Eating behaviors moderate the associations between risk factors in the first 1000 days and adiposity outcomes at 6 years of age

Abstract

Background: Several risk factors in the first 1000 d are linked with increased obesity risk in later childhood. The role of potentially modifiable eating behaviors in this association is unclear.

Objectives: This study examined whether the association between cumulated risk factors in the first 1000 d and adiposity at 6 y is moderated by eating behaviors.

Methods: Participants were 302 children from the GUSTO (Growing Up in Singapore Towards healthy Outcomes) cohort. Risk factors included maternal prepregnancy and paternal overweight, excessive gestational weight gain, raised fasting plasma glucose during pregnancy, short breastfeeding duration, and early introduction of solid foods. Composite risk scores reflecting the prevalence and the importance of the risk factors present were computed. Adiposity outcomes were child BMI and sum of skinfolds (SSF), and candidate eating behavior moderators were portion size, eating rate, and energy intake during lunch and in an eating in the absence of hunger task.

Results: Higher composite risk score predicted higher BMI z scores (B = 0.08; 95% CI: 0.04, 0.13) and larger SSF (0.70 mm; 0.23, 1.18 mm), and was associated with larger self-served food portions (5.03 kcal; 0.47, 9.60 kcal), faster eating rates (0.40 g/min; 0.21, 0.59 g/min), and larger lunch intakes (7.05 kcal; 3.37, 10.74 kcal). Importantly, the association between composite risk score and adiposity was moderated by eating behaviors. The composite risk score was unrelated to SSF in children who selected smaller food portions, ate slower, and consumed less energy, but was positively associated with SSF among children who selected larger food portions, ate faster, and consumed more energy (eating behavior × risk score interactions: P < 0.05).

Conclusions: The association between risk factors in the first 1000 d and adiposity at 6 y varies by eating behaviors, highlighting modifiable behavioral targets for interventions.This trial was registered at clinicaltrials.gov as NCT01174875.

Keywords: 1000 days; adiposity; adiposity outcomes; childhood obesity; eating behavior; eating in the absence of hunger; eating rate; energy intake; portion size; risk factors.

Conflict of interest statement

Conflicts of interest: KMG, CGF, YSL and YSC have received reimbursement for speaking at conferences sponsored by companies selling nutritional products. They are part of an academic consortium that has received research funding from Abbott Nutrition, Nestec and Danone. CGF currently serves on the scientific advisory council for Kerry Taste and Nutrition. The other authors have no financial or personal conflict of interests.

Copyright © The Author(s) 2020.

Figures

Figure 1

(A-F). Simple slopes demonstrating the associations between risk scores and BMI z-scores at 6 years at different levels of eating behavior: mean ideal portion size (A), serving size at lunch (B), eating rate (C), intake of energy at lunch (D), eating in the absence of hunger (E) and cumulative intake of energy at lunch and during the EAH task (F). For simple slopes analysis both risk scores and eating behaviorus were centered; * FDR-corrected p< 0.05 for interaction term

Figure 2

(A-F). Simple slopes demonstrating the associations between risk scores and sum of skinfolds (SSF) at 6 years at different levels of eating behavior: mean ideal portion size (A), serving size at lunch (B), eating rate (C), intake of energy at lunch (D), eating in the absence of hunger (E) and cumulative intake of energy at lunch and during the EAH task (F). For simple slopes analysis both risk scores and eating behaviorus were centered. * FDR-corrected p< 0.05 for interaction term