The effects of antenatal dietary and lifestyle advice for women who are overweight or obese on maternal diet and physical activity: the LIMIT randomised trial Association of nutrition in early life with body fat and serum leptin at adult age Hypertension, Diabetes and Overweight: Looming Legacies of the Biafran Famine Mothers' intake of sugar-containing beverages during pregnancy and body composition of their children during childhood: the Generation R Study. Chronic Sleep Curtailment and Adiposity Development of overweight in an atherosclerosis prevention trial starting in early childhood. The STRIP study Modifiable early-life risk factors for childhood adiposity and overweight: an analysis of their combined impact and potential for prevention1234 Association of Maternal Diabetes Mellitus in Pregnancy With Offspring Adiposity Into Early Adulthood: Sibling Study in a Prospective Cohort of 280 866 Men From 248 293 Families Low‐birthweight infants born to short‐stature mothers are at additional risk of stunting and poor growth velocity: Evidence from secondary data analyses Association Between Cesarean Birth and Risk of Obesity in Offspring in Childhood, Adolescence, and Early Adulthood. Impact of a walking intervention during pregnancy on post-partum weight retention and infant anthropometric outcomes. Infant growth and later body composition: evidence from the 4-component model. Prebiotic supplementation improves appetite control in children with overweight and obesity: a randomized controlled trial. 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Early life risk factors for obesity in childhood: cohort study Effect of oligofructose supplementation on body weight in overweight and obese children: a randomised, double-blind, placebo-controlled trial. Adequacy of Infant Formula With Protein Content of 1.6 g/100 kcal for Infants Between 3 and 12 Months Effects of promoting longer-term and exclusive breastfeeding on adiposity and insulin-like growth factor-I at age 11.5 years: a randomized trial. Maternal fatty acid intake during pregnancy and the development of childhood overweight: a birth cohort study What are the causal effects of breastfeeding on IQ, obesity and blood pressure? Evidence from comparing high-income with middle-income cohorts The impact of early growth patterns and infant feeding on body composition at 3 years of age. The role of gestational diabetes, pre-pregnancy body mass index and gestational weight gain on the risk of newborn macrosomia: results from a prospective multicentre study Maternal macronutrient and energy intakes in pregnancy and offspring intake at 10 y: exploring parental comparisons and prenatal effects1234 Maternal Prepregancy BMI and Lipid Profile during Early Pregnancy Are Independently Associated with Offspring's Body Composition at Age 5–6 Years: The ABCD Study Developmental trajectories of Body Mass Index from infancy to 18 years of age: prenatal determinants and health consequences Infant adiposity following a randomised controlled trial of a behavioural intervention in obese pregnancy Effect of a cholesterol-lowering diet on maternal, cord, and neonatal lipids, and pregnancy outcome: a randomized clinical trial. Maternal plasma PUFA concentrations during pregnancy and childhood adiposity: the Generation R Study. Relationship between maternal pre‐pregnancy body mass index, gestational weight gain and childhood fatness at 6–7 years by air displacement plethysmography Protein intake during pregnancy and offspring body composition at 6 years: the Generation R Study Leisure time physical activity before and during mid-pregnancy and offspring adiposity in mid-childhood. Nutrition in infancy and long-term risk of obesity: evidence from 2 randomized controlled trials. Gestational weight gain in relation to offspring body mass index and obesity from infancy through adulthood Tracking of obesity and body fatness through mid-childhood The optimal postnatal growth trajectory for term small for gestational age babies: a prospective cohort study. Duration of sleep at 3 years of age is associated with fat and fat-free mass at 4 years of age: the Southampton Women's Survey. Does maternal weight gain in pregnancy have long-term effects on offspring adiposity? A sibling study in a prospective cohort of 146,894 men from 136,050 families. Fish Intake in Pregnancy and Child Growth: A Pooled Analysis of 15 European and US Birth Cohorts. Gestational weight gain and obesity, adiposity and body size in African-American and Dominican children in the Bronx and Northern Manhattan. Maternal size in pregnancy and body composition in children. Combined effects of oligofructose and Bifidobacterium animalis on gut microbiota and glycemia in obese rats. Does an intervention that improves infant sleep also improve overweight at age 6? Follow-up of a randomised trial Effects of Promoting Long-term, Exclusive Breastfeeding on Adolescent Adiposity, Blood Pressure, and Growth Trajectories: A Secondary Analysis of a Randomized Clinical Trial Variation in the Heritability of Child Body Mass Index by Obesogenic Home Environment Oligofructose promotes satiety in healthy human: a pilot study Impact of maternal diet on neonatal anthropometry: a randomized controlled trial. Ethnic Differences in Effects of Maternal Pre-Pregnancy and Pregnancy Adiposity on Offspring Size and Adiposity. Weight loss during oligofructose supplementation is associated with decreased ghrelin and increased peptide YY in overweight and obese adults.
Background Overweight and obesity is a significant health concern during pregnancy . Our aim was to investigate the effect of providing antenatal dietary and lifestyle advice to women who are overweight or obese on components of maternal diet and physical activity . Methods We conducted a r and omised controlled trial , in which pregnant women with a body mass index ≥25 kg/m2 , and singleton gestation between 10 + 0 to 20 + 0 weeks were recruited and r and omised to Lifestyle Advice ( involving a comprehensive dietary and lifestyle intervention over their pregnancy ) or St and ard Care . Within the intervention group , we conducted a nested r and omised trial in which a subgroup of women were further r and omised to receive access to supervised group walking sessions in addition to the st and ard information presented during the intervention contacts ( the Walking group ) or st and ard information only . The outcome measures were maternal dietary intake , ( including food groups , macronutrient and micronutrient intake , diet quality ( using the Healthy Eating Index ; HEI ) , dietary glycaemic load , and glycaemic index ) and maternal physical activity . Women completed the Harvard Semi-Structured Food Frequency Question naire , and the Short Question naire to Assess Health-enhancing Physical Activity ( SQUASH ) , at trial entry , 28 and 36 weeks ’ gestational age , and 4 months postpartum . Analyses were performed on an intention-to-treat basis , using linear mixed effects models with adjustment for the stratification variables . Results Women r and omised to Lifestyle Advice demonstrated a statistically significant increase in the number of servings of fruit and vegetables consumed per day , as well as increased consumption of fibre , and reduced percentage energy intake from saturated fats ( P < 0.05 for all ) . Maternal HEI was significantly improved at both 28 ( 73.35 ± 6.62 versus 71.86 ± 7.01 ; adjusted difference in means 1.58 ; 95 % CI 0.89 to 2.27 ; P < 0.0001 ) and 36 ( 72.95 ± 6.82 versus 71.17 ± 7.69 ; adjusted difference in means 1.77 ; 95 % CI 1.01 to 2.53 ; P < 0.0001 ) weeks . There were no differences in dietary glycaemic index or glycaemic load . Women r and omised to Lifestyle Advice also demonstrated greater total physical activity ( adjusted difference in means 359.76 metabolic equivalent task units ( MET ) minutes/week ; 95 % CI 74.87 to 644.65 ; P = 0.01 ) compared with women receiving St and ard Care . The supervised walking group was poorly utilised . Conclusions For women who are overweight or obese , antenatal lifestyle advice improves maternal diet and physical activity during pregnancy . Please see related articles : http://www.biomed central .com/1741 - 7015/12/163 and http://www.biomed central .com/1741 - 7015/12/201.Trial registration Australian and New Zeal and Clinical Trials Registry ( http://ACTRN12607000161426 Background : There is overwhelming evidence that experiences during early life could have long-term health consequences . However , the role of early nutrition in programming obesity and leptin resistance is still poorly understood . Objective : We aim ed at determining whether nutritional intakes in early life are associated with body composition and hormonal status at 20 years . Subjects : Healthy infants participating in the two-decade-long prospect i ve ELANCE ( Etude Longitudinale Alimentation Nutrition Croissance des Enfants ) study were examined at 10 months and 2 years . At 20 years , weight , height , subscapular and triceps skinfold thicknesses , fat mass ( FM ) and fat-free mass ( FFM ) assessed via bioelectrical impedance analysis , and serum leptin concentration were recorded in 73 subjects still participating in the follow-up . Results : In adjusted linear regression models , an increase by 100 kcal in energy intake at 2 years was associated with higher subscapular skinfold thickness ( β=6.4 % SF , 95 % confidence interval 2.53–10.30 , P=0.002 ) and higher FFM ( 0.50 kg , 0.06–0.95 , P=0.03 ) at 20 years . An increase by 1 % energy from fat at 2 years was associated with lower subscapular skinfold thickness ( −2.3 % SF , −4.41 to −0.18 , P=0.03 ) , lower FM ( −0.31 kg , −0.60 to −0.01 , P=0.04 ) and lower serum leptin concentration ( −0.21 μg l−1 , −0.39 to −0.03 , P=0.02 ) at 20 years . Conclusions : Low-fat intake in early life was negatively associated with body fat ( particularly at the trunk site ) and serum leptin concentration at 20 years , suggesting that early low-fat intake could increase the susceptibility to develop overweight and leptin resistance at later ages . These findings substantiate current recommendations against restricting fat intake in early life and open new directions for investigating the origin of obesity Background Sub-Saharan Africa is facing rapidly increasing prevalences of cardiovascular disease , obesity , diabetes and hypertension . Previous and ongoing undernutrition among pregnant women may contribute to this development as suggested by epidemiological studies from high income countries linking undernutrition in fetal life with increased burden of non-communicable diseases in later life . We undertook to study the risks for hypertension , glucose intolerance and overweight  forty years after fetal exposure to famine afflicted Biafra during the Nigerian civil war ( 1967–1970 ) . Methods and Findings Cohort study performed in June 27–July 31 , 2009 in Enugu , Nigeria . Adults ( n = 1,339 ) born before ( 1965–67 ) , during ( 1968–January 1970 ) , or after ( 1971–73 ) the years of famine were included . Blood pressure ( BP ) , r and om plasma glucose ( p-glucose ) and anthropometrics , as well as prevalence of hypertension ( BP>140/90 mmHg ) , impaired glucose tolerance ( IGT ; p-glucose 7.8–11.0 mmol/l ) , diabetes ( DM ; p-glucose ≥11.1 mmol/l ) , or overweight ( BMI > 25 kg/m2 ) were compared between the three groups . Fetal-infant exposure to famine was associated with elevated systolic ( + 7 mmHg ; p<0.001 ) and diastolic ( + 5 mmHg ; p<0.001 ) BP , increased p-glucose ( + 0.3 mmol/L ; p<0.05 ) and waist circumference ( + 3 cm , p<0.001 ) , increased risk of systolic hypertension ( adjusted OR 2.87 ; 95 % CI 1.90–4.34 ) , IGT ( OR 1.65 ; 95 % CI 1.02–2.69 ) and overweight ( OR 1.41 ; 95 % CI 1.03–1.93 ) as compared to people born after the famine . Limitations of this study include the lack of birth weight data and the inability to separate effects of fetal and infant famine . Conclusions Fetal and infant undernutrition is associated with significantly increased risk of hypertension and impaired glucose tolerance in 40-year-old Nigerians . Prevention of undernutrition during pregnancy and in infancy should therefore be given high priority in health , education , and economic agendas Background : High intake of sugar-containing beverages ( SCBs ) has been linked to increased risk of obesity . However , associations of SCB intake during pregnancy with child body composition have been unclear . Objectives : We explored whether SCB intake during pregnancy was associated with children 's body mass index ( BMI ) and detailed measures of body composition . In addition , we examined different types of SCBs ( i.e. , fruit juice , soda , and concentrate ) . Design : We included 3312 mother-child pairs of the Generation R Study , a prospect i ve cohort from fetal life onward in the Netherl and s. Energy-adjusted  SCB  intake was assessed in the first trimester with a food-frequency question naire . Anthropometric data of the children were collected repeatedly ≤6 y of age , and BMI was calculated . At 6 y of age , we further measured fat mass index ( FMI ) and fat-free mass index with dual-energy X-ray absorptiometry . All outcomes were sex- and age-st and ardized . Associations of SCB intake with  children 's BMI trajectories and body composition were analyzed with multivariable linear mixed and regression models . Results : Results from linear mixed models showed that , after adjustment for confounders including the SCB intake of the child itself , mothers ' total SCB intake was positively associated with children 's BMI ≤6 y of age [ per serving per day : 0.04 SD score ( SDS ) ; 95 % CI : 0.00 , 0.07 SDS ] . In addition , intakes of total SCBs and fruit juice , but not of soda or concentrate , were associated with a higher FMI [ total SCBs : 0.05 SDS ( 95 % CI : 0.01 , 0.08 SDS ) ; fruit juice : 0.04 SDS ( 95 % CI : 0.01 , 0.06 SDS ) ] of the 6-y-old children . These associations remained significant ( P < 0.05 ) after additional adjustment for gestational weight gain , birth weight , and children 's insulin concentrations . Conclusion : Our study suggests that maternal SCB intake during pregnancy is positively associated with children 's BMI during early childhood and particularly with higher fat mass OBJECTIVES : To examine the extent to which chronic sleep curtailment from infancy to mid-childhood is associated with total and central adiposity . METHODS : We studied 1046 children participating in a prospect i ve cohort study . At age 6 months and yearly from age 1 to 7 years , mothers reported their children ’s sleep duration in a usual 24-hour period . The main exposure was a sleep curtailment score from age 6 months to 7 years . The range of the total score was 0 to 13 , where 0 indicated the maximal sleep curtailment and 13 indicated never having curtailed sleep . Outcomes in mid-childhood were BMI z score , dual X-ray absorptiometry total and trunk fat mass index ( kg/m2 ) , and waist and hip circumferences ( cm ) . RESULTS : The mean ( SD ) sleep score was 10.2 ( 2.7 ) ; 4.4 % scored a 0 to 4 , indicating multiple exposures to sleep curtailment between age 6 months to 7 years , 12.3 % scored 5 to 7 , 14.1 % scored 8 to 9 , 28.8 % scored 10 to 11 , and 40.3 % scored 12 to 13 . In multivariable models , children who had a sleep score of 0 to 4 had a BMI z score that was 0.48 U ( 95 % confidence interval , 0.13 to 0.83 ) higher than those who had a sleep score of 12 to 13 . We observed similar associations of higher total and trunk fat mass index and waist and hip circumferences , and higher odds of obesity ( odds ratio , 2.62 ; 95 % confidence interval , 0.99 to 6.97 ) among children who had a score of 0 to 4 vs 12 to 13 . CONCLUSIONS : Chronic sleep curtailment from infancy to school age was associated with higher overall and central adiposity in mid-childhood Context : Recent data indicate a marked increase in the prevalence of  obesity among school-aged children . Thus , efficacious programmes that prevent overweight development in children are urgently needed . Objective : To evaluate the impact of repeatedly given , individualised dietary and lifestyle counselling on the prevalence of overweight during the first 10 years of life . Design and participants : This study was a part of the Special Turku Coronary Risk Factor Intervention Project for Children ( STRIP ) , which is a prospect i ve , r and omised trial aim ed at reducing the exposure of the intervention children to the known risk factors of atherosclerosis . At the child 's age of 7 months , 1062 children were assigned to an intervention group ( n=540 ) or to a control group ( n=522 ) . The intervention children received individualised counselling focused on healthy diet and physical activity biannually . Height and weight of the children were measured at least once a year . Main outcome measure : Prevalence of overweight and obesity among the intervention and control children by sex and age . Children were classified as  overweight or  obese if their weight for height was > 20 % or ⩾40 % above the mean weight for height of healthy Finnish children , respectively . Results : After the age of 2 years , there were continuously fewer overweight girls in the intervention group than in the control group . At the age of 10 years , 10.2 % of the intervention girls and 18.8 % of the control girls were overweight ( P=0.0439 ) , whereas 11.6 % of the intervention boys and 12.1 % of the control boys were overweight ( P≈1.00 ) . Only three children in the intervention group were obese at some age point , whereas 14 control children were classified as obese at some age point . Conclusion : Individualised dietary and lifestyle counselling given twice a year since infancy decreases prevalence of overweight in school-aged girls even without any primary energy restrictions Background : Early life may be a “ critical period ” when appetite and regulation of energy balance are programmed , with lifelong consequences for obesity risk . Insight into the potential impact of modifying early-life risk factors on later obesity can be gained by evaluating their combined effects . Objective : The objective was to examine the relation between the number of early-life risk factors and obesity  outcomes among children in a prospect i ve birth cohort ( Southampton Women 's Survey ) . Design : Five risk factors were defined : maternal obesity  [ prepregnant body mass index ( BMI ; in kg/m2 ) > 30 ] , excess gestational weight gain ( Institute of Medicine , 2009 ) , smoking during pregnancy , low maternal vitamin D status ( < 64 nmol/L ) , and short duration of breastfeeding ( none or < 1 mo ) . Obesity outcomes examined when the children were aged 4 and 6 y were BMI , dual-energy X-ray absorptiometry – assessed fat mass , overweight , or obesity ( International Obesity Task Force ) . Data were available for 991 mother-child pairs , with children born between 1998 and 2003 . Results : Of the children , 148 ( 15 % ) had no early-life risk factors , 330 ( 33 % ) had 1 , 296 ( 30 % ) had 2 , 160 ( 16 % ) had 3 , and 57 ( 6 % ) had 4 or 5 . At both 4 and 6 y , there were positive grade d associations between number of early-life risk factors and each obesity outcome ( all P < 0.001 ) . After taking account of confounders , the relative risk of being overweight or obese for children who had 4 or 5 risk factors was 3.99 ( 95 % CI : 1.83 , 8.67 ) at 4 y and 4.65 ( 95 % CI : 2.29 , 9.43 ) at 6 y compared with children who had none ( both P < 0.001 ) . Conclusions : Having a greater number of early-life risk factors was associated with large differences in adiposity and risk of overweight and obesity in later childhood . These findings suggest that early intervention to change these modifiable risk factors could make a significant contribution to the prevention of childhood obesity Background — Maternal diabetes mellitus in pregnancy results in greater  offspring adiposity  at birth . It is unclear whether it is associated with greater adiposity into adulthood , and if so , whether this is via intrauterine mechanisms or shared familial characteristics . Methods and Results — A record-linkage prospect i ve cohort study of 280 866 singleton-born Swedish men from 248 293 families was used to explore the intrauterine effect of maternal diabetes mellitus on offspring body mass index ( BMI ) in early adulthood . Maternal diabetes mellitus during pregnancy was associated with greater mean BMI at age 18 in their sons . The difference in BMI was similar within brothers and between nonsiblings . BMI of men whose mothers had diabetes mellitus during their pregnancy was on average 0.94 kg/m2 greater ( 95 % confidence interval [ CI ] , 0.35 to 1.52 ) than in their brothers born before their mother was diagnosed with diabetes , after adjustment for birth year , maternal age , parity and education , birth weight , gestational age , and age at assessment of BMI . Early-pregnancy BMI was positively associated with son 's BMI between nonsiblings , but there was no association within brothers . Adjustment of the maternal diabetes-offspring BMI association for maternal BMI did not alter the association either within brothers or between nonsiblings . Results were also robust to sensitivity analyses restricting the within-sibling analyses to siblings born within 3 years of each other . Conclusion — Maternal diabetes mellitus has long-term consequences for greater BMI in offspring ; this association is likely to be via intrauterine mechanisms , and is independent of maternal BMI in early pregnancy Abstract Low‐birthweight ( LBW ) infants are at an increased risk of stunting and poor linear growth . The risk might be additionally higher in these infants when born to short mothers . However , this hypothesis has been less explored . The objective of this secondary data analysis was to determine the risk of linear growth faltering and difference in linear growth velocity in LBW infants born to short mothers ( < 150 cm ) compared to those born to mothers with height ≥150 cm during the first year of life . This analysis uses data from a community‐based r and omized controlled trial of 2,052 hospital‐born term infants with birthweight ≤2,500 g from urban low – middle socioeconomic neighbourhoods in Delhi , India . Data on maternal height and infant birth length were available from 1,858 ( 90.5 % ) of the infants .  Infant anthropometry outcomes were measured at birth , 3 , 6 , 9 , and 12 months of age . We found that infants born to short mothers had around twofold higher odds of stunting and lower attained length‐for‐age Z scores compared to infants of mothers with height ≥150 cm , at all ages of assessment . Linear growth velocity was significantly lower in infants of short mothers particularly in the first 6 months of life . We conclude that LBW infants born to short mothers are at a higher risk of stunting and have slower postnatal growth velocity result ing in lower attained length‐for‐age Z scores in infancy . Evidence ‐based strategies need to be tested to optimize growth velocity in LBW infants especially those born to short mothers Importance Cesarean birth has been associated with higher risk of  obesity in offspring , but previous studies have focused primarily on childhood obesity and have been hampered by limited control for confounders . Objective To investigate the association between cesarean birth and risk of obesity in offspring . Design , Setting , and Participants A prospect i ve cohort study was conducted from September 1 , 1996 , to December 31 , 2012 , among participants of the Growing Up Today Study , including 22 068 offspring born to 15 271 women , followed up via question naire from ages 9 to 14 through ages 20 to 28 years . Data analysis was conducted from October 10 , 2015 , to June 14 , 2016 . Exposure Birth by cesarean delivery . Main Outcomes and Measures Risk of obesity based on International Obesity Task Force or World Health Organization body mass index cutoffs , depending on age . Secondary outcomes included risks of obesity associated with changes in mode of delivery and differences in risk between siblings whose modes of birth were discordant . Results Of the 22 068 offspring ( 20 950 white ; 9359 male and 12 709 female ) , 4921 individuals ( 22.3 % ) were born by cesarean delivery .  The cumulative risk of obesity through the end of follow-up was 13 % among all participants . The adjusted risk ratio for obesity among offspring delivered via cesarean birth vs those delivered via vaginal birth was 1.15 ( 95 % CI , 1.06 - 1.26 ; P = .002 ) . This association was stronger among women without known indications for cesarean delivery ( adjusted risk ratio , 1.30 ; 95 % CI , 1.09 - 1.54 ; P = .004 ) . Offspring delivered via vaginal birth among women who had undergone a previous cesarean delivery had a 31 % ( 95 % CI , 17%-47 % ) lower risk of obesity compared with those born to women with repeated cesarean deliveries . In within-family analysis , individuals born by cesarean delivery had 64 % ( 8%-148 % ) higher odds of obesity than did their siblings born via vaginal delivery . Conclusions and Relevance Cesarean birth was associated with  offspring obesity after accounting for major confounding factors . Although additional research is needed to clarify the mechanisms underlying this association , clinicians and patients should weigh this risk when considering cesarean delivery in the absence of a clear indication Few studies have investigated the impact of lifestyle interventions during pregnancy on post-partum weight retention and infant growth .  Thirty seven previously non-exercising , overweight or obese pregnant women were r and omly assigned to a walking intervention or non-intervention control . For the follow-up study , weight of the mother and weight , length and body composition of the infant were collected at 1 month post-partum ( n=37 ) and 6 months post-partum ( n=33 ) . Analysis of variance and linear regression were conducted to determine the differences and association in maternal post-partum weight retention and child outcomes . At 6 months post-partum , weight retention of obese women in the intervention group ( Int-OB ) was -0.10±8.11 kg ; while , obese women in the control group ( Con-OB ) was 6.35±7.47 kg . A significantly higher percentage of Con-OB women retained more than 5 kg at 6 months post-partum ( P=0.046 ) . Even though statistically non-significant between the groups , the growth trend observed among offspring of obese women in the control group was consistently higher than the offspring of obese women in the intervention group from birth to 6-months . Third trimester gestational weight gain rate significantly predicted 6-m weight-for-length z-score after controlling for birth weight , treatment group and pre-pregnancy body mass index ( r 2=0.31 , β=1.75 , P=0.03 ) . The reduced post-partum weight retention observed among the obese women in the intervention group may be explained in part by the lifestyle modification during pregnancy BACKGROUND Rapid weight gain in infancy is associated with higher body mass index in later life , but its relation with individual body-composition components remains unclear . OBJECTIVE We aim ed to investigate associations between weight gain during different periods in infancy and later fat mass ( FM ) and fat-free mass ( FFM ) . DESIGN Body composition was assessed by using the 4-component model , dual-energy X-ray absorptiometry , and anthropometry in 234 healthy UK children and adolescents ( 105 boys ; x + /- SD age : 11.4 + /- 3.8 y ) . Early growth measurements were prospect i ve in 52 subjects and retrospective in 182 .  Relative weight gain was calculated as change in SD score ( SDS ) during different periods . RESULTS Relative weight gain from 0 to 3 mo and from 3 to 6 mo showed positive relations with childhood FM , waist circumference , and trunk FM that were equivalent to increases in FMI ( FM/height(2 ) ) of 0.24 SDS ( 95 % CI : 0.04 , 0.44 ) and 0.50 SDS ( 0.25 , 0.75 ) per 1-SDS increase in early weight and that were comparable to the effect of current obesity risk factors . Relative weight gain from 0 to 3 mo was also positively associated with later FFMI ( FFM/height(2 ) ) . Relative weight gain from 6 to 12 mo was not associated with later body composition . Associations were independent of birth weight , sex , puberty , physical activity , socioeconomic class , ethnicity , and parental body mass index . CONCLUSIONS In this Western population , greater relative weight gain during early infancy was positively associated with later FM and central fat distribution and with FFM . Rapid weight gain in infancy may be a risk factor for later adiposity . Early infancy may provide an opportunity for interventions aim ed at reducing later obesity risk Background : Prebiotics have been shown to improve satiety in adults with overweight and obesity ; however , studies in children are limited . Objective : We examined the effects of prebiotic supplementation on appetite control and energy intake in children with overweight and obesity . Design : This study was a r and omized , double-blind , placebo-controlled trial . Forty-two boys and girls , ages 7 - 12 y , with a body mass index ( BMI ) of ≥85th percentile were r and omly assigned to 8 g oligofructose-enriched inulin/d or placebo ( maltodextrin ) for 16 wk . Objective measures of appetite included energy intake at an ad libitum breakfast buffet , 3-d food records , and fasting satiety hormone concentrations . Subjective appetite ratings were obtained from visual analog scales before and after the breakfast . Children 's Eating Behavior Question naires were also completed by caregivers . Results : Compared with placebo , prebiotic intake result ed in significantly higher feelings of fullness ( P = 0.04 ) and lower prospect i ve food consumption ( P = 0.03 ) at the breakfast buffet at 16 wk compared with baseline . Compared with placebo , prebiotic supplementation significantly reduced energy intake at the week 16 breakfast buffet in 11- and 12-y-olds ( P = 0.04 ) but not in 7- to 10-y-olds . Fasting adiponectin ( P = 0.04 ) and ghrelin ( P = 0.03 ) increased at 16 wk with the prebiotic compared with placebo . In intent-to-treat analysis , there was a trend for prebiotic supplementation to reduce BMI z score to a greater extent than placebo ( -3.4 % ; P = 0.09 ) and a significant -3.8 % reduction in per- protocol analysis ( P = 0.043 ) . Conclusions : Independent of other lifestyle changes , prebiotic supplementation in children with overweight and  obesity improved subjective appetite ratings . This translated into reduced energy intake in a breakfast buffet in older but not in younger children . This simple dietary change has the potential to help with appetite regulation in children with obesity . This trial was registered at clinical trials.gov as NCT02125955 Background : Overweight has its origins largely in early life . We aim ed to identify the most important parental , fetal , and infant risk factors of preschool overweight . Methods : In a prospect i ve cohort study , among 3,610 Caucasian preschool children , we assessed the associations of 34 putative parental , fetal , and infant factors with overweight risk . Results : Higher maternal BMI , paternal BMI , and birth weight were associated with higher risk of preschool overweight ( odds ratio ( OR ) : 1.23 , 95 % confidence interval ( CI ) : 1.10 , 1.39 ; OR : 1.35 , 95 % CI : 1.19 , 1.53 ; and OR : 2.71 , 95 % CI : 2.27 , 3.25 , respectively , per SD increase ) . The same model identified low household income ( OR : 1.74 , 95 % CI : 1.24 , 2.45 ) , being female ( OR : 1.55 , 95 % CI : 1.20 , 2.01 ) , and experiencing third-trimester accelerated growth ( OR : 1.73 , 95 % CI : 1.24 , 2.40 ) or postnatal accelerated growth ( OR : 6.39 , 95 % CI : 4.54 , 8.99 ) as risk factors for preschool overweight . Higher polyunsaturated fat intake at 14 mo was associated with a lower risk of preschool overweight ( OR : 0.77 , 95 % CI : 0.62 , 0.96 per SD ) . Conclusion : Parental anthropometrics and household income , fetal and infant accelerated growth , and infant dietary fat intake are the major risk factors for the development of preschool overweight . Further studies need to explore whether these risk factors could be potential targets for preventive interventions OBJECTIVE To examine whether infant growth rates are influenced by fetal growth characteristics and are associated with the risks of overweight and obesity in early childhood . DESIGN This study was embedded in the Generation R Study , a population -based prospect i ve cohort study from fetal life onward . METHODS  Fetal growth characteristics ( femur length ( FL ) and estimated fetal weight ( EFW ) ) were assessed in the second and third trimesters and at birth ( length and weight ) . Infant peak weight velocity ( PWV ) , peak height velocity ( PHV ) , and body mass index at adiposity peak ( BMI AP ) were derived for 6267 infants with multiple height and weight measurements . RESULTS EFW measured during the second trimester was positively associated with PWV and BMI AP during infancy . Subjects with a smaller weight gain between the third trimester and birth had a higher PWV . FL measured during the second trimester was positively associated with PHV . Gradual length gain between the second and third trimesters and between the third trimester and birth were associated with higher PHV . Compared with infants in the lowest quintile , the infants in the highest quintile of PWV had strongly increased risks of overweight/obesity at the age of 4 years ( odds ratio ( 95 % confidence interval ) : 15.01 ( 9.63 , 23.38 ) ) . CONCLUSION Fetal growth characteristics strongly influence infant growth rates . A higher PWV , which generally occurs in the first month after birth , was associated with an increased risk of overweight and obesity at 4 years of age . Longer follow-up studies are necessary to determine how fetal and infant growth patterns affect the risk of disease in later life The effect of protein intake on growth velocity  in infancy may be mediated by insulin-like growth factor-1 ( IGF-1 ) . This study aim ed to determine the effects of formulae containing 1·8 ( F1·8 ) or 2·7 g ( F2·7 ) protein/418·4 kJ ( 100 kcal ) on IGF-1 concentrations and growth .  Healthy term infants were r and omly assigned to receive F1·8 ( n 74 ) or F2·7 ( n 80 ) exclusively for the first 4 months of life . A group of breast-fed infants ( n 84 ) was followed-up simultaneously ( reference ) . Growth and body composition were measured at 0·5 , 4 , 6 , 12 , 36 , 48 and 60 months of life . The IGF-1 concentrations at 4 months ( primary outcome ) were similar in the F1·8 ( 67·1 ( sd 20·8 ) ng/l ; n 70 ) and F2·7 ( 71·2 ( sd 27·5 ) ng/l ; n 73 ) groups ( P=0·52 ) . Both formula groups had higher IGF-1 concentrations than the breast-fed group at 4 and 9 months of age ( P≤0·0001 ) . During the first 60 months of life , anthropometric parameters in the F1·8 group were lower compared with the F2·7 group , and the differences were significant for head circumference from 2 to 60 months , body weight at 4 and 6 months and length at 9 , 12 and 36 months of age . There were no significant differences in body composition between these two groups at any age . We conclude that , in formula-fed infants , although increased protein intake did not affect the IGF-1 concentration during the first 12 months of life , it did affect length and head circumference growth , suggesting that factors other than IGF-1 could play roles in determining growth velocity BACKGROUND Behavioural interventions might improve clinical outcomes in pregnant women who are obese . We aim ed to investigate whether a complex intervention addressing diet and physical activity could reduce the incidence of gestational diabetes and large-for-gestational-age infants . METHODS The UK Pregnancies Better Eating and Activity Trial ( UPBEAT ) is a r and omised controlled trial done at antenatal clinics in eight hospitals in multi-ethnic , inner-city locations in the UK . We recruited pregnant women ( 15 - 18 weeks plus 6 days of gestation ) older than 16 years who were obese ( BMI ≥30 kg/m(2 ) ) . We r and omly assigned participants to either a behavioural intervention or st and ard antenatal care with an internet-based , computer-generated , r and omisation procedure , minimising by age , ethnic origin , centre , BMI , and parity . The intervention was delivered once a week through eight health trainer-led sessions . Primary outcomes were gestational diabetes ( diagnosed with an oral glucose tolerance test and by criteria from the International Association of Diabetes in Pregnancy Study Groups ) and large-for-gestational-age infants ( ≥90th customised birthweight centile ) . Analysis was by intention to treat . This trial is registered with Current Controlled Trials , ISCRTN89971375 . Recruitment and pregnancy outcomes are complete but childhood follow-up is ongoing . FINDINGS Between March 31 , 2009 , and June 2 , 2014 , we assessed 8820 women for eligibility and recruited 1555 , with a mean BMI of 36·3 kg/m(2 ) ( SD 4·8 ) . 772 were r and omly assigned to st and ard antenatal care and 783 were allocated the behavioural intervention , of which 651 and 629 women , respectively , completed an oral glucose tolerance test . Gestational diabetes was reported in 172 ( 26 % ) women in the st and ard care group compared with 160 ( 25 % ) in the intervention group ( risk ratio 0·96 , 95 % CI 0·79 - 1·16 ; p=0·68 ) . 61 ( 8 % ) of 751 babies in the st and ard care group were large for gestational age compared with 71 ( 9 % ) of 761 in the intervention group ( 1·15 , 0·83 - 1·59 ; p=0·40 ) . Thus , the primary outcomes did not differ between groups , despite improvements in some maternal secondary outcomes in the intervention group , including reduced dietary glycaemic load , gestational weight gain , and maternal sum-of-skinfold thicknesses , and increased physical activity . Adverse events included neonatal death ( two in the st and ard care group and three in the intervention group ) and fetal death in utero ( ten in the st and ard care group and six in the intervention group ) . No maternal deaths were reported . Incidence of miscarriage ( 2 % in the st and ard care group vs 2 % in the intervention group ) , major obstetric haemorrhage ( 1 % vs 3 % ) , and small-for-gestational-age infants ( ≤5th customised birthweight centile ; 6 % vs 5 % ) did not differ between groups . INTERPRETATION A behavioural intervention addressing diet and physical activity in women with obesity during pregnancy is not adequate to prevent gestational diabetes , or to reduce the incidence of large-for-gestational-age infants . FUNDING National Institute for Health Research , Guys and St Thomas ' Charity , Chief Scientist Office Scotl and , Tommy 's Charity The PROmotion of Breastfeeding Intervention Trial ( PROBIT ) is a multicentre , cluster-r and omized controlled trial conducted in the Republic of Belarus , in which the experimental intervention was the promotion of increased breastfeeding duration and exclusivity , modelled on the Baby-friendly hospital initiative . Between June 1996 and December 1997 , 17,046 mother-infant pairs were recruited during their postpartum hospital stay from 31 maternity hospitals , of which 16 hospitals and their affiliated polyclinics had been r and omly assigned to the arm of PROBIT investigating the promotion of breastfeeding and 15 had been assigned to the control arm , in which breastfeeding practice s and policies in effect at the time of r and omization was continued . Of the mother-infant pairs originally recruited for the study , 16,492 ( 96.7 % ) were followed at regular intervals until the infants were 12 months of age ( PROBIT I ) for the outcomes of breastfeeding duration and exclusivity ; gastrointestinal and respiratory infections ; and atopic eczema . Subsequently , 13,889 ( 81.5 % ) of the children from these mother-infant pairs were followed-up at age 6.5 years ( PROBIT II ) for anthropometry , blood pressure ( BP ) , behaviour , dental health , cognitive function , asthma and atopy outcomes , and 13,879 ( 81.4 % ) children were followed to the age of 11.5 years ( PROBIT III ) for anthropometry , body composition , BP , and the measurement of fasted glucose , insulin , adiponectin , insulin-like growth factor-I , and apolipoproteins . The trial registration number for Current Controlled Trials is IS RCT N37687716 and that for Clinical Trials.gov is NCT01561612 . Proposals for collaboration are welcome , and enquires about PROBIT should be made to an executive group of the study steering committee ( M.S.K. , R.M.M. , and E.O. ) . More information , including information about how to access the trial data , data collection documents , and bibliography , is available at the trial website ( http://www.bristol.ac.uk/social-community-medicine/projects/probit/ ) CONTEXT While gluten ingestion is responsible for the signs and symptoms of celiac disease , it is not known what factors are associated with initial appearance of the disease . OBJECTIVE To examine whether the timing of gluten exposure in the infant diet was associated with the development of celiac disease autoimmunity ( CDA ) . DESIGN , SETTING , AND PATIENTS Prospect i ve observational study conducted in Denver , Colo , from 1994 - 2004 of 1560 children at increased risk for celiac disease or type 1 diabetes , as defined by possession of either HLA-DR3 or DR4 alleles , or having a first-degree relative with type 1 diabetes . The mean follow-up was 4.8 years . MAIN OUTCOME MEASURE Risk of CDA defined as being positive for tissue transglutaminase ( tTG ) autoantibody on 2 or more consecutive visits or being positive for tTG once and having a positive small bowel biopsy for celiac disease , by timing of introduction of gluten-containing foods into the diet . RESULTS Fifty-one children developed CDA .  Findings adjusted for HLA-DR3 status indicated that children exposed to foods containing wheat , barley , or rye ( gluten-containing foods ) in the first 3 months of life ( 3 [ 6 % ] CDA positive vs 40 [ 3 % ] CDA negative ) had a 5-fold increased risk of CDA compared with children exposed to gluten-containing foods at 4 to 6 months ( 12 [ 23 % ] CDA positive vs 574 [ 38 % ] CDA negative ) ( hazard ratio [ HR ] , 5.17 ; 95 % confidence interval [ CI ] , 1.44 - 18.57 ) . Children not exposed to gluten until the seventh month or later ( 36 [ 71 % ] CDA positive vs 895 [ 59 % ] CDA negative ) had a marginally increased risk of CDA compared with those exposed at 4 to 6 months ( HR , 1.87 ; 95 % CI , 0.97 - 3.60 ) . After restricting our case group to only the 25 CDA-positive children who had biopsy-diagnosed celiac disease , initial exposure to wheat , barley , or rye in the first 3 months ( 3 [ 12 % ] CDA positive vs 40 [ 3 % ] CDA negative ) or in the seventh month or later ( 19 [ 76 % ] CDA positive vs 912 [ 59 % ] CDA negative ) significantly increased risk of CDA compared with exposure at 4 to 6 months ( 3 [ 12 % ] CDA positive vs 583 [ 38 % ] CDA negative ) ( HR , 22.97 ; 95 % CI , 4.55 - 115.93 ; P = .001 ; and HR , 3.98 ; 95 % CI , 1.18 - 13.46 ; P = .04 , respectively ) . CONCLUSION Timing of introduction of gluten into the infant diet is associated with the appearance of CDA  in children at increased risk for the disease BACKGROUND Early nutrition is recognized as a target for the effective prevention of  childhood obesity .  Protein intake was associated with more rapid weight gain during infancy-a known risk factor for later obesity . OBJECTIVE We tested whether the reduction of protein in infant formula reduces body mass index ( BMI ; in kg/m(2 ) ) and the prevalence of obesity at 6 y of age . DESIGN The Childhood Obesity Project was conducted as a European multicenter , double-blind , r and omized clinical trial that enrolled healthy infants born between October 2002 and July 2004 . Formula-fed infants ( n = 1090 ) were r and omly assigned to receive higher protein (HP)- or lower protein (LP)-content formula ( within recommended amounts ) in the first year of life ; breastfed infants ( n = 588 ) were enrolled as an observational reference group . We measured the weight and height of 448 ( 41 % ) formula-fed children at 6 y of age . BMI was the primary outcome . RESULTS HP children had a significantly higher BMI ( by 0.51 ; 95 % CI : 0.13 , 0.90 ; P = 0.009 ) at 6 y of age . The risk of becoming obese in the HP group was 2.43 ( 95 % CI : 1.12 , 5.27 ; P = 0.024 ) times that in the LP group . There was a tendency for a higher weight in HP children ( 0.67 kg ; 95 % CI : -0.04 , 1.39 kg ; P = 0.064 ) but no difference in height between the intervention groups . Anthropometric measurements were similar in the LP and breastfed groups . CONCLUSIONS Infant formula with a lower protein content reduces BMI and obesity risk at school age . Avoidance of infant foods that provide excessive protein intakes could contribute to a reduction in childhood obesity . This trial was registered at clinical trials.gov as NCT00338689 Abstract Objective To identify risk factors in early life ( up to 3 years of age ) for obesity in children in the United Kingdom . Design Prospect i ve cohort study . Setting Avon longitudinal study of parents and children , United Kingdom . Participants 8234 children in cohort aged 7 years and a sub sample of 909 children ( children in focus ) with data on additional early growth related risk factors for obesity . Main outcome measures Obesity at age 7 years , defined as a body mass index 3 95th centile relative to reference data for the UK population in 1990 . Results Eight of 25 putative risk factors were associated with a risk of obesity in the final models : parental obesity ( both parents : adjusted odds ratio , 10.44 , 95 % confidence interval 5.11 to 21.32 ) , very early ( by 43 months ) body mass index or adiposity rebound ( 15.00 , 5.32 to 42.30 ) , more than eight hours spent watching television per week at age 3 years ( 1.55 , 1.13 to 2.12 ) , catch-up growth ( 2.60 , 1.09 to 6.16 ) , st and ard deviation score for weight at age 8 months ( 3.13 , 1.43 to 6.85 ) and 18 months ( 2.65 , 1.25 to 5.59 ) ; weight gain in first year ( 1.06 , 1.02 to 1.10 per 100 g increase ) ; birth weight , per 100 g ( 1.05 , 1.03 to 1.07 ) ; and short ( < 10.5 hours ) sleep duration at age 3 years ( 1.45 , 1.10 to 1.89 ) . Conclusion Eight factors in early life are associated with an increased risk of obesity in childhood Limited evidence suggests that the dietary inclusion of oligofructose , an inulin-type fructan with prebiotic properties , may increase satiety and , thus , reduce energy intake and body weight in overweight and obese adults . The aim of the present study was to assess the effect of oligofructose supplementation for 12 weeks on the BMI of overweight and obese children . A total of ninety-seven children aged 7 - 18 years who were overweight and obese ( BMI > 85th percentile ) were r and omly assigned to receive placebo ( maltodextrin ) or oligofructose ( both at an age-dependent dose : 8 g/d for children aged 7 - 11 years and 15 g/d for children aged 12 - 18 years ) for 12 weeks . Before the intervention , all children received dietetic advice and they were encouraged to engage in physical activity . The primary outcome measure was the BMI -for-age z-score difference between the groups at the end of the intervention . Data from seventy-nine ( 81 % ) children were available for analysis . At 12 weeks , the BMI -for-age z-score difference did not differ between the experimental ( n 40 ) and control ( n 39 ) groups ( mean difference 0.002 , 95 % CI - 0.11 , 0.1 ) . There were also no significant differences between the groups with regard to any of the secondary outcomes , such as the mean BMI -for-age z-score , percentage of body weight reduction and the difference in total body fat . Adverse effects were similar in both groups . In conclusion , oligofructose supplementation for 12 weeks has no effect on body weight in overweight and obese children Objectives : Infant formulas provide more protein than breast milk . High protein intakes may place infants at risk of later obesity . The present study tested whether a formula with protein content below the regulatory level supports normal growth from age 3 months . Methods : R and omized double-blind trial enrolled healthy infants less than age 3 months . At 3 months , formula-fed infants were assigned to experimental ( EXPL , 1.61 g protein/100 kcal ; modified bovine whey proteins with caseinoglycomacropeptide removed ) or control ( CTRL 2.15 g protein/100 kcal ; unmodified bovine milk protein with a whey/casein ratio of 60/40 ) formula ;  breast-fed ( BF ) infants  were enrolled in a reference group . Complementary foods were allowed in small amounts from 4 to 6 months and unrestricted after 6 months . Results : Weight gain ( g/day ) from 3 to 6 months was similar in the EXPL and CTRL groups ( EXPL-CTRL −0.84 g/day ; 95 % confidence interval −2.25 to 0.57 ) and faster in the EXPL and CTRL groups than in the BF group . Weight analyzed longitudinally from 4 to 12 months was lower in the EXPL group than in the CTRL group ( P = 0.031 ) but higher than in the BF group ( P < 0.0001 ) . Longitudinal analysis of odds ratios from 4 to 12 months indicated fewer infants with weight > 85th percentile in the EXPL group than in the CTRL group ( P = 0.015 ) . Length z scores were lower than , and body mass index z scores were similar to , World Health Organization St and ards in all of the groups . Serum biochemical parameters in the EXPL group reflected lower protein intake and were closer to parameters in the BF infants than in the CTRL group . Conclusions : A formula with 1.61 g of protein/100 kcal supports normal growth of infants after age 3 months . This protein content is adequate if provided from a high- quality source IMPORTANCE Evidence that longer-term and exclusive breastfeeding reduces child obesity risk is based on observational studies that are prone to confounding . OBJECTIVE To investigate effects of an intervention to promote increased duration and exclusivity of breastfeeding on child adiposity and circulating insulin-like growth factor (IGF)-I , which regulates growth . DESIGN , SETTING , AND PARTICIPANTS Cluster-r and omized controlled trial in 31 Belarusian maternity hospitals and their affiliated clinics , r and omized into 1 of 2 groups : breastfeeding promotion intervention  ( n = 16 ) or usual practice s ( n = 15 ) . Participants were 17,046 breastfeeding mother-infant pairs enrolled in 1996 and 1997 , of whom 13,879 ( 81.4 % ) were followed up between January 2008 and December 2010 at a median age of 11.5 years . INTERVENTION Breastfeeding promotion intervention modeled on the WHO/UNICEF Baby-Friendly Hospital Initiative ( World Health Organization/United Nations Children 's Fund ) . MAIN OUTCOME MEASURES Body mass index ( BMI ) , fat and fat-free mass indices ( FMI and FFMI ) , percent body fat , waist circumference , triceps and subscapular skinfold thicknesses , overweight and obesity , and whole-blood IGF-I. Primary analysis was based on modified intention-to-treat ( without imputation ) , accounting for clustering within hospitals and clinics . RESULTS The experimental intervention substantially increased breastfeeding duration and exclusivity when compared with the control ( 43 % vs 6 % exclusively breastfed at 3 months and 7.9 % vs 0.6 % at 6 months ) . Cluster-adjusted mean differences in outcomes at 11.5 years of age between experimental vs control groups were : 0.19 ( 95 % CI , -0.09 to 0.46 ) for BMI ; 0.12 ( -0.03 to 0.28 ) for FMI ; 0.04 ( -0.11 to 0.18 ) for FFMI ; 0.47 % ( -0.11 % to 1.05 % ) for percent body fat ; 0.30 cm ( -1.41 to 2.01 ) for waist circumference ; -0.07 mm ( -1.71 to 1.57 ) for triceps and -0.02 mm ( -0.79 to 0.75 ) for subscapular skinfold thicknesses ; and -0.02 st and ard deviations ( -0.12 to 0.08 ) for IGF-I. The cluster-adjusted odds ratio for overweight/obesity ( BMI ≥ 85th vs < 85th percentile ) was 1.18 ( 95 % CI , 1.01 to 1.39 ) and for obesity ( BMI ≥ 95th vs < 85th percentile ) was 1.17 ( 95 % CI , 0.97 to 1.41 ) . CONCLUSIONS AND RELEVANCE Among healthy term infants in Belarus , an intervention that succeeded in improving the duration and exclusivity of breastfeeding did not prevent overweight or obesity , nor did it affect IGF-I levels at age 11.5 years . Breastfeeding has many advantages but population strategies to increase the duration and exclusivity of breastfeeding are unlikely to curb the obesity epidemic . TRIAL REGISTRATION is rct n.org : IS RCT N37687716 ; and clinical trials.gov : NCT01561612 BACKGROUND Maternal diet during pregnancy may contribute to the risk of offspring adiposity .  OBJECTIVES The objective of the study is to explore the associations between maternal  antenatal dietary fatty acid intake and the risk of offspring overweight and obesity at the ages of 2 to 7 years . METHODS In a prospect i ve Finnish birth cohort with 3807 mother-child pairs ,  maternal diet in  late pregnancy was assessed with a food frequency question naire . Intakes of total fatty acids and individual saturated , monounsaturated and polyunsaturated fatty acids ( PUFAs ) were calculated . Generalized estimating equation models were used to study the associations of maternal dietary variables with repeatedly measured offspring overweight and obesity . RESULTS In girls , maternal intake ratio of n-6:n-3 PUFAs had a U-shaped association with obesity ( adjusted OR for the lowest 2.0 [ 95 % CI 1.27 - 3.20 ] and the highest 1.7 [ 1.03 - 2.73 ] vs. the two middle quartiles of n-6:n-3 PUFAs , p = 0.01 ) . In boys , arachidonic acid ( 20:4n-6 ) : docosahexaenoic acid + eicosapentaenoic acid ratio was associated with obesity ( adjusted OR for the lowest 1.0 [ 0.60 - 1.57 ] and the highest 0.5 [ 0.26 - 0.88 ] vs. the two middle quartiles , p = 0.02 ) . Saturated fatty acids and monounsaturated fatty acids were not associated with overweight or obesity in either sex . CONCLUSIONS Maternal intakes of PUFAs in late pregnancy were associated with risk of later obesity differently in girls and boys Background A novel approach is explored for improving causal inference in observational studies by comparing cohorts from high-income with low- or middle-income countries ( LMIC ) , where confounding structures differ . This is applied to assessing causal effects of  breastfeeding  on child blood pressure ( BP ) , body mass index ( BMI ) and intelligence quotient ( IQ ) . Methods St and ardized approaches for assessing the confounding structure of breastfeeding by socio-economic position were applied to the British Avon Longitudinal Study of Parents and Children ( ALSPAC ) ( N ≃ 5000 ) and Brazilian Pelotas 1993 cohorts ( N ≃ 1000 ) . This was used to improve causal inference regarding associations of breastfeeding with child BP , BMI and IQ . Analyses were extended to include results from a meta- analysis of five LMICs ( N ≃ 10 000 ) and compared with a r and omized trial of breastfeeding promotion . Findings Although higher socio-economic position was strongly associated with breastfeeding in ALSPAC , there was little such patterning in Pelotas . In ALSPAC , breastfeeding was associated with lower BP , lower BMI and higher IQ , adjusted for confounders , but in the directions expected if due to socioeconomic patterning . In contrast , in Pelotas , breastfeeding was not strongly associated with BP or BMI but was associated with higher IQ . Differences in associations observed between ALSPAC and the LMIC meta- analysis were in line with those observed between ALSPAC and Pelotas , but with robust evidence of heterogeneity detected between ALSPAC and the LMIC meta- analysis associations . Trial data supported the conclusions inferred by the cross-cohort comparisons , which provided evidence for causal effects on IQ but not for BP or BMI . Conclusion While reported associations of breastfeeding with child BP and BMI are likely to reflect residual confounding , breastfeeding may have causal effects on IQ . Comparing associations between population s with differing confounding structures can be used to improve causal inference in observational studies Early excessive weight gain is positively associated with later obesity , and yet the effect of weight gain during specific periods and the impact of infant feeding practice s are debated . The objective of the present study was to examine the impact of weight gain in periods of early childhood on body composition at 3 years , and whether infant feeding modified the relationship between early growth and body composition at 3 years . We studied 233 children from the prospect i ve cohort study , SKOT ( in Danish : Småbørns Kost og Trivsel ) .  Birth weight z-scores ( BWZ ) and change in weight-for-age z-scores ( WAZ ) from 0 to 5 , 5 to 9 , 9 to 18 and 18 to 36 months were analysed for relations with body composition ( anthropometry and bioelectrical impedance ) at 3 years by multivariate regression analysis . BWZ and change in WAZ from 0 to 5 months were positively associated with BMI , fat mass index ( FMI ) and fat-free mass index ( FFMI ) at 3 years . Full breastfeeding for 6 months ( compared to less than 1 month ) eliminated the effect of early growth ( P = 0.01 ) . Full breastfeeding for 6 months ( compared to less than 1 month ) also eliminated the positive relation between BWZ and FMI ( P = 0.009 ) . No effect modification of infant feeding was found for FFMI . In conclusion , high birth weight and rapid growth from 0 to 5 months were associated with increased FMI and FFMI at 3 years . Longer duration of full breastfeeding reduced the effect of birth weight and early weight gain on fat mass Background It is crucial to identify in large population sample s the most important determinants of excessive fetal growth . The aim of the study was to evaluate the independent role of pre-pregnancy body mass index ( BMI ) , gestational weight gain and gestational diabetes on the risk of macrosomia . Methods A prospect i ve study collected data on mode of delivery and maternal/neonatal outcomes in eleven Hospitals in Italy . Multiple pregnancies and preterm deliveries were excluded . The sample included 14109 women with complete records . Associations between exposure variables and newborn macrosomia were analyzed using Pearson ’s chi squared test . Multiple logistic regression models were built to assess the independent association between potential predictors and macrosomia . Results Maternal obesity ( adjusted OR 1.7 , 95 % CI 1.4 - 2.2 ) , excessive gestational weight gain ( adjusted OR 1.9 , 95 % CI 1.6 - 2.2 ) and diabetes ( adjusted OR 2.1 , 95 % CI 1.5 - 3.0 for gestational ; adjusted OR 3.0 , 95 % CI 1.2 - 7.6 for pre-gestational ) result ed to be independent predictors of macrosomia , when adjusted for other recognized risk factors . Since no significant interaction was found between pre-gestational BMI and gestational weight gain , excessive weight gain should be considered an independent risk factor for macrosomia . In the sub-group of women affected by gestational or pre-gestational diabetes , pre-gestational BMI was not significantly associated to macrosomia , while excessive pregnancy weight gain , maternal height and gestational age at delivery were significantly associated . In this sub- population , pregnancy weight gain less than recommended was not significantly associated to a reduction in macrosomia . Conclusions Our findings indicate that maternal obesity , gestational weight gain excess and diabetes should be considered as independent risk factors for newborn macrosomia . To adequately evaluate the clinical evolution of pregnancy all three variables need to be carefully assessed and monitored Background : High maternal dietary intakes in pregnancy may lead to increased fetal growth and program neuroendocrine pathways that result in greater appetite , energy intake , and adiposity in offspring later in life . Few prospect i ve dietary studies have explored this relation . Objective : The objective was to assess associations of maternal dietary intake in pregnancy and maternal and paternal dietary intake postnatally with child dietary intake and adiposity . Design : Dietary intakes of energy , protein , total fat , and carbohydrate were assessed prospect ively in mothers during pregnancy , in mothers and their partners at 47 mo postnatally , and in children at 10 y ( n = 5717 mother-child pairs prenatally , 5593 mother-child pairs postnatally , and 3009 father-child pairs ) . Child body composition was assessed at 9 and 11 y ( n = 5725 ) . Results : Maternal dietary intakes of protein , fat ( when adjusted for energy intake ) , and carbohydrate in pregnancy were positively associated with child dietary intakes of the same nutrients , and these associations were greater than those observed for paternal dietary intake , which was not strongly associated with offspring diet . Associations of maternal prenatal-offspring intakes were stronger than those of maternal postnatal-offspring intakes for protein and fat . Greater child energy and macronutrient intakes were only associated with greater adiposity in children when adjusted for potential energy underreporting . Maternal diet during pregnancy was not associated with offspring adiposity or lean mass . Conclusion : The stronger prenatal maternal associations with child dietary intake , particularly protein and fat , compared with both paternal intake associations and maternal postnatal intake associations provide some evidence for in utero programming of offspring appetite by maternal intake during pregnancy Background There is growing evidence that disturbances in maternal metabolism and , subsequently , intrauterine conditions affect foetal metabolism . Whether this has metabolic consequences in offspring later in life is not fully eluci date d. We investigated whether maternal pre-pregnancy  body mass index ( p BMI ) is associated with  offspring 's adiposity  at age 5–6 years and whether this association is mediated by the mother 's lipid profile during early pregnancy . Methods Data were derived from a multi-ethnic birth cohort , the Amsterdam Born Children and their Development ( ABCD ) study ( inclusion 2003–2004 ) . During early gestation mothers completed a question naire during pregnancy ( p BMI ) and r and om non-fasting blood sample s were analysed for total cholesterol ( TC ) , triglycerides ( TG ) , apolipoprotein A1 ( ApoA1 ) , apolipoprotein B ( ApoB ) and total free fatty acids ( FFA ) in early gestation . At age 5–6 years , child 's BMI , waist-to-height-ratio ( WHtR ) and fat% were assessed . Results Only non-diabetic mothers with at term-born children were included(n = 1727 ) . Of all women , 15.1 % were overweight ( BMI : 25–29.9 kg/m2 ) and 4.3 % were obese ( BMI ≥30 kg/m2 ) . After adjustments for confounders , every unit increase in p BMI was linearly associated with various offspring variables : BMI ( β 0.10 ; 95 % CI 0.08–0.12 ) , WHtR*100(β 0.13 ; 95 % CI 0.09–0.17 ) , fat%(β 0.21 ; 95 % CI 0.13–0.29 ) and increased risk for overweight(OR:1.15 ; 95 % CI 1.10–1.20 ) . No convincing proof for mediation by maternal lipid profile during early gestation was found . Moreover , maternal FFA was associated with the child 's fat percentage , BMI and risk for overweight . Maternal ApoB and TC were positively associated with the offspring 's fat percentage and maternal TG was positively associated with their children 's WHtR. Conclusions Both p BMI and maternal lipids during early pregnancy are independently related to offspring adiposity Background Knowledge on the long-term development of adiposity throughout childhood/adolescence and its prenatal determinants and health sequelae is lacking . We sought to ( 1 ) identify trajectories of Body Mass Index ( BMI ) from 1 to 18 years of age , ( 2 ) examine associations of  maternal gestational smoking and early pregnancy overweight with offspring BMI trajectories and ( 3 ) determine whether BMI trajectories predict health outcomes : asthma , lung function parameters ( forced expiratory volume in one second (FEV1)/forced vital capacity ( FVC ) ratio ) , and blood pressure , at 18 years . Methods The Isle of Wight birth cohort , a population -based sample of 1456 infants born between January 1989 and February 1990 , was prospect ively assessed at ages 1 , 2 , 4 , 10 and 18 years . Group-based trajectory modelling was applied to test for the presence of latent BMI trajectories . Associations were assessed using log-binomial and linear regression models . Results Four trajectories of BMI were identified : ‘ normal ’ , ‘ early persistent obesity ’ , ‘ delayed overweight ’ , and ‘ early transient overweight ’ . Risk factors for being in the early persistent obesity trajectory included maternal smoking during pregnancy ( RR 2.16 , 95 % CI 1.02 to 4.68 ) and early pregnancy overweight ( 3.16 , 1.52 to 6.58 ) . When comparing the early persistent obesity to the normal trajectory , a 2.15-fold ( 1.33 to 3.49 ) increased risk of asthma , 3.2 % ( 0.4 % to 6.0 % ) deficit in FEV1/FVC ratio , and elevated systolic 11.3 mm Hg ( 7.1 to 15.4 ) and diastolic 12.0 mm Hg ( 8.9 to 15.1 ) blood pressure were observed at age 18 years . Conclusions Maternal prenatal exposures show prolonged effects on offspring 's propensity towards overweight-obesity . Distinct morbid BMI trajectories are evident during the first 18 years of life that are associated with higher risk of asthma , reduced FEV1/FVC ratio , and elevated blood pressure Objectives : R and omised controlled trials are required to address causality in the reported associations between maternal influences and offspring adiposity . The aim of this study was to determine whether an antenatal lifestyle intervention , associated with improvements in maternal diet and reduced gestational weight gain ( GWG ) in obese pregnant women leads to a reduction in infant adiposity and sustained improvements in maternal lifestyle behaviours at 6 months postpartum . Subjects and methods : We conducted a planned postnatal follow-up of a r and omised controlled trial ( UK Pregnancies Better Eating and Activity Trial ( UPBEAT ) ) of a complex behavioural intervention targeting maternal diet ( glycaemic load ( GL ) and saturated fat intake ) and physical activity in 1555 obese pregnant women . The main outcome measure was infant adiposity , assessed by subscapular and triceps skinfold thicknesses . Maternal diet and physical activity , indices of the familial lifestyle environment , were assessed by question naire . Results : A total of 698 ( 45.9 % ) infants ( 342 intervention and 356 st and ard antenatal care ) were followed up at a mean age of 5.92 months . There was no difference in triceps skinfold thickness z-scores between the intervention vs st and ard care arms ( difference −0.14 s.d . , 95 % confidence interval −0.38 to 0.10 , P=0.246 ) , but subscapular skinfold thickness z-score was 0.26 s.d . ( −0.49 to −0.02 ; P=0.03 ) lower in the intervention arm . Maternal dietary GL ( −35.34 ; −48.0 to −22.67 ; P<0.001 ) and saturated fat intake ( −1.93 % energy ; −2.64 to −1.22 ; P<0.001 ) were reduced in the intervention arm at 6 months postpartum . Causal mediation analysis suggested that lower infant subscapular skinfold thickness was partially mediated by changes in antenatal maternal diet and GWG rather than postnatal diet . Conclusions : This study provides evidence from follow-up of a r and omised controlled trial that a maternal behavioural intervention in obese pregnant women has the potential to reduce infant adiposity and to produce a sustained improvement in maternal diet at 6 months postpartum OBJECTIVE We assessed the effect of a cholesterol-lowering diet on  maternal , cord , and neonatal plasma lipids and pregnancy outcome . STUDY DESIGN Nonsmoking white women with singleton pregnancies ( n = 290 ) , aged 21 to 38 years , and with no previous pregnancy-related complications , were r and omized to either continue their usual diet or to adopt a diet that promoted fish , low-fat meats and dairy products , oils , whole grains , fruits , vegetables , and legumes from gestational week 17 to 20 to birth . RESULTS Maternal total and low-density lipoprotein cholesterol levels were lowered in the intervention compared with the control group ( P < .01 ) . Lipid levels in cord blood and in neonates born to mothers in the intervention versus the control groups did not differ . In the intention-to-treat cohort 1 ( 0.7 % ) of 141 women in the intervention group versus 11 ( 7.4 % ) of 149 women in the control group delivered before 37 weeks ( RR 0.10 ; 95 % CI 0.01 - 0.77 ) . The incidence of other pregnancy complications and birth weight was similar in both groups . CONCLUSION A cholesterol-lowering diet may modify maternal lipid levels but not cord and neonatal lipids . The marked observed effect of this diet on the reduction of preterm delivery in low-risk pregnancies should encourage future larger studies to clarify the role of such a diet in the prevention of preterm birth BACKGROUND Maternal polyunsaturated fatty acid ( PUFA ) concentrations during pregnancy may have persistent effects on growth and adiposity in the offspring . A suboptimal maternal diet during pregnancy might lead to fetal cardiometabolic adaptations with persistent consequences in the offspring . OBJECTIVE We examined the associations of maternal PUFA concentrations during pregnancy with childhood general and abdominal fat-distribution measures . DESIGN In a population -based , prospect i ve cohort study of 4830 mothers and their children , we measured maternal second-trimester plasma n-3 ( ω-3 ) and n-6 ( ω-6 ) PUFA concentrations .  At the median age of 6.0 y ( 95 % range : 5.6 , 7.9 y ) , we measured childhood body mass index ( BMI ) , the fat mass percentage , and the and roid : gynoid fat ratio with the use of dual-energy X-ray absorptiometry and measured the preperitoneal abdominal fat area with the use of ultrasound . Analyses were adjusted for maternal and childhood sociodemographic- and lifestyle-related characteristics . RESULTS We observed that higher maternal total n-3 PUFA concentrations , and specifically those of eicosapentaenoic acid , docosapentaenoic acid , and docosahexaenoic acid , were associated with a lower childhood total-body fat percentage and a lower and roid : gynoid fat mass ratio ( P < 0.05 ) but not with childhood BMI and the abdominal preperitoneal fat mass area . Higher maternal total n-6 PUFA concentrations , and specifically those of dihomo-γ-linolenic acid , were associated with a higher childhood total-body fat percentage , and roid : gynoid fat mass ratio , and abdominal preperitoneal fat mass area ( P < 0.05 ) but not with childhood BMI . In line with these findings , a higher maternal n-6:n-3 PUFA ratio was associated with higher childhood total-body and abdominal fat mass . CONCLUSIONS Lower maternal n-3 PUFA concentrations and higher n-6 PUFA concentrations during pregnancy are associated with higher body fat and abdominal fat in childhood . Additional studies are needed to replicate these observations and to explore the causality , the underlying pathways , and the long-term cardiometabolic consequences Abstract This study aims to investigate the effect of  maternal pre‐pregnancy body mass index ( BMI ) and gestational weight gain ( GWG ) on offspring body composition . In this prospect i ve cohort study , offspring body composition at 6 years of age was obtained through air displacement plethysmography . Linear regression was used to obtain crude and adjusted coefficients . Information regarding offspring body composition and maternal pre‐pregnancy BMI was available for 3156 children and on offspring body composition and GWG for 3129 children . There was a direct association of maternal pre‐pregnancy BMI and GWG with offspring 's fat mass ( FM ) , fat‐free mass ( FFM ) , fat mass index ( FMI ) , fat‐free mass index ( FFMI ) and body fat percent ( BF% ) in crude and adjusted analyses . After adjustment for co‐variables , for each kg m−2 of maternal pre‐pregnancy BMI increase , there was a mean increment of 0.13 kg in the offspring FFM , 0.06 kg m−2 in FFMI , 0.11 kg in FM , 0.07 kg m−2 in FMI and 0.18 % in BF% . For each kilogram of maternal GWG increase , there was a mean increment of 0.08 kg in offspring 's FM , 0.05 kg m−2 in FMI , 0.04 kg in FFM , 0.01 kg m−2 in FFMI and 0.18 % in BF% . Mothers with a higher pre‐pregnancy BMI or GWG tend to have children with greater adiposity at age 6 years . Fetal overnutrition is more likely among mothers with greater BMI during pregnancy ; as a consequence , it can accelerate the childhood obesity epidemic Purpose Intra-uterine exposure to protein may affect body composition and may increase the prevalence of childhood adiposity . Therefore , we examined whether protein intake during pregnancy is associated with  offspring body composition at the age of 6 years and whether associations differ for animal protein and vegetable protein . Methods We included 2694 Dutch mother – child pairs participating in a prospect i ve population -based cohort in Rotterdam , the Netherl and s. Energy-adjusted protein was measured in pregnancy using a food-frequency question naire and analyzed in quartiles . At a mean age of 6.1 ± 0.4 years , we measured children ’s body mass index , and fat-free mass index and fat mass index using dual-energy X-ray absorptiometry . Outcomes were st and ardized for age and sex . BMI was used to classify children ’s overweight status . Results After adjustment for sociodemographic and lifestyle factors , a higher maternal protein  intake was associated with a higher children ’s fat-free mass index [ difference 0.14 st and ard deviation ( 95 % CI 0.03 , 0.25 ) for highest vs. lowest quartile of protein intake ] , but not with children ’s fat mass index or body mass index . Comparable associations were found for animal protein and vegetable protein . Maternal protein intake was not associated with children ’s overweight . Conclusions and relevance This study suggests that higher protein intake during pregnancy is associated with a higher fat-free mass in children at the age of 6 years , but not with their fat mass . Our results do not suggest specific recommendations regarding maternal protein intake during pregnancy to prevent overweight in the offspring BACKGROUND Effects of maternal leisure time physical activity ( LTPA ) on  paediatric obesity  are unknown . The objective of this study was to examine associations of maternal LTPA with offspring overall and central adiposity in mid-childhood . METHODS We analysed data from 802 mother-child dyads from Project Viva , a prospect i ve pre-birth cohort study . Women reported average weekly LTPA before and during mid-pregnancy . At age 7 - 10 years , we measured fat , truncal fat and lean mass with dual-energy X-ray absorptiometry . Using multivariable linear regression , we examined associations of maternal LTPA with offspring adiposity , adjusting for child age and sex , maternal race/ethnicity , education , age , pre-pregnancy body mass index , marital status and smoking status . RESULTS Mean ( st and ard deviation ) of LTPA before and during mid-pregnancy were 9.5 ( 8.1 ) and 7.1 ( 7.0 ) h week(-1 ) . At mean age 7.8 ( 0.8 ) years , childhood fat , truncal fat and lean mass indices were 4.3 ( 1.8 ) , 1.4 ( 0.8 ) and 12.9 ( 1.4 ) kg m(-2 ) . We did not find that higher maternal LTPA was associated with lower child adiposity outcomes . For example , compared with 0 - 3 h week(-1 ) of LTPA during mid-pregnancy , children of mothers with + 8 h week(-1 ) had fat mass index 0.07 kg m(-2 ) ( 95 % confidence interval : -0.22 , 0.36 ) . In analyses of within-person LTPA change from before to mid-pregnancy , compared with + 2 h week(-1 ) decrease in LTPA , increased LTPA ( 2 ± h week(-1 ) ) was associated with a 0.09 kg m(-2 ) fat mass index ( -0.25 , 0.43 ) . CONCLUSIONS Contrary to our hypothesis , higher LTPA before and during mid-pregnancy , and the change between them , were not associated with lower adiposity in mid-childhood BACKGROUND Growth acceleration as a consequence of relative overnutrition in infancy has been suggested to increase the risk of later obesity . However , few studies have investigated this association by using an experimental study design . OBJECTIVE We investigated the effect of early growth promotion on later body composition in 2 studies of infants born small for gestational age ( weight < 10th percentile in study 1 and < 20th percentile in study 2 ) . DESIGN We review ed a subset of children ( n = 153 of 299 in study 1 and 90 of 246 in study 2 ) r and omly assigned at birth to receive either a  control formula or a nutrient-enriched formula  ( which contained 28 - 43 % more protein and 6 - 12 % more energy than the control formula ) at 5 - 8 y of age . Fat mass was measured by using bioelectric impedance analysis in study 1 and deuterium dilution in study 2 . RESULTS Fat mass was lower in children assigned to receive the control formula than in children assigned to receive the nutrient-enriched formula in both trials [ mean ( 95 % CI ) difference for fat mass after adjustment for sex : study 1 : -38 % ( -67 % , -10 % ) , P = 0.009 ; study 2 : -18 % ( -36 % , -0.3 % ) , P = 0.04 ] . In nonr and omized analyses , faster weight gain in infancy was associated with greater fat mass in childhood . CONCLUSIONS In 2 prospect i ve r and omized trials , we showed that a nutrient-enriched diet in infancy increased fat mass later in childhood . These experimental data support a causal link between faster early weight gain and a later risk of obesity , have important implication s for the management of infants born small for gestational age , and suggest that the primary prevention of obesity could begin in infancy Objective : Gestational weight gain ( GWG ) is associated with childhood obesity . We analyzed whether this effect persists into adulthood and is mediated by effects in childhood . Design : The design of the study a prospect i ve birth cohort study established in 1959–1961.Subjects : The subjects were offspring ( n=4234 of whom 2485 had information from the last follow-up ) of mothers included in ‘ The Copenhagen Perinatal Cohort ’ during pregnancy or at birth . Measurements : Information on  maternal pre-pregnancy body mass index ( BMI ) , GWG  and several potential  confounders were collected around delivery . Information on offspring BMI was available from various follow-up examinations from 1 to 42 years of age . The association of GWG with offspring BMI was analyzed by regression models including confounders . Using path analysis , the association of GWG with adult BMI was disentangled into an association mediated through childhood BMI and one independent hereof . Results : GWG was associated with offspring BMI at all ages . At the age of 42 years ( n=1540 ) , there was an increasing risk of obesity ( odds ratio ( OR ) 1.08 , 95 % confidence interval ( CI ) 1.03–1.14 per kg GWG , P=0.003 ) . Only half of the association of GWG on offspring adult BMI was mediated through birth weight and BMI up to 14 years of age . Conclusion : Greater GWG is associated with an increased BMI in childhood through adulthood and with an increased risk of obesity  in adults . Only part of the association with adult BMI is mediated by childhood BMI , suggesting that excessive GWG induces a persisting susceptibility to obesogenic environments . As GWG is greater in women with small pre-pregnancy body weight , this implies a reinforcement of the obesity epidemic in the next generation . Our findings provide support for avoiding excessive GWG Objectives To explore how fat , lean and body mass index ( BMI ) track in childhood and how this relates to parental obesity . Design and Setting Prospect i ve population -based cohort study : Avon Longitudinal Study of Parents and Children , UK . Method Height , weight and leg-to-leg bioelectrical impedance ( BIA ) were collected at ages 7 and 11 years , as well as pre-pregnancy parental heights and weights . For BMI International Obesity Task Force thresholds of obesity and overweight were used . Impedance data were expressed as separate lean and fat z scores , internally st and ardised for gender , height and age and a child was defined as over-fat if fat z score was > 85th and very over-fat if > 95th internal centile . Results Data were available for 7723 and 7252 children at ages 7 and 11 years , respectively ( 6066 at both time points ) . Of those obese at age 7 , 75 % were still obese at age 11 , while of those who had been overweight 16 % had become obese and 20 % now had normal BMI . Both fat and lean z scores showed moderate levels of tracking ( correlation coefficients 0.70 and 0.73 , respectively ) . Children with one or two obese parents had higher fat z scores at age 7 and showed greater increases in fat thereafter . They were more likely to be very over-fat at age 7 and , of these , 69 % remained so at age 11 compared to only 45 % with non-obese parents ( p < 0.001 ) . Conclusions Children of obese parents already have high fat levels at age 7 and are more likely to remain very over-fat OBJECTIVES To identify an optimal growth trajectory for term small for gestational age ( SGA ) babies from birth to 7-years-old . STUDY DESIGN Data were from the Collaborative Perinatal Project , a US multicenter prospect i ve cohort study from 1959 - 1976 . Five weight growth trajectories of the 1957 term SGA babies were grouped by a latent class model . We selected the optimal growth pattern based on the lowest overall risks of childhood diseases . RESULTS Compared with appropriate for gestational age children , SGA babies with no catch-up growth ( 439 , 22.4 % ) had higher risks of infection in infancy ( aOR 1.2 , 95 % CI 1.0 - 1.6 ) , growth restriction ( 11.2 , 8.6 - 14.6 ) , and low IQ ( 2.1 , 1.7 - 2.8 ) at age 7 years . Those with excessive catch-up growth ( 176 , 8.9 % ) had higher risks of overweight/obesity ( 7.5 , 5.4 - 10.5 ) and elevated blood pressure ( 1.7 , 1.1 - 2.4 ) at age 7 years . Babies with slow catch-up growth ( 328 , 16.8 % ) or regression after 4 months ( 285 , 14.6 % ) were associated with higher risks of low IQ ( 1.6 , 1.2 - 2.1 ) and growth restriction ( 2.2 , 1.5 - 3.2 ) , respectively . Only babies with appropriate catch-up growth ( 729 , 37.3 % ) did not have increased risk of adverse outcomes . Further , we also tested linear growth trajectories with similar findings . CONCLUSIONS The optimal growth trajectory for term SGA infants may be fast catch-up growth to about the 30th percentile in the first several months , with modest catch-up growth thereafter , to be around the 50th percentile by 7-years-old Many studies have shown that shorter sleep duration in childhood is associated with higher body mass index ( BMI ) , and have proposed that it is due to an effect of sleep on adiposity . There is little evidence about the association of sleep with fat-free mass . This study examined the association between  child 's sleep duration  at age 3 years and fat and fat-free mass at 4 years of age in a prospect i ve cohort study of 302 boys and 285 girls . Study participants were taking part in the Southampton Women 's Survey , a longitudinal study of mothers and children from preconception onwards .  Total sleep duration  at age 3 years was derived from parental report of night sleep and nap duration .  Body composition was assessed by Dual-energy X-ray Absorptiometry ( DXA ) at 4 years . Mean total sleep duration was 11.5 hours . In linear regression analyses , adjusted for potentially confounding factors ( maternal educational attainment , prepregnancy BMI , smoking during pregnancy , child 's gestational age at birth , age at DXA , sex , age last breastfed , dietary quality at 3 years , TV watching and hours actively on the move and parental social class ) , shorter sleep in hours was associated with higher BMI ( kg/m(2 ) ) [ β : -0.2340 , 95 % confidence interval ( CI ) : -0.373 to -0.096 ] , a greater fat mass index ( kg ) ( β : -0.1182 , 95 % CI : -0.218 to -0.018 ) and a greater fat-free mass index ( kg ) ( β : -0.100 , 95 % CI : -0.185 to -0.015 ) . Previous research suggested that the association between shorter sleep and higher body mass index is due to an effect on adiposity . Our findings are novel , suggesting that the relationship between sleep and BMI is also determined by an effect on muscle BACKGROUND A small number of relatively small studies have found greater gestational weight gain to be associated with greater offspring body mass index ( BMI ; in kg/m(2 ) ) , but whether this association is caused by intrauterine mechanisms or by shared genetic and environmental risk factors for adiposity is unclear . OBJECTIVE The objective was to examine the association of greater  maternal weight gain  ( MWG ; postnatal weight minus weight at the first antenatal clinic assessment ) with greater offspring BMI and to explore whether any observed association is explained by intrauterine mechanisms . DESIGN This was a prospect i ve cohort study that used  record linkage data ( n = 146,894 individuals from 136,050 families ) . To compare the within-sibling and between-nonsibling associations , we used fixed- and between-cluster linear regression models . RESULTS Associations of MWG with later offspring BMI differed by the mother 's early-pregnancy overweight or obesity status ( P for interaction < 0.0001 ) . MWG was positively associated with BMI at a mean age of 18 y in the offspring of normal-weight women but only between unrelated men ( 0.07 ; 95 % CI : 0.06 , 0.07 ) per 1-kg greater MWG ; no within-sibling association ( 0.00 ; 95 % CI : -0.02 , 0.02 ) per 1-kg greater MWG was found . In contrast , in overweight and obese women we found a within-sibling association ( 0.06 ; 95 % CI : 0.01 , 0.12 ) and an association between unrelated men ( 0.02 ; 95 % CI : 0.01 , 0.03 ) per 1-kg greater MWG . CONCLUSION In normal-weight mothers , most of the association between MWG and later offspring BMI is explained by shared familial ( genetic and early environmental ) characteristics , whereas evidence indicates a contribution of intrauterine mechanisms in overweight and obese women IMPORTANCE Maternal fish intake in pregnancy has been shown to influence fetal growth . The extent to which fish intake affects  childhood growth and obesity  remains unclear . OBJECTIVE To examine whether fish intake in pregnancy is associated with  offspring growth and the risk of childhood overweight and obesity .  DESIGN , SETTING , AND PARTICIPANTS Multicenter , population -based birth cohort study of singleton deliveries from 1996 to 2011 in Belgium , France , Greece , Irel and , Italy , the Netherl and s , Norway , Pol and , Portugal , Spain , and Massachusetts . A total of 26,184 pregnant women and their children were followed up at 2-year intervals until the age of 6 years . EXPOSURES Consumption of fish during pregnancy . MAIN OUTCOMES AND MEASURES We estimated offspring body mass index percentile trajectories from 3 months after birth to 6 years of age . We defined rapid infant growth as a weight gain z score greater than 0.67 from birth to 2 years and childhood overweight/obesity at 4 and 6 years as body mass index in the 85th percentile or higher for age and sex . We calculated cohort-specific effect estimates and combined them by r and om-effects meta- analysis . RESULTS This multicenter , population -based birth cohort study included the 26,184 pregnant women and their children . The median fish intake during pregnancy ranged from 0.5 times/week in Belgium to 4.45 times/week in Spain . Women who ate fish more than 3 times/week during pregnancy gave birth to offspring with higher body mass index values from infancy through middle childhood compared with women with lower fish intake ( 3 times/week or less ) . High fish intake during pregnancy ( > 3 times/week ) was associated with increased risk of rapid infant growth , with an adjusted odds ratio ( aOR ) of 1.22 ( 95 % CI , 1.05 - 1.42 ) and increased risk of offspring overweight/obesity at 4 years ( aOR , 1.14 [ 95 % CI , 0.99 - 1.32 ] ) and 6 years ( aOR , 1.22 [ 95 % CI , 1.01 - 1.47 ] ) compared with an intake of once per week or less . Interaction analysis showed that the effect of high fish intake during pregnancy on rapid infant growth was greater among girls ( aOR , 1.31 [ 95 % CI , 1.08 - 1.59 ] ) than among boys ( aOR , 1.11 [ 95 % CI , 0.92 - 1.34 ] ; P = .02 for interaction ) . CONCLUSIONS AND RELEVANCE High maternal fish intake during pregnancy was associated with increased risk of rapid growth in infancy and childhood obesity . Our findings are in line with the fish intake limit proposed by the US Food and Drug Administration and Environmental Protection Agency Gestational  weight gain ( GWG )  is potentially modifiable and is associated with infant size and body composition ; however , long-term effects on childhood obesity have not been reported among multi-ethnic urban population s. We examined the association between GWG and child anthropometric measures and body composition at 7 years [ waist circumference ( WC ) , body mass index z-score ( BMI Z ) , obesity ( BMI Z ≥95%ile ) and bioelectrical impedance analysis estimates of percentage body fat ( % fat ) ] in African-American and Dominican dyads ( n = 323 ) in the Columbia Center for Children 's Environmental Health prospect i ve birth cohort study from 1998 to 2013 . Linear and logistic regression evaluated associations between excessive GWG [ > Institute of Medicine ( IOM ) 2009 guidelines ] and outcomes , adjusting for pre-pregnancy BMI and covariates . Pre-pregnancy BMI ( mean ± st and ard deviation , all such values ) and total GWG were 25.8 ± 6.2 kg m(-2 ) ( 45 % overweight/obese ) and 16.4 ± 7.9 kg ( 64 % > IOM guidelines ) , respectively . Excessive GWG was associated with higher BMI Z { 0.44 [ 95 % confidence interval ( CI ) : 0.2 , 0.7 ] , P < 0.001 } , WC [ β : 2.9 cm ( 95 % CI : 1.1 , 4.6 ) , P = 0.002 ] , % fat at 7 years [ β : 2.2 % ( 95 % CI : 1.0 , 3.5 ) , P = 0.001 ) ] and obesity [ odds ratio : 2.93 ( 95 % CI : 1.5 , 5.8 ) , P = 0.002 ] . Pre-pregnancy BMI was positively associated with child size , adiposity and obesity ( all P < 0.05 ) . Excessive GWG was highly prevalent and was associated with child obesity , greater percentage body fat and abdominal adiposity . Strategies to support healthy GWG are warranted to promote healthy growth and prevent childhood obesity CONTEXT Evidence suggests that babies ' fat mass at birth is greater if their mothers were themselves fatter during pregnancy , but it is unclear whether this association persists into childhood . OBJECTIVE Our objective was to examine the relation between maternal size in pregnancy , early growth and body composition in children . DESIGN AND SETTING We conducted a prospect i ve cohort study in Southampton , United Kingdom . PARTICIPANTS Participants included 216 9-yr-old children whose mothers had participated in a study of nutrition during pregnancy . MAIN OUTCOME MEASURES Fat mass and lean mass were measured by dual-energy x-ray absorptiometry and adjusted for height ( fat mass index and lean mass index ) . RESULTS Fat mass index at age 9 yr was greater in children whose mothers had a larger mid-upper arm circumference in late pregnancy or a higher prepregnant body mass index . For 1 sd increase in maternal mid-upper arm circumference in late pregnancy , fat mass index rose by 0.26 [ 95 % confidence interval ( CI ) 0.06 - 0.46 ] sd in boys and by 0.44 ( 95 % CI 0.31 - 0.57 ) sd in girls . For 1 sd increase in maternal prepregnant BMI , fat mass index rose by 0.26 ( 95 % CI 0.04 - 0.48 ) sd in boys and by 0.42 ( 95 % CI 0.29 - 0.56 ) sd in girls . CONCLUSIONS Mothers with a higher prepregnant body mass index or a larger mid-upper arm circumference during pregnancy tend to have children with greater adiposity at age 9 . The extent to which this is attributable to genetic factors , the influence of maternal lifestyle on that of her child , or maternal adiposity acting specifically during pregnancy on the child 's fat mass can not be determined in this study OBJECTIVE Prebiotics and probiotics may be able to modify an obesity-associated gut microbiota . The aim of this study was to examine the individual and combined effects of the prebiotic oligofructose ( OFS ) and the probiotic Bifidobacterium animalis subsp . lactis BB-12 ( BB-12 ) on gut microbiota and host metabolism in obese rats . METHODS Adult male , diet-induced obese Sprague Dawley rats were r and omized to : ( 1 ) Control ( C ) ; ( 2 ) 10 % OFS ; ( 3 ) BB-12 ; ( 4 ) OFS + BB-12 for 8 weeks ( n = 9 - 10 rats/group ) . Body composition , glycemia , gut permeability , satiety hormones , cytokines , and gut microbiota were examined . RESULTS Prebiotic , but not probiotic  reduced energy intake , weight gain , and fat mass ( P < 0.01 ) . OFS , BB-12 , and the combined OFS + BB-12  improved glycemia ( P < 0.05 ) . Individually , OFS and BB-12  reduced insulin levels ( P < 0.05 ) . Portal GLP-1 was increased with OFS , whereas probiotic increased GLP-2 ( P < 0.05 ) . There was a marked increase in bifidobacteria and lactobacilli ( P < 0.01 ) with OFS that was not observed with probiotic alone . CONCLUSIONS The impact of prebiotic intake on body composition and gut microbiota was of greater magnitude than the probiotic BB-12 . Despite this , an improvement in glucose AUC with both prebiotic or probiotic demonstrates the beneficial role of each of these " biotic " agents in glycemic control Objective Short sleep duration may contribute to childhood obesity . Amenable to intervention , sleep thus provides a potential path for prevention . The authors aim ed to determine the impact of a behavioural intervention that successfully reduced parent-reported infant sleep problems on adiposity at age 6 . Design 5-year follow-up of a previously reported population -based cluster r and omised trial . Participant allocation was concealed to research ers and data collection blinded . Setting Recruitment from well-child centres in Melbourne , Australia . Participants 328 children ( 174 intervention ) with parent-reported sleep problems at age 7–8 months drawn from 49 centres ( clusters ) . Intervention Behavioural sleep strategies delivered over one to three structured individual nurse consultations from 8 to 10 months , versus usual care . Main outcomes at age 6 years Body mass index ( BMI ) z-score , percentage overweight/obese and waist circumference . Analyses Intention-to-treat regression analyses adjusted for potential confounders . Results Anthropometric data were available for 193 children ( 59 % retention ) at age 6 . There was no evidence of a difference between intervention ( N=101 ) and control ( N=92 ) children for BMI z-score ( adjusted mean difference 0.2 , 95 % CI −0.1 to 0.4 ) , overweight/obese status ( 20 % vs 17 % ; adjusted OR 1.4 , 95 % CI 0.7 to 2.8 ) and waist circumference ( adjusted mean difference −0.3 , 95 % CI −1.6 to 1.1 ) . In posthoc analyses , neither infant nor childhood sleep duration were associated with anthropometric outcomes . Conclusions A brief infant sleep intervention did not reduce overweight/obesity at 6 years . Population -based primary care sleep services seem unlikely to reduce the early childhood obesity epidemic . Trial registration IS RCT Importance Evidence that breastfeeding reduces child obesity risk and lowers blood pressure ( BP ) is based on potentially confounded observational studies . Objective To investigate the effects of a breastfeeding promotion intervention on adiposity and BP at age 16 years and on longitudinal growth trajectories from birth . Design , Setting , and Participants Cluster-r and omized Promotion of Breastfeeding Intervention Trial . Belarusian maternity hospitals and affiliated polyclinics ( the clusters ) were allocated into intervention ( n = 16 ) or control arms ( n = 15 ) in 1996 and 1997 . The trial participants were 17 046 breastfeeding mother-infant pairs ; of these , 13 557 children ( 79.5 % ) were followed up at 16 years of age between September 2012 and July 2015 . Interventions Breastfeeding promotion , modeled on the Baby-Friendly Hospital Initiative . Main Outcomes and Measures Body mass index ( BMI , calculated as weight in kilograms divided by height in meters squared ) ; fat and fat-free mass indices and percentage of body fat from bioimpedance ; waist circumference ; overweight and obesity ; height ; BP ; and longitudinal growth trajectories . The primary analysis was modified intention-to-treat ( without imputation for losses to follow-up ) accounting for within-clinic clustering . Results We examined 13 557 children at a median age of 16.2 years ( 48.5 % were girls ) . The intervention substantially increased breastfeeding duration and exclusivity compared with the control arm ( exclusively breastfed : 45 % vs 6 % at 3 months , respectively ) . Mean differences at 16 years between intervention and control groups were 0.21 ( 95 % CI , 0.06 - 0.36 ) for BMI ; 0.21 kg/m2 ( 95 % CI , −0.03 to 0.44 ) for fat mass index ; 0.00 kg/m2 ( 95 % CI , −0.21 to 0.22 ) for fat-free mass index ; 0.71 % ( 95 % CI , −0.32 to 1.74 ) for percentage body fat ; −0.73 cm ( −2.48 to 1.02 ) for waist circumference ; 0.05 cm ( 95 % CI , −0.85 to 0.94 ) for height ; −0.54 mm Hg ( 95 % CI , −2.40 to 1.31 ) for systolic BP ; and 0.71 mm Hg ( 95 % CI , −0.68 to 2.10 ) for diastolic BP . The odds ratio for overweight/obesity ( BMI ≥85th percentile vs < 85th percentile ) was 1.14 ( 95 % CI , 1.02 - 1.28 ) and the odds ratio for obesity ( BMI ≥95th percentile vs < 95th percentile ) was 1.09 ( 95 % CI , 0.92 - 1.29 ) . The intervention result ed in a more rapid rate of gain in postinfancy height ( 1 to 2.8 years ) , weight ( 2.8 to 14.5 years ) , and BMI ( 2.8 to 8.5 years ) compared with the control arm . The intervention had little effect on BMI z score changes after 8.5 years . Conclusions and Relevance A r and omized intervention that increased the duration and exclusivity of breastfeeding was not associated with lowered adolescent obesity risk or BP . On the contrary , the prevalence of overweight/obesity was higher in the intervention arm . All mothers initiated breastfeeding , so findings may not apply to comparisons of the effects of breastfeeding vs formula feeding . Trial Registration is rct n.org : IS RCT N37687716 ; and clinical trials.gov : NCT01561612 Importance The early obesogenic home environment is consistently identified as a key influence on child weight trajectories , but little research has examined the mechanisms of that influence . Such research is essential for the effective prevention and treatment of overweight and obesity . Objective To test behavioral susceptibility theory ’s hypothesis that the heritability of body mass index ( BMI ) is higher among children who live in more obesogenic home environments . Design , Setting , and Participants This study was a gene-environment interaction twin study that used cross-sectional data from 925 families ( 1850 twins ) in the Gemini cohort ( a population -based prospect i ve cohort of twins born in Engl and and Wales between March and December 2007 ) . Data were analyzed from July to October 2013 and in June 2018 . Exposures Parents completed the Home Environment Interview , a comprehensive measure of the obesogenic home environment in early childhood . Three st and ardized composite scores were created to capture food , physical activity , and media-related influences in the home ; these were summed to create an overall obesogenic risk score . The 4 composite scores were split on the mean , reflecting higher-risk and lower-risk home environments . Main Outcomes and Measures Quantitative genetic model fitting was used to estimate heritability of age-adjusted and sex-adjusted BMI ( BMI SD score , estimated using British 1990 growth reference data ) for children living in lower-risk and higher-risk home environments . Results Among 1850 twins ( 915 [ 49.5 % ] male and 935 [ 50.5 % ] female ; mean [ SD ] age , 4.1 [ 0.4 ] years ) , the heritability of BMI SD score was significantly higher among children living in overall higher-risk home environments ( 86 % ; 95 % CI , 68%-89 % ) compared with those living in overall lower-risk home environments ( 39 % ; 95 % CI , 21%-57 % ) . The findings were similar when examining the heritability of BMI in the separate food and physical activity environment domains . Conclusions and Relevance These findings support the hypothesis that obesity-related genes are more strongly associated with BMI in more obesogenic home environments . Modifying the early home environment to prevent weight gain may be particularly important for children genetically at risk for obesity Objective : The administration of a fermentable dietary fibre ( oligofructose ) in rats increases satietogenic gut peptides and lowered spontaneous energy intake . The aim of the study was to assess the relevance of those effects of oligofructose on satiety and energy intake in humans . Design : Single-blinded , crossover , placebo-controlled design , pilot study .Subjects : Volunteers included five men and five women aged 21–39 years , BMI ranging from 18.5 to 27.4 kg/m2 , were r and omly assigned as described below . Interventions : Subjects were included in two 2-week experimental phases during which they received either fibre ( oligofructose ( OFS ) ) or placebo ( dextrine maltose ( DM ) ) ; a 2-week washout period was included between crossover phases . In total , 8 g OFS or 8 g DM were ingested twice daily ( 16 g/day in total ) . Energy intake , hunger , satiety , fullness and prospect i ve food consumption were assessed with analogue scales at the end of each experimental phase . Results : During breakfast , OFS significantly increases the satiety ( P=0.04 ) without any difference on other sensations as compared to DM treatment periods . After lunch , no significant differences are observed between treatment period . At dinner , OFS significantly increases satiety ( P=0.04 ) , reduces hunger ( P=0.04 ) and prospect i ve food consumption ( P=0.05 ) . The energy intake at breakfast and lunch are significantly lower ( P=0.01 , 0.03 , respectively ) after OFS treatment than after DM  treatment . Total energy intake per day is 5 % lower during OFS than in DM period . Conclusion : Oligofructose treatment increases satiety following breakfast and dinner , reduces hunger and prospect i ve food consumption following dinner . This pilot study presents a rationale to propose oligofructose supplements in the management of food intake in overweight and obese patients .Sponsorship : This project is supported by an FSR grant from the Université catholique de Louvain OBJECTIVE Large for gestational age infants are at increased risk of childhood obesity and maternal nutrition impacts birthweight . The aim of this study was to assess the impact of a maternal low glycaemic index ( GI ) diet on neonatal anthropometry . METHODS The ROLO ( R and omised Control Trial of Low Glycaemic Index Diet in Pregnancy ) study was a r and omized controlled trial to assess the impact of a low GI diet versus usual diet on birthweight . It took place in a tertiary maternity hospital in Irel and and women were r and omized to receive either a low GI diet or no dietary intervention from early pregnancy to term . Two hundred sixty-five neonates had anthropometric measurements  on day 1 - 2 of life , 126 in the intervention group and 139 in the control group . Measurements included birthweight , length and circumferences of the head , chest , abdominal , thigh and mid-upper arm . A subgroup of 219 ( 82 % ) neonates also had skin-fold measurements . RESULTS Neonates whose mothers had a low GI diet in pregnancy had lower thigh circumference ( 15.9 ± 1.7 cm vs. 16.6 ± 1.5 cm , P = 0.04 ) . There was no difference between the intervention and control groups in head , chest abdominal or mid-upper arm circumferences . No difference was noted between the two groups for any skin-fold measurements ( subscapular , thigh , biceps and triceps ) . CONCLUSION Neonatal thigh circumference was altered by maternal low GI diet in pregnancy . These findings suggest that maternal low GI diet is safe in pregnancy and may positively impact infant adiposity CONTEXT Maternal adiposity and overnutrition , both before and during pregnancy , plays a key role in the subsequent development of obesity and metabolic outcomes in offspring . OBJECTIVE We explored the hypothesis that maternal adiposity  ( pre-pregnancy and at 26 - 28 weeks ' gestation ) and mid-pregnancy gestational weight gain ( GWG ) are independently associated with offspring size and adiposity in early childhood , and determined whether these effects are ethnicity dependent . DESIGN In a prospect i ve mother-offspring cohort study ( N = 976 , 56 % Chinese , 26 % Malay , and 18 % Indian ) , we assessed the associations of  offspring size ( weight , length ) and adiposity ( subscapular and triceps skinfolds ) , measured at birth and age 6 , 12 , 18 , and 24 mo , with  maternal pre-pregnancy body mass index  ( pp BMI ) , mid-pregnancy GWG , and mid-pregnancy four-site skinfold thicknesses ( triceps , biceps , subscapular , suprailiac ) . RESULTS pp BMI and mid-pregnancy GWG were independently associated with postnatal weight up to 2 y and skinfold thickness at birth . Weight and subscapular and triceps skinfolds at birth increased by 2.56 % ( 95 % confidence interval , 1.68 - 3.45 % ) , 3.85 % ( 2.16 - 5.57 % ) , and 2.14 % ( 0.54 - 3.75 % ) , respectively for every SD increase in pp BMI . Similarly , a one-SD increase in GWG increased weight and subscapular and triceps skinfolds at birth by 2.44 % ( 1.66 - 3.23 % ) , 3.28 % ( 1.75 - 4.84 % ) , and 3.23 % ( 1.65 - 4.84 % ) , respectively . pp BMI and mid-pregnancy suprailiac skinfold independently predicted postnatal skinfold adiposity up to 2 years of age , whereas only GWG predicted postnatal length . The associations of GWG with postnatal weight and length were present only among Chinese and Indians , but not Malays ( P < .05 for interaction ) . CONCLUSIONS pp BMI and GWG are independent modifiable factors for child size and adiposity up to 2 years of age . The associations are ethnic-dependent , and underscore the importance of ethnic specific studies before generalizing the applicability of risk factors reported in other population BACKGROUND Rodent studies show that oligofructose promotes weight loss , stimulates satiety hormone secretion , reduces energy intake , and improves lipid profiles . OBJECTIVE Our objective was to examine the effects of oligofructose supplementation on body weight and satiety hormone concentrations in overweight and obese adults . DESIGN This study was a r and omized , double-blind , placebo-controlled trial . Forty-eight otherwise healthy adults with a body mass index ( in kg/m2 ) > 25 were r and omly assigned to receive 21 g oligofructose/d or a placebo ( maltodextrin ) for 12 wk . Body composition ( by dual-energy X-ray absorptiometry ) ; meal tolerance tests , including satiety hormone response ; food intake ; and subjective appetite ratings were determined . RESULTS There was a reduction in body weight of 1.03 + /- 0.43 kg with oligofructose supplementation , whereas the control group experienced an increase in body weight of 0.45 + /- 0.31 kg over 12 wk ( P = 0.01 ) . A lower area under the curve ( AUC ) for ghrelin ( P = 0.004 ) and a higher AUC for peptide YY ( PYY ) with oligofructose ( P = 0.03 ) coincided with a reduction in self-reported caloric intake ( P < or = 0.05 ) . Glucose decreased in the oligofructose group and increased in the control group between initial and final tests ( P < or = 0.05 ) . Insulin concentrations mirrored this pattern ( P < or = 0.05 ) . Oligofructose supplementation did not affect plasma active glucagon-like peptide 1 secretion . According to a visual analog scale design ed to assess side effects , oligofructose was well tolerated . CONCLUSIONS Independent of other lifestyle changes , oligofructose supplementation has the potential to promote weight loss and improve glucose regulation in overweight adults . Suppressed ghrelin and enhanced PYY may contribute in part to the reduction in energy intake . The trial was registered at clinical trials.gov as NCT00522353
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