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: 3.73). 09/2008; 16(11). DOI: 10.1038/oby.2008.403
Source: OAI


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.

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Available from: Jaap Seidell, Sep 02, 2014
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    • "Although most relationships between BF duration and healthy dietary outcomes at adulthood in our study were not statistically significant, they all point to a positive relationship between BF duration and healthy dietary outcomes. This is in line with studies that revealed relationships between BF and several healthy dietary outcomes at later ages: it has been shown that BF is positively related to fruit and vegetable intake at 2-6 years and at 8 years [15,16], to fruit intake by 6-14 year olds [34], and negatively related to the intake of sweetened drinks and added sugars at 12 months of age [19], and intake of white bread, carbonated soft drinks, chocolate bars and fried snacks at 8 years of age [16]. As we studied the relationships until adulthood, it might be that other exposures during later phases in life masked these associations. "
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    ABSTRACT: Breastfeeding (BF) is protective against overweight and is associated with dietary behaviour. The aims of our study were to assess the relationship between exclusive BF duration and BMI, waist circumference (WC) and waist-hip ratio (WHR) at adulthood, and to study whether dietary behaviour could explain the relationship between BF duration and the proxies of fat mass. In 2004-2005, 822 subjects from the Terneuzen Birth Cohort (n = 2,604), aged 18-28 years, filled in postal questionnaires including sociodemographic factors and aspects of dietary behaviour (dietary pattern, and consumption of fruit and vegetables, snacks, sweetened beverages and alcohol); 737 subjects also underwent anthropometric measurements of weight, height, and waist and hip circumference. The relationship between exclusive BF duration and dietary outcomes was investigated by logistic regression analysis. The relationships of BF duration with the anthropometric measures were investigated by linear regression analyses. All results were corrected for age, gender and possible confounders. Finally, regression analyses were performed to investigate if diet factors had a mediating effect on the relationship between BF duration and fat mass. A significant inverse dose-response relationship of BF duration was found for BMI (β-0.13, SE 0.06), WC (β-0.39, SE 0.18) and WHR (β-0.003, SE 0.001), after correction for age, gender and confounders. The odds ratio (OR) of exclusive BF duration in months for a breakfast frequency of at least 5 times a week was 1.16 (95%CI 1.06-1.27), and for snack consumption of less than twice a week was 1.15 (95%CI 1.06-1.25). Both ORs were corrected for age, gender and confounders. For other dietary outcomes, the results point in the same direction, i.e. a positive relationship with BF duration, but these were not statistically significant. A mediating effect of the diet factors on the association between BF and anthropometric outcomes was not shown. Exclusive BF duration had a significant inverse dose-response relationship with BMI, WC and WHR at young adulthood. BF duration was positively related to a healthier diet at adulthood, but this did not explain the protective effect of BF against body fat. Our results underline the recommendation of the WHO to exclusively breastfeed for 6 months or longer.
    Full-text · Article · May 2011 · BMC Pediatrics
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    • "The number of obese children was too small for analyses with fully adjusted regression models, and obesity was therefore not used as outcome measure in these analyses. In previous studies in the PIAMA cohort, breast feeding was investigated in relation to overweight risk and was found to be associated with reduced overweight risk [12] [13] "
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    ABSTRACT: Objective. To prospectively identify behavioral risk factors for childhood overweight and to assess their relevance in high risk sub groups (children of mothers with overweight or low education). Methods. In the PIAMA birth cohort (n = 3963), questionnaire data were obtained at ages 5 and 7 on “screen time”, walking or cycling to school, playing outside, sports club membership, fast food consumption, snack consumption and soft drink consumption. Weight and height were measured at age 8 years. Results. Screen time, but none of the other hypothesized behavioral factors, was associated with overweight (aOR 1.4 (CI: 1.2–1.6)). The adjusted population attributable risk fraction for screen time > 1 hr/day was 10% in the high risk and 17% in the low risk sub groups. Conclusion. Reduction of screen time to < 1 hr/day could result in a reduction of overweight prevalence in the order of 2 percentage points in both high and low risks sub groups.
    Full-text · Article · Jun 2010 · Journal of obesity
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    • "A number of primary and review articles provide strong evidence of the protective effect of breastfeeding against overweight/obesity [1] [2] [3] [4] [5] [6] [7] [8] [9]. Despite this strong evidence, other studies have reported an inverse relationship or no relationship at all between breastfeeding and overweight/obesity [10]. "
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    ABSTRACT: Research studies have produced conflicting results of the impact of breastfeeding on overweight/obesity. This study evaluated the impact of infant feeding on infant body composition. There were two groups of mother-infant pairs (exclusive breastfeeding [EBF; n = 27] and mixed feeding [MF; n = 13]) in this study. At baseline, participants were similar in their demographic characteristics except prepregnancy weight, where MF mothers tended to be heavier than their EBF counterparts (67.3 kg versus 59.9 kg; P = .034). Infant birth weight was slightly higher among the MF group than their EBF counterparts (3.5 kg versus 3.4 kg), although the differences were not statistically significant. At 3 months postpartum, mean infant FMI (4.1 kg/m(2) versus 3.8 kg/m(2)) and percent body fat (24.4% versus 23.1%) were slightly higher among EBF infants than MF infants. In terms of growth velocity, EBF infants gained weight faster than their MF counterparts, although the differences were not statistically significant. The findings from this study suggest that EBF may promote faster weight gain and increase in both fat mass index (FMI) and percent body fat in the early postpartum period in addition to the numerous health benefits enjoyed by the infant and the mother who exclusively breastfeeds her newborn.
    Full-text · Article · Mar 2009 · International Journal of Pediatrics
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