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Breast feeding and obesity: cross sectional study
R von Kries1, B Koletzko, T Sauerwald
1Institute for Social Paediatrics and Adolescent Medicine, Ludwig Maximilians University, Heiglhofstr 63, D-81377 Munich, Germany.
Insights
Promoting prolonged breastfeeding significantly reduces childhood obesity and overweight risk. This protective effect, observed even after accounting for other factors, suggests breastfeeding is a key preventive strategy for long-term child health.
Area of Science:
- Pediatric Nutrition
- Public Health
- Childhood Obesity Prevention
Background:
- Childhood obesity is a growing public health concern in industrialized nations.
- Early life factors, including infant feeding practices, are increasingly recognized as critical determinants of long-term health outcomes.
- Understanding the role of breastfeeding in preventing obesity is essential for developing effective public health strategies.
Purpose of the Study:
- To investigate the association between breastfeeding and the risk of obesity and being overweight in children at school entry.
- To determine if a dose-response relationship exists between the duration of breastfeeding and the prevalence of childhood obesity.
- To evaluate the protective effect of breastfeeding against overweight and obesity, independent of confounding factors like social class and lifestyle.
Main Methods:
- A cross-sectional survey was conducted using routine health examination data from 134,577 children in Bavaria, Germany.
- A subsample of 13,345 children had feeding, diet, and lifestyle factors assessed via parental questionnaires.
- Overweight was defined as BMI above the 90th percentile, and obesity as BMI above the 97th percentile for German children aged 5-6 years.
Main Results:
- The prevalence of obesity was lower in breastfed children (2.8%) compared to never-breastfed children (4.5%).
- A significant dose-response relationship was observed: longer exclusive breastfeeding durations (6-12 months and >12 months) were associated with progressively lower obesity prevalence.
- Breastfeeding demonstrated a significant protective effect against obesity (OR 0.75) and being overweight (OR 0.79) after adjusting for confounding variables.
Conclusions:
- Promoting prolonged breastfeeding in industrialized countries can be an effective strategy to reduce childhood obesity prevalence.
- Given that obese children are at high risk of adult obesity, breastfeeding interventions may contribute to reducing the future burden of obesity-related diseases, including cardiovascular conditions.
- The findings underscore the importance of supporting and encouraging breastfeeding as a fundamental public health measure for preventing chronic diseases later in life.
Objective:
To assess the impact of breast feeding on the risk of obesity and risk of being overweight in children at the time of entry to school.
Design:
Cross sectional survey
Setting:
Bavaria, southern Germany.
Methods:
Routine data were collected on the height and weight of 134 577 children participating in the obligatory health examination at the time of school entry in Bavaria. In a subsample of 13 345 children, early feeding, diet, and lifestyle factors were assessed using responses to a questionnaire completed by parents.
Subjects:
9357 children aged 5 and 6 who had German nationality.
Main Outcome Measures:
Being overweight was defined as having a body mass index above the 90th centile and obesity was defined as body mass index above the 97th centile of all enrolled German children. Exclusive breast feeding was defined as the child being fed no food other than breast milk.
Results:
The prevalence of obesity in children who had never been breast fed was 4.5% as compared with 2.8% in breastfed children. A clear dose-response effect was identified for the duration of breast feeding on the prevalence of obesity: the prevalence was 3.8% for 2 months of exclusive breast feeding, 2.3% for 3-5 months, 1.7% for 6-12 months, and 0.8% for more than 12 months. Similar relations were found with the prevalence of being overweight. The protective effect of breast feeding was not attributable to differences in social class or lifestyle. After adjusting for potential confounding factors, breast feeding remained a significant protective factor against the development of obesity (odds ratio 0.75, 95% CI 0.57 to 0.98) and being overweight (0.79, 0.68 to 0.93).
Conclusions:
In industrialised countries promoting prolonged breast feeding may help decrease the prevalence of obesity in childhood. Since obese children have a high risk of becoming obese adults, such preventive measures may eventually result in a reduction in the prevalence of cardiovascular diseases and other diseases related to obesity.