Introduction
In 2022, over 37 million children aged five and younger were overweight1. Emerging global evidence is linking excessive weight gain before the age of 3 years with later cardiometabolic risks2. Breastfeeding has been reported to be protective against early obesity in children between 2 and 6 years of age3. Additionally, in the literature, breastfeeding infants reduces rapid weight gain at the end of infancy4. Waist-to-hip ratio (WHR) and mid-upper-arm circumference (MUAC) are cost-effective methods of measuring fat distribution in the body. Studies employing these methods in children, particularly in South Africa (SA) are lacking. This study investigates whether WHR & MUAC are useful predictors of adiposity in breastfed children at the end of infancy in an SA cohort.
Methods
A cross-sectional study consisting of 258 SA Zulu-speaking Black African children aged 1-to-5 years of age was conducted. Data was collected from children during their routine immunisation clinic visits. Ethics were granted by the SA Health Department and London Metropolitan University ethics committees. Data were analysed using SPSS version 29.0.0.0 (IBM 2022). The WHR & MUAC were measured using standard methods by trained personnel. Duration of breastfeeding (weeks) was used as the outcome variable and the WHR (data not shown) and MUAC (figure 1) were used as predictor variables. ANOVA test was used to measure the relationship between the predictor variables. A p-value of <0.05 was considered significant.
Results
Of the total 258 children that participated in our study, 50.5% were male while 49.5% were female. The average age of the participants was three years (range 1-5). The minimum breastfeeding duration was zero weeks while the maximum was 104 weeks (24 months). The mean WHR ratio was 0.9140 with a p-value of 0.293 (f=1.775), while the mean MUAC was 16.2cm with a p-value of 0.923 (f=1.220). According to the Pearson correlation test, breastfeeding duration is negatively associated with both WHR (r=-0.18, p< 0.768) and MUAC (r=0.17 p< 0.790), but this association is not statistically significant.  
Conclusion
There is no association between BD and MUAC or WHR at this early stage of life in our cohort. We need to investigate other obesity biomarkers in this population which includes novel genetic marks such as telomere length. Breastfeeding remains an important protective factor in reducing lifelong risk of disease and it remains possible that a positive association between BD and WHR or MUAC, or both, may emerge, with time in our population.
References
1. World Health Organization (2024). Geneva: World Health Organization: https://www.who.int/news-room/fact-sheets/detail/obesity-andoverweight (accessed 29/04/2024) 
2. Arisaka O, Ichikawa G, Koyama S et al. (2020). Childhood obesity: rapid weight gain in early childhood and subsequent cardiometabolic risk. Clin Pediatr Endocrinol 29, 135 – 142 
3. Qiao J, Dai LJ, Zhang Q et al. (2020). A Meta-Analysis of the Association Between Breastfeeding and Early Childhood Obesity. J Pediatr Nurs 53, 57 - 664. 
4. Dharod JM, Frazier CM, Labban J et al. (2023). Breastfeeding duration and associations with prevention of accelerated growth among infants from low-income, racially and ethnically diverse backgrounds. Public Health Nutr 27 

Introduction
In 2022, over 37 million children aged five and younger were overweight^1^. Emerging global evidence is linking excessive weight gain before the age of 3 years with later cardiometabolic risks^2^. Breastfeeding has been reported to be protective against early obesity in children between 2 and 6 years of age^3^. Additionally, in the literature, breastfeeding infants reduces rapid weight gain at the end of infancy^4^. Waist-to-hip ratio (WHR) and mid-upper-arm circumference (MUAC) are cost-effective methods of measuring fat distribution in the body. Studies employing these methods in children, particularly in South Africa (SA) are lacking. This study investigates whether WHR & MUAC are useful predictors of adiposity in breastfed children at the end of infancy in an SA cohort.
Methods
A cross-sectional study consisting of 258 SA Zulu-speaking Black African children aged 1-to-5 years of age was conducted. Data was collected from children during their routine immunisation clinic visits. Ethics were granted by the SA Health Department and London Metropolitan University ethics committees. Data were analysed using SPSS version 29.0.0.0 (IBM 2022). The WHR & MUAC were measured using standard methods by trained personnel. Duration of breastfeeding (weeks) was used as the outcome variable and the WHR (data not shown) and MUAC (figure 1) were used as predictor variables. ANOVA test was used to measure the relationship between the predictor variables. A p-value of <0.05 was considered significant.
Results
Of the total 258 children that participated in our study, 50.5% were male while 49.5% were female. The average age of the participants was three years (range 1-5). The minimum breastfeeding duration was zero weeks while the maximum was 104 weeks (24 months). The mean WHR ratio was 0.9140 with a p-value of 0.293 (f=1.775), while the mean MUAC was 16.2cm with a p-value of 0.923 (f=1.220). According to the Pearson correlation test, breastfeeding duration is negatively associated with both WHR (r=-0.18, p< 0.768) and MUAC (r=0.17 p< 0.790), but this association is not statistically significant.  
Conclusion
There is no association between BD and MUAC or WHR at this early stage of life in our cohort. We need to investigate other obesity biomarkers in this population which includes novel genetic marks such as telomere length. Breastfeeding remains an important protective factor in reducing lifelong risk of disease and it remains possible that a positive association between BD and WHR or MUAC, or both, may emerge, with time in our population.
References
1. World Health Organization (2024). Geneva: World Health Organization: https://www.who.int/news-room/fact-sheets/detail/obesity-andoverweight (accessed 29/04/2024) 
2. Arisaka O, Ichikawa G, Koyama S et al. (2020). Childhood obesity: rapid weight gain in early childhood and subsequent cardiometabolic risk. Clin Pediatr Endocrinol 29, 135 – 142 
3. Qiao J, Dai LJ, Zhang Q et al. (2020). A Meta-Analysis of the Association Between Breastfeeding and Early Childhood Obesity. J Pediatr Nurs 53, 57 - 664. 
4. Dharod JM, Frazier CM, Labban J et al. (2023). Breastfeeding duration and associations with prevention of accelerated growth among infants from low-income, racially and ethnically diverse backgrounds. Public Health Nutr 27 

OC157 - The association between breastfeeding duration and adiposity using waist-to-hip ratio and mid-upper arm circumference in South African children aged between one and five years.

Unique to the new Congress (previously the Summer Conference) is that you will have greater opportunity to engage with more nutrition science than ever before. In 2024 the core programme will be delivered by the Irish Section of The Nutrition Society, supported by the Science Committee. The theme of these symposia will be ‘new data – focused approaches and challenges’. Outside of the core programme you will have the chance to hear the latest research from the Society’s partner organisations, universities, the private sector and more, on a diverse range of research.