Letter Regarding Article by Stettler et al, “Weight Gain in the First Week of Life and Overweight in Adulthood: A Cohort Study of European American Subjects Fed Infant Formula”
To the Editor:
Recently, Stettler et al1 published exciting data from a large cohort of formula-fed infants on the association between weight gain in the first neonatal week and risk of overweight in adulthood. Suggesting that this early, short period has such a long-term impact on later health is fascinating and provoking. We have data strongly supporting this hypothesis.
There seems to exist an exception to the important rule that breast-feeding prevents later overweight in children: Maternal diabetes may alter breast milk composition, with unknown consequences for offspring. In the Kaulsdorf Cohort Study, a prospective study in offspring of diabetic mothers, we observed a positive dose-dependent relationship between the amount of breast milk ingested during the first neonatal week and childhood risk of overweight.2 In our study, infants did not receive formula but breast milk from their diabetic mothers.2,3 Using multivariate analyses, we showed that breast milk intake during the first neonatal week influences later risk of overweight even independently of total milk intake and the kind of nutrition taken in during later periods of neonatal life and early infancy.3 Moreover, infants with higher diabetic breast milk intake during the first neonatal week showed higher neonatal weight gain and, consequently, higher blood pressure in childhood.4
Therefore, analyzing a population that crucially differed from that of Stettler et al,1 we draw similar conclusions with regard to an independent, dose-dependent effect of the kind and amount of nutrition during the first neonatal week on later risk of overweight and accompanying cardiovascular risk. This strongly supports the notion that this narrow window of time represents a particular critical period for nutritional programming of lasting health risks, implying important new possibilities for perinatal primary prevention.
Stettler N, Stallings VA, Troxel AB, Zhao J, Schinnar R, Nelson SE, Ziegler EE, Strom BL. Weight gain in the first week of life and overweight in adulthood: a cohort study of European American subjects fed infant formula. Circulation. 2005; 111: 1897–1903.
Plagemann A, Harder T, Franke K, Kohlhoff R. Long-term impact of neonatal breast feeding on body weight and glucose tolerance in children of diabetic mothers. Diabetes Care. 2002; 25: 16–22.
Rodekamp E, Harder T, Kohlhoff R, Franke K, Dudenhausen JW, Plagemann A. Long-term impact of breast feeding on body weight and glucose tolerance in children of diabetic mothers: role of the late neonatal period and early infancy. Diabetes Care. 2005; 28: 1457–1462.