The contribution of feeding mode to obesogenic growth trajectories in American Samoan infants
Article first published online: 5 FEB 2013
© 2013 The Authors. Pediatric Obesity © 2013 International Association for the Study of Obesity
Volume 9, Issue 1, pages e1–e13, February 2014
How to Cite
Hawley, N. L., Johnson, W., Nu'usolia, O. and McGarvey, S. T. (2014), The contribution of feeding mode to obesogenic growth trajectories in American Samoan infants. Pediatric Obesity, 9: e1–e13. doi: 10.1111/j.2047-6310.2012.00137.x
- Issue published online: 21 JAN 2014
- Article first published online: 5 FEB 2013
- Manuscript Accepted: 29 NOV 2012
- Manuscript Revised: 3 NOV 2012
- Manuscript Received: 24 AUG 2012
- NIH Grants. Grant Numbers: R25-TW008102, R18-DK075371, R01-HL093093
- Brown University Undergraduate Teaching and Research Awards
- American Samoa;
- Samoan adults are recognized for their particularly high body mass index and prevalent obesity.
- While Polynesians are understudied, in other populations infancy is a critical period in the development of obesity.
- Breastfeeding has been shown to attenuate obesity risk.
- Samoan infants show remarkably rapid gain in weight but not length in early infancy resulting in a prevalence of overweight and obesity far higher than has been previously reported elsewhere.
- Breastfeeding is associated with slower weight gain in infancy suggesting that its protective benefits for obesity risk are generalizable outside of European-derived populations.
Samoans are recognized for their particularly high body mass index and prevalent adult obesity but infants are understudied.
To examine the prevalence of overweight and obesity and determine the contribution of feeding mode to obesogenic growth trajectories in American Samoan infants.
Data were extracted from the well baby records of 795 (n = 417 male) Samoan infants aged 0–15 months. Mixed-effects growth models were used to produce individual weight and length curves. Further mixed-effects models were fitted with feeding mode (breastfed, formula- or mixed-fed) as a single observation at age 4 (±2) months. Weight and length values were converted to z-scores according to the Centers for Disease Control 2000 reference.
At 15 months, 23.3% of boys and 16.7% of girls were obese (weight-for-length > 95th percentile). Feeding mode had a significant effect on weight and length trajectories. Formula-fed infants gained weight and length faster than breastfed infants. Formula-fed boys were significantly more likely to be obese at 15 months (38.6%) than breastfed boys (23.4%), χ2 = 8.4, P < 0.01, odds ratio = 2.05, 95% confidence interval (1.04, 4.05).
Obesity in American Samoans is not confined to adults. Obesity prevention efforts should be targeted at early life and promotion of breastfeeding may be a suitable intervention target.