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Sharaf-Alddin R, Almathkoori R, Kostakis H, Albatineh AN, Al-Taiar A, Akpinar-Elci M. Obesity during Adolescence and Feeding Practices during Infancy: Cross-Sectional Study. EPIDEMIOLOGIA 2023; 4:106-116. [PMID: 36975619 PMCID: PMC10048365 DOI: 10.3390/epidemiologia4010011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/27/2023] [Accepted: 03/13/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Breastfeeding is proposed to play a role in reducing the risk of obesity throughout life. Kuwait has an extremely high prevalence of childhood obesity (45% of adolescents are overweight/obese) and extremely low breastfeeding indicators, particularly exclusive breastfeeding. In fact, little is known about the association between breastfeeding and obesity from Kuwait and the broader Middle East. AIMS To estimate the prevalence of overweight/obesity in female adolescents in Kuwait and assess its association with breastfeeding during infancy. METHODS This is a cross-sectional study that included 775 girls randomly selected from public and private high schools in Kuwait. The primary exposure was breastfeeding in the first four months of life, and the outcome was overweight/obesity during adolescence. Multivariable logistic regression was used to assess the association between breastfeeding and overweight/obesity while adjusting for potential confounders. RESULTS Approximately 45% of adolescent girls were either overweight/obese. We found no significant association between breastfeeding (exclusive/mixed breastfeeding and formula feeding/no breastfeeding) and overweight/obesity neither in univariable analysis (Crude Prevalence Ratio: 1.14, 95%CI [0.92-1.36] & Crude Prevalence Ratio: 1.29, 95%CI [0.86-1.68]; p = 0.293) for mixed feeding and no breastfeeding respectively, nor in multivariable analysis (Adjusted Prevalence Ratio: 1.14, 95%CI [0.85-1.42] & Adjusted Prevalence Ratio: 1.20, 95%CI [0.68-1.68]; p = 0.589) for mixed feeding and no breastfeeding respectively. CONCLUSION Breastfeeding during infancy was not significantly associated with overweight/obesity during adolescence. However, breastfeeding should be encouraged for its indisputable benefits for infants and their mothers alike. Further prospective studies are needed to assess the association.
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Affiliation(s)
| | - Radhia Almathkoori
- Department of Public Health, Ministry of Health, Kuwait City 13001, Kuwait
| | - Hara Kostakis
- London School of Hygiene & Tropical Medicine, University of London, London WC1E 7HT, UK
| | | | - Abdullah Al-Taiar
- School of Community & Environmental Health, College of Health Sciences, Old Dominion University, Norfolk, VA 23508, USA
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The Effects of Breastfeeding for Four Months on Thinness, Overweight, and Obesity in Children Aged 3 to 6 Years: A Retrospective Cohort Study from National Physical Fitness Surveillance of Jiangsu Province, China. Nutrients 2022; 14:nu14194154. [PMID: 36235805 PMCID: PMC9571296 DOI: 10.3390/nu14194154] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/26/2022] [Accepted: 10/01/2022] [Indexed: 11/24/2022] Open
Abstract
Objective: To explore the effects of breastfeeding during the first four months of life on thinness, overweight, and obesity and to analyze the influential factors in children aged three to six years in eastern China. Methods: This study was designed as a retrospective cohort study, and the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines were followed. A total of 8053 subjects were included in this secondary analysis of data from the 2015 “Physical Fitness Surveillance data of Jiangsu, China”. The subjects were classified into three groups on the basis of feeding patterns: breastfeeding, mixed feeding, and formula feeding. The International Obesity Task Force (IOTF) definitions of BMI were used to define thinness, overweight, and obesity. Multivariate logistic regression models and subgroup analysis were used to assess the association between feeding patterns and childhood thinness, overweight, obesity, and overweight/obesity, adjusted for potential confounders (sex, age grade, area, region/economy, gestational age, birthweight, childbearing age, mother’s education, and caretaker). Results: The prevalence of breastfeeding was 63.8%, and the prevalence of thinness, overweight, obesity, and overweight/obesity reached 2.7%, 11.2%, 4.7%, and 15.9%, respectively. Breastfeeding participants had a lower risk of overweight and overweight/obesity with adjusted ORs of 0.652 (95% CI: 0.533, 0.797; p < 0.001) and 0.721 (95% CI: 0.602, 0.862; p < 0.001), respectively; however, there was no difference in thinness and obesity (both p > 0.05) compared with formula feeding. There was no statistical difference between mixed and formula feeding, in terms of thinness, overweight, obesity, or overweight/obesity (all p > 0.05). Subgroup analysis showed that breastfeeding for three years, preterm, and a childbearing age of 25−29 years had higher adjusted ORs for thinness, and in 5−6 years, urban areas, southern/developed economy regions, post-mature, childbearing age ≥ 25 years, and other caretakers had higher and invalid breastfeeding-adjusted ORs (all p > 0.05 except overweight in the urban grade) for both overweight and overweight/obesity. Conclusions: Breastfeeding during the first four months was not associated with the thinness of children aged 3−6 years in eastern China, and the protective effect of breastfeeding against overweight or overweight/obesity could be confirmed. However, the effects of breastfeeding on thinness, overweight, and obesity may change or become invalid in some subgroups, suggesting that there may be potential interactions between feeding patterns and influential factors.
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Mantzorou M, Papandreou D, Vasios GK, Pavlidou E, Antasouras G, Psara E, Taha Z, Poulios E, Giaginis C. Exclusive Breastfeeding for at Least Four Months Is Associated with a Lower Prevalence of Overweight and Obesity in Mothers and Their Children after 2-5 Years from Delivery. Nutrients 2022; 14:nu14173599. [PMID: 36079855 PMCID: PMC9459704 DOI: 10.3390/nu14173599] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 08/23/2022] [Accepted: 08/30/2022] [Indexed: 12/16/2022] Open
Abstract
Introduction: Obesity is a current public health concern. Higher body weight is influenced by genetic and environmental parameters, and their interplay and is associated with a greater risk for several chronic diseases. Breastfeeding has been suggested as a preventive measure against obesity, which can further reduce long-term negative health outcomes for both women and children. Aim: The aim of the present study was to evaluate the role of breastfeeding on maternal and childhood overweight and obesity. Materials and Methods: This is a cross-sectional study conducted on 2515 healthy mothers and their children, aged 2−5 years, enrolled from nine different Greek rural and urban regions. Validated, standardized questionnaires were administrated that included anthropometric indices, socio-demographic characteristics of mothers and children, as well as breastfeeding practices. Results: Overall, 68% of participated women exclusively breastfed their children for at least 4 months. Mothers that exclusively breastfed showed a significantly lower prevalence of overweight and obesity after 2−5 years from delivery (p < 0.0001). Children that had exclusively been breastfed showed a significantly lower prevalence of overweight and obesity at the age of 2−5 years (p < 0.0001). Using multivariate regression analysis, exclusive breastfeeding for at least 4 months was associated with a two-fold lower risk for maternal and childhood overweight and obesity after 2−5 years from delivery, independent from maternal age, educational and economic status, and smoking habits (p < 0.0001). Conclusion: Exclusive breastfeeding for at least 4 months had a positive effect on childhood overweight and obesity, also contributing beneficially to post-natal maternal weight control. The beneficial effects of breastfeeding should be communicated to future and new mothers, while supportive actions for all mothers to initiate and continue breastfeeding their offspring should be implemented.
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Affiliation(s)
- Maria Mantzorou
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece
| | - Dimitrios Papandreou
- Department of Health Sciences, College of Natural and Health Sciences, Zayed University, Abu Dhabi P.O. Box 144534, United Arab Emirates
- Correspondence:
| | - Georgios K. Vasios
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece
| | - Eleni Pavlidou
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece
| | - Georgios Antasouras
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece
| | - Evmorfia Psara
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece
| | - Zainab Taha
- Department of Health Sciences, College of Natural and Health Sciences, Zayed University, Abu Dhabi P.O. Box 144534, United Arab Emirates
| | - Efthymios Poulios
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece
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Liu F, Lv D, Wang L, Feng X, Zhang R, Liu W, Han W. Breastfeeding and overweight/obesity among children and adolescents: a cross-sectional study. BMC Pediatr 2022; 22:347. [PMID: 35710383 PMCID: PMC9202207 DOI: 10.1186/s12887-022-03394-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 05/25/2022] [Indexed: 11/14/2022] Open
Abstract
Background Overweight and obesity are major public health crises among children and adolescents and contribute to a significant economic burden. We aimed to investigate the relationship between breastfeeding duration and overweight and obesity in children and adolescents in Qingdao, China in 2017. Methods This study conducted a survey with 10,753 students (5370 boys and 5383 girls) aged 6 to 16 years from the Shibei District of Qingdao, China in 2017. Anthropometric measurements were taken by well-trained personnel and self-completed questionnaires were used to collect data from students. A variety of statistical methods were used in this study, including univariate and multivariate analyses, as well as linear and nonlinear regression models. Results The prevalence of overweight and obesity was 15.45% and 19.76%, respectively. There was a significant negative correlation between breastfeeding duration and BMI in children and adolescents (β = -0.025, 95% CI: -0.033, -0.005, P < 0.01). Among boys, the BMI in children and adolescences of those who have been breastfed for more than 12 months was significantly lower than that of others whose breastfeeding duration was less than 12 months (β = -0.440, 95%CI -0.655, -0.224, P < 0.01). Breastfeeding has a particularly positive effect on the prevalence of obesity in boys aged 9 to 11 years (OR = 0.978, 95% CI: 0.958,0.999, P < 0.05). Conclusion Breastfeeding can significantly reduce the prevalence of overweight and obesity among children and adolescents aged 6 to 16 years. Those who were breastfed for more than 12 months had a lower risk of developing overweight and obesity, especially boys between the ages of 9 and 11. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-022-03394-z.
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Affiliation(s)
- Fange Liu
- Pediatric Nephrology and Endocrinology Department, the First Affiliated Hospital of Shandong First Medical University &Shandong Provincial Qianfoshan Hospital, No.16766 Jingshi Road, Lixia District, Jinan, 250014, China.
| | - Di Lv
- Department of Pediatrics, Qingdao Municipal Hospital, Affiliated to Qingdao University, Qingdao, 266071, China.,Qingdao Medical College, Qingdao University, Qingdao, 266071, China
| | - Lumin Wang
- Department of Pediatrics, Qilu Hospital of Shandong University, Qingdao, 266035, Shandong, China
| | - Xiaoyu Feng
- Pediatric Nephrology and Endocrinology Department, the First Affiliated Hospital of Shandong First Medical University &Shandong Provincial Qianfoshan Hospital, No.16766 Jingshi Road, Lixia District, Jinan, 250014, China
| | - Rongjun Zhang
- Pediatric Nephrology and Endocrinology Department, the First Affiliated Hospital of Shandong First Medical University &Shandong Provincial Qianfoshan Hospital, No.16766 Jingshi Road, Lixia District, Jinan, 250014, China
| | - Wendong Liu
- Department of Pediatrics, Qingdao Municipal Hospital, Affiliated to Qingdao University, Qingdao, 266071, China
| | - Wenchao Han
- Department of Pediatrics, Qingdao Municipal Hospital, Affiliated to Qingdao University, Qingdao, 266071, China
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Hildebrand JS, Ferguson PL, Sciscione AC, Grobman WA, Newman RB, Tita AT, Wapner RJ, Nageotte MP, Palomares K, Skupski DW, Cooper DM, Zhang C, Neelon B, Vena JE, Hunt KJ. Breastfeeding Associations with Childhood Obesity and Body Composition: Findings from a Racially Diverse Maternal-Child Cohort. Child Obes 2022; 18:178-187. [PMID: 34669515 PMCID: PMC8982114 DOI: 10.1089/chi.2021.0138] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: Studies suggest breastfeeding lowers obesity risk in childhood, but generalizability of existing evidence is limited. We examined associations of breastfeeding with childhood overweight, obesity, and percentage body fat, in a racially diverse maternal-child cohort. Methods: This cross-sectional study included 823 children, ages 4-8 years, enrolled in the Environmental Exposures and Child Health Outcomes (ECHO) cohort, a subset of the National Institute of Child Health and Human Development Fetal Growth Studies cohort. Logistic regression was used to estimate odds ratios and 95% confidence intervals (CIs) for overweight [BMI (kg/m2) 85th to <95th percentile] and obesity (BMI ≥95th percentile) in relation to breastfeeding including duration of exclusive and total breastfeeding. Linear regression was used to evaluate association between breastfeeding and percentage body fat measured by bioelectrical impedance analysis. Results: Fifty-two percent of children were male, 32% non-Hispanic Black, 29% Hispanic, 27% non-Hispanic White, and 13% Asian; 16% were overweight and 13% obese. Six months of exclusive breastfeeding, compared with no breastfeeding, was associated with 60% lower odds of obesity (95% CI 0.18-0.91) adjusting for age, gender, race, socioeconomic status, maternal BMI, and child's activity. Percentage body fat was inversely associated with breastfeeding duration. For none, <6, and ≥6 months of exclusive breastfeeding, adjusted mean percentage body fat was 16.8, 14.5, and 13.4, respectively. Results did not differ by gender, race/ethnicity, or maternal BMI status. Conclusions: Exclusive breastfeeding for the first 6 months of life is inversely and significantly associated with obesity and percentage body fat at ages 4-8 years. These findings support current breastfeeding guidelines.
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Affiliation(s)
- Janet S. Hildebrand
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA.,Target RWE Health Evidence Solutions, Durham, NC, USA
| | - Pamela L. Ferguson
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Anthony C. Sciscione
- Department of Obstetrics & Gynecology, Christiana Care Health System, Newark, DE, USA
| | - William A. Grobman
- Department of Obstetrics & Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Roger B. Newman
- Department of Obstetrics & Gynecology, Medical University of South Carolina, Charleston, SC, USA
| | - Alan T. Tita
- Department of Obstetrics & Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ronald J. Wapner
- Department of Obstetrics & Gynecology, Columbia University Medical Center, New York, NY, USA
| | - Michael P. Nageotte
- Department of Obstetrics & Gynecology, Long Beach Memorial Medical Center, Long Beach, CA, USA
| | - Kristy Palomares
- Department of Obstetrics & Gynecology, Saint Peter's University Hospital, New Brunswick, NJ, USA
| | - Daniel W. Skupski
- Department of Obstetrics & Gynecology, New York Presbyterian Queens Hospital, Queens, NY, USA
| | - Daniel M. Cooper
- Department of Pediatrics, University of California at Irvine School of Medicine, Irvine, CA, USA,Department of Pediatrics, Fountain Valley Regional Hospital and Medical Center, Fountain Valley, CA, USA
| | - Cuilin Zhang
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Brian Neelon
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - John E. Vena
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Kelly J. Hunt
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA.,Address correspondence to: Kelly J. Hunt, PhD, Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Suite 303, Charleston, SC 29425, USA
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6
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Kanellopoulou A, Antonogeorgos G, Kokkou S, Notara V, Rojas-Gil AP, Kornilaki EN, Lagiou A, Kosti RI, Panagiotakos DB. Assessing the association between breastfeeding, type of childbirth and family structure with childhood obesity: results from an observational study among 10-12 years old children. Int J Food Sci Nutr 2021; 73:522-530. [PMID: 34814801 DOI: 10.1080/09637486.2021.2006151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study examined the association between breastfeeding, type of childbirth, and family structure with childhood obesity. During 2014-2016, 1728 Greek students attending primary schools and their parents were enrolled. Children's weight status was measured and classified according to the International Obesity Task Force criteria. A self-administered questionnaire assessing the type of childbirth, the family structure, and several perinatal and demographic characteristics was used. Factors associated with higher breastfeeding rates were the type of childbirth, high maternal educational level, and nuclear family structure. No association was found between childhood obesity and type of childbirth (p = 0.64) and family structure (p = 0.26). Although the short-term beneficial effects of breastfeeding on childhood obesity are undeniable and it is of great importance to all health professionals to promote breastfeeding, no significant long-term effects on obesity in adolescence were observed. More studies are needed in order to elucidate the role of breastfeeding in obesity status in adolescence.
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Affiliation(s)
- Aikaterini Kanellopoulou
- Department of Nutrition & Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece
| | - George Antonogeorgos
- Department of Nutrition & Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece
| | - Stamatia Kokkou
- Department of Nutrition & Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece
| | - Venetia Notara
- Department of Public and Community Health, Laboratory of Hygiene and Epidemiology, School of Public Health, University of West Attica, Athens, Greece
| | - Andrea Paola Rojas-Gil
- Department of Nursing, Faculty of Health Sciences, University of Peloponnese, Tripoli, Greece
| | - Ekaterina N Kornilaki
- Department of Preschool Education, School of Education, University of Crete, Rethymnon, Greece
| | - Areti Lagiou
- Department of Public and Community Health, Laboratory of Hygiene and Epidemiology, School of Public Health, University of West Attica, Athens, Greece
| | - Rena I Kosti
- Department of Nutrition and Dietetics, School of Physical Education, Sports and Dietetics, University of Thessaly, Trikala, Greece
| | - Demosthenes B Panagiotakos
- Department of Nutrition & Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece.,University of Canberra, ACT, Canberra, Australia
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Ludvigsson J, Faresjö Å, Faresjö T. Breastfeeding and cortisol in hair in children. Int Breastfeed J 2021; 16:75. [PMID: 34620189 PMCID: PMC8499545 DOI: 10.1186/s13006-021-00419-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 09/13/2021] [Indexed: 11/30/2022] Open
Abstract
Background One of the most important protective health factors for children is breast-feeding, but the mechanisms for this effect are not fully elucidated. Our objective was to assess if the duration of breastfeeding influences cortisol in hair, used as a biomarker for stress in children still at school-age. Methods ABIS (All Babies in Southeast Sweden) is a prospective population-based child cohort study of 17,055 children born Oct 1st1997- Oct 1st 1999, with the aim to study development of immune-mediated diseases. Questionnaires were answered at birth and then at regular follow-ups, and biological samples were collected. As a biomarker of stress, we measured the child’s cortisol in hair collected at 8 years of age, those randomly selected N = 126 children among those with enough hair samples for analyses of hair at 8 years of age. Duration of breastfeeding had been registered as well as psycho-social factors related to breastfeeding and/or stress. Results There was a negative correlation (r = − 0.23, p = 0.01) between total duration of breastfeeding and hair cortisol levels at 8 years of age. In a multivariate analysis this association persisted (p = 0.01) even when adjusted for other potential intervening factors like age of mother at delivery and early psychosocial vulnerability in the family, an index based on 11 factors (Multivariate model: df = 5, adj R2 = 0.15, F = 5.38, p < 0.01). Conclusion Our results show that longer breastfeeding is associated with lower cortisol levels in the child many years later. These associations should be more elaborated in further studies, and these findings also give some implications for public health. Mothers should be encouraged to breastfeed their children also in the modern society, since breastfeeding promotes health in the child. This information could be given via the obstetric departments and later at the well-baby clinics.
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Affiliation(s)
- Johnny Ludvigsson
- Crown Princess Victoria Children's Hospital and Division of Pediatrics, Department of Biomedical and Clinical Sciences, Linköping University, SE-581 85, Linköping, Sweden.
| | - Åshild Faresjö
- Division of Community Medicine, Department of Health, Medicine and Care, Linköping University, SE-581 83, Linköping, Sweden
| | - Tomas Faresjö
- Division of Community Medicine, Department of Health, Medicine and Care, Linköping University, SE-581 83, Linköping, Sweden
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A Meta-Analysis of the Association Between Breastfeeding and Early Childhood Obesity. J Pediatr Nurs 2020; 53:57-66. [PMID: 32464422 DOI: 10.1016/j.pedn.2020.04.024] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 04/29/2020] [Accepted: 04/30/2020] [Indexed: 01/11/2023]
Abstract
PROBLEM Several studies have indicated a protective effect of breastfeeding on reducing the risk of childhood obesity, however, this remains controversial. The aim of this meta-analysis is to clarify the association between breastfeeding and the risk of preschoolers' obesity. ELIGIBILITY CRITERIA Prospective cohort studies published prior to December 1, 2019 were systematically searched in PubMed, EMBASE, the Web of Science and the Cochrane Library databases. Meta-analysis was performed using Stata 15.1. SAMPLE Twenty-six publications involving 332,297 participants were eligible for inclusion. RESULTS The pooled odds ratio (OR) of the risk of obesity in ever-breastfed preschoolers was 0.83 (95%CI [0.73,0.94]) compared with their never-breastfed counterparts. Random-effects dose-response model revealed a negative correlation between the duration of breastfeeding and risk of obesity (regression coefficient = -0.032, p = .001). Categorical analysis confirmed this dose-response association (1 day to <3 months of breastfeeding: OR = 1.07, 95%CI [0.94,1.21]; 3 months to <6 months: OR = 0.96, 95%CI [0.60,1.54]; ≥6 months: OR = 0.67, 95%CI [0.58,0.77]). One month of breastfeeding was associated with a 4.0% decrease in risk of obesity (OR = 0.96/month of breastfeeding, 95% CI [0.95, 0.97]). Under the reference of never breastfeeding, the summary OR of exclusive breastfeeding was 0.53 (95%CI [0.45,0.63]). CONCLUSIONS Breastfeeding is inversely associated with a risk of early obesity in children aged two to six years. Moreover, there is a dose-response effect between duration of breastfeeding and reduced risk of early childhood obesity. IMPLICATIONS Clinical nurses' guidance and advice that prolong the duration of breastfeeding and promote exclusive breastfeeding are needed to prevent the development of later childhood obesity.
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Houle B, Rochat TJ, Newell ML, Stein A, Bland RM. Breastfeeding, HIV exposure, childhood obesity, and prehypertension: A South African cohort study. PLoS Med 2019; 16:e1002889. [PMID: 31454346 PMCID: PMC6711496 DOI: 10.1371/journal.pmed.1002889] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 07/22/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Evidence on the association between breastfeeding and later childhood obesity and blood pressure (BP) is inconsistent, especially in HIV-prevalent areas where, until recently, HIV-infected women were discouraged from breastfeeding, but obesity is increasingly prevalent. METHODS AND FINDINGS The Siyakhula cohort (2012-2014), a population-based prospective cohort study, collected data over 3 visits on HIV-negative children ages 7 to 11 years in rural South Africa. We used weight (body mass index [BMI]), fat, and BP as outcome variables and incorporated early life (including mother's age at delivery and HIV status) and current life factors (including maternal education and current BMI). Our primary exposure was breastfeeding duration. We dichotomized 3 outcome measures using pre-established thresholds for clinical interpretability: (1) overfat: ≥85th percentile of body fat; (2) overweight: >1 SD BMI z score; and (3) prehypertension: ≥90th percentile for systolic BP (SBP) or diastolic BP (DBP). We modelled each outcome using multivariable logistic regression, including stopping breastfeeding, then early life, and finally current life factors. Of 1,536 children (mean age = 9.3 years; 872 girls; 664 boys), 7% were overfat, 13.2% overweight, and 9.1% prehypertensive. Over half (60%) of the mothers reported continued breastfeeding for 12+ months. In multivariable analyses, continued breastfeeding between 6 and 11 months was associated with approximately halved odds of both being overfat (adjusted odds ratio [aOR] = 0.43, 95% confidence interval [CI] 0.21-0.91, P = 0.027) and overweight (aOR = 0.46, CI 0.26-0.82, P = 0.0083), but the association with prehypertension did not reach statistical significance (aOR = 0.72, CI 0.38-1.37, P = 0.32). Children with a mother who was currently obese were 5 times more likely (aOR = 5.02, CI 2.47-10.20, P < 0.001) to be overfat and over 4 times more likely to be overweight (aOR = 4.33, CI 2.65-7.09, P < 0.001) than children with normal weight mothers. Differences between HIV-exposed and unexposed children on any of the outcomes were minimal and not significant. The main study limitation was that duration of breastfeeding was based on maternal recall. CONCLUSIONS To our knowledge, this is the first study examining and quantifying the association between breastfeeding and childhood obesity in an African setting with high HIV prevalence. We observed that breastfeeding was independently associated with reduced childhood obesity for both HIV-exposed and unexposed children, suggesting that promoting optimal nutrition throughout the life course, starting with continued breastfeeding, may be critical to tackling the growing obesity epidemic. In the era of widespread effective antiretroviral treatment for HIV-infected women for life, these data further support the recommendation of breastfeeding for all women.
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Affiliation(s)
- Brian Houle
- School of Demography, The Australian National University, Canberra, Australia
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- CU Population Center, Institute of Behavioral Science, University of Colorado at Boulder, Boulder, Colorado
| | - Tamsen J. Rochat
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- MRC/Developmental Pathways to Health Research Unit, Department of Paediatrics, School of Clinical Medicine, Faculty of Health Sciences, University of Witwatersrand, South Africa
| | - Marie-Louise Newell
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Alan Stein
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Section of Child and Adolescent Psychiatry, Department of Psychiatry, University of Oxford, United Kingdom
| | - Ruth M. Bland
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- Institute of Health and Wellbeing and Royal Hospital for Children, University of Glasgow, Glasgow, United Kingdom
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Kuniyoshi Y, Kikuya M, Matsubara H, Ishikuro M, Obara T, Kure S, Kuriyama S. Association of Feeding Practice with Childhood Overweight and/or Obesity in Affected Areas Before and After the Great East Japan Earthquake. Breastfeed Med 2019; 14:382-389. [PMID: 30985196 DOI: 10.1089/bfm.2018.0254] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Backgrounds: The effect of breastfeeding on weight status of individuals after a large-scale natural disaster in a developed country is unclear. We aimed to investigate the association of breastfeeding with childhood overweight and/or obesity in areas affected by the Great East Japan Earthquake. Materials and Methods: From health examination records of 15,563 children, we retrospectively obtained anthropometric and feeding practice (formula, mixed, and breastfeeding) data during early childhood. According to their age at the time of the earthquake, we subdivided the children into study groups 1 (42-48 months), 2 (18-24 months), and 3 (<3 months). Overweight, obesity, and underweight were defined on the basis of body mass index. To assess the association between feeding practice at 3 months of age and the risk of overweight and/or obesity at 3 years of age, we developed generalized linear mixed models that included a random effect of the municipality of residence; for this analysis, we combined "mixed feeding" and "formula feeding" into a single category: "mixed plus formula feeding." Results: Mixed- plus formula-fed children had a significantly higher risk of overweight and/or obesity than breastfed children in all three study groups (odds ratios, 1.20-2.22; all p ≤ 0.047). The rate of underweight at 3 years of age was ≤0.3%, irrespective of feeding practices. Conclusion: Breastfeeding, even during a large-scale natural disaster in a developed country, maintained its protective effect against overweight and/or obesity in childhood.
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Affiliation(s)
- Yasutaka Kuniyoshi
- 1 Department of Disaster Public Health, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
| | - Masahiro Kikuya
- 2 Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.,3 Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Hiroko Matsubara
- 3 Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,4 Department of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Mami Ishikuro
- 3 Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,4 Department of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Taku Obara
- 3 Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,4 Department of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Shigeo Kure
- 3 Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,5 Department of Pediatrics, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Shinichi Kuriyama
- 1 Department of Disaster Public Health, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan.,3 Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,4 Department of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, Sendai, Japan
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11
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Frondelius K, Oudin A, Malmqvist E. Traffic-Related Air Pollution and Child BMI-A Study of Prenatal Exposure to Nitrogen Oxides and Body Mass Index in Children at the Age of Four Years in Malmö, Sweden. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15102294. [PMID: 30347657 PMCID: PMC6210059 DOI: 10.3390/ijerph15102294] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 09/28/2018] [Accepted: 10/16/2018] [Indexed: 12/21/2022]
Abstract
Traffic-related air pollution could be a danger to the health of children. Earlier studies have linked prenatal exposure to an increased risk of a range of diseases and negative health outcomes, including overweight and obesity. Presently, a knowledge gap exists in investigating the risk of overweight and obesity among children exposed to lower levels of air pollution in utero. This study aimed to investigate the relationship between prenatal traffic-related air pollution (nitrogen dioxides (NOx) and traffic density) and childhood overweight and obesity in Malmö, Sweden. A cohort, based on attendance of a four-year check-up examination at Swedish Child Health Care (CHC) centers, and a parent-assessed questionnaire provided data on body-mass index adjusted for four-year-old children (ISO-BMI) as well as socioeconomic and health variables. We estimated exposure by using traffic density and levels of NOx at the maternal geocoded residential level. Analysis of 5815 children was performed using binary logistic regression models. This study showed no associations of increased risk for childhood overweight or obesity through to prenatal exposure to NOx in this low-exposure setting. We further suggest analysis of risks related to exposure levels ranging between the ones presented here and those proposed in previous literature.
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Affiliation(s)
- Kasper Frondelius
- Occupational and Environmental Medicine, Department for Laboratory Medicine, Lund University, 221 85 Lund, Sweden.
| | - Anna Oudin
- Occupational and Environmental Medicine, Department for Laboratory Medicine, Lund University, 221 85 Lund, Sweden.
| | - Ebba Malmqvist
- Occupational and Environmental Medicine, Department for Laboratory Medicine, Lund University, 221 85 Lund, Sweden.
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Notara V, Kokkou S, Panagiotakos D. The impact of perinatal history in the occurrence of childhood obesity: a litera-ture review. Hippokratia 2018; 22:155-161. [PMID: 31695302 PMCID: PMC6825419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND It is widely accepted, that the increased prevalence of childhood overweight and obesity poses an important public health problem since it increases the risk for early onset of non-communicable diseases with potentially increased health complications during adulthood. Childhood obesity prevention is therefore of primary importance; hence it is mandatory to understand its main causes and identify the mechanisms associated with weight gain. Although its etiology can be partly attributed to genetic and behavioral factors, evidence from existing literature indicates that the perinatal environment may also increase the risk of childhood obesity; the latter, however, has not been thoroughly investigated and discussed. METHODS A literature search was conducted in scientific databases (PubMed, Embase, Web of Science, and Scopus) in order to reveal recent epidemiologic studies, with emphasis on works from the last decade. Studies whose primary or secondary object was the association between type of delivery, breastfeeding and/or gestational diabetes mellitus with overweight and obesity in childhood and preadolescence were taken into account. Studies that did not meet the aim of the current review were excluded. RESULTS The retrieved information revealed that there is a noteworthy association between perinatal factors and childhood and preadolescence overweight/obesity occurrence, though the exact pathways still need to be elucidated. CONCLUSIONS Public health professionals should take into account perinatal determinants when estimating a child's risk of overweight and obesity development. HIPPOKRATIA 2018, 22(4): 155-161.
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Affiliation(s)
- V Notara
- Department of Public & Community Health, School of Public Health, University of West Attica Athens, Greece
- Department of Nutrition & Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece
| | - S Kokkou
- Department of Nutrition & Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece
| | - D Panagiotakos
- Department of Nutrition & Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece
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13
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Ortega-García JA, Kloosterman N, Alvarez L, Tobarra-Sánchez E, Cárceles-Álvarez A, Pastor-Valero R, López-Hernández FA, Sánchez-Solis M, Claudio L. Full Breastfeeding and Obesity in Children: A Prospective Study from Birth to 6 Years. Child Obes 2018; 14:327-337. [PMID: 29912590 PMCID: PMC6066191 DOI: 10.1089/chi.2017.0335] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Obesity is a major public health crisis among both children and adults and contributes to significant physical, psychological, and economic burden. We aim to investigate the effect of duration of breastfeeding on excessive weight and obesity at 6 years of age. SUBJECTS/METHODS Data on breastfeeding and child anthropometric measurements were collected in a birth-cohort study in Murcia, Spain (n = 350). Breastfeeding status and body mass index (BMI) were established according to WHO definitions. Other factors potentially related to children's weight were considered. Multiple log-linear and ordinal regressions were used to analyze the effects of breastfeeding on overweight and obesity when considering potential confounders. RESULTS 33% and 17.3% of children in the study were of excess weight and obesity, respectively. Univariate predictors of BMI in children aged 6 were as follows: pregestational maternal BMI (kg/m2) (R2 = 0.127, p < 0.01); full breastfeeding (weeks) R2 = -0.035, p < 0.01); infant weight gain (kg) (R2 = 0.348, p < 0.01); and maternal alcohol consumption during pregnancy (g/day) (R2 = 0.266, p < 0.01) at age 6. In the ordinal logistic regression, full breastfeeding was associated with a significant decrease in obesity -0.052 (95% CI, -0.10 to -0.003). CONCLUSIONS The delay of bottle feeding introduction may have a protective effect against obesity at 6 years of age. Our findings reinforce the need for greater support of breastfeeding and to promote a healthy environment and antipoverty interventions during pregnancy and infancy, alongside other strategies for obesity prevention.
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Affiliation(s)
- Juan Antonio Ortega-García
- Pediatric Environmental Health Speciality Unit, Laboratory of Environmental and Human Health (A5), Department of Paediatrics, Institute of Biomedical Research, IMIB-Arrixaca, Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain
| | - Nicole Kloosterman
- Pediatric Environmental Health Speciality Unit, Laboratory of Environmental and Human Health (A5), Department of Paediatrics, Institute of Biomedical Research, IMIB-Arrixaca, Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain
| | - Lizbeth Alvarez
- Pediatric Environmental Health Speciality Unit, Laboratory of Environmental and Human Health (A5), Department of Paediatrics, Institute of Biomedical Research, IMIB-Arrixaca, Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain
| | - Esther Tobarra-Sánchez
- Pediatric Environmental Health Speciality Unit, Laboratory of Environmental and Human Health (A5), Department of Paediatrics, Institute of Biomedical Research, IMIB-Arrixaca, Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain
| | - Alberto Cárceles-Álvarez
- Pediatric Environmental Health Speciality Unit, Laboratory of Environmental and Human Health (A5), Department of Paediatrics, Institute of Biomedical Research, IMIB-Arrixaca, Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain
| | - Rebeca Pastor-Valero
- Pediatric Environmental Health Speciality Unit, Laboratory of Environmental and Human Health (A5), Department of Paediatrics, Institute of Biomedical Research, IMIB-Arrixaca, Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain
| | | | - Manuel Sánchez-Solis
- Pediatric Environmental Health Speciality Unit, Laboratory of Environmental and Human Health (A5), Department of Paediatrics, Institute of Biomedical Research, IMIB-Arrixaca, Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain
| | - Luz Claudio
- Division of International Health, Mount Sinai School of Medicine, New York, NY
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Lee A, Cheung CKM, Lo K, Keung VMW, Mui LWH, Tam WWS. Studying Impact of Nutrition on Growth (SING): a prospective cohort for comparing the health outcomes of young children with the dietary quality score. BMJ Open 2017; 7:e018380. [PMID: 29122800 PMCID: PMC5695350 DOI: 10.1136/bmjopen-2017-018380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION This study aims to explore the prospective association between the dietary quality (DQ) of preschoolers and their health status in Hong Kong, with the body mass index as the main outcome variable. METHODS AND ANALYSIS This prospective cohort study has recruited 3539 children aged between 2 and 4 years old, with a follow-up period of 4 years. Their diet was reported by their parents by a 3-day food diary, and their body weight and height were measured yearly with standardised instruments. Questionnaires were administered to parents to acquire information of the children's prenatal development and dietary intake before their age of 2 years and of their baseline lifestyle and family backgrounds. The DQ was measured by the Healthy Eating Index as a continuous scale, while the exposure was defined as having a higher dietary quality score. Data were analysed using SPSS V.24. Linear and logistic regressions were used to examine the association of those predictive factors to the outcomes. Generalised estimating equations will be used to examine the longitudinal changes of the outcomes. A pilot study has been conducted, the preliminary results from which are presented in this cohort profile. ETHICS AND DISSEMINATION This study has been approved by the Joint Chinese University of Hong Kong and New Territory East Cluster Clinical Research Ethics Committee (CREC Ref No: 2013-632). Written informed consent was obtained from all subjects. The results will be published in due course.
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Affiliation(s)
- Albert Lee
- Centre for Health Education and Health Promotion, The Chinese University of Hong Kong, Lek Yuen Health Centre, Shatin, Hong Kong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Calvin Ka-man Cheung
- Centre for Health Education and Health Promotion, The Chinese University of Hong Kong, Lek Yuen Health Centre, Shatin, Hong Kong
| | - Kenneth Lo
- Centre for Health Education and Health Promotion, The Chinese University of Hong Kong, Lek Yuen Health Centre, Shatin, Hong Kong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Vera Mei-wan Keung
- Centre for Health Education and Health Promotion, The Chinese University of Hong Kong, Lek Yuen Health Centre, Shatin, Hong Kong
| | - Lancelot Wai-ho Mui
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Wilson W S Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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15
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Vehapoglu A, Goknar N, Turel O, Torun E, Ozgurhan G. Risk factors for childhood obesity: Do the birth weight, type of delivery, and mother's overweight have an implication on current weight status? World J Pediatr 2017; 13:457-464. [PMID: 28434072 DOI: 10.1007/s12519-017-0030-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 07/29/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND The aim of this study was to identify risk factors, including the type of delivery, breastfeeding and its duration, birth weight, the timing of solid food introduction, the mother's education level at birth, and smoking status during pregnancy, that are associated with obesity in children living in Istanbul. METHODS This study involving 4990 healthy children aged 2-14 years, at an outpatient clinic in a tertiary care hospital from June 2012 to July 2014. RESULTS The overall rates of overweight and obesity in children were 13.1% and 7.8%, respectively. Results demonstrated that 44.5% of children were delivered by caesarean section. In all age groups, 7.8% of children delivered by caesarean section were obese compared with 7.9% of children born vaginally. No significant association between caesarean section delivery and obesity in childhood was found in our study [odds ratio (OR)=0.98, 95% confidence interval (CI)=0.64-2.87, P=0.454]. There was also no association between duration of breastfeeding and the introduction of solid foods before 4 months or after 6 months of age and childhood obesity (OR=0.95, 95% CI=0.69-1.3, P=0.771; OR=0.99, 95% CI=0.64-1.53, P=0.261). Regression analyses revealed that children with birth weights greater than 3801 g or those with maternal body mass index (BMI) equal to or greater than 30 had an increased risk of being obese or overweight (OR=1.78, 95% CI=1.19-2.65; OR=3.95, 95% CI=1.94-5.81). CONCLUSIONS This study demonstrated that increased birth weight and maternal BMI are significant risk factors for obesity in children living in Istanbul, Turkey. No relation between caesarean section delivery and childhood obesity was found in this study.
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Affiliation(s)
- Aysel Vehapoglu
- Department of Pediatrics, Bezmialem Vakıf University, Faculty of Medicine, Vatan Street, Fatih, Istanbul, 34093, Turkey.
| | - Nilufer Goknar
- Department of Pediatrics, Bezmialem Vakıf University, Faculty of Medicine, Vatan Street, Fatih, Istanbul, 34093, Turkey
| | - Ozden Turel
- Department of Pediatrics, Bezmialem Vakıf University, Faculty of Medicine, Vatan Street, Fatih, Istanbul, 34093, Turkey
| | - Emel Torun
- Department of Pediatrics, Bezmialem Vakıf University, Faculty of Medicine, Vatan Street, Fatih, Istanbul, 34093, Turkey
| | - Gamze Ozgurhan
- Department of Pediatrics, Suleymaniye Obstetrics and Gynecology Hospital, Istanbul, Turkey
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Zamora-Kapoor A, Omidpanah A, Nelson LA, Kuo AA, Harris R, Buchwald DS. Breastfeeding in Infancy Is Associated with Body Mass Index in Adolescence: A Retrospective Cohort Study Comparing American Indians/Alaska Natives and Non-Hispanic Whites. J Acad Nutr Diet 2017; 117:1049-1056. [PMID: 28082060 PMCID: PMC5586593 DOI: 10.1016/j.jand.2016.11.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 11/17/2016] [Indexed: 01/16/2023]
Abstract
BACKGROUND American Indians and Alaska Natives have the highest obesity prevalence in the United States, but the influence of early childhood variables on body mass index (BMI; calculated as kg/m2) is not well understood. Previous studies have investigated the association between breastfeeding in infancy and offspring BMI, but rarely included American Indians and Alaska Natives. OBJECTIVE This study investigated the association between breastfeeding in infancy and BMI in American Indians and Alaska Native and non-Hispanic white adolescents and young adults. DESIGN Longitudinal analysis based on data from the National Longitudinal Study of Adolescent to Adult Health (1994 to 2008). PARTICIPANTS Adolescent respondents who self-identified as American Indians and Alaska Native or non-Hispanic white, and whose parents completed the parental questionnaire, reported their height and weight. The final sample included 655 American Indians and Alaska Native and 10,305 non-Hispanic white respondents. STATISTICAL ANALYSES PERFORMED Generalized estimating equations were used to measure the mean differences, 95% CIs, and P values of the association between breastfeeding in infancy and offspring BMI in adolescence, stratifying by race, and adjusting for demographic and socioeconomic variables. RESULTS The length of breastfeeding was inversely associated with BMI in both populations. American Indians and Alaska Natives that were breastfed for 6 to 12 months or for more than 12 months had a mean BMI of 2.69 (95% CI -3.46 to -1.92; P<0.01) and 1.54 (95% CI -2.75 to -0.33; P<0.05) units lower than those that were never breastfed. Non-Hispanic whites that were breastfed for 3 to 6 months, 6 to 12 months, or more than 12 months had a mean BMI of 0.71 (95% CI -0.93 to -0.50; P<0.01), 0.68 (95% CI -0.87 to -0.50; P<0.01), and 0.85 (95% CI -1.09 to -0.62; P<0.01) units lower than those that were never breastfed. The association between the length of breastfeeding and offspring BMI varied by race (P<0.01). CONCLUSIONS Breastfeeding in infancy is associated with lower mean BMI. Future research should investigate causal pathways and whether interventions promoting breastfeeding in American Indians and Alaska Natives can prevent increasing BMI.
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Affiliation(s)
- Anna Zamora-Kapoor
- Initiative for Research and Education to Advance Community Health (IREACH), Washington State University, Seattle, WA
- Department of Pediatrics, University of Washington, Seattle, WA
| | - Adam Omidpanah
- Initiative for Research and Education to Advance Community Health (IREACH), Washington State University, Seattle, WA
| | - Lonnie A. Nelson
- Initiative for Research and Education to Advance Community Health (IREACH), Washington State University, Seattle, WA
| | - Alice A. Kuo
- Department of Pediatrics, University of California-Los Angeles, Los Angeles, CA
| | - Raymond Harris
- Initiative for Research and Education to Advance Community Health (IREACH), Washington State University, Seattle, WA
| | - Dedra S. Buchwald
- Initiative for Research and Education to Advance Community Health (IREACH), Washington State University, Seattle, WA
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17
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Breast-feeding duration for the prevention of excess body weight of mother-child pairs concurrently: a 2-year cohort study. Public Health Nutr 2017. [PMID: 28625232 DOI: 10.1017/s1368980017001239] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To examine the association between breast-feeding duration and the risk of excess body weight (children >85th percentile, mothers BMI≥25·0 kg/m2) concurrently in mother-child pairs two years after delivery. DESIGN Prospective cohort study in Joinville, Brazil. Multivariable logistic regression was used to examine the independent relationship between breast-feeding duration and risk of excess body weight. SETTING Brazilian public maternity hospital. SUBJECTS Three hundred and five mother-child pairs. RESULTS At 2-year follow-up, 23·6 % of mother-child pairs had excess body weight. Children breast-fed for <2 months were more likely to have excess body weight than children breast-fed for ≥6 months (OR=2·4; 95 % CI 1·1, 5·1). Breast-feeding for <2 months was also associated with a greater likelihood of maternal excess body weight compared with those who breast-fed for ≥6 months (OR=2·9; 95 % CI 1·1, 8·1). There was a progressive increase in the likelihood of mother-child pairs having excess body weight as breast-feeding duration decreased. In addition to breast-feeding duration, other independent determinants of excess body weight were pre-pregnancy weight, gestational weight gain and number of pregnancies in mothers, and birth weight in children. CONCLUSIONS Breast-feeding for a longer duration has a parallel protective effect on the risk of excess body weight in mother-child pairs two years after birth. Since members of the same family could be influenced by the same risk factors, continued promotion and support of breast-feeding may help to attenuate the rising prevalence of overweight in mother-child pairs.
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18
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Uwaezuoke SN, Eneh CI, Ndu IK. Relationship Between Exclusive Breastfeeding and Lower Risk of Childhood Obesity: A Narrative Review of Published Evidence. Clin Med Insights Pediatr 2017; 11:1179556517690196. [PMID: 28469518 PMCID: PMC5398325 DOI: 10.1177/1179556517690196] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 01/02/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The pattern of infant feeding during the first 1000-day period-from conception to the second birthday-has a significant influence on the child's growth trajectory. The relationship between exclusive breastfeeding and lower risk of childhood obesity has elicited much scientific interest, given the fact that this form of malnutrition is becoming a global epidemic. AIM This narrative review aims to examine the evidence in the literature linking exclusive breastfeeding with reduction in obesity in children. LITERATURE SEARCH Using appropriate search terms, PubMed database was searched for relevant articles that met the review objective. RESULTS Evidence for the protective effect of exclusive breastfeeding against childhood obesity have been provided by studies which explored 5 physiologic mechanisms and those that established the causality between breastfeeding and lower risk of obesity. The few studies that disputed this relationship highlighted the influence of confounding factors. A new insight on molecular mechanisms, however, points to a direct and indirect effect of human milk oligosaccharides on the prevention of overweight and obesity. CONCLUSIONS The preponderance of current evidence strongly suggests that exclusivity in breastfeeding can prevent the development of obesity in children.
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Affiliation(s)
- Samuel N Uwaezuoke
- Department of Pediatrics, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Chizoma I Eneh
- Department of Pediatrics, Enugu State University Teaching Hospital, Enugu, Nigeria
| | - Ikenna K Ndu
- Department of Pediatrics, Enugu State University Teaching Hospital, Enugu, Nigeria
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19
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Contarato AAPF, Rocha EDDM, Czarnobay SA, Mastroeni SSDBS, Veugelers PJ, Mastroeni MF. Independent effect of type of breastfeeding on overweight and obesity in children aged 12-24 months. CAD SAUDE PUBLICA 2016; 32:e00119015. [PMID: 28001206 DOI: 10.1590/0102-311x00119015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 03/11/2016] [Indexed: 11/21/2022] Open
Abstract
This study aimed to analyze the effect of type of breastfeeding on the nutritional status of children between 12-24 months of age. This cohort study included 435 children born in 2012 in a public hospital in Joinville, Santa Catarina State, Brazil. Two years after delivery the mothers and their children were contacted in their homes for a new investigation of demographic, economic, nutritional, and anthropometric data. In the unadjusted analysis, children who were not exclusively breastfed were more likely to be overweight (including obesity) at 2 years of age (OR = 1.6; p = 0.049) than exclusively breastfed children. After adjusting for several covariates, children who were not exclusively breastfed had a 12% higher risk of overweight including obesity compared to unadjusted analysis (OR = 2.6 vs. OR = 1.8; p = 0.043). In addition, birthweight was also an independent determinant of overweight including obesity (OR = 2.5; p = 0.002). The practice of exclusive breastfeeding can reduce the risk of overweight in children from developing countries such as Brazil.
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Affiliation(s)
| | | | - Sandra Ana Czarnobay
- Departamento de Nutrição, Associação Educacional Luterana Bom Jesus, Joinville, Brasil
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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: 563] [Impact Index Per Article: 70.4] [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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Ruiz M, Goldblatt P, Morrison J, Porta D, Forastiere F, Hryhorczuk D, Antipkin Y, Saurel-Cubizolles MJ, Lioret S, Vrijheid M, Torrent M, Iñiguez C, Larrañaga I, Bakoula C, Veltsista A, van Eijsden M, Vrijkotte TGM, Andrýsková L, Dušek L, Barros H, Correia S, Järvelin MR, Taanila A, Ludvigsson J, Faresjö T, Marmot M, Pikhart H. Impact of Low Maternal Education on Early Childhood Overweight and Obesity in Europe. Paediatr Perinat Epidemiol 2016; 30:274-84. [PMID: 26945670 DOI: 10.1111/ppe.12285] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Comparable evidence on adiposity inequalities in early life is lacking across a range of European countries. This study investigates whether low maternal education is associated with overweight and obesity risk in children from distinct European settings during early childhood. METHODS Prospective data of 45 413 children from 11 European cohorts were used. Children's height and weight obtained at ages 4-7 years were used to assess prevalent overweight and obesity according to the International Obesity Task Force definition. The Relative/Slope Indices of Inequality (RII/SII) were estimated within each cohort and by gender to investigate adiposity risk among children born to mothers with low education as compared to counterparts born to mothers with high education. Individual-data meta-analyses were conducted to obtain aggregate estimates and to assess heterogeneity between cohorts. RESULTS Low maternal education yielded a substantial risk of early childhood adiposity across 11 European countries. Low maternal education yielded a mean risk ratio of 1.58 (95% confidence interval (CI) 1.34, 1.85) and a mean risk difference of 7.78% (5.34, 10.22) in early childhood overweight, respectively, measured by the RII and SII. Early childhood obesity risk by low maternal education was as substantial for all cohorts combined (RII = 2.61 (2.10, 3.23)) and (SII = 4.01% (3.14, 4.88)). Inequalities in early childhood adiposity were consistent among boys, but varied among girls in a few cohorts. CONCLUSIONS Considerable inequalities in overweight and obesity are evident among European children in early life. Tackling early childhood adiposity is necessary to promote children's immediate health and well-being and throughout the life course.
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Affiliation(s)
- Milagros Ruiz
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Peter Goldblatt
- Research Department of Epidemiology and Public Health, UCL Institute of Health Equity, University College London, London, UK
| | - Joana Morrison
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Daniela Porta
- Department of Epidemiology, Lazio Regional Health System, Rome, Italy
| | | | - Daniel Hryhorczuk
- Center for Global Health, University of Illinois College of Medicine, Chicago, IL, USA
| | - Youriy Antipkin
- Institute of Pediatrics, Obstetrics, and Gynecology, Kyiv, Ukraine
| | - Marie-Josèphe Saurel-Cubizolles
- Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics, Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France
| | - Sandrine Lioret
- Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1153, Early Origin of the Child's Health and Development Team (ORCHAD), Center for Epidemiology and Statistics, Sorbonne Paris Cité, Paris Descartes University, Paris, France
| | - Martine Vrijheid
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Maties Torrent
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Barcelona, Spain.,IB-Salut Menorca Health Area, Balearic Islands, Spain
| | - Carmen Iñiguez
- FISABIO - Universitat Jaume I - Universitat de València Joint Research Unit of Epidemiology and Environmental Health, Castellón de la Plana, Spain
| | - Isabel Larrañaga
- Public Health Department of Gipuzkoa, Gipuzkoa, Spain.,BIODONOSTIA Health Research Institute, San Sebastian, Spain
| | - Chryssa Bakoula
- First Department of Paediatrics, Aghia Sophia Children's Hospital, University of Athens, Athens, Greece
| | - Alexandra Veltsista
- First Department of Paediatrics, Aghia Sophia Children's Hospital, University of Athens, Athens, Greece
| | - Manon van Eijsden
- Department of Epidemiology and Health Promotion, Public Health Service of Amsterdam, Amsterdam, The Netherlands
| | - Tanja G M Vrijkotte
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Lenka Andrýsková
- Faculty of Science, Research Centre of Toxic Compounds in the Environment (RECETOX), Masaryk University, Brno, Czech Republic
| | - Ladislav Dušek
- Faculty of Science, Research Centre of Toxic Compounds in the Environment (RECETOX), Masaryk University, Brno, Czech Republic.,Institute of Biostatistics & Analyses (IBA), Masaryk University, Brno, Czech Republic
| | - Henrique Barros
- EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal.,Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal
| | - Sofia Correia
- EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal.,Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal
| | - Marjo-Riitta Järvelin
- Department of Epidemiology and Biostatistics, MRC Health Protection Agency (HPE), Centre for Environment and Health, School of Public Health, Imperial College London, London, UK.,Biocenter Oulu, University of Oulu, Oulu, Finland.,Unit of Primary Care, Oulu University Hospital, Oulu, Finland.,Faculty of Medicine, Center for Life Course Epidemiology, University of Oulu, Oulu, Finland
| | - Anja Taanila
- Institute of Health Sciences, University of Oulu, Oulu, Finland
| | - Johnny Ludvigsson
- Division of Pediatrics, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Tomas Faresjö
- Department of Medicine and Health, Community Medicine/General Practice Faculty of Health Sciences, Linköping University, Linköping, Sweden
| | - Michael Marmot
- Research Department of Epidemiology and Public Health, University College London, London, UK.,Research Department of Epidemiology and Public Health, UCL Institute of Health Equity, University College London, London, UK
| | - Hynek Pikhart
- Research Department of Epidemiology and Public Health, University College London, London, UK
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22
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Magnusson M, Lagerberg D, Wallby T. No widening socioeconomic gap within a general decline in Swedish breastfeeding. Child Care Health Dev 2016; 42:415-23. [PMID: 26918563 DOI: 10.1111/cch.12327] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Accepted: 01/03/2016] [Indexed: 12/01/2022]
Abstract
AIM To study potential socioeconomic differences within the general decline in breastfeeding over time. METHODS Data was collected for 51 415 infants born 2004-2010 from the databases of statistics of the Preventive Child Health Care Services in Uppsala and Orebro counties in Sweden and socioeconomic indicators from Swedish national registers. Breastfeeding data (breastfed/not breastfed) from 1 week, 4 months and 6 months of age were used as the main outcome variables. Educational level of the mother was defined as the highest level on a three-grade scale, low, medium and high. Family type was defined as whether the mother was single or married/cohabiting. Family disposable income was divided into quartiles where quartile 1 included the 25% children in families with the lowest incomes. Analyses were conducted by logistic regression models using the methodology of generalized estimating equations (GEE). An exchangeable correlation structure was used to control for the dependence among infants with the same mother. RESULTS Breastfeeding rate in Sweden has declined gradually since the late 1990s. The results indicated that overall breastfeeding rates over the study period were influenced by socioeconomic status in a gradient manner but no widening socioeconomic gap was detected. Rather the interaction analyses showed a narrowing socioeconomic gap over the study period between high and low educational level and single versus cohabiting mothers at 4 months. The narrowing socioeconomic gap between the educational level categories was also detectable at 6 months. CONCLUSION No increase in socioeconomic gap was detected within the general decline in Swedish breastfeeding. However, there are reasons to maintain and strengthen the overall breastfeeding supportive measures including extended support for vulnerable groups.
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Affiliation(s)
- M Magnusson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Central Child Healthcare Unit, Uppsala Akademiska Hospital, Uppsala, Sweden
| | - D Lagerberg
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - T Wallby
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Central Child Healthcare Unit, Uppsala Akademiska Hospital, Uppsala, Sweden
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23
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Tchoubi S, Sobngwi-Tambekou J, Noubiap JJN, Asangbeh SL, Nkoum BA, Sobngwi E. Prevalence and Risk Factors of Overweight and Obesity among Children Aged 6-59 Months in Cameroon: A Multistage, Stratified Cluster Sampling Nationwide Survey. PLoS One 2015; 10:e0143215. [PMID: 26636970 PMCID: PMC4670227 DOI: 10.1371/journal.pone.0143215] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 11/02/2015] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Childhood obesity is one of the most serious public health challenges of the 21st century. The prevalence of overweight and obesity among children (<5 years) in Cameroon, based on weight-for-height index, has doubled between 1991 and 2006. This study aimed to determine the prevalence and risk factors of overweight and obesity among children aged 6 months to 5 years in Cameroon in 2011. METHODS Four thousand five hundred and eighteen children (2205 boys and 2313 girls) aged between 6 to 59 months were sampled in the 2011 Demographic Health Survey (DHS) database. Body Mass Index (BMI) z-scores based on WHO 2006 reference population was chosen to estimate overweight (BMI z-score > 2) and obesity (BMI for age > 3). Regression analyses were performed to investigate risk factors of overweight/obesity. RESULTS The prevalence of overweight and obesity was 8% (1.7% for obesity alone). Boys were more affected by overweight than girls with a prevalence of 9.7% and 6.4% respectively. The highest prevalence of overweight was observed in the Grassfield area (including people living in West and North-West regions) (15.3%). Factors that were independently associated with overweight and obesity included: having overweight mother (adjusted odds ratio (aOR) = 1.51; 95% CI 1.15 to 1.97) and obese mother (aOR = 2.19; 95% CI = 155 to 3.07), compared to having normal weight mother; high birth weight (aOR = 1.69; 95% CI 1.24 to 2.28) compared to normal birth weight; male gender (aOR = 1.56; 95% CI 1.24 to 1.95); low birth rank (aOR = 1.35; 95% CI 1.06 to 1.72); being aged between 13-24 months (aOR = 1.81; 95% CI = 1.21 to 2.66) and 25-36 months (aOR = 2.79; 95% CI 1.93 to 4.13) compared to being aged 45 to 49 months; living in the grassfield area (aOR = 2.65; 95% CI = 1.87 to 3.79) compared to living in Forest area. Muslim appeared as a protective factor (aOR = 0.67; 95% CI 0.46 to 0.95).compared to Christian religion. CONCLUSION This study underlines a high prevalence of early childhood overweight with significant disparities between ecological areas of Cameroon. Risk factors of overweight included high maternal BMI, high birth weight, male gender, low birth rank, aged between 13-36 months, and living in the Grassfield area while being Muslim appeared as a protective factor. Preventive strategies should be strengthened especially in Grassfield areas and should focus on sensitization campaigns to reduce overweight and obesity in mothers and on reinforcement of measures such as surveillance of weight gain during antenatal consultation and clinical follow-up of children with high birth weight. Meanwhile, further studies including nutritional characteristics are of great interest to understand the association with religion, child age and ecological area in this age group, and will help in refining preventive strategies against childhood overweight and obesity in Cameroon.
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Affiliation(s)
| | - Joëlle Sobngwi-Tambekou
- Ministry of Public Health, Yaoundé, Cameroon
- Clinton Health Access Initiative, Yaoundé, Cameroon
| | - Jean Jacques N. Noubiap
- Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
- Medical Diagnostic Center, Yaoundé, Cameroon
| | - Serra Lem Asangbeh
- School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon
| | | | - Eugene Sobngwi
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Science, University of Yaoundé I, Yaoundé, Cameroon
- Laboratory for Molecular Medicine and Metabolism, Biotechnology Center, University of Yaoundé I, Yaoundé, Cameroon
- National Obesity Center, Yaoundé Central Hospital, Yaoundé, Cameroon
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24
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Epidemiology of elevated blood pressure and associated risk factors in Chinese children: the SNEC study. J Hum Hypertens 2015; 30:231-6. [PMID: 26446390 DOI: 10.1038/jhh.2015.104] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 08/27/2015] [Accepted: 09/07/2015] [Indexed: 12/19/2022]
Abstract
Despite the association of childhood blood pressure (BP) with hypertension later in the life course, there remains dearth of information regarding the prevalence and emergence of hypertension in children, especially in China. To investigate the current status of BP, prevalence of elevated BP and related factors in Chinese children, a cross-sectional survey in a representative sample of 9354 Chinese children 5-17 years old was conducted in seven cities in Northeastern China during 2011 and 2012. BP measurements were taken by mercury sphygmomanometer. Elevated BP in children was defined as an average diastolic BP or systolic BP that is in the 95th percentile or higher for their gender, age and height. Overall, total prevalence of elevated BP was 13.8%, and no significant difference between males and females was identified. Multivariate analyses revealed that children having a higher area of residence had a lower of elevated BP. Increased odds for elevated BP were found for individuals who were lean (odds ratio (OR)=2.12; 95% confidence interval (CI): 1.67-2.69), overweight (OR=2.05; 95% CI: 1.74-2.42), obese (OR=3.15; 95% CI: 2.70-3.68), were born with low birth weight (OR=1.26; 95%CI: 1.01-1.63), premature birth (OR=1.46; 95%CI: 1.13-1.88), and were with home coal use (OR=1.24; 95%CI: 1.02-1.52). In conclusion, elevated BP was found to be prevalent in children in urban areas of Northeast China. These results underscore the importance of implementing a package of measures aimed at reducing malleable risk for this cardiovascular condition in school-aged children in Northeast China.
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25
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Barriuso L, Miqueleiz E, Albaladejo R, Villanueva R, Santos JM, Regidor E. Socioeconomic position and childhood-adolescent weight status in rich countries: a systematic review, 1990-2013. BMC Pediatr 2015; 15:129. [PMID: 26391227 PMCID: PMC4578240 DOI: 10.1186/s12887-015-0443-3] [Citation(s) in RCA: 117] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 09/04/2015] [Indexed: 01/09/2023] Open
Abstract
Background Childhood obesity is a major problem in rich countries due to its high prevalence and its harmful health consequences. An exploratory analysis conducted in the PubMed database highlighted that the number of papers published on the relationship between socioeconomic position (SEP) and childhood-adolescent weight status had risen substantially with respect to an earlier review which had covered the period 1990–2005. Methods To describe the findings on the relationship between SEP and childhood-adolescent weight status in papers published in rich countries from 1990 through 2013, studies were identified in the following databases: PubMed; Web of Knowledge (WOK); PsycINFO; Global Health; and Embase. We included observational studies from the 27 richest OECD countries, which covered study populations aged 0 to 21 years, and used parental education, income and/or occupation as family SEP indicators. A total of 158 papers met the inclusion criteria and reported 134 bivariable and 90 multivariable analyses. Results Examination of the results yielded by the bivariable analyses showed that 60.4 % of studies found an inverse relationship, 18.7 % of studies did not found relationship, and 20.9 % of studies found a relationship that varied depending on another variable, such as age, sex or ethnic group; the corresponding percentages in the multivariable analyses were 51.1, 20.0 and 27.8 %, respectively. Furthermore, 1.1 % found a positive relationship. Conclusion The relationship between SEP and childhood-adolescent weight status in rich countries is predominantly inverse and the positive relationship almost has disappeared. The SEP indicator that yields the highest proportion of inverse relationships is parents’ education. The proportion of inverse relationships is higher when the weight status is reported by parents instead using objective measurements. Electronic supplementary material The online version of this article (doi:10.1186/s12887-015-0443-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Laura Barriuso
- Instituto de Salud Pública y Laboral de Navarra, Pamplona, Spain.
| | - Estrella Miqueleiz
- Department of Sociology, Universidad Pública de Navarra, Campus de Arrosadía, s/n, 31006, Pamplona, Spain.
| | - Romana Albaladejo
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.
| | - Rosa Villanueva
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.
| | - Juana M Santos
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain. .,Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
| | - Enrique Regidor
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain. .,Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain. .,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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26
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Ruiz M, Goldblatt P, Morrison J, Kukla L, Švancara J, Riitta-Järvelin M, Taanila A, Saurel-Cubizolles MJ, Lioret S, Bakoula C, Veltsista A, Porta D, Forastiere F, van Eijsden M, Vrijkotte TGM, Eggesbø M, White RA, Barros H, Correia S, Vrijheid M, Torrent M, Rebagliato M, Larrañaga I, Ludvigsson J, Olsen Faresjö Å, Hryhorczuk D, Antipkin Y, Marmot M, Pikhart H. Mother's education and the risk of preterm and small for gestational age birth: a DRIVERS meta-analysis of 12 European cohorts. J Epidemiol Community Health 2015; 69:826-33. [PMID: 25911693 PMCID: PMC4552914 DOI: 10.1136/jech-2014-205387] [Citation(s) in RCA: 129] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 02/02/2015] [Accepted: 02/10/2015] [Indexed: 11/11/2022]
Abstract
BACKGROUND A healthy start to life is a major priority in efforts to reduce health inequalities across Europe, with important implications for the health of future generations. There is limited combined evidence on inequalities in health among newborns across a range of European countries. METHODS Prospective cohort data of 75 296 newborns from 12 European countries were used. Maternal education, preterm and small for gestational age births were determined at baseline along with covariate data. Regression models were estimated within each cohort and meta-analyses were conducted to compare and measure heterogeneity between cohorts. RESULTS Mother's education was linked to an appreciable risk of preterm and small for gestational age (SGA) births across 12 European countries. The excess risk of preterm births associated with low maternal education was 1.48 (1.29 to 1.69) and 1.84 (0.99 to 2.69) in relative and absolute terms (Relative/Slope Index of Inequality, RII/SII) for all cohorts combined. Similar effects were found for SGA births, but absolute inequalities were greater, with an SII score of 3.64 (1.74 to 5.54). Inequalities at birth were strong in the Netherlands, the UK, Sweden and Spain and marginal in other countries studied. CONCLUSIONS This study highlights the value of comparative cohort analysis to better understand the relationship between maternal education and markers of fetal growth in different settings across Europe.
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Affiliation(s)
- Milagros Ruiz
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Peter Goldblatt
- Research Department of Epidemiology and Public Health, UCL Institute of Health Equity, University College London, London, UK
| | - Joana Morrison
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Lubomír Kukla
- Faculty of Science, Research Centre for Toxic Compounds in the Environment (RECETOX), Masaryk University, Brno, Czech Republic
| | - Jan Švancara
- Faculty of Science, Research Centre for Toxic Compounds in the Environment (RECETOX), Masaryk University, Brno, Czech Republic
- Faculty of Medicine, Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic
| | - Marjo Riitta-Järvelin
- Department of Epidemiology and Biostatistics, MRC Health Protection Agency (HPE), Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
- Unit of Primary Care, Oulu University Hospital, Oulu, Finland
- Center for Life Course Epidemiology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Institute of Health Sciences, University of Oulu, Oulu, Finland
| | - Anja Taanila
- Biocenter Oulu, University of Oulu, Oulu, Finland
| | - Marie-Josèphe Saurel-Cubizolles
- Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics, Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France
| | - Sandrine Lioret
- Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1153, Early Origin of the Child's Health and Development Team (ORCHAD), Center for Epidemiology and Statistics, Sorbonne Paris Cité, Paris Descartes University, Paris, France
| | - Chryssa Bakoula
- First Department of Paediatrics, University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - Alexandra Veltsista
- First Department of Paediatrics, University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - Daniela Porta
- Department of Epidemiology of the Lazio Regional Health System, Rome, Italy
| | | | - Manon van Eijsden
- Department of Epidemiology and Health Promotion, Public Health Service of Amsterdam, Amsterdam, The Netherlands
| | - Tanja G M Vrijkotte
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Merete Eggesbø
- Department of Genes and Environment, Norwegian Institute of Public Health, Oslo, Norway
| | - Richard A White
- Department of Genes and Environment, Norwegian Institute of Public Health, Oslo, Norway
| | - Henrique Barros
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal
- EPIUnit – Institute of Public Health, University of Porto, Porto, Portugal
| | - Sofia Correia
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal
- EPIUnit – Institute of Public Health, University of Porto, Porto, Portugal
| | - Martine Vrijheid
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Maties Torrent
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Barcelona, Spain
- IB-Salut Menorca Health Area, Balearic Islands, Spain
| | - Marisa Rebagliato
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Barcelona, Spain
- Departamento de Medicina, Universitat Jaume I, Castellon, Spain
| | - Isabel Larrañaga
- Public Health Department of Gipuzkoa, Gipuzkoa, Spain
- BIODONOSTIA Health Research Institute, San Sebastian, Spain
| | - Johnny Ludvigsson
- Division of Pediatrics, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Åshild Olsen Faresjö
- Department of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | - Daniel Hryhorczuk
- Center for Global Health, University of Illinois College of Medicine, Chicago, Illinois, USA
| | - Youriy Antipkin
- Institute of Pediatrics, Obstetrics, and Gynecology, Kyiv, Ukraine
| | - Michael Marmot
- Research Department of Epidemiology and Public Health, University College London, London, UK
- Research Department of Epidemiology and Public Health, UCL Institute of Health Equity, University College London, London, UK
| | - Hynek Pikhart
- Research Department of Epidemiology and Public Health, University College London, London, UK
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27
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Marseglia L, Manti S, D’Angelo G, Cuppari C, Salpietro V, Filippelli M, Trovato A, Gitto E, Salpietro C, Arrigo T. Obesity and breastfeeding: The strength of association. Women Birth 2015; 28:81-6. [PMID: 25595034 DOI: 10.1016/j.wombi.2014.12.007] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 12/14/2014] [Accepted: 12/30/2014] [Indexed: 02/08/2023]
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28
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Assunção ML, Ferreira HS, Coutinho SB, Santos LMP, Horta BL. Protective effect of breastfeeding against overweight can be detected as early as the second year of life: a study of children from one of the most socially-deprived areas of Brazil. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2015; 33:85-91. [PMID: 25995725 PMCID: PMC4438652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Millions of children live in Brazil's semi-arid region, one of the most socially-deprived areas of the country, where undernutrition co-exists with obesity as a consequence of the nutrition transition. There is evidence that childhood obesity predisposes adult obesity and, thus, that obesity should be prevented as early as possible. Some studies have shown that breastfeeding is a protective factor against overweight and obesity while other studies have not found this association. There have been few studies on this association in developing countries and of children below two years of age. The present study aimed to investigate whether children exposed to exclusive breastfeeding for ≥ 6 months showed a lower prevalence of overweight in the second year of life, based on a probability sample of 2,209 children (aged 12 to 24 months). The dependent variable was overweight, defined as weight-for-length z-scores of >2, based on the WHO 2006 standard while the independent variable was exclusive breastfeeding (≥ 6 months). The prevalence ratio (PR) and its 95% CI were estimated using Poisson regression with robust adjustment of variance. After adjusting for potential confounding factors (socioeconomic, demographic and health-related variables), children on exclusive breastfeeding for ≥ 6 months showed a lower prevalence of overweight (5.7% vs 9.1%, PR 0.62, 95% CI 0.45-0.89). It was found that exclusive breastfeeding for six months or more is a protective factor against overweight in children in the second year of life living in the Brazilian semi-arid region.
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Affiliation(s)
- Monica L Assunção
- Faculty of Nutrition, Federal University of Alagoas. Maceió, Alagoas, Brazil
| | - Haroldo S Ferreira
- Postgraduate Programme in Nutrition, Faculty of Nutrition, Federal University of Alagoas. Maceió, Alagoas, Brazil
| | - Sônia B Coutinho
- Postgraduate Programme in Child and Adolescent Health, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Leonor M P Santos
- Department of Public Health, University of Brasília, Brasília, Federal District, Brazil
| | - Bernardo L Horta
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
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29
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Veghari G, Ahmadpour-Kacho M, Zahedpasha Y. The comparison of parents' educational level on the breastfeeding status between turkman and non-turkman ethnic groups in the north of iran. Ann Med Health Sci Res 2014; 4:899-903. [PMID: 25506483 PMCID: PMC4250988 DOI: 10.4103/2141-9248.144908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Mother's milk plays an important role in infant's health, and World Health Organization (WHO) recommends infants should be breastfed for 2 years or up. AIM The main objective of this study was to evaluate the breastfeeding status based on parents' educational level with comparison between Turkman and non-Turkman ethnic groups in the North of Iran in 2010. SUBJECTS AND METHODS This is a descriptive, cross-sectional study, which was carried out on 6519 subjects (3897 = non-Turkman and 2622 = Turkman) in urban and rural areas. Data have been collected through interviewing with primary school children's mothers. The schools and students were selected using multi-cluster random sampling methods. Breastfeeding was defined based on WHO predominant definition. RESULTS Of all mothers, 5.8% (377/6519) breastfed for 6 months, 34.8% (2265/6519) for 7-18 months, 57.4% (3745/6519) for 18-24 months and 2% (132/6519) didn't breastfeed their infants. Breastfeeding prevalence at 19-24 months in Turkman ethnic group (64.7%; 1696/2622) was significantly more than in non-Turkman ethnic group (52.6%; 2049/3897) (P < 0.01) besides early weaning prevalence (at 6 months) in Turkman group was significantly less than in non-Turkman group (4.7%; 123/2622 vs. 6.5%; 254/3897) (P < 0.01). Odds ratio for weaning before 6 months in non-Turkman mothers were 0.563 (0.365-0.786, confidence interval [CI] 95%) in 1-12 years schooling and 0.665 (0.486-0.910, CI: 95%) in uneducated groups compared to college educated. This ratio in Turkman fathers was 3.413 (1.726-6.746, CI: 95%) in 1-12 years schooling compared with college educated. CONCLUSION The duration of breastfeeding was longer among Turkman compared with non-Turkman mothers, and longer duration of breastfeeding was associated with higher educational level in the Turkman but not in the non-Turkman mothers.
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Affiliation(s)
- G Veghari
- Department of Biochemistry and Nutrition, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - M Ahmadpour-Kacho
- Department of Pediatrics and Non-Communicable Pediatric Disease Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Y Zahedpasha
- Department of Pediatrics and Non-Communicable Pediatric Disease Research Center, Babol University of Medical Sciences, Babol, Iran
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Yan J, Liu L, Zhu Y, Huang G, Wang PP. The association between breastfeeding and childhood obesity: a meta-analysis. BMC Public Health 2014; 14:1267. [PMID: 25495402 PMCID: PMC4301835 DOI: 10.1186/1471-2458-14-1267] [Citation(s) in RCA: 416] [Impact Index Per Article: 41.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 12/08/2014] [Indexed: 12/30/2022] Open
Abstract
Background The increase in childhood obesity is a serious public health concern. Several studies have indicated that breastfed children have a lower risk of childhood obesity than those who were not breastfed, while other studies have provided conflicting evidence. The objective of this meta-analysis was to investigate the association between breastfeeding and the risk of childhood obesity. Methods The PubMed, EMBASE and CINAHL Plus with Full Text databases were systematically searched from start date to 1st August 2014. Based on the meta-analysis, pooled adjusted odds ratio (AOR) and 95% confidence interval (CI) were calculated. I2 statistic was used to evaluate the between-study heterogeneity. Funnel plots and Fail-safe N were used to assess publication bias and reliability of results, and results from both Egger test and Begg test were reported. Results Twenty-five studies with a total of 226,508 participants were included in this meta-analysis. The studies’ publication dates ranged from 1997 to 2014, and they examined the population of 12 countries. Results showed that breastfeeding was associated with a significantly reduced risk of obesity in children (AOR = 0.78; 95% CI: 0.74, 0.81). Categorical analysis of 17 studies revealed a dose-response effect between breastfeeding duration and reduced risk of childhood obesity. Conclusion Results of our meta-analysis suggest that breastfeeding is a significant protective factor against obesity in children.
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Affiliation(s)
| | | | | | - Guowei Huang
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St, John's, Newfoundland and Labrador A1B 3 V6, Canada.
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Zanini RV, Santos IS, Gigante DP, Matijasevich A, Barros FC, Barros AJD. Body composition assessment using DXA in six-year-old children: the 2004 Pelotas Birth Cohort, Rio Grande do Sul State, Brazil. CAD SAUDE PUBLICA 2014; 30:2123-33. [DOI: 10.1590/0102-311x00153313] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Accepted: 02/17/2014] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to describe fat (FM) and lean body mass (LBM) in six-year-old children from the 2004 Pelotas Birth Cohort, stratified by gender. Dual-Energy X-ray Absorptiometry was used to measure FM and LBM, FM and LBM indexes, and percentage (%) of FM and LBM. Mean measures of adiposity were higher among girls (6.3kg, 4.2kg/m2 and 23.4% vs. 5kg, 3.3kg/m2 and 18%) while LBM measures were higher among boys (19.3kg, 13kg/m2 and 78.5% vs. 17.7kg, 12.2kg/m2 and 73.2%). In both boys and girls mean measures of adiposity increased with socioeconomic status and maternal education. Mean measures of adiposity were higher among white-skinned children while %LBM was higher among black-skinned children. Preterm compared to full-term children showed lower mean measures of adiposity and LBM. Female sex, white skin color and higher socioeconomic conditions are associated with higher adiposity in childhood.
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Abstract
The aim of this review is to examine two factors that may be associated with development of childhood overweight: early feeding, namely exclusive breastfeeding practices; family structure. Findings from the Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS (IDEFICS) study are presented in the context of the literature. IDEFICS is a multi-centre European study exploring the risks for overweight and obesity in children, which recruited 16,224 children aged 2-9 years from September 2007 to June 2008 at survey centres in Italy, Estonia, Cyprus, Belgium, Sweden, Hungary, Germany and Spain. Among the IDEFICS sample, after controlling for confounders, exclusive breastfeeding for 4-6 months was protective of overweight (including obesity) when compared with children never exclusively breastfed (OR 0·73, 95% CI 0·63, 0·85). Family structure and number of siblings may also be associated with overweight. IDEFICS children without siblings were more likely (OR 1·52, 95% CI 1·34, 1·72) to be overweight than their peers with siblings when controlling for factors related to childhood overweight such as country, parental education, parental weight, maternal age, child's age, birth weight and gender. Both early feeding practices and family structure play a role in the future development of obesity. The impact of breastfeeding on future development of overweight is dependent upon the dose. Exclusive breastfeeding for the recommended 6 months appears to be protective of overweight. Family structure is also an important component and emerging research suggests only children are at increased risk for overweight in comparison with those with siblings. In European countries, approximately 22 million children are overweight. Early dietary exposures, genetic, environmental and social factors have all been proposed as potential causal factors. Two such factors include exclusive breastfeeding and the impact of being an only child. We have investigated these two factors for associations with overweight; our studies, in the context of previous findings, are the focus of this review.
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Zheng JS, Liu H, Li J, Chen Y, Wei C, Shen G, Zhu S, Chen H, Zhao YM, Huang T, Li D. Exclusive breastfeeding is inversely associated with risk of childhood overweight in a large Chinese cohort. J Nutr 2014; 144:1454-9. [PMID: 25008581 DOI: 10.3945/jn.114.193664] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The association between breastfeeding status and childhood overweight is inconclusive. The aim of the present study was to investigate the relation between exclusive breastfeeding and childhood overweight risk in children 4-5 y of age in Southeast China. Among 97,424 children enrolled between 1999 and 2009 in the Jiaxing Birth Cohort, 42,550 of them were included in the final analysis with complete records on breastfeeding status and anthropometric measurements at 4-5 y of age (48-60 mo). Overweight and being at risk of overweight were identified as a body mass index (BMI)-for-age Z-score ≥ 2 and between 1 and 2, respectively. After 4-5 y of follow-up, 4845 (11.4%) children were identified as being at risk of overweight, and 1343 (3.16%) children were overweight. Adjusting for important child and maternal characteristics, longer duration of breastfeeding was associated with lower risk of childhood overweight (P-trend = 0.009) and being at risk of overweight (P-trend < 0.001). Children exclusively breastfed for 3-5 mo and ≥6 mo had 13% (RR = 0.87; 95% CI: 0.77, 0.99) and 27% (RR = 0.73; 95% CI: 0.56, 0.95) lower risk of becoming overweight compared with children exclusively breastfed for <1 mo, respectively. In boys, there were inverse associations of 3-5 mo (RR = 0.83; 95% CI: 0.71, 0.98) or ≥6 mo (RR = 0.65; 95% CI: 0.47, 0.91) of exclusive breastfeeding against becoming overweight, but there were no significant associations in girls (3-5 mo: RR = 0.96, 95% CI: 0.76, 1.22; ≥6 mo: RR = 0.92, 95% CI: 0.60, 1.41). In conclusion, the present findings suggest that longer duration of exclusive breastfeeding is associated with lower risk of becoming overweight in Chinese children.
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Affiliation(s)
- Ju-Sheng Zheng
- Department of Food Science and Nutrition, Zhejiang University, Hangzhou, China
| | - Huijuan Liu
- Jiaxing Maternity and Child Health Care Hospital, Jiaxing, China; and
| | - Jing Li
- Jiaxing Maternity and Child Health Care Hospital, Jiaxing, China; and
| | - Yu Chen
- Jiaxing Maternity and Child Health Care Hospital, Jiaxing, China; and
| | - Chunlei Wei
- Jiaxing Maternity and Child Health Care Hospital, Jiaxing, China; and
| | - Genmei Shen
- Jiaxing Maternity and Child Health Care Hospital, Jiaxing, China; and
| | - Shanlin Zhu
- Jiaxing Maternity and Child Health Care Hospital, Jiaxing, China; and
| | - Hua Chen
- Jiaxing Maternity and Child Health Care Hospital, Jiaxing, China; and
| | - Yi-Min Zhao
- Department of Food Science and Nutrition, Zhejiang University, Hangzhou, China
| | - Tao Huang
- Department of Nutrition, Harvard School of Public Health, Boston, MA
| | - Duo Li
- Department of Food Science and Nutrition, Zhejiang University, Hangzhou, China
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Jwa SC, Fujiwara T, Kondo N. Latent protective effects of breastfeeding on late childhood overweight and obesity: a nationwide prospective study. Obesity (Silver Spring) 2014; 22:1527-37. [PMID: 24591416 DOI: 10.1002/oby.20735] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 02/28/2014] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To investigate the latent effect of breastfeeding on overweight and obesity in late childhood. METHODS Data on breastfeeding and child anthropometric measurements were collected annually from a nation-wide population-based prospective cohort study in Japan (21,425 boys and 20,147 girls). Breastfeeding status (exclusiveness and duration) was assessed when the child was 6 months old. Mixed effects models were used to evaluate trajectories of body mass index (BMI), together with overweight and obesity status, from 1.5 to 8 years of age. RESULTS Mixed-fed boys and exclusively breastfed boys showed lower BMI as the main effect, as well as a slower increase of inclination in BMI as interaction term between feeding type and age, than exclusively formula-fed boys. Breastfed boys had lower BMI at the ages of 7 and 8, in comparison with exclusively formula fed boys (P = 0.002 and P < 0.001, respectively). A similar association was found for girls, although the main effect of feeding type was not statistically significant. The analysis of breastfeeding duration had similar results. CONCLUSIONS Breastfeeding, even if partial or for short duration, has a latent protective effect against overweight and obesity in late childhood, especially for boys.
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Affiliation(s)
- Seung Chik Jwa
- Department of Social Medicine, National Research Institute for Child Health and Development, National Center for Child Health and Development, Tokyo, Japan
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Meller FDO, Araújo CLP, Madruga2 SW. Fatores associados ao excesso de peso em crianças brasileiras menores de cinco anos. CIENCIA & SAUDE COLETIVA 2014; 19:943-55. [DOI: 10.1590/1413-81232014193.01552013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Accepted: 03/15/2013] [Indexed: 11/21/2022] Open
Abstract
O objetivo do estudo foi identificar os fatores associados ao excesso de peso em crianças brasileiras menores de cinco anos. Foram utilizados dados da Pesquisa Nacional de Demografia e Saúde (PNDS) de 2006, um estudo transversal de base domiciliar. O diagnóstico do excesso de peso baseou-se no índice peso-para-altura superior a 2 escores z acima da mediana do padrão antropométrico da Organização Mundial de Saúde - 2006. A população estudada constituiu-se de 4.388 crianças. A prevalência de excesso de peso nas crianças foi descrita segundo variáveis socioeconômicas, demográficas, antropométricas e comportamentais. Foram realizadas análises bruta e ajustada através da Regressão de Poisson e todas foram estratificadas pelo sexo da criança. A prevalência de excesso de peso foi de 6,6%. Após análise ajustada, o índice de massa corporal materno e o peso ao nascer foram associados ao excesso de peso. Além disso, o excesso de peso mostrou-se associado ao tempo de amamentação exclusiva, nos meninos e ao nível socioeconômico e situação conjugal, nas meninas. Enfatiza-se a necessidade da implementação de políticas públicas que atuem, o mais precocemente possível, nos principais determinantes do excesso de peso.
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Infant Obesity and Severe Obesity Growth Patterns in the First Two Years of Life. Matern Child Health J 2013; 18:613-24. [DOI: 10.1007/s10995-013-1285-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Zhang J, Himes JH, Guo Y, Jiang J, Yang L, Lu Q, Ruan H, Shi S. Birth weight, growth and feeding pattern in early infancy predict overweight/obesity status at two years of age: a birth cohort study of Chinese infants. PLoS One 2013; 8:e64542. [PMID: 23755127 PMCID: PMC3673988 DOI: 10.1371/journal.pone.0064542] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2012] [Accepted: 04/16/2013] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To investigate the early determinants of overweight and obesity status at age two years. METHODS A total of 1098 healthy neonates (563 boys and 535 girls) were involved in this community-based prospective study in China. Data on body weight and length were collected at birth, the 3(rd) and 24(th) month. A self-administered questionnaire was used to collect data on social demography and feeding patterns of children, etc. Three multivariable logistic regression models were employed to make various comparisons of weight status, i.e., model 1 (obesity vs. non-obesity), model 2 (combined overweight and obesity vs. normal weight, and model 3 (obesity, overweight and normal weight). RESULTS Prevalences of overweight/obesity (95(th) >BMI ≥85(th) p and BMI ≥95(th) p, referring to WHO BMI standards) at 2 years of age are 15.8%/11.2% for boys and 12.9%/9.0% for girls, respectively. Being born with macrosomia (OR: 1.80-1.88), relatively greater BMI increment in the first 3 months (OR: 1.15-1.16) and bottle emptying by encouragement at age two (OR: 1.30-1.57) were found in all three models to be significant risk factors for higher BMI status at 2 years. Pre-pregnancy maternal BMI (OR: 1.09-1.12), paternal BMI (OR: 1.06), and mixed breastfeeding (OR: 1.54-1.57) or formula feeding (OR: 1.90-1.93) in the first month were identified as significant in models 2 and 3. Child-initiated bottle emptying at age two was observed to increase the risk of obesity by 1.31 times but only in model 1. CONCLUSION Fetal and early postnatal growth and feeding pattern appear to have significant impacts on early childhood overweight and obesity status independent of parental BMI. Policy-based and multidisciplinary approaches to promote breastfeeding and enhancement of feeding skills of care takers may be promising intervention strategies.
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Affiliation(s)
- Jianduan Zhang
- Department of Woman and Child's Care and Adolescence Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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Ludington-Hoe SM, Gittner LS, Haller HS. A pilot study: does obesity begin in the first year of life? Clin Pediatr (Phila) 2013; 52:507-12. [PMID: 23539686 DOI: 10.1177/0009922813482750] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
AIM To determine if growth patterns in healthy infants can identify associations with obesity at age 5 years. METHOD Body mass index growth patterns from birth to 1 year were described for cohorts of children who were classified at 5 years as normal weight (n = 61), overweight (n = 47), obese (n = 41), and morbidly obese (n = 72). A longitudinal analysis of body mass index means based on the age postbirth was conducted and graphed. RESULTS Distinctions in growth patterns were evident before 1 year postbirth. Children who were normal weight at 5 years demonstrated a growth pattern in the first year that differed from children who were overweight, obese, or morbidly obese at 5 years. CONCLUSIONS Obesity growth patterns were seen in infancy and are clinically important because identification of infants who do not fit a normal weight pattern can occur and thus guide individualized interventions in the first year postbirth while precursors of later health are still forming.
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Lakshman R, Zhang J, Zhang J, Koch FS, Marcus C, Ludvigsson J, Ong KK, Sobko T. Higher maternal education is associated with favourable growth of young children in different countries. J Epidemiol Community Health 2013; 67:595-602. [PMID: 23450064 DOI: 10.1136/jech-2012-202021] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Childhood growth affects long-term health and could contribute to health inequalities that persist throughout life. METHODS We compared growth data of 4-year-old to 6-year-old children born 1997-2002 in UK (n=15,168), Sweden (n=6749) and rural China (n=10,327). SD scores (SDS) were calculated against the WHO Growth Standard. Obesity and overweight were defined by the International Obesity Taskforce cut-offs, and stunting, underweight and thinness by height, weight or body mass index (BMI)<-2 SDS. Associations with maternal education were standardised by calculating the Slope Index of Inequality (SII). RESULTS Mean SDS height, weight and BMI in the UK (-0.01, 0.42, 0.62, respectively) and Sweden (0.45, 0.59, 0.45) were higher than in China (-0.98, -0.82, -0.29). Higher maternal education was consistently associated with taller offspring height SDS (SII: UK 0.25; Sweden 0.17; China 1.06). Underweight and stunting were less common in the UK (prevalence: 0.6% and 2.2%, respectively) and Sweden (0.3% and 0.6%) than in China (9.5% and 16.4%), where these outcomes were inversely associated with maternal education (SII: -25.8% and -12.7%). Obesity prevalence in the UK, Sweden and China was 4.8%, 3.7% and 0.4%, respectively. Maternal education was inversely associated with offspring obesity in the UK (SII: -3.3%) and Sweden (-2.8%), but not in China (+0.3%). CONCLUSIONS Higher maternal education was associated with more favourable growth in young children: lower obesity and overweight in the UK and Sweden, and lower stunting and underweight in rural China. Public health strategies to optimise growth in early childhood need to acknowledge socioeconomic factors, but possibly with a different emphasis in different settings.
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Weng SF, Redsell SA, Swift JA, Yang M, Glazebrook CP. Systematic review and meta-analyses of risk factors for childhood overweight identifiable during infancy. Arch Dis Child 2012; 97:1019-26. [PMID: 23109090 PMCID: PMC3512440 DOI: 10.1136/archdischild-2012-302263] [Citation(s) in RCA: 409] [Impact Index Per Article: 34.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Accepted: 08/21/2012] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To determine risk factors for childhood overweight that can be identified during the first year of life to facilitate early identification and targeted intervention. DESIGN Systematic review and meta-analysis. SEARCH STRATEGY Electronic database search of MEDLINE, EMBASE, PubMed and CAB Abstracts. ELIGIBILITY CRITERIA Prospective observational studies following up children from birth for at least 2 years. RESULTS Thirty prospective studies were identified. Significant and strong independent associations with childhood overweight were identified for maternal pre-pregnancy overweight, high infant birth weight and rapid weight gain during the first year of life. Meta-analysis comparing breastfed with non-breastfed infants found a 15% decrease (95% CI 0.74 to 0.99; I(2)=73.3%; n=10) in the odds of childhood overweight. For children of mothers smoking during pregnancy there was a 47% increase (95% CI 1.26 to 1.73; I(2)=47.5%; n=7) in the odds of childhood overweight. There was some evidence associating early introduction of solid foods and childhood overweight. There was conflicting evidence for duration of breastfeeding, socioeconomic status at birth, parity and maternal marital status at birth. No association with childhood overweight was found for maternal age or education at birth, maternal depression or infant ethnicity. There was inconclusive evidence for delivery type, gestational weight gain, maternal postpartum weight loss and 'fussy' infant temperament due to the limited number of studies. CONCLUSIONS Several risk factors for both overweight and obesity in childhood are identifiable during infancy. Future research needs to focus on whether it is clinically feasible for healthcare professionals to identify infants at greatest risk.
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Affiliation(s)
- Stephen Franklin Weng
- Division of Psychiatry, Institute of Mental Health, University of Nottingham Innovation Park, Nottingham, UK
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Magalhães TCA, Vieira SA, Priore SE, Ribeiro AQ, Lamounier JA, Franceschini SCC, Sant'Ana LFR. Exclusive breastfeeding and other foods in the first six months of life: effects on nutritional status and body composition of Brazilian children. ScientificWorldJournal 2012; 2012:468581. [PMID: 23193378 PMCID: PMC3485488 DOI: 10.1100/2012/468581] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Accepted: 06/28/2012] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To evaluate the effect of exclusive breastfeeding and consumption of other foods in the first six months of life in the nutritional status and body composition of children. METHODS A retrospective cohort study with 185 children aged from 4 to 7 years was monitored during the first months of life in a program of support to breastfeeding. We evaluated weight, height, waist circumference, and body composition by using DEXA. The nutritional status was assessed by the BMI/age index. The parameters of adiposity were classified by using as the cutoff point, the 85th percentile of the sample itself, according to gender and age. Confounding factors considered were variables related to maternal, pregnancy, birth, sociodemographic, health, lifestyle, and diet. Bivariate and multivariate analyses were performed, the latter by means of multiple logistic regression. RESULTS The median exclusive breastfeeding was 3 months. Of the children, 42.7% received cow's milk and 35.7% received infant formula. Regarding nutritional status, 21.1% of the children showed changes. The variables of infant feeding were not independently associated with nutritional status and body composition of the children and there were no differences between the groups studied. CONCLUSION Breastfeeding was not a protective factor to overweight and body fat in children.
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Affiliation(s)
- Taís C A Magalhães
- Center of Biological Sciences and Health, Department of Nutrition and Health, Federal University of Viçosa, University Campus, Avenida P. H. Rolfs s/n, 36570-000 Viçosa, MG, Brazil.
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Veghari G, Mansourian A, Abdollahi A. Breastfeeding status and some related factors in northern iran. Oman Med J 2012; 26:342-8. [PMID: 22125729 DOI: 10.5001/omj.2011.84] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Accepted: 06/26/2011] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES The main objective of this study is to assess the Breastfeeding Duration, Exclusive Breastfeeding Duration and other related factors among children aged less than 5 years old in rural areas of Northern Iran. METHODS This is a descriptive cross-sectional conducted on 2520 children aged 6-60 months (male: 1309, female: 1211) chosen by cluster random sampling from 20 out of 118 villages. Data were collected from mothers using a questionnaire. The duration of breastfeeding was computed only for children aged over 24 months old. Breastfeeding duration and Exclusive Breastfeeding Duration were classified based on WHO definition. SPSS Version 16 was used for data analysis. RESULTS The mean Exclusive Breastfeeding Duration was 5.59 months, while 66.4% of children had exclusive breastfeeding for at least 6 months. The lowest Exclusive Breastfeeding Duration and the highest Breastfeeding Duration were observed among the Turkman ethnic group. Exclusive Breastfeeding duration of at least 5 months was 14.6%, thus the results were significantly higher than in the Turkman ethnic group (p=0.001). Meanwhile, the results showed that exclusive breastfeeding duration significantly increased with maternal education level (p=0.004). The study found that the mean breastfeeding duration was 20.6 months, and 89.3% and 74.7% of children were breastfed for at least 18 and 24 months, respectively. A positive correlation was reported between breastfeeding duration and family size, birth order, maternal age and children nutritional status, (p<0.05). Additionally, lactation period in underweight children was significantly higher than in obese children, (p=0.023). CONCLUSION The study found that two-thirds of children exclusively breastfed during the first six months of life and the mean breastfeeding duration was 20.6 months. While both exclusive breastfeeding duration and breastfeeding duration were influenced by socio-demographic factors in the rural areas of Northern Iran.
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Abstract
PURPOSE OF REVIEW Obesity is well recognized as a major public health crisis throughout the USA. In recent years, governmental bodies at the federal, state and local levels have enacted policies intended to prevent the transition to obesity. Researchers have had the opportunity to study these policies and evaluate their impact on prevention of obesity. RECENT FINDINGS Most public policies have been directed principally, but not exclusively, to the prevention of obesity in school-age children. Interventions have been directed to encouraging breast-feeding, to changing school lunches, limiting access to sugar-sweetened beverages, encouraging physical activity, changing the composition of competitive foods and affecting food advertising directed at children as well as collecting BMI information. Efforts more directed at adults include encouraging workplace wellness programs and improving the nutrition label on packaged foods with front-of-package labels and caloric information on restaurant menus. SUMMARY For the most part, evaluations of the interventions reveal weak or modest benefits. The actual picture might be less positive due to the poor quality of research and publication bias. Push back by industry and others will require higher quality experimental and real world studies. All interventions fail to accommodate the multifactorial aspects of obesity.
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Affiliation(s)
- Morgan Downey
- Downey Obesity Report, Washington, District of Columbia, USA.
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Infant feeding practices and prevalence of obesity in eight European countries - the IDEFICS study. Public Health Nutr 2012; 16:219-27. [PMID: 22916704 DOI: 10.1017/s1368980012003850] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To assess the association between exclusive breast-feeding and childhood overweight. DESIGN Cross-sectional data are from the baseline survey of the longitudinal cohort study IDEFICS. Exclusive rather than partial breast-feeding is the focus of the study due to the theoretical relationship between exclusive breast-feeding and development of dietary self-regulation. Children's measured heights and weights were used to calculate weight status, while waist-to-height ratio (WtHR) and skinfold measures were examined as alternative indicators of adiposity and fat patterning. SETTING Examination centres in eight European countries (Italy, Estonia, Cyprus, Belgium, Sweden, Hungary, Germany and Spain). SUBJECTS The analysis included 14 726 children aged 2-9 years for whom early feeding practices were reported by parents in standardized questionnaires. RESULTS After controlling for education, income and other potential confounders, breast-feeding exclusively for 4-6 months was protective of overweight (including obesity) when compared with children never exclusively breast-fed (OR = 0·73; 95 % CI 0·63, 0·85) across all measures of overweight. Exclusively breast-feeding for 6 months offered slightly more protection than for 4 and 5 months combined (OR = 0·71; 95 % CI 0·58, 0·85). The associations could not be explained by socio-economic characteristics or maternal overweight. CONCLUSIONS This multi-country investigation indicated that exclusive breast-feeding for 4-6 months may confer protection against overweight in addition to other known benefits. There was no demonstrated benefit of exclusive breast-feeding for more than 6 months or combination feeding for any duration across all measures of overweight examined.
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Bartz S, Freemark M. Pathogenesis and prevention of type 2 diabetes: parental determinants, breastfeeding, and early childhood nutrition. Curr Diab Rep 2012; 12:82-7. [PMID: 22125180 DOI: 10.1007/s11892-011-0246-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Among the factors predisposing to type 2 diabetes in children, adolescents, and young adults, the health and behavior of both the mother and father are critical. Prevention and treatment of parental nutritional disorders (including obesity and malnutrition), promotion of breastfeeding, and avoidance of overfeeding of young children are essential for childhood health and metabolic function. Focusing research and policy on parental influences on childhood health should reduce the risks of obesity and type 2 diabetes in future generations.
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Affiliation(s)
- Sarah Bartz
- Division of Pediatric Endocrinology and Diabetes, Duke University Medical Center, Box 102820, Durham, NC 27710, USA.
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Chu L, Retnakaran R, Zinman B, Hanley AJG, Hamilton JK. Impact of maternal physical activity and infant feeding practices on infant weight gain and adiposity. Int J Endocrinol 2012; 2012:293821. [PMID: 23056043 PMCID: PMC3463916 DOI: 10.1155/2012/293821] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2012] [Revised: 06/25/2012] [Accepted: 07/11/2012] [Indexed: 11/18/2022] Open
Abstract
Increasing evidence supports the contribution of intrauterine environmental exposures on obesity risk in offspring. Few studies have included maternal and infant lifestyle factors. Our objective was to study the impact of maternal physical activity, infant feeding, and screen time on offspring weight gain and adiposity. In a prospective cohort study, 246 mothers underwent testing during pregnancy to assess glucose tolerance status and insulin sensitivity. Anthropometry and questionnaires on physical activity, infant feeding, and screen time were completed. Multiple-linear regression was performed to examine the impact of maternal and infant factors on infant weight gain and weight-for-length z-score at 1 year. Infant weight outcomes were negatively predicted by maternal pregravid vigorous/sport index and exclusive breastfeeding duration. After adjustment, each unit increase in maternal pregravid vigorous/sport index decreased infant weight gain by 218.6 g (t = 2.44, P = 0.016) and weight-for-length z-score by 0.20 (t = 2.17, P = 0.031). Each month of exclusive breastfeeding reduced infant weight gain by 116.4 g (t = 3.97, P < 0.001) and weight-for-length z-score by 0.08 (t = 2.59, P = 0.01). Maternal pregravid physical activity and exclusive breastfeeding duration are associated with weight gain and adiposity as early as 1 year of age.
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Affiliation(s)
- Lisa Chu
- The Hospital for Sick Children, Department of Pediatrics, University of Toronto, 555 University Avenue, Toronto, ON, Canada M5G 1X8
| | - Ravi Retnakaran
- Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Joseph and Wolf Lebovic Health Complex, 60 Murray Street, Toronto, ON, Canada M5T 3L9
- Division of Endocrinology, University of Toronto, Toronto, ON, Canada
| | - Bernard Zinman
- Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Joseph and Wolf Lebovic Health Complex, 60 Murray Street, Toronto, ON, Canada M5T 3L9
- Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Joseph and Wolf Lebovic Health Complex, 600 University Avenue, Toronto, ON, Canada M5G 1X5
| | - Anthony J. G. Hanley
- Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Joseph and Wolf Lebovic Health Complex, 60 Murray Street, Toronto, ON, Canada M5T 3L9
- Division of Endocrinology, University of Toronto, Toronto, ON, Canada
- Department of Nutritional Sciences, University of Toronto, FitzGerald Building, 150 College Street, Toronto, ON, Canada M5S 3E2
| | - Jill K. Hamilton
- The Hospital for Sick Children, Department of Pediatrics, University of Toronto, 555 University Avenue, Toronto, ON, Canada M5G 1X8
- Division of Endocrinology, University of Toronto, Toronto, ON, Canada
- *Jill K. Hamilton:
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El-Sayed AM, Scarborough P, Galea S. Socioeconomic inequalities in childhood obesity in the United Kingdom: a systematic review of the literature. Obes Facts 2012; 5:671-92. [PMID: 23108336 DOI: 10.1159/000343611] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2010] [Accepted: 01/28/2012] [Indexed: 12/28/2022] Open
Abstract
Childhood obesity is a major public health challenge worldwide. There is a growing literature documenting socioeconomic inequalities in childhood obesity risk. Here we draw inference from the literature about inequalities in childhood obesity risk in the UK. We summarize and appraise the extant peer-reviewed literature about socioeconomic inequalities in childhood obesity in the UK. Common area-level indices of socioeconomic position, including the Carstairs Deprivation Index, the Index of Multiple Deprivation and the Townsend Deprivation Index, as well as common household and individual-level metrics of childhood socioeconomic position, including head-of-household social class and maternal education, were generally inversely associated with childhood obesity in the UK. We summarize key methodological limitations to the extant literature and suggest avenues for future research.
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Mangrio E, Lindström M, Rosvall M. Early life factors and being overweight at 4 years of age among children in Malmö, Sweden. BMC Public Health 2010; 10:764. [PMID: 21159203 PMCID: PMC3022848 DOI: 10.1186/1471-2458-10-764] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2010] [Accepted: 12/15/2010] [Indexed: 11/24/2022] Open
Abstract
Background Rising rates of obesity and overweight is an increasing public health problem all over the world. Recent research has shown the importance of early life factors in the development of child overweight. However, to the best of our knowledge there are no studies investigating the potential synergistic effect of early life factors and presence of parental overweight on the development of child overweight. Methods The study was population-based and cross-sectional. The study population consisted of children who visited the Child Health Care (CHC) centers in Malmö for their 4-year health check during 2003-2008 and whose parents answered a self-administered questionnaire (n = 9009 children). Results The results showed that having overweight/obese parents was strongly associated with the child being overweight or obese. Furthermore, there was an association between unfavorable early life factors (i.e., mother smoking during pregnancy, presence of secondhand tobacco smoke early in life, high birth weight) and the development of child overweight/obesity at four years of age, while breastfeeding seemed to have a protective role. For example, maternal smoking during pregnancy was associated with an odds ratio (OR) of 1.47 (95% CI: 1.22, 1.76) for overweight and 2.31 (95% CI: 1.68, 3.17) for obesity. The results further showed synergistic effects between parental overweight and exposure to unfavourable early life factors in the development of child overweight. Conclusions The present study shows the importance of early life factors in the development of child overweight and obesity, and thus puts focus on the importance of early targeted interventions.
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Affiliation(s)
- Elisabeth Mangrio
- Department of Clinical Sciences, Social Medicine and Health Politics, Lund University, Malmö, Sweden
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Dedoussis GVZ, Yannakoulia M, Timpson NJ, Manios Y, Kanoni S, Scott RA, Papoutsakis C, Deloukas P, Pitsiladis YP, Davey-Smith G, Hirschhorn JN, Lyon HN. Does a short breastfeeding period protect from FTO-induced adiposity in children? ACTA ACUST UNITED AC 2010; 6:e326-35. [PMID: 20863147 DOI: 10.3109/17477166.2010.490269] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONTEXT A number of studies have reported replicable associations between common genetic loci and obesity indices. One of these loci is the fat mass and obesity associated locus (FTO). We aimed to assess whether breastfeeding mediated the known association between FTO and indices of body fatness. METHODS This study includes three independent pediatric cohorts, two of Greek origin (the Gene-Diet Attica Investigation: GENDAI, n=1 138 and the "Growth, Exercise and Nutrition Epidemiological Study In preschoolers": the GENESIS study, n=2 374) and one British (the Avon Longitudinal Study of Parents and Children:ALSPAC, n=4 325). Among other information, breastfeeding history was recorded. A DNA sample was ascertained by either blood or saliva. Genotyping for FTO variants was performed in GENDAI and ALSPAC for the rs9939609, while in GENESIS, for the rs17817449 variant. RESULTS In all cohorts, multivariate analysis showed that the association between FTO:rs9939609 and measures of obesity was consistent across newly presented cohorts (GENDAI: Body mass index [BMI], β=0.43, p=0.009; Waist Circumference, β=1.067, p=0.019; triceps skinfold, β=0.972, p=0.003; subscapular skinfold, β=0.593, p=0.023; GENESIS: Waist Circumference, β=0.473, p=0.008 and subscapular skinfold, β=0.227, p=0.014). Inclusion of one month of breastfeeding as an interaction term effectively removed these associations with indices of obesity (BMI, Waist-Hip-Ratio and subscapular skinfold). No evidence of such interaction was observed for the independent cohort of British children. CONCLUSIONS Our findings indicate that in two moderately sized Greek samples, breastfeeding may exert a modifying effect on the relationship between variants at the FTO locus and indices of adiposity. These findings were not replicated in a larger British collection.
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