Abstract
BACKGROUND: Nutritional practices during early life are critical in shaping long-term health outcomes. Poor or inappropriate nutrition may influence adiposity gain and the overall cardiometabolic risk among children born with low birth weight. Our study investigates how early feeding patterns, the timing of adiposity rebound, and DNA methylation of key genes influence cardiometabolic health at two years in low-birth-weight children. METHODS: This study will be conducted as a longitudinal follow-up study among children with low birth weight (children born with a birth weight of less than 2500 grams). A thousand four hundred children will be recruited consecutively for this study. Birth weight, gestational age, and early neonatal and perinatal details will be collected from clinical records. Information on sociodemographic characteristics, dietary practices, and antenatal, obstetric, and postnatal histories will also be collected. The two-year follow-up assessment will include anthropometric measurements (height, weight, head circumference, chest circumference, waist circumference, and skinfold thickness) and blood pressure. Biochemical investigations will include a lipid profile, serum proteins, insulin resistance assessment, and hemoglobin levels. In addition, DNA methylation at six specific CpG sites relevant to adipogenesis and cardiometabolic health will be assessed. Left ventricular mass and ejection fraction will be evaluated using echocardiography. Carotid intima-media thickness will be measured using an appropriate ultrasound probe. The neurodevelopmental status of the children will be assessed using the Developmental Assessment Scales for Indian Infants (DASII) and Vineland Social Maturity Scale (VSMS). CONCLUSIONS: Elucidating the impact of early life nutritional practices is vital for promoting cardiometabolic health. This understanding supports the formulation of tailored feeding interventions that are essential for safeguarding cardiovascular health in children with low birth weight.