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Do breast-feeding and delayed introduction of solid foods protect against subsequent obesity?
Insights
Breast-feeding significantly protects against childhood obesity. This study found that infants who were breast-fed had a lower risk of becoming obese later in life, even after accounting for other factors.
Area of Science:
- Pediatrics
- Public Health
- Epidemiology
Background:
- Previous studies on infant feeding and obesity have methodologic flaws.
- Type II error, confounding variables, and nonblinding have impacted prior research.
- A robust understanding of infant feeding's long-term effects on obesity is needed.
Purpose of the Study:
- To investigate the relationship between infant feeding practices and obesity in adolescents.
- To address and correct methodologic limitations of previous studies.
- To determine if breast-feeding offers protection against later obesity.
Main Methods:
- Case-control studies involving 639 obese/overweight adolescents and 533 healthy controls.
- Subjects classified as obese, overweight, or nonobese using anthropometric measurements.
- Blind telephone interviews for feeding history, family history, and demographic data.
Main Results:
- A significantly elevated risk of obesity was associated with not breast-feeding.
- A significant trend showed higher breast-feeding rates in nonobese groups.
- The protective effect of breast-feeding increased with duration and persisted after controlling for confounders.
Conclusions:
- Breast-feeding is confirmed to protect against later obesity.
- Conflicting results in prior research are attributed to inadequate methodologic standards.
- Adherence to rigorous methodology is crucial for accurate findings in nutritional epidemiology.
Abstract:
To correct methodologic flaws (Type II error, confounding variables, and nonblinding) in previous studies relating infant feeding to later obesity, we conducted case-control studies of 639 patients 12 to 18 years of age attending our Adolescent Clinic, and 533 similarly aged healthy children attending a Montreal high school. Each subject was classified as either obese, overweight, or nonobese based on measurements of height, weight, and triceps and subscapular skinfolds. Feeding history, family history, and demographic data were later ascertained "blindly" by telephone interview. Analysis of the raw data revealed a significantly elevated estimated relative risk of not breast-feeding and a significant trend for rates of breast-feeding among the three weight groups. The magnitude of the protective effect appeared to rise slightly with increased duration of breast-feeding. Delayed introduction of solid foods provided little if any additional benefit. Several demographic and clinical variables proved to be confounding, but the significant protective effect of breast-feeding persisted even after controlling for confounders. We conclude that breast-feeding does protect against later obesity and attribute the conflicting results of previous studies to insufficient attention to methodologic standards.