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Aljahdali AA, Cantoral A, Peterson KE, Perng W, Mercado-García A, Téllez-Rojo MM, Ramírez-Silva CI, Jansen EC. Breastfeeding Duration and Cardiometabolic Health during Adolescence: A Longitudinal Analysis. J Pediatr 2024; 265:113768. [PMID: 37802388 DOI: 10.1016/j.jpeds.2023.113768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 09/04/2023] [Accepted: 09/29/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVE To investigate the longitudinal association between breastfeeding duration and cardiometabolic health, using repeated measures study design among children and adolescents. STUDY DESIGN This study included 634 offsprings aged 10 to 21 years (52% female) from the Early Life Exposure in Mexico to Environmental Toxicants birth cohort followed up to four time points during adolescence. Breastfeeding duration was prospectively quantified using questionnaires during early childhood. Cardiometabolic risk factors, body composition, and weight-related biomarkers were assessed as outcomes during adolescent follow-up visits. Sex-stratified linear mixed-effects models were used to model the association between quartiles of breastfeeding duration and outcomes, adjusting for age and additional covariates. RESULTS Median breastfeeding duration was 7 months (minimum = 0, maximum = 36). Boys in the second quartile (median breastfeeding = 5 months) had lower total fat mass % (β (SE) -3.2 (1.5) P = .037), and higher lean mass % (3.1 (1.6) P = .049) and skeletal muscle mass % (1.8 (0.8) P = .031) compared with the reference group (median breastfeeding = 2 months). A positive linear trend between breastfeeding duration and trunk lean mass % (0.1 (0.04) P = .035) was found among girls. No association was found with other cardiometabolic indicators. CONCLUSION Despite sex-specific associations of breastfeeding duration with body composition, there was a lack of substantial evidence for the protective effects of breastfeeding against impaired cardiometabolic health during adolescence among Mexican youth. Further longitudinal studies with a robust assessment of breastfeeding are recommended.
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Affiliation(s)
- Abeer A Aljahdali
- Department of Clinical Nutrition, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Nutritional Sciences, University of Michigan, Ann Arbor, MI
| | | | - Karen E Peterson
- Department of Nutritional Sciences, University of Michigan, Ann Arbor, MI; Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI.
| | - Wei Perng
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Adriana Mercado-García
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Martha M Téllez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | | | - Erica C Jansen
- Department of Nutritional Sciences, University of Michigan, Ann Arbor, MI
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Association between birth weight and childhood cardiovascular disease risk factors in West Virginia. J Dev Orig Health Dis 2019; 11:86-95. [PMID: 31412965 DOI: 10.1017/s204017441900045x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The reported associations between birth weight and childhood cardiovascular disease (CVD) risk factors have been inconsistent. In this study, we investigated the relationship between birth weight and CVD risk factors at 11 years of age. This study used longitudinally linked data from three cross-sectional datasets (N = 22,136) in West Virginia; analysis was restricted to children born full-term (N = 19,583). The outcome variables included resting blood pressure [systolic blood pressure (SBP), diastolic blood pressure (DBP)] and lipid profile [total cholesterol (TC), low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, non-HDL, and triglycerides (TG)]. Multiple regression analyses were performed, adjusting for child's body mass index (BMI), sociodemographics, and lifestyle characteristics. Unadjusted analyses showed a statistically significant association between birth weight and SBP, DBP, HDL, and TG. When adjusted for the child's BMI, the association between birth weight and HDL [b = 0.14 (95% CI: 0.11, 0.18) mg/dl per 1000 g increase] and between birth weight and TG [b = -0.007 (-0.008, -0.005) mg/dl per 1000 g increase] remained statistically significant. In the fully adjusted model, low birth weight was associated with higher LDL, non-HDL, and TGs, and lower HDL levels. The child's current BMI at 11 years of age partially (for HDL, non-HDL, and TG) and fully mediated (for SBP and DBP) the relationship between birth weight and select CVD risk factors. While effects were modest, these risk factors may persist and amplify with age, leading to potentially unfavorable consequences in later adulthood.
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Umer A, Hamilton C, Edwards RA, Cottrell L, Giacobbi P, Innes K, John C, Kelley GA, Neal W, Lilly C. Association Between Breastfeeding and Childhood Cardiovascular Disease Risk Factors. Matern Child Health J 2019; 23:228-239. [PMID: 30499064 DOI: 10.1007/s10995-018-2641-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Introduction The immediate benefits of breastfeeding are well-established but the long-term health benefits are less well-known. West Virginia (WV) has a higher prevalence of cardiovascular disease (CVD) and lower breastfeeding rates compared to national averages. There is a paucity of research examining the relationship between breastfeeding and subsequent childhood CVD risk factors, an issue of particular relevance in WV. Methods This study used longitudinally linked data from three cross-sectional datasets in WV (N = 11,980). The information on breastfeeding was obtained retrospectively via parental recall when the child was in the fifth grade. The outcome variables included blood pressure measures [systolic blood pressure (SBP), diastolic blood pressure (DBP)] and lipid profile [total cholesterol (TC), low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), non-HDL, and triglycerides (TG)]. Multiple regression analyses were performed, adjusting for childhood body mass index (BMI) and additional covariates. Results Only 43% of mothers self-reported ever breastfeeding. The unadjusted analysis showed that children who were ever vs. never breastfed had significantly lower SBP (b = - 1.39 mmHg; 95% CI - 1.97, - 0.81), DBP (b = - 0.79 mmHg; 95% CI - 1.26, - 0.33), log-TG (b = - 0.08; 95% CI - 0.1, - 0.05), and higher HDL (b = 0.95 mg/dL; 95% CI 0.33, 1.56). After adjustment for the child's BMI, socio-demographic and lifestyle factors, log-TG remained significantly associated with breastfeeding (b = - 0.04; 95% CI - 0.06, - 0.01; p = 0.01). Conclusion The observed protective effect of any breastfeeding on childhood TG level was small but significant. This finding provides some support for a protective effect of breastfeeding on later CVD risk.
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Affiliation(s)
- Amna Umer
- Department of Pediatrics, School of Medicine, West Virginia University, Morgantown, WV, 26506, USA.
| | - Candice Hamilton
- Department of Pediatrics, School of Medicine, West Virginia University, Morgantown, WV, 26506, USA
| | - Roger A Edwards
- Department Health Professions Education Program, Center for Interprofessional Studies and Innovation, MGH Institute of Health Professions, Boston, MA, USA
| | - Lesley Cottrell
- Department of Pediatrics, School of Medicine, West Virginia University, Morgantown, WV, 26506, USA
| | - Peter Giacobbi
- Department of Social and Behavioral Sciences, School of Public Health, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, WV, 26506, USA
| | - Kim Innes
- Department of Epidemiology, School of Public Health, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, WV, 26506, USA
| | - Collin John
- Department of Pediatrics, School of Medicine, West Virginia University, Morgantown, WV, 26506, USA
| | - George A Kelley
- Department of Biostatistics, School of Public Health, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, WV, 26506, USA
| | - William Neal
- Department of Pediatrics, School of Medicine, West Virginia University, Morgantown, WV, 26506, USA
| | - Christa Lilly
- Department of Biostatistics, School of Public Health, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, WV, 26506, USA
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Breastfeeding and cardiometabolic markers at age 12: a population-based birth cohort study. Int J Obes (Lond) 2019; 43:1568-1577. [PMID: 30886238 DOI: 10.1038/s41366-018-0317-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 08/15/2018] [Accepted: 08/29/2018] [Indexed: 01/15/2023]
Abstract
BACKGROUND There is growing evidence for a protective effect of breastfeeding against overweight and diabetes. It is less clear though, whether breastfed infants also have a more favorable cardiometabolic profile in childhood. OBJECTIVE We investigated whether children who were breastfed in infancy had more favorable cardiometabolic markers at 12 years of age than children who were never breastfed and received formula milk instead, and whether associations depended on the duration of breastfeeding. METHODS In 1509 participants of the population-based PIAMA birth cohort study, cardiometabolic markers were measured at 12 years of age. Duration of breastfeeding in weeks was assessed through parental questionnaires at 3 months and 1 year of age. Multivariable linear regression analysis was used to investigate associations of breastfeeding (any vs. never breastfeeding and duration of breastfeeding in categories <3 months, 3 to <6 months, and ≥6 months breastfeeding vs. never breastfeeding) with systolic and diastolic blood pressure (SBP and DBP, in Z-scores adjusted for age, sex, and height), total-to-high-density lipoprotein cholesterol (TC/HDLC), glycated hemoglobin (HbA1c, in mmol/mol), body mass index (BMI, in Z-scores adjusted for age and sex) and waist circumference (WC, in cm). Multivariable logistic regression was used to investigate the association of breastfeeding with odds of being overweight. RESULTS 1288 of 1509 children (85.3%) received any breastmilk in infancy. Breastfed children had a lower SBP Z-score (-0.21 SD (≈ -2.29 mmHg), 95% CI -0.37, -0.06), a lower DBP Z-score (-0.10 SD (≈ -1.19 mmHg), 95% CI -0.20, -0.00), a smaller WC (-1.12 cm, 95% CI -2.20; -0.04), and lower odds of being overweight (OR 0.61, 95% CI 0.38, 0.97) than never breastfed children. These associations were not different between children with shorter and longer duration of breastfeeding. No statistically significant differences in TC/HDLC, HbA1c, and BMI were observed between breastfed and never breastfed children. CONCLUSIONS We observed that breastfeeding was associated with a lower blood pressure, a smaller waist circumference and a lower risk of overweight in 12-year old children. These associations were independent of the duration of breastfeeding. No associations were observed between breastfeeding and other cardiometabolic markers.
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Güngör D, Nadaud P, LaPergola CC, Dreibelbis C, Wong YP, Terry N, Abrams SA, Beker L, Jacobovits T, Järvinen KM, Nommsen-Rivers LA, O'Brien KO, Oken E, Pérez-Escamilla R, Ziegler EE, Spahn JM. Infant milk-feeding practices and cardiovascular disease outcomes in offspring: a systematic review. Am J Clin Nutr 2019; 109:800S-816S. [PMID: 30982872 PMCID: PMC6500930 DOI: 10.1093/ajcn/nqy332] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND During the Pregnancy and Birth to 24 Months Project, the US Departments of Agriculture and Health and Human Services initiated a review of evidence on diet and health in these populations. OBJECTIVES The aim of these systematic reviews was to examine the relation of 1) never versus ever feeding human milk, 2) shorter versus longer durations of any human milk feeding, 3) shorter versus longer durations of exclusive human milk feeding, and 4) lower versus higher intensities of human milk fed to mixed-fed infants with intermediate and endpoint cardiovascular disease (CVD) outcomes in offspring. METHODS The Nutrition Evidence Systematic Review team conducted systematic reviews with external experts. We searched CINAHL, Cochrane, Embase, and PubMed for articles published January 1980-March 2016, dual-screened the results using predetermined criteria, extracted data from and assessed the risk of bias for each included study, qualitatively synthesized the evidence, developed conclusion statements, and graded the strength of the evidence. RESULTS The 4 systematic reviews included 13, 24, 6, and 0 articles, respectively. The evidence was insufficient to draw conclusions about endpoint CVD outcomes across all 4 systematic reviews. Limited evidence suggests that never versus ever being fed human milk is associated with higher blood pressure within a normal range at 6-7 y of age. Moderate evidence suggests there is no association between the duration of any human milk feeding and childhood blood pressure. Limited evidence suggests there is no association between the duration of exclusive human milk feeding and blood pressure or metabolic syndrome in childhood. Additional evidence about intermediate outcomes for the 4 systematic reviews was scant or inconclusive. CONCLUSIONS There is insufficient evidence to draw conclusions about the relationships between infant milk-feeding practices and endpoint CVD outcomes; however, some evidence suggests that feeding less or no human milk is not associated with childhood hypertension.
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Affiliation(s)
- Darcy Güngör
- Panum Group, Bethesda, MD,Address correspondence to DG (e-mail: )
| | | | | | | | | | - Nancy Terry
- National Institutes of Health Library, Bethesda, MD
| | - Steve A Abrams
- Dell Medical School at the University of Texas, Austin, TX
| | - Leila Beker
- US Food and Drug Administration, contractor, College Park, MD
| | | | | | | | | | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA and Department of Nutrition, Harvard School of Public Health, Boston, MA
| | - Rafael Pérez-Escamilla
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT
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Thorsdottir I, Gunnarsdottir I, Ingolfsdottir SE, Palsson G. Fruit and vegetable intake: vitamin C and β-carotene intake and serum concentrations in six-year-old children and their parents. SCANDINAVIAN JOURNAL OF FOOD & NUTRITION 2016. [DOI: 10.1080/17482970600774702] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- I. Thorsdottir
- Unit for Nutrition ResearchLandspitali-University HospitalReykjavikIceland
| | | | | | - G. Palsson
- Children's HospitalLandspitali-University HospitalReykjavikIceland
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Woo Baidal JA, Locks LM, Cheng ER, Blake-Lamb TL, Perkins ME, Taveras EM. Risk Factors for Childhood Obesity in the First 1,000 Days: A Systematic Review. Am J Prev Med 2016; 50:761-779. [PMID: 26916261 DOI: 10.1016/j.amepre.2015.11.012] [Citation(s) in RCA: 554] [Impact Index Per Article: 69.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 11/17/2015] [Accepted: 11/18/2015] [Indexed: 12/27/2022]
Abstract
CONTEXT Mounting evidence suggests that the origins of childhood obesity and related disparities can be found as early as the "first 1,000 days"-the period from conception to age 2 years. The main goal of this study is to systematically review existing evidence for modifiable childhood obesity risk factors present from conception to age 2 years. EVIDENCE ACQUISITION PubMed, Embase, and Web of Science were searched for studies published between January 1, 1980, and December 12, 2014, of childhood obesity risk factors present during the first 1,000 days. Prospective, original human subject, English-language research with exposure occurrence during the first 1,000 days and with the outcome of childhood overweight or obesity (BMI ≥85th percentile for age and sex) collected between age 6 months and 18 years were analyzed between December 13, 2014, and March 15, 2015. EVIDENCE SYNTHESIS Of 5,952 identified citations, 282 studies met inclusion criteria. Several risk factors during the first 1,000 days were consistently associated with later childhood obesity. These included higher maternal pre-pregnancy BMI, prenatal tobacco exposure, maternal excess gestational weight gain, high infant birth weight, and accelerated infant weight gain. Fewer studies also supported gestational diabetes, child care attendance, low strength of maternal-infant relationship, low SES, curtailed infant sleep, inappropriate bottle use, introduction of solid food intake before age 4 months, and infant antibiotic exposure as risk factors for childhood obesity. CONCLUSIONS Modifiable risk factors in the first 1,000 days can inform future research and policy priorities and intervention efforts to prevent childhood obesity.
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Affiliation(s)
- Jennifer A Woo Baidal
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts; Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Medical Center, New York City, New York
| | - Lindsey M Locks
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Erika R Cheng
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts
| | - Tiffany L Blake-Lamb
- Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, Massachusetts; Kraft Center for Community Health Leadership, Partners Healthcare, Boston, Massachusetts
| | - Meghan E Perkins
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts
| | - Elsie M Taveras
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
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Azadbakht L, Kelishadi R, Saraf-Bank S, Qorbani M, Ardalan G, Heshmat R, Taslimi M, Motlagh ME. The association of birth weight with cardiovascular risk factors and mental problems among Iranian school-aged children: the CASPIAN-III study. Nutrition 2013; 30:150-8. [PMID: 24206820 DOI: 10.1016/j.nut.2013.06.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Revised: 05/10/2013] [Accepted: 06/02/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Both high and low birth weights (HBW and LBW) are risk factors for adulthood diseases. The aim of this study was to investigate the association of birth weight with cardiovascular disease (CVD) risk factors and mental problems among Iranian school-aged children. METHODS This national multicenter study of school-aged children entitled CASPIAN III was conducted among 5528 students in ranging from ages 10 to 18 y. Biochemical indices and anthropometric measurements were collected. Mental health was assessed by questionnaire. To investigate the association between birth weight categories and CVD risk factors and mental problems, multivariate logistic regression was used. RESULTS HBW adolescents were at higher risk for elevated diastolic blood pressure (DBP) (Ptrend < 0.05), low levels of high-density lipoprotein cholesterol (HDL-C) (Ptrend < 0.05), and lower risk for general obesity (Ptrend < 0.05) compared with the LBW category. HBW had no significant association with mental problems (Ptrend > 0.05) compared with LBW adolescents. The results of regression analysis, which considered normal birth weight as the reference group, showed that LBW students had lower risk for overweight and obesity (P < 0.01), as well as higher DBP (P < 0.05) but they were at higher risk for lower levels of HDL-C (P < 0.01). Furthermore, birth-weight categories had a U-shaped relationship with mental problems and sleep disorders (P < 0.05). Risk for confusion was higher among the LBW group (P < 0.05). CONCLUSION Findings from this population-based study revealed a positive relation between birth weight categories and CVD risk factors. Compared with students born with normal weight, those born with HBW and LBW were at higher risk for mental problems, sleep disorders, and confusion.
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Affiliation(s)
- Leila Azadbakht
- Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Kelishadi
- Pediatrics Department, Faculty of Medicine and Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Sahar Saraf-Bank
- Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mostafa Qorbani
- Department of Public Health, Alborz University of Medical Sciences, Karaj, Iran
| | - Gelayol Ardalan
- Office of School Health, Health and Medical Education, Tehran, Iran
| | - Ramin Heshmat
- Department of Epidemiology, Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Bekkers MBM, Brunekreef B, Smit HA, Kerkhof M, Koppelman GH, Oldenwening M, Wijga AH. Early-life determinants of total and HDL cholesterol concentrations in 8-year-old children; the PIAMA birth cohort study. PLoS One 2011; 6:e25533. [PMID: 21980486 PMCID: PMC3181258 DOI: 10.1371/journal.pone.0025533] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2011] [Accepted: 09/06/2011] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Adult cholesterol concentrations might be influenced by early-life factors, such as breastfeeding and birth weight, referred to as "early programming". How such early factors exert their influence over the life course is still poorly understood. Evidence from studies in children and adolescents is scarce and conflicting. We investigated the influence of 6 different perinatal risk factors on childhood total and HDL cholesterol concentrations and total-to-HDL cholesterol ratio measured at 8 years of age, and additionally we studied the role of the child's current Body Mass Index (BMI). METHODS Anthropometric measures and blood plasma samples were collected during a medical examination in 751 8-year-old children participating in the prospective Prevention and Incidence of Asthma and Mite Allergy (PIAMA) birth cohort study. Linear and logistic regression were performed to estimate associations of total and HDL cholesterol concentrations with breastfeeding, birth weight, infant weight gain, maternal overweight before pregnancy, gestational diabetes and maternal smoking during pregnancy, taking into account the child's current BMI. RESULTS Linear regressions showed an association between total-to-HDL cholesterol ratio and maternal pre-pregnancy overweight (β = 0.15, Confidence Interval 95% (CI): 0.02, 0.28), rapid infant weight gain (β = 0.13, 95%CI: 0.01, 0.26), and maternal smoking during pregnancy (β = 0.14, 95%CI: 0.00, 0.29). These associations were partly mediated by the child's BMI. CONCLUSION Total-to-HDL cholesterol ratio in 8-year-old children was positively associated with maternal pre-pregnancy overweight, maternal smoking during pregnancy and rapid infant weight gain.
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Affiliation(s)
- Marga B M Bekkers
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.
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10
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Novaes JF, Lamounier JA, Colosimo EA, Franceschini SCC, Priore SE. Breastfeeding and obesity in Brazilian children. Eur J Public Health 2011; 22:383-9. [PMID: 21616992 DOI: 10.1093/eurpub/ckr067] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The association between breastfeeding and obesity is inconsistent by the literature. This study aims to assess whether obesity is associated to occurrence of breastfeeding and to duration of total and exclusive breastfeeding in Brazilian children. METHODS A cross-sectional study was conducted with 764 children enrolled in public and private schools from Viçosa, Minas Gerais, Brazil. Obesity (outcome variable) was defined as body mass index above the +2 standard deviations score using sex and age specific standards of World Health Organization. Exposure was the occurrence and duration of breastfeeding. Potential confounders were controlled by multiple logistic regression analysis and were divided in two groups: children (gender, age, birth weight, gestational age, order of birth, number of siblings, number of persons in the residence, type of school, physical activity patterns and time watching television) and mothers (age, nutritional status, level of education, weight gain during pregnancy, smokes currently and during the pregnancy). RESULTS Prevalence of obesity was 10.7%; 6.8% of the children were not breastfed and 59.0% did not receive exclusive breastfeeding. After adjustment for confounding variables by logistic regression analysis, no statistically significant association was observed between obesity and the occurrence and/or duration of total and exclusive breastfeeding. There was no dose-response effect of duration of breastfeeding on prevalence of obesity. CONCLUSION Our results do not support the hypothesis that breastfeeding promotion would reduce obesity in this population. Controversial findings regarding this association by literature indicate a need for further investigations.
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Affiliation(s)
- Juliana F Novaes
- Departamento de Nutrição e Saúde, Centro de Ciências Biológicas e da Saúde, Universidade Federal de Viçosa. Viçosa, MG, Brazil.
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11
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Cope MB, Allison DB. Critical review of the World Health Organization's (WHO) 2007 report on 'evidence of the long-term effects of breastfeeding: systematic reviews and meta-analysis' with respect to obesity. Obes Rev 2008; 9:594-605. [PMID: 18554244 DOI: 10.1111/j.1467-789x.2008.00504.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Obesity among children and adults has become a highly recognized public health concern and there is an increasing need to discover causes and evaluate preventative measures. One putatively causal influence on obesity is breastfeeding (BF). The World Health Organization (WHO) recently published a report (WR) on 'Evidence of the Long-Term Effects of Breastfeeding: Systematic Reviews and Meta-Analysis' and concluded 'that the evidence suggests that breastfeeding may have a small protective effect[emphasis added] on the prevalence of obesity . . . [and] the effect of breastfeeding was not likely to be due to publication bias or confounding.' Here we provide a critical overview of the WR's section on BF and obesity by addressing eight questions: Q1: Is there sufficient evidence to conclude that BF is associated with lower rates of obesity in children? Q2: Is there sufficient evidence to conclude that BF is associated with lower rates of obesity among breastfed offspring once they reach adulthood? Q3: If there are such associations, what are their magnitudes in comparison with other putatively causal factors and with respect to the potential impact on individual or population levels of obesity? Q4: Is there sufficient evidence to conclude that BF causes a reduction in risk of obesity during childhood? Q5: Is there sufficient evidence to conclude that BF does not cause a reduction in risk of obesity during childhood? Q6: Is there sufficient evidence to conclude that BF causes a long-term reduction in risk of obesity that persists into adulthood? Q7: Is there sufficient evidence to conclude that BF does not cause a long-term reduction in risk of obesity that persists into adulthood? Q8: What further research might be done to address these questions? We conclude that, while BF may have benefits beyond any putative protection against obesity, and benefits of BF most likely outweigh any harms, any statement that a strong, clear or consistent body of evidence shows that BF causally reduces the risk of overweight or obesity is unwarranted at this time.
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Affiliation(s)
- M B Cope
- Department of Pharmacology and Toxicology, University of Alabama at Birmingham, Birmingham, AL, USA
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12
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Amir LH, Donath S. A systematic review of maternal obesity and breastfeeding intention, initiation and duration. BMC Pregnancy Childbirth 2007; 7:9. [PMID: 17608952 PMCID: PMC1937008 DOI: 10.1186/1471-2393-7-9] [Citation(s) in RCA: 280] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2007] [Accepted: 07/04/2007] [Indexed: 11/10/2022] Open
Abstract
Background Breastfeeding behaviour is multifactorial, and a wide range of socio-cultural and physiological variables impact on a woman's decision and ability to breastfeed successfully. An association has been reported between maternal obesity and low breastfeeding rates. This is of public health concern because obesity is rising in women of reproductive age and the apparent association with increased artificial feeding will lead to a greater risk of obesity in children. The aim of this paper is to examine the relationship between maternal overweight and obesity and breastfeeding intention and initiation and duration. Methods A systematic review was conducted in January and February 2007, using the following databases: Medline, CINAHL and the Australian Breastfeeding Association's Lactation Resource Centre. Studies which have examined maternal obesity and infant feeding intention, initiation, duration and delayed onset of lactation were tabulated and summarised. Results Studies have found that obese women plan to breastfeed for a shorter period than normal weight women and are less likely to initiate breastfeeding. Of the four studies that examined onset of lactation, three reported a significant relationship between obesity and delayed lactogenesis. Fifteen studies, conducted in the USA, Australia, Denmark, Kuwait and Russia, have examined maternal obesity and duration of breastfeeding. The majority of large studies found that obese women breastfed for a shorter duration than normal weight women, even after adjusting for possible confounding factors. Conclusion There is evidence from epidemiological studies that overweight and obese women are less likely to breastfeed than normal weight women. The reasons may be biological or they may be psychological, behavioral and/or cultural. We urgently need qualitative studies from women's perspective to help us understand women in this situation and their infant feeding decisions and behaviour.
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Affiliation(s)
- Lisa H Amir
- Mother & Child Health Research, La Trobe University, Melbourne, Australia
| | - Susan Donath
- Clinical Epidemiology and Biostatistics Unit, Murdoch Childrens Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Australia
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Gunnarsdottir I, Aspelund T, Birgisdottir BE, Benediktsson R, Gudnason V, Thorsdottir I. Infant feeding patterns and midlife erythrocyte sedimentation rate. Acta Paediatr 2007; 96:852-6. [PMID: 17537014 DOI: 10.1111/j.1651-2227.2007.00324.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To assess the erythrocyte sedimentation rate (ESR), and other coronary heart disease (CHD) risk factors in adults who were either breast- or bottle-fed in early infancy. METHODS Subjects were 3614 men and women born 1914-1935. Information on infant feeding patterns was gathered from original midwife's birth records. Adult ESR, triglycerides, total cholesterol, blood pressure, fasting glucose, weight and height were measured. RESULTS The number of subjects bottle-fed in early infancy was 186 (5.2%). The geometric mean of ESR was 15.9% (95% CI 1.8%-31.8%) higher in those who were bottle-fed compared with those breastfed, p = 0.026, when adjusting for age and gender. Those who had been breastfed in early infancy had on average 2.9% higher BMI in adulthood (p = 0.012). The hazard ratio for event of CHD for bottle-fed persons versus breastfed was 1.18 (95% CI 0.88-1.57), adjusting for potential confounding factors. CONCLUSIONS Higher adult ESR, a moderate risk factor for CHD, among those bottle-fed compared to those breastfed in early infancy might indicate a long term anti-inflammatory influence of breast milk.
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Affiliation(s)
- Ingibjorg Gunnarsdottir
- Unit for Nutrition Research, Landspitali-University Hospital & Department of Food Science, University of Iceland, 101 Reykjavik, Iceland.
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Abstract
This paper explores the importance of breastfeeding as a women's issue in the health and political contexts, covering the role of global institutions, health practitioners, and national decision-makers in furthering the goals of supporting breastfeeding as a woman's right to health. The roles and responsibilities of the Obstetrician/Gynecologist are highlighted.
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Affiliation(s)
- M Labbok
- Center for Infant and Young Child Feeding and Care, Department of Maternal and Child Health, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Ahrens W, Bammann K, de Henauw S, Halford J, Palou A, Pigeot I, Siani A, Sjöström M. Understanding and preventing childhood obesity and related disorders--IDEFICS: a European multilevel epidemiological approach. Nutr Metab Cardiovasc Dis 2006; 16:302-308. [PMID: 16679223 DOI: 10.1016/j.numecd.2006.01.011] [Citation(s) in RCA: 112] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2005] [Accepted: 01/27/2006] [Indexed: 11/21/2022]
Abstract
The environment of children has drastically changed in Europe during the last decades as reflected in unhealthy dietary habits and sedentary lifestyle. Nutrition obviously plays a part in the development of overweight in childhood. However, dietary factors and physical activity are also involved in the development of metabolic syndrome, type II diabetes, cardiovascular diseases, osteoporosis, and postural deformities like scoliosis, effects related in part to excessive weight gain. To stop the resulting epidemic of diet- and lifestyle-induced morbidity, efficient evidence-based approaches are needed. These issues are the focus of IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants), a five-year project proposed under the sixth EU framework. The IDEFICS consortium comprises 25 research centres and SMEs across Europe. The planned prospective study will identify risk profile inventories for children susceptible to any of these disorders with emphasis on obesity and its co-morbid conditions. Genetic and non-genetic factors, psychosocial factors and social settings will be considered. The project will devise tailored prevention strategies that are effective, easy to implement and that account for the needs of different social groups. Population-based studies will investigate the impact of sensory perception and provide results concerning internal and external triggers of food choices and children's consumer behaviour. The ethical implications of a "right not to know" of genetic factors will be addressed. We will propose knowledge-based guidelines on dietary and lifestyle activities for health promotion and disease prevention in children for health professionals, stakeholders and consumers.
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Affiliation(s)
- W Ahrens
- Division of Epidemiological Methods and Etiologic Research, Bremen Institute for Prevention Research and Social Medicine (BIPS), University of Bremen, Linzer Strasse 10, D-28359 Bremen, Germany.
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Lande B, Andersen LF, Henriksen T, Baerug A, Johansson L, Trygg KU, Bjørneboe GE, Veierød MB. Relations between high ponderal index at birth, feeding practices and body mass index in infancy. Eur J Clin Nutr 2006; 59:1241-9. [PMID: 16106264 DOI: 10.1038/sj.ejcn.1602235] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE We compared feeding practices between infants of high ponderal index (PI) at birth (PI above the 90th percentile) and normal PI at birth (PI between 10th and 90th percentiles), and examined how birth size and infant feeding practices were related to body mass index (BMI) at 12 months. DESIGN In a cohort of 3000 infants invited to participate in a national Norwegian dietary survey, 1825 participated both at 6 and 12 months of age, and the present study included those born full term and with a PI (weight/length3) at birth > or =10th percentile (n=1441). Data on feeding practices were collected by food-frequency questionnaires, and anthropometrical data were measured by health-care personnel. RESULTS A lower proportion of infants born with high PI were exclusively breastfed for at least 4 months compared with infants born with normal PI (37 and 47%, respectively; P=0.03). Earlier introduction of solid foods and higher consumption of some foods were also observed among infants of high PI. In a multivariate analysis, adjusted mean BMI (kg/m2) at 12 months was higher for infants of high PI at birth than for infants of normal PI (17.6 and 17.0, respectively; P<0.001) and higher for infants exclusively breastfed <3 months than for infants exclusively breastfed > or =3 months (17.5 and 17.2, respectively; P=0.001). CONCLUSIONS High PI at birth was associated with a shorter duration of exclusive breastfeeding. Furthermore, high PI at birth and short-term exclusive breastfeeding were both associated with higher BMI at 12 months.
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Affiliation(s)
- B Lande
- Department for Nutrition, Directorate for Health and Social Affairs, Oslo, Norway.
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Thorsdottir I, Gunnarsdottir I, Kvaran MA, Gretarsson SJ. Maternal body mass index, duration of exclusive breastfeeding and children's developmental status at the age of 6 years. Eur J Clin Nutr 2005; 59:426-31. [PMID: 15674314 DOI: 10.1038/sj.ejcn.1602092] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To investigate whether the duration of exclusive breastfeeding and maternal body mass index (BMI) are associated with children's developmental status at the time of beginning elementary school. DESIGN AND SUBJECTS The subjects in the sample came from a longitudinal study on infant nutrition in Iceland. Food records were made once a month from birth to the age of 12 months, from which duration of exclusive breastfeeding could be determined. Mothers filled in The Icelandic developmental inventory for evaluation of motor and verbal development close to their children's sixth birthday (n = 85). Maternal self-reported weight and height was recorded. Information on socioeconomic factors was gathered by a questionnaire. RESULTS Duration of exclusive breastfeeding, in months, was positively related to children's motor component (B = 0.5+/-0.5, P = 0.054) and to the total developmental index (B = 1.0+/-0.5, P = 0.044) at 6 y, adjusting for gender and socioeconomic factors (maternal and paternal education, and family income). Children's learning score was negatively related to maternal BMI (B = -0.5+/-0.2, P=0.047). An inverse association also appeared between maternal BMI and two out of the three developmental composite scores, that is, verbal component and the total developmental index (B = -0.6+/-0.3, P=0.049) and (B = -0.4+/-0.2, P=0.057), respectively. In multiple regression the developmental indexes were most strongly independently associated with maternal BMI (negatively) and infants' birth weight (positively). CONCLUSION Maternal BMI and duration of breastfeeding were associated with verbal and motor development of 6-y-old children, independent of socioeconomic factors. Birth weight was also an independent determinant for developmental scores.
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Affiliation(s)
- I Thorsdottir
- Unit for Nutrition Research, Landspitali-University Hospital & Department of Food Science, University of Iceland, IS-101 Reykjavik, Iceland.
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