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Li S, Wang X, Li X, Zhang W, Guo Y, Xu N, Luo J, Zhu S, He W. Breastfeeding in infancy and cardiovascular disease in middle-aged and older adulthood: a prospective study of 0.36 million UK Biobank participants. J Nutr Health Aging 2024; 28:100347. [PMID: 39216149 DOI: 10.1016/j.jnha.2024.100347] [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: 06/15/2024] [Revised: 08/20/2024] [Accepted: 08/22/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Cardiovascular disease originates in early life. We aimed to investigate the association between breastfeeding in infancy and cardiovascular disease in adult life. METHODS We followed 364,240 participants from UK Biobank aged 40-73 years from 2006 - 2010 to 2021. Information on breastfeeding in infancy was self-reported by questionnaire. Cox proportional hazard regression models were used to estimate the hazard ratios (HR) and 95% confidence intervals (CI) for the association between breastfeeding and cardiovascular disease in middle-aged and older adulthood. The multivariable Cox models were used by adjusting for the age (used as the time scale), sex, ethnicity, assessment centre, birth weight, multiple birth status, maternal smoking during pregnancy, Townsend deprivation index, smoking status, alcohol drinker status, physical activity, and menopausal status for women. Binary and multinomial multivariable logistic regression models were used to explore the associations of breastfeeding in infancy with cardiovascular disease risk factors including obesity, body composition, metabolic and inflammatory disorders. RESULTS During a median of 12.6 years of follow-up, we documented 29,796 new cases of cardiovascular disease, including 24,797 coronary heart disease and 6229 stroke. The multivariable adjusted HRs for breastfed versus non-breastfed were 0.94 (95% CI: 0.91, 0.96) for cardiovascular disease, 0.94 (95% CI: 0.91, 0.96) for coronary heart disease, and 0.95 (95% CI: 0.89, 1.01) for stroke. Furthermore, the strength of observed association between breastfeeding and cardiovascular disease seems to decrease with age (P for interaction <0.001), and increase with polygenic risk for cardiovascular disease (P for interaction <0.001). Consistently, breastfeeding in infancy was associated with cardiovascular disease risk factors including lower body mass index 0.92 (95% CI: 0.89, 0.95), body fat percentage 0.85 (95% CI: 0.83, 0.87), android to gynoid fat ratio 0.89 (95% CI: 0.83, 0.96), visceral adipose tissue 0.92 (95% CI: 0.84, 1.01), as well as lower C-reactive protein level 0.95 (95% CI: 0.94, 0.97) and a lower risk of metabolic syndrome 0.89 (95% CI: 0.85, 0.92). CONCLUSIONS Breastfeeding in infancy was associated with a lower risk of cardiovascular disease in middle-aged and older adulthood. Promoting breastfeeding is vital not only for promoting child health, but also for halting the increasing trend of cardiovascular disease in adults.
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Affiliation(s)
- Shanshan Li
- Chronic Disease Research Institute, The Children's Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xiaoyan Wang
- Chronic Disease Research Institute, The Children's Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xinmei Li
- Chronic Disease Research Institute, The Children's Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Weiwei Zhang
- Chronic Disease Research Institute, The Children's Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yingying Guo
- Chronic Disease Research Institute, The Children's Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Nuo Xu
- Chronic Disease Research Institute, The Children's Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Junkai Luo
- Chronic Disease Research Institute, The Children's Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Shankuan Zhu
- Chronic Disease Research Institute, The Children's Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
| | - Wei He
- Chronic Disease Research Institute, The Children's Hospital, and National Clinical Research Center for Child Health, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Department of Nutrition and Food Hygiene, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
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Li W, Yuan J, Wang L, Qiao Y, Liu E, Wang S, Leng J. The association between breastfeeding and childhood obesity/underweight: a population-based birth cohort study with repeated measured data. Int Breastfeed J 2022; 17:82. [PMID: 36457121 PMCID: PMC9714094 DOI: 10.1186/s13006-022-00522-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 11/14/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The impact of breastfeeding on childhood obesity has long been under debate, with most research showing significant association, and others showing weak or no association between breastfeeding and childhood obesity. What's more, almost all of the previous studies focused on the association between breastfeeding and childhood obesity, and no studies have assessed the association between breastfeeding and childhood underweight. This study aimed to examine the association between breastfeeding and childhood obesity as well as childhood underweight from 1 to 6 years old. METHODS A retrospective population-based cohort study of 59,564 children born between May 2009 and April 2013 in China was conducted using the healthcare records data from the Tianjin Maternal and Child Healthcare System. Information on infant breastfeeding (exclusive breastfeeding, mixed feeding, and exclusive formula feeding) within 6 months old and childhood growth (6 times of repeated measured weight and height from 1 to 6 years old) was collected. Multinomial logistic regression was used to test the potential associations between infant feeding modalities and childhood growth (underweight, normal weight and obesity). RESULTS Compared with exclusive formula feeding, breastfeeding was inversely associatied with childhood obesity from 2 to 6 years old, and there was a trend from mixed feeding to exclusive breastfeeding (Ptrend < 0.05). The largest association with obesity was displayed at 3 years old, with the multivariable adjusted odds ratios (ORs) for exclusive formula feeding, mixed feeding and exclusive breastfeeding of 1.00, 0.62 (95% CI 0.49, 0.80) and 0.57 (95% CI 0.44, 0.74) (Ptrend = 0.001), respectively. Compared with exclusive breastfeeding, exclusive formula feeding may increase the risk of childhood underweight at 3 and 5 years old. CONCLUSIONS Breastfeeding was inversely associated with the risk of childhood obesity from 2 to 6 years old, and there was a trend from mixed feeding to exclusive breastfeeding. Infant exclusive formula feeding might be a risk factor for childhood underweight at preschool time.
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Affiliation(s)
- Weiqin Li
- Tianjin Women’s and Children’s Health Center, Tianjin, 300070 China
| | - Jiarong Yuan
- Tianjin Women’s and Children’s Health Center, Tianjin, 300070 China
| | - Leishen Wang
- Tianjin Women’s and Children’s Health Center, Tianjin, 300070 China
| | - Yijuan Qiao
- Tianjin Women’s and Children’s Health Center, Tianjin, 300070 China
| | - Enqing Liu
- Tianjin Women’s and Children’s Health Center, Tianjin, 300070 China
| | - Shuo Wang
- Tianjin Women’s and Children’s Health Center, Tianjin, 300070 China
| | - Junhong Leng
- Tianjin Women’s and Children’s Health Center, Tianjin, 300070 China
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Nagpal N, Messito MJ, Katzow M, Gross RS. Obesity in Children. Pediatr Rev 2022; 43:601-617. [PMID: 36316265 DOI: 10.1542/pir.2021-005095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Child obesity is widely prevalent, and general pediatricians play an important role in identifying and caring for patients with obesity. Appropriate evaluation and treatment require an understanding of the complex etiology of child obesity, its intergenerational transmission, and its epidemiologic trends, including racial/ethnic and socioeconomic disparities. The American Academy of Pediatrics has published screening, evaluation, and treatment guidelines based on the best available evidence. However, gaps in evidence remain, and implementation of evidence-based recommendations can be challenging. It is important to review optimal care in both the primary care and multidisciplinary weight management settings. This allows for timely evaluation and appropriate referrals, with the pediatrician playing a key role in advocating for patients at higher risk. There is also a role for larger-scale prevention and policy measures that would not only aid pediatricians in managing obesity but greatly benefit child health on a population scale.
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Affiliation(s)
- Nikita Nagpal
- New York University Grossman School of Medicine, New York, NY.,Bellevue Hospital Center, New York, NY
| | - Mary Jo Messito
- New York University Grossman School of Medicine, New York, NY.,Bellevue Hospital Center, New York, NY
| | - Michelle Katzow
- Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY
| | - Rachel S Gross
- New York University Grossman School of Medicine, New York, NY.,Bellevue Hospital Center, New York, NY
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Saha J, Chouhan P, Ahmed F, Ghosh T, Mondal S, Shahid M, Fatima S, Tang K. Overweight/Obesity Prevalence among Under-Five Children and Risk Factors in India: A Cross-Sectional Study Using the National Family Health Survey (2015-2016). Nutrients 2022; 14:3621. [PMID: 36079879 PMCID: PMC9460849 DOI: 10.3390/nu14173621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 08/28/2022] [Accepted: 08/30/2022] [Indexed: 11/25/2022] Open
Abstract
The occurrence of overweight and obesity has increased in recent years in India. In this study, we investigate the prevalence and associated risk factors of overweight/obesity among children aged 0-59 months in India. Using data from the 2015-2016 National Family Health Survey-4 (NFHS-4), the research sample included 176,255 children aged 0 to 59 months. Bivariate and multivariate techniques were used to analyze children's risk factors for overweight/obesity. We identified that the prevalence of overweight/obesity among children aged 0-59 was 2.6% in India. The study findings reveal that factors such as child sex, age, birth weight, birth rank, maternal education, number of children, age at marriage, mother's BMI, media exposure, social group, and dietary diversity score were most significantly correlated with childhood overweight and obesity in India. Furthermore, we found that male children (ARR: 1.08) aged between 0 and 11 months (ARR: 3.77) with low birth rank (ARR: 1.24), obese (ARR: 1.81) children whose mothers married after the age of 18 (ARR: 1.15), children who belong to a scheduled tribe family (ARR: 1.46), and children who consumed 7-9 food items (ARR: 1.22) were at highest risk of being overweight and obese. However, breastfeeding (ARR: 0.85) and Muslim families (ARR: 0.87) appeared to be protective factors with respect to childhood overweight and obesity in India. Pertinent public health programs, clinical follow-up, and awareness about sedentary lifestyles can help to reduce overweight/obesity risks in children.
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Affiliation(s)
- Jay Saha
- Department of Geography, University of Gour Banga (UGB), Malda 732103, West Bengal, India
| | - Pradip Chouhan
- Department of Geography, University of Gour Banga (UGB), Malda 732103, West Bengal, India
| | - Farooq Ahmed
- Vanke School of Public Health, Tsinghua University, Beijing 100029, China
- Department of Anthropology, Quaid-i-Azam University Islamabad 44000, Pakistan
| | - Tanmoy Ghosh
- Department of Geography, University of Gour Banga (UGB), Malda 732103, West Bengal, India
| | - Sabbir Mondal
- Department of Geography, University of Gour Banga (UGB), Malda 732103, West Bengal, India
| | - Muhammad Shahid
- Vanke School of Public Health, Tsinghua University, Beijing 100029, China
- School of Insurance and Economics, University of International Business and Economics (UIBE), Beijing 100029, China
| | - Saireen Fatima
- Fazaia Medical College, Air University, Islamabad 44000, Pakistan
| | - Kun Tang
- Vanke School of Public Health, Tsinghua University, Beijing 100029, China
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de Melo JMM, Dourado BLLFS, de Menezes RCE, Longo-Silva G, da Silveira JAC. Early onset of overweight among children from low-income families: The role of exclusive breastfeeding and maternal intake of ultra-processed food. Pediatr Obes 2021; 16:e12825. [PMID: 34169658 DOI: 10.1111/ijpo.12825] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 05/21/2021] [Accepted: 06/09/2021] [Indexed: 11/28/2022]
Abstract
CONTEXT There is an increasing prevalence of overweight during early childhood in the most impoverished areas in Brazil, although there is a lack of evidence regarding its onset. OBJECTIVES To investigate the incidence and risk factors associated with overweight among low-income children during their first year of life. METHODS We analysed data from a prospective birth cohort study conducted in Brazil, which followed-up children at birth, 3rd, 6th and 12th months (n = 196). The overweight incidence (zBMI/A > 2SD) was analysed using the Kaplan-Meier survival estimator and its associated factors by the Coxs regression model. Missing data were addressed with multiple imputations and results on the final adjusted model were calculated by pooling the estimates generated for each imputed dataset. RESULTS The overweight incidence was 17 events/100 children-year, and most cases occurred before the 6th month. The final model showed that children exclusively breastfed up to 30 days (vs. >30 days; HR 2.68; 95%CI 1.11-6.49) and whose mothers consumed ultra-processed foods more than 4 times/day (vs. ≤4 times/day; HR 3.02; 95%CI 1.28-7.13) presented a higher risk of developing overweight. CONCLUSION The overweight incidence was high in this impoverished population. Shorter exclusive breastfeeding duration and an unhealthy household food environment provided a short-term risk increase.
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Affiliation(s)
- Jayanne Mayara Magalhães de Melo
- Center for Studies and Research on Food Environment, Nutrition Graduate Program, Faculty of Nutrition, Universidade Federal de Alagoas, Maceió, Alagoas, Brazil
| | - Bruna Larine Lemos Fontes Silva Dourado
- Center for Studies and Research on Food Environment, Nutrition Graduate Program, Faculty of Nutrition, Universidade Federal de Alagoas, Maceió, Alagoas, Brazil
| | - Risia Cristina Egito de Menezes
- Center for Studies and Research on Food Environment, Nutrition Graduate Program, Faculty of Nutrition, Universidade Federal de Alagoas, Maceió, Alagoas, Brazil
| | - Giovana Longo-Silva
- Center for Studies and Research on Food Environment, Nutrition Graduate Program, Faculty of Nutrition, Universidade Federal de Alagoas, Maceió, Alagoas, Brazil
| | - Jonas Augusto Cardoso da Silveira
- Center for Studies and Research on Food Environment, Nutrition Graduate Program, Faculty of Nutrition, Universidade Federal de Alagoas, Maceió, Alagoas, Brazil.,Department of Nutrition, Center for Health Sciences, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
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Campos AP, Vilar-Compte M, Hawkins SS. Association Between Breastfeeding and Child Overweight in Mexico. Food Nutr Bull 2021; 42:414-426. [PMID: 34044629 DOI: 10.1177/03795721211014778] [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: 11/16/2022]
Abstract
BACKGROUND Globally, the prevalence of child overweight has increased over the past few decades. The largest burden of child overweight is identified among upper-middle-income countries, such as Mexico. Breastfeeding has been identified as one of the key affordable and modifiable maternal health behaviors protecting against child overweight. OBJECTIVE To examine the association between breastfeeding and child overweight while sequentially controlling for individual, household, and area factors in Mexican children. METHODS Secondary data analysis using the 2012 Mexican National Health and Nutrition Survey which included risk factors for overweight on 2089 children aged 6 to 35 months and analyzed data to estimate fixed- and mixed-effects logistic regression models. RESULTS Overall, 9.0% of children were overweight and 71.1% of mothers reported any breastfeeding for ≥ 6 months. We found no evidence for a protective effect of any breastfeeding for ≥ 6 months on child overweight when compared to children who were never breastfed in the fully adjusted model and across all models (model 4, adjusted odds ratio [AOR] [95% CI] = 0.76 [0.31-1.86]). We identified risk factors for child overweight at the individual and area levels, with maternal obesity and offspring high birthweight being significant in the fully adjusted model and across all models (model 4, AOR [95% CI] = 2.26 [1.32-3.85] and 2.83 [1.44-5.56], correspondingly). CONCLUSIONS Our results suggest shared obesogenic environment influences from which the overweight-obese maternal-child dyads are emerging in Mexican households. More research is needed to better understand these obesogenic environments grounded on the particular contexts among upper-middle-income countries.
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Affiliation(s)
- Ana Paola Campos
- 205730Boston College School of Social Work, McGuinn Hall, Chestnut Hill, MA, USA
| | - Mireya Vilar-Compte
- EQUIDE Research Institute, 27829Iberoamericana University, Mexico City, Mexico
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Baran J, Weres A, Czenczek-Lewandowska E, Łuszczki E, Sobek G, Pitucha G, Leszczak J, Mazur A. Early Eating Patterns and Overweight and Obesity in a Sample of Preschool Children in South-East Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3064. [PMID: 31450738 PMCID: PMC6747484 DOI: 10.3390/ijerph16173064] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 08/13/2019] [Accepted: 08/19/2019] [Indexed: 12/29/2022]
Abstract
The aim of this study was to assess the impact of a child's diet in the first year of life (breastfeeding duration, introduction of solid meals to the diet, the time of starting nutrition consistent with an adult diet) on the prevalence of overweight and obesity in preschool age. Three-hundred children aged 4-6 were included in the analysis. The children's height and body weight were assessed and their body mass category was determined based on the BMI (Body Mass Index) percentile. Parents provided a photocopy of the child's health book (with information concerning breastfeeding period, start of eating the same meals as the rest of the family, etc.). Obese children were breastfed for the shortest time, cow's milk was introduced to their diets the earliest, they started eating the same food as the rest of the family the earliest, and they received vegetables, fruits, cereals, and meat products in their diet the latest. The results of this study suggest that extending the breastfeeding period beyond 6 months, starting to feed the child the same meals as the rest of the family after 12 months of age, and later introduction of cow's milk to the diet would reduce the risk of the occurrence of excessive body weight in preschool children.
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Affiliation(s)
- Joanna Baran
- Medical Faculty, University of Rzeszów, al. Mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland.
| | - Aneta Weres
- Medical Faculty, University of Rzeszów, al. Mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland
| | | | - Edyta Łuszczki
- Medical Faculty, University of Rzeszów, al. Mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland
| | - Grzegorz Sobek
- Medical Faculty, University of Rzeszów, al. Mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland
| | - Grzegorz Pitucha
- Faculty of Biology and Agriculture, University of Rzeszów, ul. Ćwiklińskiej 1, 35-601 Rzeszów, Poland
| | - Justyna Leszczak
- Medical Faculty, University of Rzeszów, al. Mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland
| | - Artur Mazur
- Medical Faculty, University of Rzeszów, al. Mjr. W. Kopisto 2a, 35-959 Rzeszów, Poland
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Risk Factors for Unhealthy Weight Gain and Obesity among Children with Autism Spectrum Disorder. Int J Mol Sci 2019; 20:ijms20133285. [PMID: 31277383 PMCID: PMC6650879 DOI: 10.3390/ijms20133285] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 07/01/2019] [Accepted: 07/03/2019] [Indexed: 02/06/2023] Open
Abstract
Autism Spectrum Disorder (ASD) is a developmental disorder characterized by social and communication deficits and repetitive behaviors. Children with ASD are also at a higher risk for developing overweight or obesity than children with typical development (TD). Childhood obesity has been associated with adverse health outcomes, including insulin resistance, diabetes, heart disease, and certain cancers. Importantly some key factors that play a mediating role in these higher rates of obesity include lifestyle factors and biological influences, as well as secondary comorbidities and medications. This review summarizes current knowledge about behavioral and lifestyle factors that could contribute to unhealthy weight gain in children with ASD, as well as the current state of knowledge of emerging risk factors such as the possible influence of sleep problems, the gut microbiome, endocrine influences and maternal metabolic disorders. We also discuss some of the clinical implications of these risk factors and areas for future research.
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Exclusive breastfeeding and partial breastfeeding reduce the risk of overweight in childhood: A nationwide longitudinal study in Korea. Obes Res Clin Pract 2018; 12:222-228. [PMID: 29396229 DOI: 10.1016/j.orcp.2018.01.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 12/25/2017] [Accepted: 01/03/2018] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Breastfeeding is generally known to reduce the risk of childhood overweight and obesity. However, the results are controversial between countries, and nationwide data are rare. This study assessed the relationship between breastfeeding types and overweight incidence using nationwide longitudinal data in Korea. METHODS We analysed 774,764 infants who participated in the longitudinal nationwide data from the Korea National Children's Health Examination 2007-2013. Childhood overweight was defined by a Z-score≥1.64 (95th centile) for infants under 24 months and Z-scores≥1.04 (85th centile) for children over 24 months. Cox proportional hazard model was used to analyse the relationship between breastfeeding types and overweight incidence. RESULTS Infants who were exclusively breastfed at 4-6 months of age had the multivariate-adjusted hazard ratio (HRs) for overweight of 0.78 (95% CI 0.77-0.79) and infants who were partially breastfed had the HRs for overweight of 0.96 (95% CI 0.94-0.98), which was lower compared to that of the exclusively formula fed group. Similar results were obtained for stratified analysis by boys and girls. CONCLUSIONS Exclusive and partial breastfeeding have preventive effect on childhood overweight in Korea. Therefore, it is necessary to encourage breastfeeding to prevent childhood obesity and its consequences in developed Asian countries.
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Abstract
BACKGROUND The present study examined the effects of breastfeeding and its duration on the development of childhood obesity from 24 months through grade 6. METHODS U.S. longitudinal data collected from 1234 children were analyzed using logistic regression models and generalized estimating equation (GEE). Child height and weight were measured six times at ages of 24 months, 36 months, 54 months, grade 1, grade 3, and grade 6. RESULTS During the early 1990s, prevalence of breastfeeding was low in the United States, 60% and 48% at 1 and 6 months, respectively. Nonsmoking, white, married mothers with both parents in the household, and with income above the poverty line, were more likely to breastfeed at 1 month of age of their babies. Obesity rate of the children increased with age from 24 months to grade 6. Logistic regression showed that breastfeeding at month 1 was associated with 53% (odds ratio [OR]: 0.47, 95% confidence interval [CI]: 0.30-0.73) and 47% (OR: 0.53, 95% CI: 0.36-0.78) decreased risks for childhood obesity at grades 1 and 6, respectively. GEE analysis showed that breastfeeding at 1 month reduced risk for childhood obesity by 36% (95% CI: 0.47-0.88) from ages 24 months through grade 6. Regarding breastfeeding duration, more than 6 months (vs. never) was associated with a decreased risk for childhood obesity by 42% (OR: 0.58, 95% CI: 0.36-0.94). CONCLUSIONS Breastfeeding at 1 month and more than 6 months reduced the risk of childhood obesity. Rate of breastfeeding was low in the United States in the 1990s, which may have had long-term implications on children.
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Affiliation(s)
- Liang Wang
- 1 Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University , Johnson City, TN
| | - Candice Collins
- 1 Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University , Johnson City, TN
| | - Melanie Ratliff
- 1 Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University , Johnson City, TN
| | - Bin Xie
- 2 School of Community and Global Health, Claremont Graduate University , Claremont, CA
| | - Youfa Wang
- 3 Fisher Institute of Health and Well-Being, Systems-Oriented Global Childhood Obesity Intervention Program, Department of Nutrition and Health Sciences, College of Health, Ball State University , Muncie, IN
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11
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Mapping of Reviews on Breastfeeding and Obesity Risk in Children. Curr Nutr Rep 2016. [DOI: 10.1007/s13668-016-0180-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Davis AM, Wambach KA, Nelson EL, Odar C, Lillis T, McKinley A, Gallagher M. Health behavior change in pregnant women: a two-phase study. Telemed J E Health 2016; 20:1165-9. [PMID: 25289706 DOI: 10.1089/tmj.2013.0374] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Maternal health behaviors during pregnancy/infancy can have a significant impact on maternal and child health. Many women engage in health risk behaviors during pregnancy. Multiple health behavior change (MHBC) interventions provide support to change health behaviors, but further information is needed on potential targets for such an intervention, as well as on the feasibility of technology use and e-health with this population. MATERIALS AND METHODS Two studies were completed as part of this project. First, a survey to examine views regarding health behaviors, desires to change health behaviors, and use of technology was completed by 68 pregnant women presenting for routine care. Based on survey findings, a brief MHBC e-health educational intervention related to breastfeeding, healthy nutrition/lifestyle, and stress management, using iPad(®) (Apple, Cupertino, CA) and text-messaging media, was then developed and piloted in the home with five pregnant women. RESULTS In the survey, the majority of participants reported interest in receiving help to improve health behaviors, including losing weight or eating a healthier diet, breastfeeding, smoking cessation, and help with depression. The majority of women reported access to a computer with Internet, a phone, and frequent use of text messaging. In the second phase, results suggest that the home-based intervention was feasible and that the technology was convenient and user-friendly. CONCLUSIONS Pregnant women are interested in improving health behaviors and found a brief technology-based e-health intervention feasible, convenient, and user-friendly. In-home technology appears to be a feasible and convenient approach to addressing the multiple health behavior change needs of pregnant women.
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Affiliation(s)
- Ann M Davis
- 1 Center for Children's Healthy Lifestyles & Nutrition , Kansas City, Missouri
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Wright M, Mendez MA, Sotres-Alvarez D, Adair L. Breastfeeding and Protein Intake Influence Body Mass Index from 2 Months to 22 Years in the Cebu Longitudinal Health and Nutrition Survey. J Nutr 2016; 146:2085-2092. [PMID: 27581582 PMCID: PMC6457088 DOI: 10.3945/jn.116.232470] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 04/15/2016] [Accepted: 08/01/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Protein intake (PI) may alter adiposity but few studies have explored the age-specific associations of PI with body mass index (BMI). OBJECTIVE We analyzed how PI and breastfeeding relate to BMI in the CLHNS (Cebu Longitudinal Health and Nutrition Survey), an observational Filipino birth cohort (1983-2005). METHODS Random-effects longitudinal regression models estimated the association of daily breastfeeding frequency and energy-adjusted PI residuals with concurrent BMI z scores (zBMI) measured bimonthly from 2 to 24 mo (n = 2899), and the association of breastfeeding history and PI residuals with concurrent BMI using 5 surveys from 2 to 22 y (n = 2435). Models included statistical interactions between PI, breastfeeding, age, and energy intake and adjusted for potential confounders. RESULTS Breastfeeding was associated with higher predicted zBMI at 6 mo (β: 0.491 SD; 95% CI: 0.422, 0.560) and at 18 mo (β: 0.114 SD; 95% CI: 0.032, 0.197). Daily breastfeeding frequency contributed to higher predicted zBMI in younger infants and lower predicted zBMI in later infancy. Those with longer breastfeeding history (19 mo) were significantly smaller at age 11 y (in kg/m2; β: -0.220; 95% CI: -0.342, -0.097) than those with a shorter (4 mo) breastfeeding duration. Total complementary PI was positively associated with predicted zBMI. Complementary animal PI was positively associated with predicted zBMI in nonbreastfed infants. Plant PI was inversely associated with predicted zBMI of nonbreastfed infants at 6 mo. At 22 y contrasts between high (75th percentile) and low (25th percentile) PIs showed that animal PI was associated with higher predicted BMI (β: 0.187; 95% CI: 0.045, 0.329), and total PI was inversely related to predicted BMI (β: -0.008; 95% CI: -0.015, -0.001). CONCLUSION Breastfeeding frequency, breastfeeding history, and PI contribute to BMI from infancy to young adulthood in the CLHNS.
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Breast, Formula and Combination Feeding in Relation to Childhood Obesity in Nova Scotia, Canada. Matern Child Health J 2015; 19:2048-56. [DOI: 10.1007/s10995-015-1717-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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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: 422] [Impact Index Per Article: 42.2] [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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Papadopoulou E, Stanner S. Early growth and obesity risk - What should health professionals be advising? NUTR BULL 2014. [DOI: 10.1111/nbu.12090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Dera de Bie E, Jansen M, Gerver WJ. Inhibiting Factors in the Prevention of Overweight in Infants: An Explorative Qualitative Study among Child Healthcare Practitioners in the Netherlands. ACTA ACUST UNITED AC 2012. [DOI: 10.1080/13575279.2012.683776] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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