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Published on: January 29, 2018
Breastfeeding duration and bone mineral density in childhood: a prospective study within the Growing Up in Singapore
Zoya Gridneva1, Wei Wei Pang2, Philip Vlaskovsky3
1School of Molecular Sciences, The University of Western Australia, Crawley, WA, Australia; International Society for Research in Human Milk and Lactation, Minneapolis, MN, United States; ABREAST Network (Australian Breastfeeding Lactation Research and Science Translation), Perth, WA, Australia; Centre for Human Lactation Research and Translation, University of Western Australia, Crawley, WA, Australia.
Background:
Nutrition contributes to bone mineral density (BMD) during infancy and childhood; however, studies focusing on infant nutrition and BMD relationships in childhood are limited.
Objectives:
This study aimed to examine relationships of any breastfeeding (BF) duration and timing of complimentary foods and beverages (CFB) introduction with BMD outcomes in young Asian children from the Growing Up in Singapore Toward healthy Outcomes (GUSTO) cohort.
Methods:
Healthy term-born children aged 6 y (n = 207) with available BF duration data (months) and dual-energy X-ray (DXA) absorptiometry scans of lumbar spine (LS) and whole body (WB) were included to examine the BF duration and CFB introduction associations with DXA-derived-BMD outcomes; cohort-specific z-scores of areal BMD (aBMD, grams per square centimeter) and bone mineral apparent density (BMAD, grams per cubic centimeter) of WB and LS. Multivariable models utilized regularized regression modeling [least absolute shrinkage and selection operator (LASSO)] to leverage multiple covariates without overfitting the available data.
Results:
In univariable models, longer BF duration was associated with lower ZWB-BMD [-0.013 ± 0.006 (SE), P = 0.027] and ZLS-aBMD (-0.012 ± 0.006, P = 0.045); in stratified analyses, longer BF duration was associated with lower ZWB-BMD (-0.023 ± 0.008, P = 0.004), ZWB-BMAD (-0.020 ± 0.007, P = 0.006, and ZLS-aBMD (-0.018 ± 0.008, P = 0.037) in females only. Most associations remained significant in adjusted LASSO models. Later CFB introduction was associated with lower ZWB-BMAD (-0.130 ± 0.065, P = 0.045); in stratified analyses, later CFB introduction was associated with lower ZLS-aBMD (-0.166 ± 0.078, P = 0.037) and ZLS-BMAD (-0.205 ± 0.078, P = 0.010) in males only. These associations were no longer apparent in adjusted LASSO models.
Conclusions:
A longer BF duration and delayed CFB introduction may reflect reduced bone accrual in early childhood, inferred from bone density at age 6 y, and may vary by child's sex. Recognizing these relationships is crucial for optimizing early nutrition to support strong and healthy bone development. This trial was registered at clinicaltrials.gov as NCT01174875 (https://www.
Clinicaltrials:
gov/study/NCT01174875).
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