Do differences in childhood diet explain the reduced overweight risk in breastfed children?

Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.
Obesity (Impact Factor: 3.92). 09/2008; DOI: 10.1038/oby.2008.403
Source: OAI

ABSTRACT Breastfeeding has been associated with a reduced risk of overweight later in life. This study investigates whether differences in diet and lifestyle at 7 years of age between breastfed and formula-fed children can explain the difference in overweight prevalence at 8 years of age. We studied 2,043 Dutch children born in 1996-1997 who participated in the Prevention and Incidence of Asthma and Mite Allergy birth cohort study. Data on breastfeeding duration and diet and lifestyle factors at 7 years were collected using questionnaires. Weight and height were measured at 8 years. Overweight was defined according to international gender- and age-specific standards. Compared to nonbreastfed children (15.5%, n = 316), children breastfed for >16 weeks (38.0%, n = 776) consumed fruit and vegetables significantly more often and meat, white bread, carbonated soft drinks, chocolate bars, and fried snacks less often. Overall, breastfed children were less likely to have an unhealthy diet (adjusted prevalence ratio: 0.77, 95% confidence interval: 0.61-0.98). The associations could only partly be explained by maternal education, maternal overweight, and smoking during pregnancy. At 8 years, 14.5% (n = 297) of the children were overweight. Breastfeeding for >16 weeks was significantly associated with a lower overweight risk at 8 years (adjusted odds ratio: 0.67, 95% confidence interval: 0.47-0.97), and the association hardly changed after adjustment for diet (adjusted odds ratio: 0.71, 95% confidence interval: 0.49-1.03). Breastfed children had a healthier diet at 7 years compared to nonbreastfed children, but this difference could not explain the lower overweight risk at 8 years in breastfed children.Obesity (2008) 16 11, 2498-2503. doi:10.1038/oby.2008.403.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The present systematic literature review is part of the 5th revision of the Nordic Nutrition Recommendations. The overall aim was to review recent scientific data valid in a Nordic setting on the short- and long-term health effects of breastfeeding (duration of both any and exclusive breastfeeding) and introduction of foods other than breast milk. The initial literature search resulted in 2,011 abstracts; 416 identified as potentially relevant. Full paper review resulted in 60 quality assessed papers (6A, 48B, and 6C). A complementary search found some additional papers. The grade of evidence was classified as convincing, probable, limited-suggestive, and limited-no conclusion. The evidence was convincing of a protective dose/duration effect of breastfeeding against overweight and obesity in childhood and adolescence, overall infections, acute otitis media, and gastrointestinal and respiratory tract infections. The evidence was probable that exclusive breastfeeding for longer than 4 months is associated with slower weight gain during the second half of the first year which could be part of the reason behind the reduced risk of later overweight or obesity. There was also probable evidence that breastfeeding is a protective factor against inflammatory bowel disease, celiac disease, and diabetes (type 1 and 2), provides beneficial effects on IQ and developmental scores of children as well as a small reductive effect on blood pressure and blood cholesterol levels in adulthood. Other associations explored were limited-suggestive or inconclusive. In conclusion, convincing and probable evidence was found for benefits of breastfeeding on several outcomes. The recommendation in NNR2004 about exclusive breastfeeding for 6 months and continued partial breastfeeding thereafter can stand unchanged. The relatively low proportion of infants in the Nordic countries following this recommendation indicates that strategies that protect, support and promote breastfeeding should be enhanced, and should also recognize the benefits for long-term health.
    Food & Nutrition Research 01/2013; 57.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: As in most countries around the globe, overweight and obesity are a major threat to public health on the Caribbean island of Aruba. Increasing evidence confirms that breastfeeding protects against overweight and obesity. However, little is known about the mechanism underlying the association between breastfeeding and obesity. One possibility is that breastfed infants are better able to control their meal size and intervals than formula-fed infants. This might lead to a healthier diet in later life and protect against overweight and obesity. To determine the relationship between breastfeeding, food pattern and being overweight in the Caribbean. In a cross-sectional school-based study in 2004-2005, weight and height were measured by two research assistants in 1776 children aged 6-11 years on Aruba, an island in the Caribbean. BMI was defined according to guidelines by the International Obesity Task Force. Parents completed a questionnaire pertaining to breastfeeding and dietary food pattern. 1451/1776 (81·7%) children were breastfed; 851/1766 (47·9%) children were breastfed for <4 months, 227/1776 (12·8%) for 4-6 months and 373/1776 (21·0%) for ≥6 months. Children who were breastfed for ≥4 months had lower odds (OR 0·32, 95%CI 0·25-0·40) of being overweight including obesity than those who either were not breastfed or who were breastfed for <4 months. Children who were breastfed for ≥4 months were more likely to have a structured food pattern of six eating moments a day (OR 7·43, 95% CI 5·87-9·39, P<0·001) and to have breakfast every day (OR 2·86, 95% CI 2·17-3·78, P<0·001) than those who were not or who were breastfed for <4 months. Breastfeeding for ≥4 months is associated with a structured food pattern (six eating moments a day including a daily breakfast) and carries a strikingly lower risk of overweight in children. Promoting prolonged breastfeeding together with a focus on a subsequent structured food pattern could be a cheap method of preventing overweight.
    Paediatrics and international child health. 01/2013; 33(1):18-22.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This study identified lifestyle patterns by examining the clustering of eating routines (e.g. eating together as a family, having the television on during meals, duration of meals) and various activity-related behaviors (i.e. physical activity (PA) and sedentary screen-based behavior) in 5-year-old children, as well as the longitudinal association of these patterns with weight status (BMI and overweight) development up to age 8. Data originated from the KOALA Birth Cohort Study (N = 2074 at age 5). Principal component analysis (PCA) was used to identify lifestyle patterns. Backward regression analyses were used to examine the association of lifestyle patterns with parent and child background characteristics, as well as the longitudinal associations between the patterns and weight status development. Four lifestyle patterns emerged from the PCA: a 'Television-Snacking' pattern, a 'Sports-Computer' pattern, a 'Traditional Family' pattern, and a "Fast' Food' pattern. Child gender and parental educational level, working hours and body mass index were significantly associated with the scores for the patterns. The Television-Snacking pattern was positively associated with BMI (standardized regression coefficient β = 0.05; p < 0.05), and children with this pattern showed a positive tendency toward being overweight at age 8 (Odds ratio (OR) = 1.27, p = 0.06). In addition, the Sports-Computer pattern was significantly positively associated with an increased risk of becoming overweight at age 7 (OR = 1.28, p < 0.05). The current study showed the added value of including eating routines in cross-behavioral clustering analyses. The findings indicate that future interventions to prevent childhood overweight should address eating routines and activity/inactivity simultaneously, using the synergy between clustered behaviors (e.g. between television viewing and snacking).
    International Journal of Behavioral Nutrition and Physical Activity 06/2012; 9:77. · 3.58 Impact Factor

Full-text (2 Sources)

Available from
Sep 2, 2014