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Watch what and when your baby eats

Pank Jit Sin
06 Jul 2018

The quality and quantity of food are not the only factors influencing a mother and baby’s health. The timing of food intake plays an important role, too.

The findings were revealed by the Growing Up in Singapore Towards healthy Outcomes (GUSTO) Study, a Singapore birth cohort study involving collaborators from KK Women’s and Children’s Hospital, National University of Singapore, National University Health System, and Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR). It has rooted in the concept of developmental origins of health and diseases, where it is believed that many of today’s diseases, i.e., diabetes, obesity, and cancer, is strongly influenced by a person’s early life and maternal nutrition (the first 1,000 days, from conception to 2 years of age).

According to Dr Loy See Ling of KK Women’s and Children’s Hospital, Singapore’s strategic location is ideal for conducting studies related to circadian health, because sunrise and sunset occur consistently at approximately 7am and 7pm each day.

The GUSTO research found that 19 percent of 12 month-old infants fed predominantly during night-time hours instead of day-time hours (i.e. they had more calorie intake from 7pm to 6.59am than from 7am to 6.59pm). Even though both groups had similar energy intake, the predominantly night-feeders had a higher fat intake. [Am J Clin Nutr 2016;104(2):380-388] The investigators also found that 41 percent of 12month-old infants had at least one post-midnight feed (i.e. they received a feed from midnight to 6am) and these post-midnight feeders had higher daily total energy, carbohydrate, protein and fat intakes. Of all post-midnight feeders, 96 percent consumed formula milk as the post-midnight feed. [Br J Nutr 2017;117(12):1702–1710]

When the babies were followed up, it was found that predominantly night-time feeders were three times more likely to be overweight or at-risk of being overweight at 24 months of age. This result took into account maternal age, education and body mass index (BMI), infant BAZ (body-mass-index-for-age z-score), feeding mode in the first 6 months and total energy intake. Dr Loy said the findings suggest that consuming large quantities of energy at night may be metabolically disadvantageous and physiologically inappropriate even in young children.

The findings echo existing research which suggests dietary regimens that restrict food intake to within specific windows and fasting thereafter lead to improved metabolic outcomes. Greater effects are observed when feeding and fasting events are done in coordination with daily circadian rhythms following light-dark phases. [Curr Nutr Rep 2014;3:204–212] Also, it is possible that frequent eating episodes, and lack of a defined fasting period may disrupt the normal counter-regulatory metabolic process and diminish repair activity that occurs during fasting. [Cell Metab 2016;23(6):1048–1059]

Mother’s eating patterns just as important
The GUSTO study also established that a mother’s timing of food intake can influence her female baby’s outcomes as longer maternal night-fasting interval during pregnancy resulted in increased neonatal adiposity and head circumference in girls but not boys.  

The findings of GUSTO come at a time when Singapore and much of Southeast Asia are facing a rise in overweight and obesity rates. Singapore is only second to Malaysia in its overweight and obesity rate at 32.8 percent. The implications of the study would be for mothers and their babies to preserve a natural rhythm of daytime feeding and nighttime sleeping patterns rather than to eat at night.  Also, the monitoring of nighttime feeding and fasting events during pregnancy and early childhood might be a new approach to potentially modify child outcomes and future obesity.

These studies are supported by the Singapore National Research Foundation under its Translational and ClinicalResearch (TCR) Flagship Programme and administered by the Singapore Ministry of Health’s National Medical Research Council (NMRC), Singapore (NMRC/TCR/004-NUS/2008; NMRC/TCR/012-NUHS/2014). Additional funding is provided by the Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore.

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Pearl Toh, 21 Aug 2018
Use of triple antiretroviral therapy (ART) during pregnancy and breastfeeding did not affect the cognitive development and function of the offspring compared with those whose mothers were not exposed to ART, reveals the IMPAACT PROMISE-BF study presented at the IAC 2018.