Effect of Infant Feeding on the Risk of Obesity across the Life Course: A Quantitative Review of Published Evidence

University of Bristol, Bristol, England, United Kingdom
PEDIATRICS (Impact Factor: 5.47). 05/2005; 115(5):1367-77. DOI: 10.1542/peds.2004-1176
Source: PubMed


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 However, a further review including large unpublished studies exploring the effect of confounding factors in more detail is needed.

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    • "The association between breastfeeding and childhood obesity is uncertain, and results are inconsistent: some studies show a strong association between breastfeeding and childhood obesity [11] [13] [14] while others do not [16– 18]. There are clinical studies that show that breastfeeding decreases the risk for adulthood obesity [8] [9] [10] [11]. "
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    ABSTRACT: Objective: The objective of this study was to evaluate whether duration of breastfeeding is associated with a lower prevalence of metabolic syndrome in obese children. Methods: A retrospective analysis of obese children aged 3 to 18 years followed at a pediatric outpatient clinic at a single center between the years 2008 and 2012. The children were divided according to their breastfeeding duration: no breastfeeding, a short period of breastfeeding, and a long term breastfeeding. Also, they were divided into metabolic and nonmetabolic syndrome groups, based on physical examination and laboratory tests. Results: Out of 4642 children who visited the clinic, 123 were obese and were included in the study. About half of them matched the metabolic syndrome criteria. There was no correlation between the prevalence of metabolic syndrome and the duration of breastfeeding. Hypertension, abnormal low levels of HDL, high levels of HbA1c, and high fasting triglyceride levels were very common in our study population, yet no statistical significance was noted among the different breastfeeding groups. Conclusion: In this study, breastfeeding was not associated with a reduced risk for metabolic syndrome, compared with formula feeding, in children who are obese.
    Full-text · Article · Aug 2015 · The Scientific World Journal
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    • "Therefore, it is important to study early determinants of cardiometabolic risk. Nutritional exposures in critical periods in pregnancy or early childhood may have a lasting influence on later cardiometabolic health [3] [4]. Lipids, especially polyunsaturated fatty acids (PUFAs), have received considerable interest in this context because of their diverse roles in cell membrane synthesis , gene expression, and eicosanoid metabolism [5]. "
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    ABSTRACT: The importance of polyunsaturated fatty acid (PUFA) intake in fetal life and infancy has been widely studied in relation to child cognitive and visual development, but whether early life PUFA exposure is related to cardiometabolic risk factors is unclear. The focus of this systematic review was to evaluate the effects of PUFA dietary intake and blood levels during pregnancy, lactation, or early childhood (⩽ 5 y) on obesity, blood pressure, blood lipids, and insulin sensitivity. We identified 4,302 abstracts in the databases Embase, Medline and Cochrane Central (April 2014), of which 56 articles, reporting on 45 unique studies, met all selection criteria. Many of the included studies focused on obesity as an outcome (33 studies), whereas studies on insulin sensitivity were relatively scarce (6 studies). Overall, results for obesity, blood pressure, and blood lipids were inconsistent, with a few studies reporting effects in opposite directions and other studies that did not observe any effects of PUFAs on these outcomes. Four studies suggested beneficial effects of PUFAs on insulin sensitivity. We conclude that there is insufficient evidence to support a beneficial effect of PUFAs in fetal life or early childhood on obesity, blood pressure, or blood lipids. More research is needed to investigate the potential favorable effects of PUFAs on insulin sensitivity, and to examine the role of specific fatty acids in early life on later cardiometabolic health. Copyright © 2015. Published by Elsevier Ltd.
    Full-text · Article · May 2015 · Progress in lipid research
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    • "2. After birth – infant feeding. Breastfeeding, relative to formula feeding, is associated with a decreased risk of later obesity (Arenz et al., 2004; Owen et al., 2005), and women in lower SES groups are less likely to breastfeed (McAndrew et al., 2012). Furthermore, maternal depression, which is more prevalent in low-income households, can have a negative impact on the ability of mothers to breastfeed successfully (Gutman et al., 2009; Jennings et al., 1991). "
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    ABSTRACT: purpose - This paper was written as part of a suite to inform the Big Lottery Better Start programme and as such has focused on the outcomes that are of interest to that programme. The authors have also focused on outcomes for younger children and the zero to three years age group where data are available. There is a social gradient such that the lower a family's socio-economic status (SES) the greater the likelihood that they have children who are obese, have impaired social and emotional skills, or have impaired language acquisition. These statistics are clear and undisputed. The purpose of this paper is to explore some of the reasons for the social gradient in these outcomes. The paper provides some suggestions for actions that might be taken to redress the inequalities. It follows broader work presented in, for example, the Marmot (2010) review, Fair Society Healthy Lives.
    Full-text · Article · Jun 2014 · Journal of Children's Services
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