Tuck Seng Cheng1, See Ling Loy2, Jia Ying Toh3, Yin Bun Cheung4, Jerry Kok Yen Chan5, Keith M Godfrey6, Peter D Gluckman7, Seang Mei Saw8, Yap-Seng Chong9, Yung Seng Lee10, Ngee Lek11, Mary Foong-Fong Chong12, Fabian Yap13. 1. Departments of Pediatrics and. 2. KK Research Center, KK Women's and Children's Hospital, Singapore; Duke-NUS Medical School, Singapore; 3. Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore; 4. Center for Quantitative Medicine, Tampere Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland; 5. Reproductive Medicine and KK Research Center, KK Women's and Children's Hospital, Singapore; Duke-NUS Medical School, Singapore; 6. Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom; National Institute for Health Research Southampton Biomedical Research Center, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom; 7. Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore; Liggins Institute, University of Auckland, Auckland, New Zealand; 8. Saw Swee Hock School of Public Health and Departments of. 9. Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore; Obstetrics and Gynaecology and. 10. Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore; Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; and. 11. Departments of Pediatrics and Duke-NUS Medical School, Singapore; 12. Clinical Nutrition Research Center, Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; and. 13. Departments of Pediatrics and Duke-NUS Medical School, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore fabian.yap.k.p@singhealth.com.sg.
Abstract
BACKGROUND: The influence of circadian feeding patterns on weight outcomes has been shown in animal and human studies but not in very young children. OBJECTIVE: We aimed to examine the association of infant circadian feeding patterns at 12 mo of age with subsequent growth and weight status after 1 y. DESIGN: Mothers from a Singapore birth cohort (n = 349) reported the food given to their infants and the feeding time at 12 mo of age. Predominantly daytime (pDT) (0700-1859; n = 282) and predominantly nighttime (pNT) (1900-0659; n = 67) feeding infants were defined by whether daytime energy intake was >50% or <50% of total energy intake as assessed with the use of a 24-h recall. Body mass index-for-age z scores (BAZs) were computed with the use of the WHO Child Growth Standards 2006 to determine changes in BAZs from 12 to 24 mo of age and weight status at 24 mo of age. Multivariable linear and logistic regression analyses were performed. RESULTS: Compared with pDT feeding, pNT feeding was associated with a higher BAZ gain from 12 to 24 mo of age (adjusted β = 0.38; 95% CI: 0.11, 0.65; P = 0.006) and increased risk of becoming overweight at 24 mo of age (adjusted OR: 2.78; 95% CI: 1.11, 6.97; P = 0.029) with adjustments for maternal age, education, ethnicity, monthly household income, parity, infant BAZ at 12 mo of age, feeding mode in the first 6 mo of life, and total daily energy intake. CONCLUSIONS: Our study suggests that the role of the daily distribution of energy consumption in weight regulation begins in infancy. The feeding of infants predominantly during nighttime hours was associated with adiposity gain and risk of overweight in early childhood. The inclusion of advice on the appropriate feeding time may be considered when implementing strategies to combat childhood obesity. This trial was registered at clinicaltrials.gov as NCT01174875.
BACKGROUND: The influence of circadian feeding patterns on weight outcomes has been shown in animal and human studies but not in very young children. OBJECTIVE: We aimed to examine the association of infant circadian feeding patterns at 12 mo of age with subsequent growth and weight status after 1 y. DESIGN: Mothers from a Singapore birth cohort (n = 349) reported the food given to their infants and the feeding time at 12 mo of age. Predominantly daytime (pDT) (0700-1859; n = 282) and predominantly nighttime (pNT) (1900-0659; n = 67) feeding infants were defined by whether daytime energy intake was >50% or <50% of total energy intake as assessed with the use of a 24-h recall. Body mass index-for-age z scores (BAZs) were computed with the use of the WHO Child Growth Standards 2006 to determine changes in BAZs from 12 to 24 mo of age and weight status at 24 mo of age. Multivariable linear and logistic regression analyses were performed. RESULTS: Compared with pDT feeding, pNT feeding was associated with a higher BAZ gain from 12 to 24 mo of age (adjusted β = 0.38; 95% CI: 0.11, 0.65; P = 0.006) and increased risk of becoming overweight at 24 mo of age (adjusted OR: 2.78; 95% CI: 1.11, 6.97; P = 0.029) with adjustments for maternal age, education, ethnicity, monthly household income, parity, infant BAZ at 12 mo of age, feeding mode in the first 6 mo of life, and total daily energy intake. CONCLUSIONS: Our study suggests that the role of the daily distribution of energy consumption in weight regulation begins in infancy. The feeding of infants predominantly during nighttime hours was associated with adiposity gain and risk of overweight in early childhood. The inclusion of advice on the appropriate feeding time may be considered when implementing strategies to combat childhood obesity. This trial was registered at clinicaltrials.gov as NCT01174875.
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