Newborn feeding and infant phenotype
File(s)
Author(s)
Gale, Christopher Robert Keith
Type
Thesis
Abstract
Breastfeeding in infancy, when compared with formula feeding, is associated
with a reduced incidence of components of the metabolic syndrome later in
life. One potential mechanism is via an effect on lipid metabolism and
storage, manifesting as altered adiposity and ectopic lipid deposition.
I have examined the null hypothesis: no association is detectable between
infant feeding and adiposity or ectopic lipid in infancy, through a meta-analysis
of published studies and a prospective cohort study of healthy infants
employing gold standard direct measurement techniques (magnetic
resonance imaging and spectroscopy).
Eleven studies were identified for meta-analysis: in formula-fed compared to
breastfed infants, fat mass was lower at 3-4 months [mean difference (95%
confidence interval)]: [-0.09 kg (-0.18, -0.01 kg)] and 6 months [-0.18 kg (-
0.34, -0.01 kg)]. Conversely, at 12 months, fat mass was higher in formula-fed
infants [0.29 kg (-0.03, 0.61 kg)] than in breastfed infants. Eighty-seven
infants were included in a prospective cohort, of which 73 were investigated at
two time points. In healthy, term, breastfed infants adipose tissue accretion
between birth and 2-3 months ages was predominantly within subcutaneous
rather than internal adipose tissue compartments, and a significant increase in
intrahepatocellular lipid was detected: median [interquartile range] 0.653
[0.367-1.900] after birth and 1.837 [1.408-2.429] at 2-3 months. Comparing
breastfed with formula fed infants within this cohort no significant differences
were detected in total adipose tissue, adipose tissue distribution or
intrahepatocellular lipid between birth and 2-3 months. Significant
associations were detected between maternal BMI, rate of weight gain in early
infancy and gender, and adipose tissue partitioning at 2-3 months.
While method of feeding is associated with altered infant fat mass up to 6
months, no association is detectable with adipose tissue partitioning or
ectopic hepatic lipid at 2-3 months.
with a reduced incidence of components of the metabolic syndrome later in
life. One potential mechanism is via an effect on lipid metabolism and
storage, manifesting as altered adiposity and ectopic lipid deposition.
I have examined the null hypothesis: no association is detectable between
infant feeding and adiposity or ectopic lipid in infancy, through a meta-analysis
of published studies and a prospective cohort study of healthy infants
employing gold standard direct measurement techniques (magnetic
resonance imaging and spectroscopy).
Eleven studies were identified for meta-analysis: in formula-fed compared to
breastfed infants, fat mass was lower at 3-4 months [mean difference (95%
confidence interval)]: [-0.09 kg (-0.18, -0.01 kg)] and 6 months [-0.18 kg (-
0.34, -0.01 kg)]. Conversely, at 12 months, fat mass was higher in formula-fed
infants [0.29 kg (-0.03, 0.61 kg)] than in breastfed infants. Eighty-seven
infants were included in a prospective cohort, of which 73 were investigated at
two time points. In healthy, term, breastfed infants adipose tissue accretion
between birth and 2-3 months ages was predominantly within subcutaneous
rather than internal adipose tissue compartments, and a significant increase in
intrahepatocellular lipid was detected: median [interquartile range] 0.653
[0.367-1.900] after birth and 1.837 [1.408-2.429] at 2-3 months. Comparing
breastfed with formula fed infants within this cohort no significant differences
were detected in total adipose tissue, adipose tissue distribution or
intrahepatocellular lipid between birth and 2-3 months. Significant
associations were detected between maternal BMI, rate of weight gain in early
infancy and gender, and adipose tissue partitioning at 2-3 months.
While method of feeding is associated with altered infant fat mass up to 6
months, no association is detectable with adipose tissue partitioning or
ectopic hepatic lipid at 2-3 months.
Version
Open Access
Date Issued
2013-04
Date Awarded
2013-09
Copyright Statement
Attribution NoDerivatives 4.0 International Licence (CC BY-ND)
Advisor
Bell, Jimmy
Thomas, Elizabeth
Modi, Neena
Publisher Department
Medicine
Publisher Institution
Imperial College London
Qualification Level
Doctoral
Qualification Name
Doctor of Philosophy (PhD)