title: Milk thickeners do not influence anthropometric indices in childhood.
abstract: BACKGROUND
  Pediatric obesity is an important risk factor for chronic diseases in adulthood. Some infant feeding practices may contribute to childhood obesity.
  
  
  OBJECTIVE
  To investigate whether the introduction of milk thickeners to bottle-fed infants between 3 and 6 months of age was associated with higher anthropometric measurements and indices at 1 and 4 years of age.
  
  
  METHODS
  A population-based birth cohort study was conducted in 1993 in the urban area of Pelotas, Brazil. Information was obtained at birth, at 1, 3, 6, and 12 months, and at 4 years. Data were analyzed from the 596 children for whom information was available from all follow-up visits. The exposure of interest was the use of milk thickener (flour added to cow's milk) between the third and sixth months of life. The outcomes investigated were weight and length/height and the anthropometric indices weight-for-age, length/height-for-age, and weight-for-length/height z-scores at 1 and 4 years.
  
  
  RESULTS
  The prevalence of use of milk thickener at any time between the third and sixth months was 44.6%. In the adjusted analysis, children who received milk thickener were, on average, 160 g heavier and 0.5 cm longer at I year than those who did not receive it. Weight-for-age and length-for-age z-scores were positively associated with use of milk thickener. No association was observed between this feeding practice and weight-for-length z-score. In the adjusted analysis, no effect of use of milk thickener on any of the anthropometric outcomes studied was observed at 4 years.
  
  
  CONCLUSIONS
  No association was found between the use of milk thickeners and weight-for-length/height z-scores in the first and fourth years of life. Future studies in other contexts would be helpful to further test this hypothesis.
authors.affiliation: Post-Graduation Program in Epidemiology, Federal University of Pelotas, Brazil.
authors.forename: Iná S
authors.initials: IS
authors.lastname: Santos
authors.forename: Alicia
authors.initials: A
authors.lastname: Matijasevich
authors.forename: Neiva C J
authors.initials: NC
authors.lastname: Valle
authors.forename: Denise P
authors.initials: DP
authors.lastname: Gigante
authors.forename: Danilo R
authors.initials: DR
authors.lastname: de Moura
mesh_terms: D000818:Animals; D000886:Anthropometry; D001938:Brazil; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D007225:Infant Food / Q000032:analysis*; D007227:Infant Nutritional Physiological Phenomena; D008137:Longitudinal Studies; D008297:Male; D008892:Milk / Q000737:chemistry*; D009765:Obesity / Q000517:prevention & control; D014783:Viscosity; D014886:Weaning