title: Complementary feeding and childhood adiposity in preschool-aged children in a large Chinese cohort.
abstract: OBJECTIVE
  To examine the association between the timing and type of complementary feeding and childhood adiposity in Mainland China.
  
  
  METHODS
  During 1999-2009, 97 424 singletons were enrolled in the Jiaxing Birth Cohort, a population-based prospective cohort study in Southeast China. Of these children, 43 848 children provided complementary diet information and other anthropometric measurements at 1, 3, and 6 months of age and were followed up until 4-5 years of age. Obesity and overweight were identified as body mass index (BMI)-for-age z-score (SD) ≥2 and between 1 and 2, respectively.
  
  
  RESULTS
  Among 40 510 children in the statistical analysis, 3.18% were overweight and 64.8% were fed complementary food before 3 months of age. Early introduction of complementary foods was associated with greater BMI z-score (P-trend < .001) and higher risk of overweight (P-trend = .033). Compared with introduction of complementary foods between 4-6 months of age, before 3 months of age of introduction was associated with 11% greater risk of overweight (OR 1.11, 95% CI 1.03-1.19). No significant association between timing of complementary feeding and obesity was observed. Fish liver oil was the major type of complementary food associated with adiposity. Early introduction of fish liver oil was associated with greater BMI z-score (P < .001) and greater risk of overweight (P-trend = .004).
  
  
  CONCLUSIONS
  Early introduction of fish liver oil is associated with greater childhood BMI and risk of overweight in Chinese children at 4-5 years of age.
authors.affiliation: Department of Food Science and Nutrition, Zhejiang University, Hangzhou, China.
authors.forename: Ju-Sheng
authors.initials: JS
authors.lastname: Zheng
authors.affiliation: Jiaxing Maternity and Child Health Care Hospital, Jiaxing, China.
authors.forename: Huijuan
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Food Science and Nutrition, Zhejiang University, Hangzhou, China.
authors.forename: Yi-Min
authors.initials: YM
authors.lastname: Zhao
authors.affiliation: Jiaxing Maternity and Child Health Care Hospital, Jiaxing, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.affiliation: Jiaxing Maternity and Child Health Care Hospital, Jiaxing, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Jiaxing Maternity and Child Health Care Hospital, Jiaxing, China.
authors.forename: Shanlin
authors.initials: S
authors.lastname: Zhu
authors.affiliation: Jiaxing Maternity and Child Health Care Hospital, Jiaxing, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, MA.
authors.forename: Tao
authors.initials: T
authors.lastname: Huang
authors.affiliation: Department of Food Science and Nutrition, Zhejiang University, Hangzhou, China. Electronic address: duoli@zju.edu.cn.
authors.forename: Duo
authors.initials: D
authors.lastname: Li
mesh_terms: D050154:Adiposity; D000367:Age Factors; D015992:Body Mass Index; D002675:Child, Preschool; D002681:China; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D008297:Male; D050177:Overweight / Q000453:epidemiology; D063766:Pediatric Obesity / Q000453:epidemiology; D011446:Prospective Studies; D018570:Risk Assessment