ESPE Abstracts

Background: Excessive gain in fat mass (FM) during the first months of life, known as the critical window for adiposity programming, is associated with an increased risk for adiposity and cardiovascular diseases in later life. Early life nutrition (breastfeeding or formula feeding) might influence body composition (FM and fat free mass (FFM)) development in early life.

Aims: To investigate differences in sex-specific longitudinal weight-for-length SDS and body composition between exclusively breastfed (BF) and formula fed (FF) infants from birth to 24 months.

Methods: 219 exclusively BF (BF for at least 3 months) infants (120 boys) and 112 exclusively FF (start FF before 1 month) infants (65 boys) were followed in the Sophia Pluto Cohort in Rotterdam, The Netherlands. Anthropometrics were measured at 1, 3, 6, 9, 12, 18 and 24 months and weight-for-length SDS was calculated by Growth Analyser (https://growthanalyser.org/). Body composition was measured at 1, 3 and 6 months by PEA POD (COSMED, Italy) and thereafter by DXA (Lunar Prodigy, GE Healthcare, UK) with vacuum cushion (465 75100, Schmidt, Germany). All DXA scans were analyzed using enCORE software version 14.10. Longitudinal growth and body composition development during the first 2 years of life were analyzed using linear mixed model analyses.

Results: Longitudinal weight-for-length SDS and FM% during the first two years of life were not different between BF and FF infants (P=0.55 and P=0.36, resp.). Girls had a higher FM% compared to boys at all time points and boys a higher FFM (both P<0.001). FFM was significantly higher in BF infants (P=0.038). During the first 6 months of age, BF infants had a higher gain in FM% compared to FF infants (P=0.014), but this was followed by a significantly faster decline in FM% from 6-24 months compared to FF infants (P=0.002).

Conclusion: During the first two years of life, BF and FF infants have similar trajectories of weight-for-length and FM%. BF infants show a greater gain in FM% during the first months of life, but also a faster decline in FM% from 6 to 24 months compared to FF infants. BF infants also have a higher FFM. Girls have significantly more FM and boys more FFM regardless of feeding mode.