NCT03634930

Brief Summary

Background: Metabolic imprinting through early childhood nutrition seems to play an important role in the aetiology of obesity. Overweight at age two and later in life is associated with excessive weight gain as early as three months of age. Breastfeeding in the first year of life appears to be protective against obesity development. Objective: of the "Josef Ressel Centre for Early Life Metabolic Programming of Dispositions of Obesity" is to identify maternal and infant predictors of metabolic risk of obesity. The main considerations of modifiable factors are early infant nutrition, 24-hours-drinking-volume, the velocity of infant weight gain, in relation to infant fat mass and fat free mass, to biomarker and to the nutritional status of the mother. A second focus is put on maternal feeding style, infant eating behaviour and the identification of satiety cues. Multi-Study design: a monocentric prospective longitudinal cohort of 100 healthy, non-obese, non-smoking pregnant mothers and their term, normal birthweight, singleton babies. Mothers and exclusively breastfed versus exclusively formula fed children (at 16 weeks) will be examined at 36 weeks of pregnancy, 4 - 8 - 12 and 16 weeks of life, follow-up at 1 and 2 years of life. Methods: four weighing protocols between 4th and 16th week of life, feeding diary, anthropometric data measurement of mother and child, child fat mass index by air displacement plethysmograph. Macronutrient and energy content of the breast milk will be analysed by MIRIS™. Well-defined biomarkers of oxidative stress and inflammation, lipid profile, adipokines, insulin, as well as micro- und macronutrients will be analysed as meaningful indicators regarding the development of obesity and/or the metabolic syndrome in newborns. Samples, such as plasma, urine, saliva, and stool of the mothers and children will be examined with High Performance Liquid Chromatography, High Performance Gas Chromatography, Mass Spectrometry, Enzyme-Linked Immunosorbent Assay (ELISA) and more. Also questionnaires for the evaluation of the maternal milk feeding style are used as well as the Baby and Child Eating and Behaviour Questionnaire at 16 weeks, 1 and 2 years. A semi-automatic recognition of infants' satiety cues during feeding will be performed. The recording environment includes video cameras and microphones, a pulse oximeter, etc. All signals are synchronously recorded with the aid of the hardware and software infrastructure.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
100

participants targeted

Target at P50-P75 for all trials

Timeline
2mo left

Started Feb 2017

Longer than P75 for all trials

Geographic Reach
1 country

1 active site

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

Study Progress98%
Feb 2017Jun 2026

Study Start

First participant enrolled

February 16, 2017

Completed
1.4 years until next milestone

First Submitted

Initial submission to the registry

July 24, 2018

Completed
24 days until next milestone

First Posted

Study publicly available on registry

August 17, 2018

Completed
7.4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 31, 2025

Completed
6 months until next milestone

Study Completion

Last participant's last visit for all outcomes

June 30, 2026

Expected
Last Updated

March 17, 2025

Status Verified

March 1, 2025

Enrollment Period

8.9 years

First QC Date

July 24, 2018

Last Update Submit

March 13, 2025

Conditions

Keywords

Breast Feeding, Exclusive versus Formula Feeding, Exclusivesatiety cueschildhood obesitybiomarkernutritional statusinfant body compositioninfant weight gain velocitymetabolic programminginflammation

Outcome Measures

Primary Outcomes (5)

  • Changes in 24 hours drinking volume of milk intake

    24 hours drinking volume (milliliter) of milk intake of exclusive breast fed versus exclusive formula fed children by 24h-testweighing on an MBC-15K2DM-Infantscale (Kern).

    Changes from 4 to 8 to 12 and to 16 weeks of life

  • Changes in Body Mass Index (BMI) child

    weight in kilograms, height in meters will be combined to report BMI in (kg/m\^2)

    Changes from 4 to 8 to 12 and to 16 weeks of life up to 1 and 2 years

  • Changes in Fat Mass Index (FMI) child

    weight of fat mass in kilograms, height in meters will be combined to report Fat Mass Index in kg/m\^2). Fat mass will be measured by air displacement plethysmography (ADP) system using whole body densitometry to determine body composition (fat and fat-free mass) using a PEA-POD™ and BOD-POD™ (COSMED Company USA).

    Changes from 8 to 16 weeks of life and 2 years

  • Change in energy content of mature breast milk

    Change in energy content of 3 ml mature breast milk will be determined by MIRIS HMA™ Human Milk Analyzer (Miris Holding AB, Sweden) in kcal/dL. Samples will be measured twice and mean values for all measured parameters will be calculated. Milk samples are gained by use of Harmony Breast Pump kit (Medela Inc., USA) and are immediately frozen at -80 °C. The samples are collected between 9 and 11 AM from one breast simultaneously to feeding at the other breast. Foremilk and hindmilk are mixed, sample size will be at least 20 ml.

    from 8 to 16 weeks of life

  • Duration of exclusive milk feeding

    The duration of the exclusivity of human milk- or formula feeding will be determined by means of a prospective feeding diary in which frequency, volume, content, administration form and the initiation of complementary food are recorded by the mother. Precise classification by trained study staff will be according to the WHO categories "sole" (exclusive), "predominant" and "partial" breastfeeding through determination of ratio of total breast milk intake per day to total milk intake of other fluids (like formula milk, water, tea etc.) or foods.

    over the period from 4 to 8 to 12 and to 16 weeks of life up to 1 and 2 years

Secondary Outcomes (6)

  • Change of Eating Behaviour - baby

    from 8 to 16 weeks of life

  • Change of Eating Behaviour - child

    change from 1 year to 2 years of life

  • Change in Maternal Milk Feeding Style - Infant

    from 8 to 16 weeks of life

  • Change in Maternal Feeding Style - Child

    From 1 year to 2 years of life

  • Changes in dietary intake - maternal

    from 36 week of pregnancy to 16 weeks, to 1 year to 2 years of life

  • +1 more secondary outcomes

Other Outcomes (7)

  • Infant satiety cues of breast- and formula fed children

    at 8 weeks of life

  • Changes in fecal microbial profile

    Changes from 36 week of pregnancy to 8, 16 weeks of life, to 1 and 2 years

  • Changes in eicosanoids profiles

    Change from 36 week of pregnancy to 8, 16 weeks of life, to 1 and 2 years

  • +4 more other outcomes

Study Arms (2)

EBF exclusive breast fed children at 16 weeks

observation of 24 hours drinking volume, weight, length, body composition, biomarker and satiety cues, as well as eating- and feeding behaviour and nutritional status of exklusiv breastfed children at the age of 8 and 16 weeks, and at 1 and 2 Years

Behavioral: observation

EFF exclusive formula fed children at 16 week

observation of 24 hours drinking volume, weight, length, body composition, biomarker and satiety cues, as well as eating- and feeding behaviour and nutritional status of exklusiv formula fed children at the age of 8 and 16 weeks, and at 1 and 2 Years

Behavioral: observation

Interventions

observationBEHAVIORAL

Observation of growth, infant bodycomposition, 24h-drinkingvolume

EBF exclusive breast fed children at 16 weeksEFF exclusive formula fed children at 16 week

Eligibility Criteria

Age18 Years - 50 Years
Sexall(Gender-based eligibility)
Gender Eligibility Detailspregnant women and young (breastfeeding) mothers. Babys of both sex
Healthy VolunteersYes
Age GroupsAdult (18-64)
Sampling MethodNon-Probability Sample
Study Population

term (37-41 gestational age), singleton healthy babies with normal birth weight (2.5-4.5 kg) from healthy, non-smoking, non-diabetic mothers with a normal pre-pregnancy BMI (18.5-30). Pregnant women, who plan to breastfeed will be selected from a primary care clinic (STGKK Graz) and young non-breastfeeding mothers will be selected at the maternity ward of the university hospital of Graz.

You may qualify if:

  • Pregnancy or mother in puerperium
  • Delivery of baby at 37+0 to 41+6 gestational age
  • Legal age (18 years old), age limit 50 years
  • Written consent of test person after having been informed
  • BMI ≥ 18.5 kg/m² to \< 30 kg/m²
  • Negative result of oGTT (oral glucose tolerance test) during pregnancy
  • Birth weight of baby 2.5-4.5 kg
  • Non-smoker since knowledge of pregnancy
  • Very good knowledge of German language and Caucasian
  • Exclusive breastfeeding or exclusive formula feeding at MR 2 (4th week of life)

You may not qualify if:

  • Birth before 37+0 week of pregnancy (WoP) or after the 41+6 WoP
  • Multiple pregnancy
  • Children with serious congenital malformations of
  • Nervous system
  • Mouth, throat, neck
  • Circulation system
  • Respiratory tract
  • Gastrointestinal tract
  • Urogenital tract
  • Chromosomal aberrations
  • Diseases or hospitalization or intensive medical care of child during neonatal period
  • Hereditary metabolic diseases of child
  • Hereditary disorders of fat metabolism (MCHAD: Medium Chain Acyl-CoA Dehydrogenase Deficiency, LCHAD: Long Chain Acyl-CoA Dehydrogenase Deficiency, VLCHAD: Very Long Chain Acyl-CoA Dehydrogenase Deficiency)
  • Hereditary disorders of amino acid metabolism (PKU: Phenylketonuria)
  • Hereditary disorders of carbohydrate metabolism (Glycogenosis, Galactosemia, Hereditary fructose intolerance, Diabetes mellitus Type 1)
  • +8 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

FH Joanneum, university of applied sciences

Graz, Styria, 8020, Austria

RECRUITING

Related Links

Biospecimen

Retention: SAMPLES WITHOUT DNA

Human Milk, blood (mother and child), urine (child), saliva (mother and child) and stool sample (mother and child), hair sample (mother and child)

MeSH Terms

Conditions

Pediatric ObesityBreast FeedingInflammation

Interventions

Observation

Condition Hierarchy (Ancestors)

ObesityOverweightOvernutritionNutrition DisordersNutritional and Metabolic DiseasesBody WeightSigns and SymptomsPathological Conditions, Signs and SymptomsFeeding BehaviorBehaviorPathologic Processes

Intervention Hierarchy (Ancestors)

MethodsInvestigative Techniques

Study Officials

  • Moenie van der Kleyn, MPH

    FH Joanneum Hebammen

    STUDY DIRECTOR

Central Study Contacts

Moenie D van der Kleyn, MPH

CONTACT

Erwin Zinser, Prof Dr.

CONTACT

Study Design

Study Type
observational
Observational Model
COHORT
Time Perspective
PROSPECTIVE
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR INVESTIGATOR
PI Title
Head of Josef Ressel Centre

Study Record Dates

First Submitted

July 24, 2018

First Posted

August 17, 2018

Study Start

February 16, 2017

Primary Completion

December 31, 2025

Study Completion (Estimated)

June 30, 2026

Last Updated

March 17, 2025

Record last verified: 2025-03

Locations