Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Pediatrics

Diet diversity, growth and adiposity in healthy breastfed infants fed homemade complementary foods

International Journal of Obesity volume 41, pages 776–782 (2017)Cite this article

Subjects

Abstract

Background/Objectives:

Infant complementary feeding is important for establishing food preferences. Few studies exist on the effects of infant complementary feeding choices (food preparation methods) on dietary intake, growth or adiposity. We examined whether provision of homemade complementary food is associated with the development of dietary diversity, nutrient intakes and quality of infant growth.

Subjects/Methods:

Secondary analysis of feeding practices from a randomized trial of vitamin D supplementation in 132 healthy breastfed 1-month-old infants from Montréal, Canada. This longitudinal study used diet records, anthropometric and body composition data (dual-energy X-ray absorptiometry) from assessments that occurred when infants were 6, 9, 12 and 36 months of age. Infants were grouped into three categories of food preparation method on the basis of whether or not they had consumed homemade or commercial meat or fruit and vegetable by 9 months (homemade, commercial and both). Multivariable regression controlled for family income, maternal education and infant sex.

Results:

Dietary data were available for 65 infants. By 9 months, 22% of infants had exclusively received homemade (n=14), 14 infants had exclusively received commercial and 37 infants had received both. The development of dietary diversity (number of World Health Organization-recommended food groups) was higher (0.76 (95% confidence interval (CI): 0.14, 1.38); P<0.05) in the homemade group versus commercial. Energy and nutrient intakes did not differ by group over time. The homemade group had 773 g (−1364, −182; P<0.01) lower whole-body fat mass and 7.1% (−12.6, −1.6; P<0.05) lower % body fat at 12 months compared with the reference group (both homemade and commercial). Reduced whole-body fat mass in the homemade group persisted at 36 months (−696 g (95% CI: −1341, −52); P<0.05). There were no differences between groups for changes in growth Z-scores (length-for-age, weight-for-age and body mass index-for-age).

Conclusions:

Provision of homemade complementary food is associated with increased dietary diversity during the first year of life and reduced adiposity.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. World Health Organization. Complementary Feeding. Version current 2016. Available at http://www.who.int/nutrition/topics/complementary_feeding/en/ (accessed 14 April 2016).

  2. Mennella JA . Ontogeny of taste preferences: basic biology and implications for health. Am J Clin Nutr 2014; 99: 704S–711S.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Mennella JA, Trabulsi JC . Complementary foods and flavor experiences: setting the foundation. Ann Nutr Metab 2012; 60 (Suppl 2): 40–50.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Kleinman RE Pediatric Nutrition Handbook, 6th edn. American Academy of Pediatrics: Chicago, USA, 2009.

  5. Grote V, Theurich M, Koletzko B . Do complementary feeding practices predict the later risk of obesity? Curr Opin Clin Nutr Metab Care 2012; 15: 293–297.

    Article  PubMed  Google Scholar 

  6. Mauch CE, Perry RA, Magarey AM, Daniels LA . Dietary intake in Australian children aged 4-24 months: consumption of meat and meat alternatives. Br J Nutr 2015; 113: 1761–1772.

    Article  CAS  PubMed  Google Scholar 

  7. Siega-Riz AM, Deming DM, Reidy KC, Fox MK, Condon E, Briefel RR . Food consumption patterns of infants and toddlers: where are we now? J Am Diet Assoc 2010; 110: S38–S51.

    Article  PubMed  Google Scholar 

  8. Cogswell ME, Gunn JP, Yuan K, Park S, Merritt R . Sodium and sugar in complementary infant and toddler foods sold in the United States. Pediatrics 2015; 135: 416–423.

    Article  PubMed  Google Scholar 

  9. Coulthard H, Harris G, Emmett P . Long-term consequences of early fruit and vegetable feeding practices in the United Kingdom. Public Health Nutr 2010; 13: 2044–2051.

    Article  PubMed  Google Scholar 

  10. Woo JG, Herbers PM, McMahon RJ, Davidson BS, Ruiz-Palacios GM, Peng YM et al. Longitudinal development of infant complementary diet diversity in 3 international cohorts. J Pediatr 2015; 167: e961.

    Article  Google Scholar 

  11. Gallo S, Comeau K, Vanstone C, Agellon S, Sharma A, Jones G et al. Effect of different dosages of oral vitamin D supplementation on vitamin D status in healthy, breastfed infants: a randomized trial. JAMA 2013; 309: 1785–1792.

    Article  CAS  PubMed  Google Scholar 

  12. Kalkwarf HJ, Abrams SA, DiMeglio LA, Koo WW, Specker BL, Weiler H . Bone densitometry in infants and young children: the 2013 ISCD Pediatric Official Positions. J Clin Densitom 2014; 17: 243–257.

    Article  PubMed  Google Scholar 

  13. Foterek K, Hilbig A, Alexy U . Breast-feeding and weaning practices in the DONALD study: age and time trends. J Pediatr Gastroenterol Nutr 2014; 58: 361–367.

    Article  PubMed  Google Scholar 

  14. Michaelsen KF, Greer FR . Protein needs early in life and long-term health. Am J Clin Nutr 2014; 99: 718s–722s.

    Article  CAS  PubMed  Google Scholar 

  15. Ruel MT . Operationalizing dietary diversity: a review of measurement issues and research priorities. J Nutr 2003; 133: 3911s–3926s.

    Article  CAS  PubMed  Google Scholar 

  16. Butte NF . Energy requirements of infants. Public Health Nutr 2005; 8: 953–967.

    PubMed  Google Scholar 

  17. Davies PS, Coward WA, Gregory J, White A, Mills A . Total energy expenditure and energy intake in the pre-school child: a comparison. Br J Nutr 1994; 72: 13–20.

    Article  CAS  PubMed  Google Scholar 

  18. Scott J, Davey K, Ahwong E, Devenish G, Ha D, Do L . A comparison by milk feeding method of the nutrient intake of a cohort of australian toddlers. Nutrients 2016; 8: 501.

    Article  PubMed Central  Google Scholar 

  19. Brophy S, Cooksey R, Gravenor MB, Mistry R, Thomas N, Lyons RA et al. Risk factors for childhood obesity at age 5: analysis of the millennium cohort study. BMC Public Health 2009; 9: 467.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Taylor RW, Gold E, Manning P, Goulding A . Gender differences in body fat content are present well before puberty. Int J Obes Relat Metab Disord 1997; 21: 1082–1084.

    Article  CAS  PubMed  Google Scholar 

  21. Harrel FEJ Regression Modeling Strategies, 2nd edn. Springer-Verlag: New York, USA, 200.

  22. Coulthard H, Harris G, Emmett P . Delayed introduction of lumpy foods to children during the complementary feeding period affects child's food acceptance and feeding at 7 years of age. Matern Child Nutr 2009; 5: 75–85.

    Article  PubMed  Google Scholar 

  23. Baird J, Fisher D, Lucas P, Kleijnen J, Roberts H, Law C . Being big or growing fast: systematic review of size and growth in infancy and later obesity. BMJ 2005; 331: 929.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Jensen SM, Ritz C, Ejlerskov KT, Molgaard C, Michaelsen KF . Infant BMI peak, breastfeeding, and body composition at age 3 y. Am J Clin Nutr 2015; 101: 319–325.

    Article  CAS  PubMed  Google Scholar 

  25. Lanigan J, Singhal A . Early nutrition and long-term health: a practical approach. Proc Nutr Soc 2009; 68: 422–429.

    Article  PubMed  Google Scholar 

  26. Foterek K, Hilbig A, Alexy U . Associations between commercial complementary food consumption and fruit and vegetable intake in children. Results of the DONALD study. Appetite 2015; 85: 84–90.

    Article  PubMed  Google Scholar 

  27. Hurley KM, Black MM . Commercial baby food consumption and dietary variety in a statewide sample of infants receiving benefits from the special supplemental nutrition program for women, infants, and children. J Am Diet Assoc 2010; 110: 1537–1541.

    Article  PubMed  Google Scholar 

  28. Northstone K, Emmett P, Nethersole F . The effect of age of introduction to lumpy solids on foods eaten and reported feeding difficulties at 6 and 15 months. J Hum Nutr Diet 2001; 14: 43–54.

    Article  CAS  PubMed  Google Scholar 

  29. Yeung DL, Pennell MD, Leung M, Hall J . Commercial or homemade baby food. CMAJ 1982; 126: 113.

    CAS  Google Scholar 

  30. Pani P, Carletti C, Knowles A, Parpinel M, Concina F, Montico M et al. Patterns of nutrients' intake at six months in the northeast of Italy: a cohort study. BMC Pediatr 2014; 14: 127.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Tang M, Krebs NF . High protein intake from meat as complementary food increases growth but not adiposity in breastfed infants: a randomized trial. Am J Clin Nutr 2014; 100: 1322–1328.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Cohen RJ, Brown KH, Canahuati J, Rivera LL, Dewey KG . Effects of age of introduction of complementary foods on infant breast milk intake, total energy intake, and growth: a randomised intervention study in Honduras. Lancet 1994; 344: 288–293.

    Article  CAS  PubMed  Google Scholar 

  33. Robinson SM, Marriott LD, Crozier SR, Harvey NC, Gale CR, Inskip HM et al. Variations in infant feeding practice are associated with body composition in childhood: a prospective cohort study. J Clin Endocrinol Metab 2009; 94: 2799–2805.

    Article  CAS  PubMed  Google Scholar 

  34. Kensara OA, Wootton SA, Phillips DI, Patel M, Jackson AA, Elia M . Fetal programming of body composition: relation between birth weight and body composition measured with dual-energy X-ray absorptiometry and anthropometric methods in older Englishmen. Am J Clin Nutr 2005; 82: 980–987.

    Article  CAS  PubMed  Google Scholar 

  35. Pearce J, Taylor MA, Langley-Evans SC . Timing of the introduction of complementary feeding and risk of childhood obesity: a systematic review. Int J Obes 2013; 37: 1295–1306.

    Article  CAS  Google Scholar 

  36. WHO Working Group on the Growth Reference Protocol and the WHO Task Force on Methods for the Natural Regulation of Fertility. Growth of healthy infants and the timing, type, and frequency of complementary foods. Am J Clin Nutr 2002; 76: 620–627.

    Article  Google Scholar 

  37. Pearce J, Langley-Evans SC . The types of food introduced during complementary feeding and risk of childhood obesity: a systematic review. Int J Obes 2013; 37: 477–485.

    Article  CAS  Google Scholar 

  38. Woo JG, Guerrero ML, Ruiz-Palacios GM, Peng YM, Herbers PM, Yao W et al. Specific infant feeding practices do not consistently explain variation in anthropometry at age 1 year in urban United States, Mexico, and China cohorts. J Nutr 2013; 143: 166–174.

    Article  CAS  PubMed  Google Scholar 

  39. Zheng JS, Liu H, Zhao YM, Li J, Chen Y, Zhu S et al. Complementary feeding and childhood adiposity in preschool-aged children in a large Chinese cohort. J Pediatr 2015; 166: e322.

    Article  Google Scholar 

  40. Burdette HL, Whitaker RC, Hall WC, Daniels SR . Breastfeeding, introduction of complementary foods, and adiposity at 5 y of age. Am J Clin Nutr 2006; 83: 550–558.

    Article  CAS  PubMed  Google Scholar 

  41. Noble S, Emmett P . Differences in weaning practice, food and nutrient intake between breast- and formula-fed 4-month-old infants in England. J Hum Nutr Diet 2006; 19: 303–313.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The study was supported by Canadian Institutes of Health Research and the Nutricia Research Foundation for research funding, and Europharm International Canada Inc. for the in-kind provision of supplements. Infrastructure support was from Canada Foundation for Innovation. EM, PL, EC and HW. designed research; EM, CV, SG and HW conducted research; EM, CV, SG and HW analyzed the data; EM and HW wrote the paper and had primary responsibility for final content. All authors read and approved the final manuscript. Clinical Trial Registration Number: clinicaltrials.gov NCT00381914.

Author information

Authors and Affiliations

  1. Research Institute – McGill University Health Centre, Montréal, Québec, Canada

    E Mok, P Li & E Constantin

  2. School of Dietetics and Human Nutrition, McGill University, Ste-Anne-de-Bellevue, Québec, Canada

    C A Vanstone, S Gallo & H A Weiler

  3. Department of Nutrition and Food Studies, George Mason University, Fairfax, VA, USA

    S Gallo

  4. Department of Pediatrics, Montreal Children’s Hospital - McGill University Health Center, Montréal, Québec, Canada

    P Li & E Constantin

Authors
  1. E Mok
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C A Vanstone
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S Gallo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. P Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. E Constantin
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. H A Weiler
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to H A Weiler.

Ethics declarations

Competing interests

Hope Weiler is a Canada Research Chair with infrastructure funding from the Canadian Foundation for Innovation. The remaining authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mok, E., Vanstone, C., Gallo, S. et al. Diet diversity, growth and adiposity in healthy breastfed infants fed homemade complementary foods. Int J Obes 41, 776–782 (2017). https://doi.org/10.1038/ijo.2017.37

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ijo.2017.37

This article is cited by

Search

Advanced search

Quick links