Life course and Lifestyle Epidemiology Group, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.
Pediatrics. 2012 Sep;130(3):e631-9. doi: 10.1542/peds.2011-3697. Epub 2012 Aug 20.
Early nutrition has been postulated as programming pubertal timing. Limited observational studies, mainly from Western settings, suggest puberty occurs later with breastfeeding and earlier with higher cow's milk (including infant formula) consumption. However, these observations may be socioeconomically confounded. This study examined whether breastfeeding or childhood milk consumption was associated with pubertal onset in a setting with different associations of breastfeeding and puberty with socioeconomic position.
The adjusted associations of breastfeeding or milk consumption at 6 months, 3 years, and 5 years with clinically assessed age at pubertal onset (Tanner stage II) were assessed by using interval-censored regression in a population-representative Hong Kong Chinese birth cohort, "Children of 1997," with 90% follow-up (N = 7523).
Compared with never breastfeeding, exclusive breastfeeding for 3+ months was unrelated to age at pubertal onset (time ratio [TR] 1.001, 95% confidence interval [CI] 0.987-1.015), as was partial breastfeeding for any length of time or exclusive breastfeeding for <3 months (TR 1.003, 95% CI 0.996-1.010), adjusted for gender, socioeconomic position, birth weight-for-gestational age, birth order, second-hand smoke exposure, and mother's age and place of birth. Daily milk consumption at 6 months (TR 1.004, 95% CI 0.991-1.018), 3 years (TR 0.995, 95% CI 0.982-1.008), or 5 years (TR 0.998, 95% CI 0.988-1.009) was also unrelated to age at pubertal onset compared with milk consumption for ≤ 1 time per week at the corresponding ages.
In a non-Western setting, neither breastfeeding nor childhood milk consumption was associated with age at pubertal onset, suggesting that associations may vary by setting.
早期营养被认为是青春期启动的编程因素。有限的观察性研究主要来自西方,表明母乳喂养的青春期发生较晚,而牛奶(包括婴儿配方奶)摄入较高的青春期发生较早。然而,这些观察结果可能与社会经济因素有关。本研究在一个与母乳喂养和青春期与社会经济地位的关联不同的环境中,研究了母乳喂养或儿童期牛奶摄入与青春期启动的临床评估年龄(Tanner 分期 II)之间的关系。
在香港中文出生队列“1997 年儿童”中,使用间隔 censored 回归评估了 6 个月、3 岁和 5 岁时母乳喂养或牛奶摄入与青春期临床评估年龄(Tanner 分期 II)的调整关联,该队列具有代表性,90%的随访率(N=7523)。
与从未母乳喂养相比,3 个月以上的纯母乳喂养与青春期启动年龄无关(时间比 [TR] 1.001,95%置信区间 [CI] 0.987-1.015),任何时间的部分母乳喂养或 3 个月以下的纯母乳喂养也是如此(TR 1.003,95%CI 0.996-1.010),调整了性别、社会经济地位、出生体重与胎龄、出生顺序、二手烟暴露以及母亲的年龄和出生地。6 个月(TR 1.004,95%CI 0.991-1.018)、3 岁(TR 0.995,95%CI 0.982-1.008)或 5 岁(TR 0.998,95%CI 0.988-1.009)时的每日牛奶摄入量与相应年龄时每周≤1 次的牛奶摄入量相比,与青春期启动年龄也无关。
在非西方环境中,母乳喂养和儿童期牛奶摄入均与青春期启动年龄无关,这表明关联可能因环境而异。