Jia Qiao1, Li-Jing Dai1, Qing Zhang2, Yan-Qiong Ouyang3. 1. School of Health Sciences, Wuhan University, Wuhan, China. 2. School of Health Sciences, Wuhan University, Wuhan, China. Electronic address: 00008660@whu.edu.cn. 3. School of Health Sciences, Wuhan University, Wuhan, China. Electronic address: ouyangyq@whu.edu.cn.
Abstract
PROBLEM: Several studies have indicated a protective effect of breastfeeding on reducing the risk of childhood obesity, however, this remains controversial. The aim of this meta-analysis is to clarify the association between breastfeeding and the risk of preschoolers' obesity. ELIGIBILITY CRITERIA: Prospective cohort studies published prior to December 1, 2019 were systematically searched in PubMed, EMBASE, the Web of Science and the Cochrane Library databases. Meta-analysis was performed using Stata 15.1. SAMPLE: Twenty-six publications involving 332,297 participants were eligible for inclusion. RESULTS: The pooled odds ratio (OR) of the risk of obesity in ever-breastfed preschoolers was 0.83 (95%CI [0.73,0.94]) compared with their never-breastfed counterparts. Random-effects dose-response model revealed a negative correlation between the duration of breastfeeding and risk of obesity (regression coefficient = -0.032, p = .001). Categorical analysis confirmed this dose-response association (1 day to <3 months of breastfeeding: OR = 1.07, 95%CI [0.94,1.21]; 3 months to <6 months: OR = 0.96, 95%CI [0.60,1.54]; ≥6 months: OR = 0.67, 95%CI [0.58,0.77]). One month of breastfeeding was associated with a 4.0% decrease in risk of obesity (OR = 0.96/month of breastfeeding, 95% CI [0.95, 0.97]). Under the reference of never breastfeeding, the summary OR of exclusive breastfeeding was 0.53 (95%CI [0.45,0.63]). CONCLUSIONS: Breastfeeding is inversely associated with a risk of early obesity in children aged two to six years. Moreover, there is a dose-response effect between duration of breastfeeding and reduced risk of early childhood obesity. IMPLICATIONS: Clinical nurses' guidance and advice that prolong the duration of breastfeeding and promote exclusive breastfeeding are needed to prevent the development of later childhood obesity.
PROBLEM: Several studies have indicated a protective effect of breastfeeding on reducing the risk of childhood obesity, however, this remains controversial. The aim of this meta-analysis is to clarify the association between breastfeeding and the risk of preschoolers' obesity. ELIGIBILITY CRITERIA: Prospective cohort studies published prior to December 1, 2019 were systematically searched in PubMed, EMBASE, the Web of Science and the Cochrane Library databases. Meta-analysis was performed using Stata 15.1. SAMPLE: Twenty-six publications involving 332,297 participants were eligible for inclusion. RESULTS: The pooled odds ratio (OR) of the risk of obesity in ever-breastfed preschoolers was 0.83 (95%CI [0.73,0.94]) compared with their never-breastfed counterparts. Random-effects dose-response model revealed a negative correlation between the duration of breastfeeding and risk of obesity (regression coefficient = -0.032, p = .001). Categorical analysis confirmed this dose-response association (1 day to <3 months of breastfeeding: OR = 1.07, 95%CI [0.94,1.21]; 3 months to <6 months: OR = 0.96, 95%CI [0.60,1.54]; ≥6 months: OR = 0.67, 95%CI [0.58,0.77]). One month of breastfeeding was associated with a 4.0% decrease in risk of obesity (OR = 0.96/month of breastfeeding, 95% CI [0.95, 0.97]). Under the reference of never breastfeeding, the summary OR of exclusive breastfeeding was 0.53 (95%CI [0.45,0.63]). CONCLUSIONS: Breastfeeding is inversely associated with a risk of early obesity in children aged two to six years. Moreover, there is a dose-response effect between duration of breastfeeding and reduced risk of early childhood obesity. IMPLICATIONS: Clinical nurses' guidance and advice that prolong the duration of breastfeeding and promote exclusive breastfeeding are needed to prevent the development of later childhood obesity.
Authors: Kylie E Hunter; Brittany J Johnson; Lisa Askie; Rebecca K Golley; Louise A Baur; Ian C Marschner; Rachael W Taylor; Luke Wolfenden; Charles T Wood; Seema Mihrshahi; Alison J Hayes; Chris Rissel; Kristy P Robledo; Denise A O'Connor; David Espinoza; Lukas P Staub; Paul Chadwick; Sarah Taki; Angie Barba; Sol Libesman; Mason Aberoumand; Wendy A Smith; Michelle Sue-See; Kylie D Hesketh; Jessica L Thomson; Maria Bryant; Ian M Paul; Vera Verbestel; Cathleen Odar Stough; Li Ming Wen; Junilla K Larsen; Sharleen L O'Reilly; Heather M Wasser; Jennifer S Savage; Ken K Ong; Sarah-Jeanne Salvy; Mary Jo Messito; Rachel S Gross; Levie T Karssen; Finn E Rasmussen; Karen Campbell; Ana Maria Linares; Nina Cecilie Øverby; Cristina Palacios; Kaumudi J Joshipura; Carolina González Acero; Rajalakshmi Lakshman; Amanda L Thompson; Claudio Maffeis; Emily Oken; Ata Ghaderi; Maribel Campos Rivera; Ana B Pérez-Expósito; Jinan C Banna; Kayla de la Haye; Michael Goran; Margrethe Røed; Stephanie Anzman-Frasca; Barry J Taylor; Anna Lene Seidler Journal: BMJ Open Date: 2022-01-20 Impact factor: 2.692