(OR05-04-23) Associations of Infant Feeding Patterns With Hepatic Fat in Childhood: The Healthy Start Study

Objectives: To test associations of breastfeeding and complementary feeding patterns in infancy with childhood hepatic fat trajectories.

Methods: Data were from the longitudinal Healthy Start Study in Colorado. In a subset (n=349), hepatic fat fraction (HFF) was assessed by magnetic resonance imaging in early childhood (median 5 yrs) and/or mid-childhood (median 9 yrs). Infant feeding patterns were assessed by maternal interviews when children were 6 and 18 months old. Three categorical predictors were defined to reflect current infant feeding guidelines: 1: exclusive breastfeeding (BF) duration (≥6 vs. < 6 mo); 2: timing of introduction of any complementary foods (CF) (≥5 vs. < 5 mo); 3: timing of introduction of soda (≥12 vs. < 12 mo). Associations of infant feeding variables with natural log-transformed HFF across childhood were examined using linear mixed models, with age as a fixed effect and random intercepts and slopes for individual ID. Potential confounding by maternal and child demographic traits and mediation by obesity (BMI z-score) in childhood were also assessed.

Results: Median (IQR) for HFF was similar in early vs. mid-childhood [1.65% (1.2-2.1%) vs. 1.64% (1.1-2.4%)]. Approximately half (44%) of children were exclusively BF ≥6 months, 74% introduced any CF ≥5 months, and 91% introduced soda ≥12 months. In unadjusted models, exclusive BF ≥6 months was inversely associated with HFF across childhood [β (95% CI): -0.14 (-0.24, -0.04)]. Adjustment for potential confounders and childhood BMI did not alter this association. Whereas, early introduction of any CF ( < 5 months) and early introduction of soda ( < 12 months) were positively associated with HFF across childhood in unadjusted models [β (95% CI): 0.14 (0.02, 0.25) for any CF; 0.18 (0.01, 0.36) for soda]. These associations were attenuated slightly after adjustment for demographic traits. Adjusting for child BMI z-score also weakened both associations, suggesting partial mediation by childhood body size.

Conclusions: Our findings support that infant feeding patterns – both longer breastfeeding duration and delayed complementary feeding timing – have protective effects against hepatic fat accumulation across early and mid-childhood and, thus, may be nutritional targets for preventing fatty liver disease in youth.

Funding Sources: NIH (NIDDK and Office of the Director)