The role of early life growth development, the FTO gene and exclusive breastfeeding on child BMI trajectories

Int J Epidemiol. 2017 Oct 1;46(5):1512-1522. doi: 10.1093/ije/dyx081.


Background: Recent studies have implicated the FTO gene in child and adult obesity. A longer duration of exclusive breastfeeding (EXBF) has been shown to reduce body mass index (BMI) and the risk of being overweight in the general population and among FTO gene carriers. However, it remains unclear whether the preventive effect of EXBF could be explained by its impact on early life growth development, e.g. ages at adiposity peak (AP) and adiposity rebound (AR) and BMI velocities in the first years of life, which are major determinants of overweight and obesity later in life.

Methods: We studied 5590 children from the British Avon Longitudinal Study of Parents and Children (ALSPAC) cohort and modelled their longitudinal BMI profiles with mixed effects models from birth to 16 years of age, as well as their ages at AP, AR and BMI velocities in relation to the FTO gene variant and EXBF.

Results: A longer duration of EXBF (i.e. at least 5 months) has substantial impact on BMI growth trajectories among children carrying the FTO adverse variant by modulating the age at AP, age at AR and BMI velocities. EXBF acts antagonistically to the FTO rs9939609 risk allele and by the age of 15, the predicted reduction in BMI after 5 months of EXBF is 0.56 kg/m2 [95% confidence interval (CI) 0.11-1.01; P = 0.003] and 1.14 kg/m2 (95% CI 0.67-1.62; P < 0.0001) in boys and girls, respectively.

Conclusions: EXBF influences early life growth development and thus plays a critical role in preventing the risks of overweight and obesity even when those are exacerbated by genetic factors.

Keywords: BMI; Breastfeeding; FTO gene; birth cohort; early child development; overweight.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adiposity / genetics*
  • Adolescent
  • Alleles
  • Alpha-Ketoglutarate-Dependent Dioxygenase FTO / genetics*
  • Body Mass Index*
  • Breast Feeding*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Linear Models
  • Longitudinal Studies
  • Male
  • Overweight / genetics*
  • Pediatric Obesity / genetics*
  • Polymorphism, Single Nucleotide
  • United Kingdom


  • Alpha-Ketoglutarate-Dependent Dioxygenase FTO
  • FTO protein, human