Sex differences in body composition early in life

doi:10.1016/j.genm.2009.07.003

Gender Medicine

Volume 6, Issue 2, July 2009, Pages 369-375

https://doi.org/10.1016/j.genm.2009.07.003 Get rights and content

Abstract

Background: Early development of the percentage of fat and muscle is rarely considered, but is important because excessive fat is related to the development of diabetes and other morbidities later in life. In pediatric medicine, there are few to no data comparing sex differences in body composition in the first months of life despite the fact that males are typically longer and weigh more than girls at birth.

Objective: The purpose of this study was to determine whether observed sex differences in body composition at birth persist through the first 6 months of life.

Methods: Participants were healthy, full-term, male and female newborns. Children throughout the Oklahoma City, Oklahoma, metropolitan area were enrolled. The inclusion criteria were: mothers aged 18 to 45 years at the time of delivery; a term pregnancy lasting ≥37 weeks of gestation (determined by mother's physician); weight adequate for gestational age; and a hospital stay for the infant of <3 days following delivery. The exclusion criteria were: maternal tobacco use or alcohol consumption (>1 drink per week) during pregnancy; gestational diabetes; preeclampsia; and infants with presumed or known congenital birth defects. Baseline assessment at birth included length and weight. Newborns had their body composition (percent fat [%fat], total fat, and fat-free mass) determined at ~1 month of age using whole body plethysmography. Mothers were invited to have their children take part in a 5-month extension that conducted additional body composition measurements at 3 and 6 months of age.

Results: Sixty-four girls (mean [SD] age at time of testing, 20.9 [7.9] days; birth weight, 3500 [388] g; birth length, 49.9 [2.4] cm; white race, 73.4%) and 53 boys (mean age at time of testing, 20.2 [7.3] days; birth weight, 3353 [413] g; birth length, 51.0 [2.4] cm; white race, 69.8%) were assessed and included in the study. At birth, girls were significantly shorter and weighed more than boys (both, P < 0.05). At ~1 month of age, body composition revealed that girls had significantly greater %fat (15.1% vs 12.7%; P < 0.05) and less fat-free mass (3182 [303] vs 3454 [361] g; P < 0.001) than did boys. At 3 months of age, girls continued to have significantly less fat-free mass (4379 [347] vs 4787 [310] g; P < 0.01) than did boys; however, by 6 months of age, no significant sex difference was observed in any body composition variable studied.

Conclusion: In this small sample of healthy, full-term newborns, at ~1 month of age, statistically significant differences in %fat and fat-free mass existed between girls and boys; however, by 6 months of age, these differences no longer existed.

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Healthy pregnant women and their term babies from the OBESO cohort were studied (1 M−3 M, n = 122; 1 M−6 M, n = 90). Registered maternal data was: pregestational body-mass-index (preBMI), GDM (2hOGTT), medications, gestational weight gain. Macrosomia (>4000 g), large/small for gestational age (LGA/SGA)(weight/age > 90° and < 90°, respectively-WHO) were recorded at birth. Infant FM (air-displacement plethysmography) was measured (1 M, 3 M, 6 M) and FM accretion computed (ΔkgFM from 1 M−3 M and 1 M−6 M). Exclusive breastfeeding (EBF) was assessed. Adjusted-multiple linear regression models were performed.
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GDM appears to program early higher adiposity accretion, independently of excessive fetal growth. SGA was associated with higher FM accretion in early infancy.
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Academic-based fertility clinic.
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A total of 1959 cycles were performed on 661 women (mean age, 31.9 ± 4.9 years). When examined by obesity class, LBR and CPR were similar for women with class I, II, and III obesity when compared with women with normal BMI. However, class III obese women (adjusted risk ratio [aRR], 1.70; 95% confidence interval [CI], 1.12–2.59) had increased pregnancy rates compared with normal BMI, but no differences in pregnancy rates were observed for women with class I or II obesity. In addition, pregnancy rates (aRR, 1.50; 95% CI, 1.12–2.02) and CPR (aRR, 1.51; 95% CI, 1.07–2.14) were higher in overweight women relative to normal BMI. Notably, among patients with ovulatory dysfunction, CPRs after IUI were reduced by 43% in obese women (aRR, 0.57; 95% CI, 0.37–1.07), whereas women without ovulatory dysfunction were twice as likely to achieve a clinical pregnancy when they were obese (aRR, 1.96; 95% CI, 1.19–3.24). The CIs for the obesity risk ratios in each stratum of ovulatory function exhibited no overlap, suggesting evidence of potential effect modification by ovulatory function.
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Citation Excerpt :
In the current study, male infants with gastroschisis had significantly more absolute FFM than female infants in both body composition measurements but similar absolute FM. These sex differences observed in body composition have been previously reported in other populations [34–36] and are primarily attributed to the action of sex hormones in utero. A recent longitudinal observational study performed by Davis et al. [36] assessed body composition using air-displacement plethysmography among 602 healthy infants and showed sex differences in body composition already present at birth and at 5 months.
Gastroschisis is an abdominal wall malformation usually associated with impaired growth.
To evaluate the growth and body composition of infants born with simple gastroschisis in a referral center.
This was a single-center, prospective case series of infants with simple gastroschisis who were measured at birth, at discharge, and at 3 months. Body composition was assessed via air-displacement plethysmography at discharge and at 3 months. The results were compared with those reported for healthy infants at an equivalent gestational age.
Simple gastroschisis infants were lighter and smaller at birth and remained similar at 3 months. All anthropometric z scores decreased from birth to discharge, followed by an increase but not a full recovery toward 3 months. Overall, gastroschisis infants had a similar FM percentage, FM% (11.1 ± 4.7), but a lower FFM, FFM (2481 ± 478 g), at discharge. FM% (18.5 ± 5.3) decreased at 3 months, and FFM remained lower (3788 ± 722 g) but improved between the two exams. Boys had significantly more FFM than girls at both evaluations. The multiple regression analysis showed that male sex, prematurity, total parenteral nutrition duration, and exclusive breast milk diets were associated with differences in body composition.
Infants with simple gastroschisis cared for in a referral center experienced growth failure at discharge and showed a similar FM% but lower FFM than healthy infants. At 3 months, they exhibited smaller FM% and FFM, but FFM improved after the first exam, representing a better protein accretion.
Prognostic.
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There is no stronger sex: Evolutionary Anthropology's conclusion based on the sex-typical susceptibility to stress factors during prenatal development
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Human males have been interpreted as the stronger sex since ancient times. Males, on average, are taller and more muscular than females. From the first prenatal trimester onward, male fetuses are larger than female ones, and they later have a significantly higher birth weight and are more often macrosomic. In contrast, adverse environmental influences and phases of stress have a greater effect on male than on female fetuses. Males show a higher stillbirth rate, are more often born preterm, show a poorer pregnancy outcome, are more commonly macrosomic, and are more often delivered by cesarean section. In particular, maternal nicotine consumption, drug abuse, obesity, or an advanced or very young maternal age reduces the sexual dimorphism in fetal growth and consequently the size of the newborn. This indicates that the female sex is better buffered against stress and supports the male disadvantage hypothesis. The male disadvantage is discussed using proximate and ultimate explanatory approaches from the perspective of Evolutionary Anthropology.
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Children with intestinal failure (IF) receiving long-term parenteral nutrition (PN) have altered body composition (BC), but data on BC changes from start of PN onwards are lacking.
We aimed to assess growth and BC in infants after neonatal intestinal surgery necessitating PN and at risk of IF, and to explore associations with clinical parameters.
A prospective cohort study in infants after intestinal surgery. IF was defined as PN dependency for >60 d. SD scores (SDS) for anthropometry were calculated until 6-mo corrected age. In a subgroup, fat mass (FM) and fat-free mass (FFM) were measured with air-displacement plethysmography at 2- and 6-mo corrected age. SDS for length-adjusted FM index and FFM index were calculated. Associations between cumulative amount of PN and BC parameters were analyzed with linear mixed-effect models.
Ninety-five neonates were included (54% male, 35% born <32 wk) and 39 infants (41%) had IF. Studied infants had compromised anthropometric parameters during follow-up. At 6-mo corrected age, they remained smaller (median weight-for-age SDS –0.9 [IQR –1.5, 0.1], P < 0.001) than the normal population. In 57 infants, 93 BC measurements were performed. FM index SDS was lower than in healthy infants at 2- and 6-mo corrected age (–0.9 [–1.6, –0.3], P < 0.001 and –0.7 [–1.3, 0.1], P = 0.001, respectively), but FFM index SDS did not differ. A higher cumulative amount of PN predicted a higher FM index in female infants but lower FM index in male infants.
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Sex differences in body composition early in life

Abstract

Am J Clin Nutr.

Best Pract Res Clin Endocrinol Metab.

J Pediatr.

Early Hum Dev.

Am J Clin Nutr.

Clin Endocrinol Metab.

J Steroid Biochem.

Am J Clin Nutr.

J Pediatr.

Waist circumference action levels in the identification of cardiovascular risk factors: Prevalence study in a random sample

BMJ.

Influence of body fat content and distribution on variation in metabolic risk

J Clin Endocrinol Metab.

Obesity in childhood and vascular changes in adulthood: Insights into the Cardiovascular Risk in Young Finns Study

Int J Obes (Lond).

Is body composition important for paediatricians?

Arch Dis Child.