Developmental origins of obesity: Early feeding environments, infant growth, and the intestinal microbiome

Department of Anthropology, University of North Carolina at Chapel Hill, USA.
American Journal of Human Biology (Impact Factor: 1.7). 05/2012; 24(3):350-60. DOI: 10.1002/ajhb.22254
Source: PubMed


Pediatric overweight and obesity are growing problems worldwide, with increasing prevalence among even infants and young children. The refractory nature of early overweight necessitates identifying the factors contributing to early excess weight gain for successful intervention. Early feeding practices may be particularly important in shaping long-term vulnerability to obesity. How and what infants are fed can influence weight gain, adiposity, and energy metabolism during infancy and across the life course through a number of interacting physiological and behavioral pathways. This article argues that these biological mechanisms interact with the social and behavioral context of infant feeding to create differential vulnerability to later obesity.
This article reviews recent research on the potential mechanisms linking infant feeding and risk of later obesity, focusing on the emerging role of microflora colonization.
The nutritive and non-nutritive components of breastmilk, formula and solid foods and the practices surrounding feeding shape the infant metabolome, programming growth rates and body composition, altering metabolism and physiology, promoting differential microfloral colonization, and shaping behavioral responses to foods and eating.
The occurrence of chronic disease precursors at increasingly younger ages and the tendency of overweight young children to become overweight adolescents and adults underscore the importance of understanding this complex early exposure and intervening early to prevent the development of obesity in increasingly weight-promoting environments.

27 Reads
  • Source
    • "In the groups receiving iron fortified cereal, there was a decline in both Firmicutes and Actinobacteria , the phylas containing Lactobacillus and Bifidobacteria respectively; these declines were not present in the meat or iron and zinc fortified groups. The dietary shift associated with the transition from human milk to family foods fundamentally alters the composition of the intestinal microbiota (Thompson, 2012) in both breastfed and formula fed infants, and likely driven primarily by the differences in macronutrients and oligosaccharides between human milk and commercial infant formula. Some of the shift may be related to changes in iron availability as originally hypothesized by Balmer and Wharton (1991), and seen in older infants and children with the addition of iron fortified biscuits as an IDA preventive treatment (Zimmermann et al., 2010). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Recently, there has been considerable debate regarding the appropriate amount of iron fortification for commercial infant formula. Globally, there is considerable variation in formula iron content, from 4 to 12 mg iron/L. However, how much fortification is necessary is unclear. Human milk is low in iron (0.2-0.5 mg/L), with the majority of infant iron stores accumulated during gestation. Over the first few months of life, these stores are depleted in breastfeeding infants. This decline has been previously largely perceived as pathological; it may be instead an adaptive mechanism to minimize iron availability to pathogens coinciding with complementary feeding. Many of the pathogens involved in infantile illnesses require iron for growth and replication. By reducing infant iron stores at the onset of complementary feeding, infant physiology may limit its availability to these pathogens, decreasing frequency and severity of infection. This adaptive strategy for iron regulation during development is undermined by the excess dietary iron commonly found in infant formula, both the iron that can be incorporated into the body and the excess iron that will be excreted in feces. Some of this excess iron may promote the growth of pathogenic, iron requiring bacteria disrupting synergistic microflora commonly found in breastfed infants. Evolutionarily, mothers who produced milk with less iron and infants who had decreased iron stores at the time of weaning may have been more likely to survive the transition to solid foods by having limited iron available for pathogens. Contemporary fortification practices may undermine these adaptive mechanisms and increase infant illness risk. Am. J. Hum. Biol. 00:000-000, 2013. © 2013 Wiley Periodicals, Inc.
    American Journal of Human Biology 01/2014; 26(1). DOI:10.1002/ajhb.22476 · 1.70 Impact Factor
    • "Various researchers have expressed their concern with regard to larger portion sizes, higher energy densities, lack of consumer information and healthy choices of available food when eating outside the home (Ledikwe, Ello-Martin, & Rolls, 2005; Prentice & Jebb, 2003). Moreover, the foods available in the early feeding environment of children may shape long-term eating patterns while parental feeding styles may enhance or suppress infants' ability to self-regulate intake in response to energetic needs for growth and activity (Thompson, 2012). "
    [Show abstract] [Hide abstract]
    ABSTRACT: The recent research focus on the human microbiota has provided data which suggests that the composition of the gut microbiota can play an important role in the modulation of body weight and of related mucosal and systemic immune responses. However, recent results from human and animal studies have raised the debate about whether specific microbial groups play a causative role in obesity or if the gut microbiota is modulated in response to diet or the obese state itself. Studies targeting selective alterations in the gut microbiota to control weight gain through the intake of probiotics and/or prebiotics or modulating undesirable populations through the use of antimicrobials or transplantation of faecal microbiota have provided promising results. Nonetheless, further placebo-controlled, double blind human studies are still required. Likewise, while it is now well accepted that obesity is followed by a low grade inflammatory response, more research studies are needed to unravel the mechanisms that would explain how different microbiota profiles affect the mucosal and systemic immune responsiveness, the intestinal barrier function and the development of adiposity.
    Trends in Food Science & Technology 11/2013; 34(1):44–53. DOI:10.1016/j.tifs.2013.08.007 · 4.65 Impact Factor
  • Source
    • "Conversely , we hypothesize that formula and solid feeding, which are associated with higher energy intake (Heinig et al., 1993) and more rapid infant growth over the first year of life (Butte et al., 2000b; Dewey, 2009), are associated with higher steroid levels. Since feeding practices are associated with differences in infant size and breastand formula-feeding may differentially influence linear growth and body composition (Thompson, 2012), we also test whether breast-, formula-, and solid-feeding are independent predictors of sex steroids, controlling for their indirect effects through differential infant growth. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Human biologists have documented variability in reproductive maturation, fertility, and cancer risk related to developmental conditions. Yet no previous studies have directly examined the impact of prenatal and postnatal energetic environments on sex steroids in infancy, a critical period for hypothalamic-pituitary-gonadal axis development. Thus, we examined the impact of maternal characteristics, birth size, and feeding practices on fecal sex steroid production in a longitudinal sample of 31 American infants followed from 2 weeks to 12 months of age. Maternal characteristics and birth size were collected at study enrollment, infant diet was assessed through weekly 24-h food diaries, and anthropometrics were measured weekly. Fecal estradiol and testosterone levels were assessed weekly using validated microassay RIA techniques. Mixed models were used to test for associations between maternal and birth characteristics, feeding practices, and sex steroids across the first year of life. Formal mediation analysis examined whether the relationship between infant feeding and hormone levels was mediated by infant size. Maternal and birth characteristics had persistent effects on fecal sex steroid levels, with taller maternal height and larger birth size associated with lower estradiol levels in girls and higher testosterone levels in boys. Infant diet was also associated with sex steroid levels independently of infant size. Formula feeding was associated with higher estradiol levels in boys and girls and with higher testosterone in girls. These results suggest that markers of early energy availability influence sex hormone levels with potential long-term consequences for reproductive development and function. Am. J. Hum. Biol., 2013. © 2013 Wiley Periodicals, Inc.
    American Journal of Human Biology 09/2013; 25(5). DOI:10.1002/ajhb.22424 · 1.70 Impact Factor
Show more