There is now compelling evidence that growth patterns in early life are associated with risk of the metabolic syndrome in adulthood, although the relative importance of prenatal v. postnatal growth for such associations remains controversial. Body composition may play a key role in the ‘programming’ of such diseases, through itself being programmed by early growth, and perhaps also by being a mediator of the programming process. Early studies reporting positive associations between birth weight and adult BMI suggested a tendency for large babies to become obese adults. Such findings appeared contradictory to the many studies linking low birth weight with increased risk of the metabolic syndrome. Recent studies now indicate that birth weight is strongly predictive of later lean mass, and has a much weaker association with later fatness. Studies that link low birth weight with a more central adipose distribution in later life remain controversial, and require confirmation using more sophisticated methodologies. Findings for infant growth rate appear population-specific, with infant weight gain predicting subsequent lean mass in developing countries, but predicting subsequent fat mass and obesity in industrialised populations. Further studies are required on this issue, to ensure that appropriate public health policies are recommended for countries across the range of economic development. Although the links between early growth and later disease risk implicate early-life nutrition, either in utero or during infancy, few prospective studies have explored the influence of early diet on later body composition. Many studies have associated breast-feeding with a reduced prevalence of obesity categorised by BMI; however, the few studies directly evaluating childhood fatness provide little support for this hypothesis. Recent advances in the ability to measure body composition during the infant period offer a major opportunity to improve the understanding of the nutritional programming of body composition and its contribution, or lack thereof, to subsequent disease risk.

Background: A routine pediatric clinical assessment of body composition is increasingly recommended but has long been hampered by the following 2 fac

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 aimed 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 prospective 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/height²) 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/height²). 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 aimed at reducing later obesity risk.

Background: Hydrometry and densitometry are widely used to assess pediatric body composition due to their ease of application. The accuracy of these

Background: Children with chronic intestinal failure (IF) treated with long-term parenteral nutrition (PN) may present with low bone mineral density (BMD). The cause may reflect small body size or suboptimal bone mineralization.