Early nutrition and signs of metabolic syndrome at 6 y of age in children born very preterm

Line Hedegaard Toftlund*, Susanne Halken, Lone Agertoft, Gitte Zachariassen

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review


Background: In term-born infants, the risk of developing metabolic syndrome (MetS) has been shown to be associated with formula feeding and early rapid growth. Breastfeeding, however, seems to be associated with a lower risk of MetS among term-born infants.

Objective: The possible association between type of early nutrition, early growth, and possible influence on different metabolic outcomes at 6 y of age was investigated in very-preterm-born children.

Design: This study is a 6-y follow-up of 281 very-preterm-born infants with a gestational age of ≤32 wk. Infants breastfed at discharge from the hospital were randomly assigned to receive unfortified or fortified mother's milk, whereas those who were not breastfed received a preterm formula. The intervention lasted until 4 mo of corrected age. At 6 y of age, height, weight, and body mass index were measured and a dual-energy X-ray absorptiometry scan and blood sampling were performed.

Results: In total, 239 children participated in the follow-up. No differences were found between the 2 breastfed groups. Formula-fed children were more often predisposed to obesity and from families with a lower social status than were children who were breastfed only. Early rapid growth (crossing of weight percentiles with >1 SD in either direction) was seen in 53% of the children from 34 wk of postmenstrual age and until 2 mo of corrected age and was significantly correlated with several metabolic outcomes at 6 y of age.

Conclusions: Children fed a preterm formula postdischarge more often showed early rapid growth than did breastfed children, and early rapid growth was correlated with early signs of MetS at 6 y of age. However, all of the values were within normal ranges. This trial was registered at as NCT02078687.

Original languageEnglish
JournalAmerican Journal of Clinical Nutrition
Issue number5
Pages (from-to)717-724
Publication statusPublished - 1. May 2018


  • BMI
  • breastfeeding
  • DXA scan
  • follow-up
  • formula feeding
  • metabolic syndrome
  • preterm nutrition
  • preterm-born children


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