Effect of Infant Feeding on the Risk of Obesity across the Life Course: A Quantitative Review of Published Evidence
ABSTRACT To examine the influence of initial infant feeding on obesity in later life.
A systematic review of published studies investigating the association between infant feeding and a measure of obesity was performed with Medline (1966 onward) and Embase (1980 onward) databases, supplemented with manual searches. Data extraction was conducted by 2 authors. Analyses were based on odds ratios of obesity among initially breastfed subjects, compared with formula-fed subjects, pooled with fixed-effects models.
Sixty-one studies reported on the relationship of infant feeding to a measure of obesity in later life; of these, 28 (298900 subjects) provided odds ratio estimates. In these studies, breastfeeding was associated with a reduced risk of obesity, compared with formula feeding (odds ratio: 0.87; 95% confidence interval [CI]: 0.85-0.89). The inverse association between breastfeeding and obesity was particularly strong in 11 small studies of <500 subjects (odds ratio: 0.43; 95% CI: 0.33-0.55) but was still apparent in larger studies of > or =500 subjects (odds ratio: 0.88; 95% CI: 0.85-0.90). In 6 studies that adjusted for all 3 major potential confounding factors (parental obesity, maternal smoking, and social class), the inverse association was reduced markedly (from an odds ratio of 0.86 to 0.93) but not abolished. A sensitivity analysis examining the potential impact of the results of 33 published studies (12505 subjects) that did not provide odds ratios (mostly reporting no relationship between breastfeeding and obesity) showed little effect on the results.
Initial breastfeeding protects against obesity in later life. However, a further review including large unpublished studies exploring the effect of confounding factors in more detail is needed.
- SourceAvailable from: Maria Ines Varela-Silva
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- "Behaviors of mothers and the choice to smoke during pregnancy and to breastfeed or not, were clearly significant risk factors of childhood obesity. These finding has been documented elsewhere (Owen et al., 2005). This study only included a two choice answer to breastfeeding (yes/no) so therefore a more detailed description and risk association on duration of breastfeeding could not be found like in previous studies (Padez et al., 2005; Ryan, 2007). "
ABSTRACT: Childhood obesity is a public health concern in Portugal. Socio-demographic and behavioral factors are highly associated with obesity but are not clearly understood. This article aims to update the prevalence of overweight and obesity in Portuguese children and to explore the influence and risks of socio-demographic factors and behavioral factors. A cross-sectional study of Portuguese children aged 3-10 years from all 18 mainland districts took place between March 2009 and January 2010. The sample was composed by 17,136 children, 3-10 years of age (8,455 boys; 8,681 girls). Height, weight, and other anthropometric measurements were obtained by trained technicians. Body mass index (BMI) was calculated along with other anthropometric variables. Data analyses took place between April and September 2012. The overweight/obesity classification was established by age-and sex-specific BMI cut-off points as defined by the International obesity task force (IOTF). Parents completed questionnaires about socio-demographic and behavioral characteristics of the family. Almost 28% of the Portuguese children were overweight or obese (19.7% overweight; 8.2% obese). Prevalence was greater in girls than in boys. Logistic regression models found that the odds of childhood obesity were significantly affected by biological, socio-demographic, and behavioral factors. The protective factors against childhood overweight/obesity in this sample of Portuguese children are: (i) being male; (ii) having been breastfeed; (iii) having been born from mothers who did not smoke during pregnancy; (iv) engaging in little sedentary behaviors (TV, PC, and playing electronic games); (iv) performing at least 1 h of moderate physical activity every day; and (v) having parents with higher educational levels who also have their BMI within the healthy ranges. Am. J. Hum. Biol., 2013. © 2013 Wiley Periodicals, Inc.American Journal of Human Biology 11/2013; DOI:10.1002/ajhb.22440 · 1.93 Impact Factor
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- "Considerations that focus on disparities between parental growth experiences and those of their progeny's first two or three post-natal years may raise concerns related to potential risks of rapid growth induced by efforts to normalize the stature of children whose parents likely experienced growth stunting. Such concerns are prompted most often by evidence that rapid weight gain in early life is associated with higher risks of childhood obesity and some chronic diseases of adult onset (Barker et al. 2005; Owen et al. 2005; Ekelund et al. 2007). Although limited, published data support the view that simultaneous proportional 'catch-up' gains in weight and stature do not entail similar risks (Jaquet et al. 2005). "
ABSTRACT: Linear growth from birth to 2 years of children enrolled in the World Health Organization Multicentre Growth Reference Study was similar despite substantial parental height differences among the six study sites. Within-site variability in child length attributable to parental height was estimated by repeated measures analysis of variance using generalized linear models. This approach was also used to examine relationships among selected traits (e.g. breastfeeding duration and child morbidity) and linear growth between 6 and 24 months of age. Differences in intergenerational adult heights were evaluated within sites by comparing mid-parental heights (average of the mother's and father's heights) to the children's predicted adult height. Mid-parental height consistently accounted for greater proportions of observed variability in attained child length than did either paternal or maternal height alone. The proportion of variability explained by mid-parental height ranged from 11% in Ghana to 21% in India. The average proportion of between-child variability accounted for by mid-parental height was 16% and the analogous within-child estimate was 6%. In the Norwegian and US samples, no significant differences were observed between mid-parental and children's predicted adult heights. For the other sites, predicted adult heights exceeded mid-parental heights by 6.2–7.8 cm. To the extent that adult height is predicted by height at age 2 years, these results support the expectation that significant community-wide advances in stature are attainable within one generation when care and nutrition approximate international recommendations, notwithstanding adverse conditions likely experienced by the previous generation.Maternal and Child Nutrition 09/2013; 9(S2). DOI:10.1111/mcn.12085 · 2.97 Impact Factor
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- "As breastfeeding is important for child health (Gartner et al. 2005), it is interesting to investigate the relationship between different maternal body compositions and associated infant feeding outcome. Recent systematic reviews have shown the association between duration of breastfeeding and the reduced risk for development of obesity and overweight in later life (Harder et al. 2005; Owen et al. 2005). Therefore, it seems important to focus on breastfeeding in the post-partum period, in particular with obese mothers, because children of obese women have an additional increased risk to develop obesity or overweight in later life (Boney et al. 2005; Dabelea & Crume 2011). "
ABSTRACT: This systematic review investigates the relationship between maternal obesity and breastfeeding intention, initiation, intensity, duration and milk supply. A comprehensive search was performed through three major databases, including Medline, Cochrane Library and Cumulative Index For Nursing and Allied Health Literature, and by screening reference lists of the relevant publications. Selection criteria were: report of original research, studies on low-risk obese mothers and the comparison with normal weight mothers which met at least two of the following primary outcomes: breastfeeding intention; initiation; intensity; duration and/or milk supply. Furthermore, the included reports had to contain a clear definition of pre-pregnant obesity, use compensation mechanisms for potential confounding factors, have a prospective cohort design and had to have been published between 1997 and 2011 and in English, French or Dutch. Effects of obesity on breastfeeding intention, initiation, intensity, duration and milk supply were analysed, tabulated and summarised in this review. Studies have found that obese women are less likely to intend to breastfeed and that maternal obesity seems to be associated with a decreased initiation of breastfeeding, a shortened duration of breastfeeding, a less adequate milk supply and delayed onset of lactogenesis II, compared with their normal weight counterparts. This systematic review indicates therefore that maternal obesity is an adverse determinant for breastfeeding success.Maternal and Child Nutrition 08/2013; 10(2). DOI:10.1111/j.1740-8709.2012.00439.x · 2.97 Impact Factor