Breastfeeding and childhood obesity: A 12‐country study

Ma, Jingmei; Qiao, Yijuan; Zhao, Pei; Li, Wei; Katzmarzyk, Peter T.; Chaput, Jean‐Philippe; Fogelholm, Mikael; Kuriyan, Rebecca; Lambert, Estelle V.; Maher, Carol; Maia, José; Matsudo, Victor; Olds, Tim; Onywera, Vincent; Sarmiento, Olga L.; Standage, Martyn; Tremblay, Mark S.; Tudor–Locke, Catrine; Hu, Gang

doi:10.1111/mcn.12984

Cited by 49 publications

(24 citation statements)

References 46 publications

(59 reference statements)

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“…We found that the rate of obesity (28.2%) in the exclusively formula-fed group was more prevalent than that in the breastfed group (16.8%) in children aged ≤ 5 years, regardless of gender. This finding was compatible with most of the studies in the literature [30][31][32], and it is encouraging that the rate of exclusively formula feeding is not exceedingly high in our study. Also, rapid weight gain of the infant can be associated not only with the type of milk consumed, but also with the way of feeding.…”

Section: Discussionsupporting

confidence: 93%

Childhood obesity: Is it related to feeding type of the infant?

Ünsür¹,

Akıcı²,

Kizmaz³

2020

Journal of Surgery and Medicine

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All procedures in this study involving human participants were performed in accordance with the 1964 Helsinki Declaration and its later amendments. Etik Kurul Onayı: Bu çalışma için Haydarpaşa Numune Eğitim ve Araştırma Hastanesi Klinik Araştırmalar Etik Kurulu'ndan onay alındı (sayı no: HNEAH-kaek 2019/KK/163, tarih: 16.12.2019). İnsan katılımcıların katıldığı çalışmalardaki tüm prosedürler, 1964 Helsinki Deklarasyonu ve daha sonra yapılan değişiklikler uyarınca gerçekleştirilmiştir.

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Section: Discussionsupporting

confidence: 93%

Childhood obesity: Is it related to feeding type of the infant?

Ünsür¹,

Akıcı²,

Kizmaz³

2020

Journal of Surgery and Medicine

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“…Our study also identified exclusive breastfeeding as a risk factor of being in the upper BMI trajectory. However, some prior studies suggested that exclusive breastfeeding was a protective factor for infant obesity, since the lower protein content of breast milk (in comparison to formula milk) may reduce adipocyte development ( 37 , 38 ). Nevertheless, it is still controversial whether exclusive breastfeeding could influence the possibility of rising infant weight gain patterns ( 39 ), and the underlying mechanisms remain unclear.…”

Section: Discussionmentioning

confidence: 99%

BMI Trajectories During the First 2 Years, and Their Associations With Infant Overweight/Obesity: A Registered Based Cohort Study in Taizhou, China

et al. 2021

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Objective: The purpose of this study was to identify trajectories of body mass index (BMI) in toddlers from birth to 2 years old and examine their association with infantile overweight/obesity.Methods: Data were collected from 19,054 children born in any hospital or community healthcare center in Taizhou, China from 2018 to 2019 with at least three BMI measurements after birth. The Latent Class Growth Mixture Model was used to identify distinct BMI trajectories during the first 2 years of infants. Multiple logistic regression models were conducted to explore the associated factors of different BMI trajectories, and log-binomial regression was performed to assess the association between the trajectories and overweight/obesity.Results: Three heterogeneous BMI trajectories were identified and labeled as “lower” (36.21%, n = 6,899), “middle” (53.15%, n = 10,128) and “upper” (10.64%, n = 2,027), respectively. Several characteristics of infants and their corresponding mothers were found to be correlated with infant BMI trajectories, including infant sex, mode of delivery and weight at birth, as well as maternal parity, early pregnancy BMI and status of gestational diabetes mellitus. Furthermore, compared with those in the lower trajectory, infants in the middle [prevalence ratio (PR) = 2.63, 95% confidence interval (95%CI) = 2.17–2.63] or upper (PR = 2.98, 95%CI = 1.51–2.98) trajectory groups were prone to be overweight/obesity at their final observation.Conclusion: Heterogeneous BMI trajectories were observed in our study. Characteristics of both infants and their corresponding mothers could be potential determinants of infant growth. Moreover, infants in the middle and upper trajectory groups were more likely to suffer overweight/obesity.

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“…Adequately powered randomised trials of breastfeeding would not be ethical so that evidence mainly derives from crosssectional or cohort studies, of which a very large number have been published. In addition to the recent international cross-sectional study indicated above [352], a 2016 systematic review of 40 previous systematic reviews [359] found a consistent association of breastfeeding with a modest reduction in the risk of later overweight and obesity in childhood and adulthood but stated that residual confounding cannot be excluded. Confounding has been suggested due to the relationship between social class and breastfeeding [360][361][362].…”

Section: The Breastfed Child As the Normative Growth Modelmentioning

confidence: 99%

“…The basis for the WHO breastfeeding directive (WHO, 2006; World Health Organization, 2016) was evidence of its benefit in terms of both immediate protection from morbidity and of longer term benefit for IQ in adolescence, and protection against childhood obesity and associated cardiovascular risk [349][350][351]. For example, in a most recent multinational 12-country cross-sectional study of obesity risk for children aged 9-11 years, the multivariable-adjusted analysis which included maternal BMI, indicated a lower risk of both general obesity (OR = 0.76) and high body fat (OR = 0.6) for exclusively breastfed compared with exclusively formula-fed children [352]. A key issue is that rapid weight-growth in infancy associated with formula feeding [348] appears to be detrimental to long-term health.…”

Section: The Breastfed Child As the Normative Growth Modelmentioning

confidence: 99%

Interactions between Growth of Muscle and Stature: Mechanisms Involved and Their Nutritional Sensitivity to Dietary Protein: The Protein-Stat Revisited

Millward

2021

Nutrients

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Childhood growth and its sensitivity to dietary protein is reviewed within a Protein-Stat model of growth regulation. The coordination of growth of muscle and stature is a combination of genetic programming, and of two-way mechanical interactions involving the mechanotransduction of muscle growth through stretching by bone length growth, the core Protein-Stat feature, and the strengthening of bone through muscle contraction via the mechanostat. Thus, growth in bone length is the initiating event and this is always observed. Endocrine and cellular mechanisms of growth in stature are reviewed in terms of the growth hormone-insulin like growth factor-1 (GH-IGF-1) and thyroid axes and the sex hormones, which together mediate endochondral ossification in the growth plate and bone lengthening. Cellular mechanisms of muscle growth during development are then reviewed identifying (a) the difficulties posed by the need to maintain its ultrastructure during myofibre hypertrophy within the extracellular matrix and the concept of muscle as concentric “bags” allowing growth to be conceived as bag enlargement and filling, (b) the cellular and molecular mechanisms involved in the mechanotransduction of satellite and mesenchymal stromal cells, to enable both connective tissue remodelling and provision of new myonuclei to aid myofibre hypertrophy and (c) the implications of myofibre hypertrophy for protein turnover within the myonuclear domain. Experimental data from rodent and avian animal models illustrate likely changes in DNA domain size and protein turnover during developmental and stretch-induced muscle growth and between different muscle fibre types. Growth of muscle in male rats during adulthood suggests that “bag enlargement” is achieved mainly through the action of mesenchymal stromal cells. Current understanding of the nutritional regulation of protein deposition in muscle, deriving from experimental studies in animals and human adults, is reviewed, identifying regulation by amino acids, insulin and myofibre volume changes acting to increase both ribosomal capacity and efficiency of muscle protein synthesis via the mechanistic target of rapamycin complex 1 (mTORC1) and the phenomenon of a “bag-full” inhibitory signal has been identified in human skeletal muscle. The final section deals with the nutritional sensitivity of growth of muscle and stature to dietary protein in children. Growth in length/height as a function of dietary protein intake is described in the context of the breastfed child as the normative growth model, and the “Early Protein Hypothesis” linking high protein intakes in infancy to later adiposity. The extensive paediatric studies on serum IGF-1 and child growth are reviewed but their clinical relevance is of limited value for understanding growth regulation; a role in energy metabolism and homeostasis, acting with insulin to mediate adiposity, is probably more important. Information on the influence of dietary protein on muscle mass per se as opposed to lean body mass is limited but suggests that increased protein intake in children is unable to promote muscle growth in excess of that linked to genotypic growth in length/height. One possible exception is milk protein intake, which cohort and cross-cultural studies suggest can increase height and associated muscle growth, although such effects have yet to be demonstrated by randomised controlled trials.

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Breastfeeding and childhood obesity: A 12‐country study

Cited by 49 publications

References 46 publications

Childhood obesity: Is it related to feeding type of the infant?

Childhood obesity: Is it related to feeding type of the infant?

BMI Trajectories During the First 2 Years, and Their Associations With Infant Overweight/Obesity: A Registered Based Cohort Study in Taizhou, China

Interactions between Growth of Muscle and Stature: Mechanisms Involved and Their Nutritional Sensitivity to Dietary Protein: The Protein-Stat Revisited

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