Early Growth Patterns and Body Composition in Indian Infants: Learnings from Contemporary Birth Cohorts

Abstract The Developmental Origins of Health and Disease (DOHaD) framework emphasises that exposures during foetal and early postnatal life influence long-term health. India’s situation, marked by low birth weight (LBW) and a high burden of adult metabolic diseases, provides an intriguing context. Our research in New Delhi examined early growth patterns and body composition in infants, challenging the “thin-fat” phenotype belief. We assessed LBW infants (1500–2500 g) (n = 54) using DXA, healthy term infants (n = 280, birth weight 1800–4000 g) using deuterium dilution and term Appropriate for gestational age (AGA) (n = 141) newborns using Peapod. Small for gestational age (SGA) infants were followed for changes in fat mass (FM) and fat-free mass (FFM) from birth to 3–5 years, along with parental anthropometry. FM, FFM as well as FM% correlated positively with birth weight. Indian newborns with restricted foetal growth do not retain fat. Higher maternal BMI was linked with higher neonatal FM%. The rate of weight gain in the first 6 months showed a positive association with both parents’ heights and BMI. Infants with early catch-up growth (CUG) had higher FM% later in infancy. Follow-up of SGA babies (predominantly from low socioeconomic status) at 3–5 years showed that CUG in the first 6 months protected against wasting but not stunting, and FM% at 3–5 years was similar regardless of CUG. Faster weight gain in the first 6 months correlated inversely with fasting insulin at 3–5 years, suggesting that undernutrition in infancy may influence later diabetes risk. These findings underscore the importance of targeted public health interventions during the critical first 1000 days, particularly in resource-limited settings, to promote healthier long-term outcomes. Information © The Authors 2025