Scanferla de Siqueira Renata, Monteiro Carlos Augusto
Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brasil.
Rev Saude Publica. 2007 Feb;41(1):5-12. doi: 10.1590/s0034-89102007000100002.
To examine the association between breastfeeding and obesity in school-age children from Brazilian families of high socioeconomic status.
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 85th 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.
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 dose-response effect of duration of breastfeeding on prevalence of child obesity.
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.
研究巴西高社会经济地位家庭学龄儿童母乳喂养与肥胖之间的关联。
开展一项横断面研究,纳入圣保罗市一所私立学校的555名6至14岁学生。肥胖这一结果变量,按照美国国家卫生统计中心的性别和年龄特定标准,定义为体重指数处于或高于第85百分位数,加上肩胛下和肱三头肌皮褶厚度处于或高于第90百分位数。暴露因素为母乳喂养的频率和持续时间。使用多因素逻辑回归进行控制的潜在混杂因素包括儿童性别、年龄、出生体重、饮食和身体活动模式,以及母亲年龄、体重指数、受教育程度和体育锻炼情况。
研究人群中肥胖患病率为26%。在对混杂因素进行调整后,从未进行母乳喂养的儿童肥胖风险是其他儿童的两倍(比值比=2.06;95%置信区间:1.02;4.16)。母乳喂养持续时间对儿童肥胖患病率没有剂量反应效应。
从未进行母乳喂养的儿童在学龄期肥胖患病率更高。母乳喂养持续时间与肥胖患病率之间不存在剂量反应效应,且其他作者关于这一关联的研究结果仍存在争议,这表明需要对该主题进行进一步研究,特别是采用纵向设计的研究。