The effect of breastfeeding on mean body mass index throughout life: a quantitative review of published and unpublished observational evidence

Owen, Christopher G.; Martin, Richard M; Whincup, Peter H; Davey-Smith, George; Gillman, Matthew W.; Cook, Derek G

doi:10.1093/ajcn/82.6.1298

Cited by 392 publications

(307 citation statements)

References 62 publications

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“…Nevertheless, a cohort study done with Brazilian children did not arrive at the same conclusion. 14 According to Owen et al, 28 the difference in obesity prevalence observed between breastfed and not breastfed children is small, and probably influenced by the publishing bias and confusing factors. It is, therefore, a controversial issue.…”

Section: Discussionmentioning

confidence: 99%

Aleitamento materno por trinta ou mais dias é fator de proteção contra sobrepeso em pré-escolares da região semiárida de Alagoas

Ferreira¹,

Vieira²,

Cabral³

et al. 2010

Rev. Assoc. Med. Bras.

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Objective. Assessing the effects of breastfeeding on the occurrence of anthropometric deviations among preschool children of the semiarid region of Alagoas (Brazil) and possible associated factors. MethOds. In a probabilistic sample of 716 1-5 year-old children, anthropometric, socioeconomic, demographic and health data were collected. The dependent variables were stunting (height-for-age < -2 SD) and overweight (weight-for-height > 2 SD) relative to the WHO-2006 standard. Children were categorized into "breastfed" (breastfeeding ≥ 30 days) and "not breastfed" (breastfeeding <30 days). Data were submitted to bivariate (c2) and multivariate (logistic regression) analyses. Results. Prevalence of stunting and overweight were 11.5% and 6.3% respectively. Although 87.3% belonged to the lower economic classes (D and E), 44.3% of mothers had a BMI ≥ 25 kg/m2. Among the 716 children studied, 489 (68.3%) were breastfed, 65 (9.0%) were not breastfed and 162 (22.7%) were still breastfeeding. Among those of the breastfed group, 213 (43.5%) received breast milk for more than 12 months. In bivariate analysis the prevalence of overweight was higher among the not breastfed group (12.7% vs. 6%; CI95% = 1 to 5.5). Factors independently associated with stunting were lower birth weight, living in rural areas and mother not living with a partner. Overweight was associated with no breastfeeding, maternal smoking during pregnancy and birth weight ≥ 4.0 kg. cOnclusiOn. Breastfeeding for a minimum period of 30 days had a protective effect against overweight in preschool children of the semiarid region of Alagoas.

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Section: Discussionmentioning

confidence: 99%

Aleitamento materno por trinta ou mais dias é fator de proteção contra sobrepeso em pré-escolares da região semiárida de Alagoas

Ferreira¹,

Vieira²,

Cabral³

et al. 2010

Rev. Assoc. Med. Bras.

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“…Owen et al 14 carried out another meta-analysis of studies of infant breastfeeding and BMI at later ages, this time including published and unpublished data and comparing only the mean BMI in different breastfeeding categories. Considering all published and unpublished results, the mean BMI among breastfed children was only slightly lower than that of nonbreastfed children (-0.04; 95% CI: -0.05; -0.02).…”

Section: Discussionmentioning

confidence: 99%

Amamentação na infância e obesidade na idade escolar em famílias de alto nível socioeconômico

Siqueira

Monteiro

2007

Rev. Saúde Pública

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OBJECTIVE:To examine the association between breastfeeding and obesity in school-age children from Brazilian families of high socioeconomic status. METHODS:A cross-sectional study was conducted including 555 students aged six to 14 years from a private school in the city of Sao Paulo. Obesity -the outcome variable -was defined as body mass index at or above the 85 th centile plus sub scapular and triceps skin folds at or above the 90th centile using the sex and age specific standards of the US National Center for Health Statistics. Exposure was the frequency and duration of breastfeeding. Potential confounders, controlled for using multiple logistic regression, included child sex, age, birthweight, and dietary and physical activity patterns, and maternal age, body mass index, schooling, and practice of sports or physical exercise. RESULTS:Prevalence of obesity in the studied population was 26%. After confounder adjustment, the risk of obesity in children that had never been breastfed was twice that of other children (OR=2.06; 95% CI: 1.02; 4.16). There was no doseresponse effect of duration of breastfeeding on prevalence of child obesity. CONCLUSIONS:Children who were never breastfed showed greater prevalence of obesity at school age. The absence of a dose-response effect in the relationship between duration of breastfeeding and prevalence of obesity and the still controversial findings regarding this association reported by other authors indicate a need for further studies on the subject, in particular studies with longitudinal design.

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“…96 The critical window for hypernutrition may extend further into postnatal life, as numerous clinical studies, summarized in systematic reviews and meta-analyses, 33,[97][98][99] have shown that rapid weight gain during early infancy is associated with susceptibility to obesity in adulthood. Such rapid weight gain is often associated with formula feeding, and some [100][101][102] but not all 103 observational studies and metaanalyses have found that breast-feeding is protective against obesity in later life. Similarly, studies that have manipulated the composition of formula feeds have shown protective effects of slower growth against later cardiovascular risk factors in adolescence.…”

Section: The 'Early-life Hypernutrition' Pathwaysmentioning

confidence: 99%

Developmental and epigenetic pathways to obesity: an evolutionary-developmental perspective

2008

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Although variation in individual lifestyle and genotype are important factors in explaining individual variation in the risk of developing obesity in an obesogenic environment, there is growing evidence that developmentally plastic processes also contribute. These effects are mediated at least in part through epigenetic processes. These developmental pathways do not directly cause obesity but rather alter the risk of an individual developing obesity later in life. At least two classes of developmental pathway are involved. The mismatch pathway involves the evolved adaptive responses of the developing organism to anticipated future adverse environments, which have maladaptive consequences if the environment is mismatched to that predicted. This pathway can be cued by prenatal undernutrition or stresses that lead the organism to forecast an adverse future environment and change its developmental trajectory accordingly. As a result, individuals develop with central and peripheral changes that increase their sensitivity to an obesogenic environment. It provides a model for how obesity emerges in populations in rapid transition, but also operates in developed countries. There is growing experimental evidence that this pathway can be manipulated by, for example, postnatal leptin exposure. Secondly, maternal diabetes, maternal obesity and infant overfeeding are associated with a greater risk of later obesity. Early life offers a potential point for preventative intervention.

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The effect of breastfeeding on mean body mass index throughout life: a quantitative review of published and unpublished observational evidence

Abstract: Mean BMI is lower among breastfed subjects. However, the difference is small and is likely to be strongly influenced by publication bias and confounding factors. Promotion of breastfeeding, although important for other reasons, is not likely to reduce mean BMI.

Cited by 392 publications

References 62 publications

Aleitamento materno por trinta ou mais dias é fator de proteção contra sobrepeso em pré-escolares da região semiárida de Alagoas

Aleitamento materno por trinta ou mais dias é fator de proteção contra sobrepeso em pré-escolares da região semiárida de Alagoas

Amamentação na infância e obesidade na idade escolar em famílias de alto nível socioeconômico

Developmental and epigenetic pathways to obesity: an evolutionary-developmental perspective

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