reported that 'thinness' at birth was associated with increased risk of diabetes and chronic disease in later life . It thus appears that being at either end of the weight spectrum in infancy is associated with health risks in later life. In a study by Euser and colleagues , with pre-term infants <32 >weeks' gestation, early weight gain (between birth and 3 months) had a more significant impact on BMI (+4.9SD) than later infancy weight gain from 3 months to 1 year (BMI+2.5SD) (p<0.05) at age 19 years. However in the Euser study, the results may not be generalisable to healthy weight infants, as the study was focused on pre-term babies (-1.5 kg). It is interesting to note, however, that the period of early catch-up growth can also be associated with detrimental metabolic effects. Current evidence indicates that intervention strategies in infancy should emphasise improvements in linear growth in the first two years rather than weight gain, and avoiding excessive weight gain relative to height gain (BMI) after the age of2 years [4, 5].