Infant feeding practices and prevalence of obesity in eight European countries - the IDEFICS study

1 Public Health Epidemiology Unit, Department of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, PO Box 454 SE-405 30, Gothenburg, Sweden.
Public Health Nutrition (Impact Factor: 2.68). 08/2012; 16(2):1-9. DOI: 10.1017/S1368980012003850
Source: PubMed


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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Available from: Monica Hunsberger, Apr 30, 2014
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    • "There is evidence that breastfeeding protects against overweight and obesity, and a systematic review found convincing evidence of a protective dose/duration effect of breastfeeding [5]. Recent findings from our group support this; we found that exclusive breastfeeding for 4–6 months protected against overweight when compared with children who were never breastfed in eight European cohorts, including the Swedish children described here [6]. Although Swedish guidelines recommend that exclusive breastfeeding should continue for 6 months [7], the majority of Swedish children are introduced to other foods before 6 months of age [5]. "
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    ABSTRACT: Aims: The aims of this study were to characterize milk cereal drink (MCD) consumption among Swedish children and to investigate the association between MCD and overweight in a longitudinally followed cohort of children over 2 years of age. Methods: In the Swedish cohort from IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS) we examined early feeding practices and weight status when children were aged 2-9 years (2007/2008) and at 2-year follow-up. Weight and height were measured at both time points in 1077 children. Characteristics of MCD consumers were explored with logistic regression. Body mass index (BMI) z-scores at both time points and weight status at follow-up were regressed on explanatory factors using mixed linear and logistic regression, respectively. Results: Nearly 69% of children had consumed MCD. The MCD consumers were more likely than never-consumers to have two native Swedish parents, parents with less than 2 years of post-secondary education, and a shorter period of breastfeeding. MCD consumers had a higher BMI z-score at follow-up compared with baseline (difference in BMI z-score=0.12, 95% confidence interval (CI)=0.07, 0.17), while the average BMI z-score in non-consumers remained stable over time (0.00, 95% CI= -0.07, 0.07). MCD consumers were nearly five times more likely than non-consumers to become overweight during the follow-up (odds ratio (OR)=4.78, 95% CI=1.68, 13.59), independent of breastfeeding. Conclusions: MCD was consumed by the majority of children in this study. MCD consumption is associated with an increased risk for overweight and less exposure to breastfeeding. Our findings motivate future research aimed at investigating how MCD should be recommended.
    Full-text · Article · Jun 2014 · Scandinavian Journal of Public Health
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    ABSTRACT: To examine variations in infant weight gain between children of parents with and without migrant background and to investigate how these differences are explained by pre- and perinatal factors. We used data on birth weight and weight at six months from well-child check-up books that were collected from a population-based German sample of children in the IDEFICS study (n = 1,287). We calculated unadjusted and adjusted means for weight z-scores at birth and six months later. We applied linear regression for change in weight z-score and we calculated odds ratios and 95% confidence intervals (95% CI) for rapid weight gain by logistic regression, adjusted for biological, social and behavioural factors. Weight z-scores for migrants and Germans differed slightly at birth, but were markedly increased for Turkish and Eastern European infants at age six months. Turkish infants showed the highest change in weight z-score during the first 6 months (ß = 0.35; 95% CI 0.14-0.56) and an increased probability of rapid weight gain compared with German infants. Examination of the joint effect of migrant and socioeconomic status (SES) showed the greatest change in weight z-scores in Turkish infants from middle SES families (ß = 0.77; 95% CI 0.40-1.14) and infants of parents from Eastern European countries with high SES (ß = 0.72; 95% CI 0.13-1.32). Our results support the hypothesis that migrant background is an independent risk factor for infant weight gain and suggest that the onset of health inequalities in overweight starts in early infancy.
    Full-text · Article · Apr 2013 · PLoS ONE
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