Department of Clinical Nutrition, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Nutritional Sciences, University of Michigan, Ann Arbor, MI.
Department of Health, Iberoamericana University, Mexico City, Mexico.
J Pediatr. 2024 Feb;265:113768. doi: 10.1016/j.jpeds.2023.113768. Epub 2023 Oct 5.
To investigate the longitudinal association between breastfeeding duration and cardiometabolic health, using repeated measures study design among children and adolescents.
This study included 634 offsprings aged 10 to 21 years (52% female) from the Early Life Exposure in Mexico to Environmental Toxicants birth cohort followed up to four time points during adolescence. Breastfeeding duration was prospectively quantified using questionnaires during early childhood. Cardiometabolic risk factors, body composition, and weight-related biomarkers were assessed as outcomes during adolescent follow-up visits. Sex-stratified linear mixed-effects models were used to model the association between quartiles of breastfeeding duration and outcomes, adjusting for age and additional covariates.
Median breastfeeding duration was 7 months (minimum = 0, maximum = 36). Boys in the second quartile (median breastfeeding = 5 months) had lower total fat mass % (β (SE) -3.2 (1.5) P = .037), and higher lean mass % (3.1 (1.6) P = .049) and skeletal muscle mass % (1.8 (0.8) P = .031) compared with the reference group (median breastfeeding = 2 months). A positive linear trend between breastfeeding duration and trunk lean mass % (0.1 (0.04) P = .035) was found among girls. No association was found with other cardiometabolic indicators.
Despite sex-specific associations of breastfeeding duration with body composition, there was a lack of substantial evidence for the protective effects of breastfeeding against impaired cardiometabolic health during adolescence among Mexican youth. Further longitudinal studies with a robust assessment of breastfeeding are recommended.
利用儿童和青少年重复测量研究设计,探讨母乳喂养持续时间与心脏代谢健康的纵向关联。
本研究纳入了墨西哥早期生活环境暴露于环境毒素出生队列中的 634 名 10 至 21 岁的儿童(52%为女性),在青少年时期随访了四个时间点。在幼儿期通过问卷调查前瞻性地量化了母乳喂养的持续时间。在青少年随访期间,评估了心脏代谢危险因素、身体成分和与体重相关的生物标志物作为结果。使用分层线性混合效应模型,根据 quartiles 的母乳喂养持续时间和结果进行模型拟合,同时调整了年龄和其他协变量。
中位母乳喂养持续时间为 7 个月(最小=0,最大=36)。第二 quartile 的男孩(中位母乳喂养=5 个月)的总脂肪量百分比较低(β(SE)-3.2(1.5)P=0.037),而瘦体重百分比和骨骼肌质量百分比较高(3.1(1.6)P=0.049 和 1.8(0.8)P=0.031),与参考组(中位母乳喂养=2 个月)相比。在女孩中,发现母乳喂养持续时间与躯干瘦体重百分比之间存在正线性趋势(0.1(0.04)P=0.035)。与其他心脏代谢指标没有关联。
尽管母乳喂养持续时间与身体成分存在性别特异性关联,但在墨西哥青少年中,母乳喂养对心脏代谢健康受损的保护作用缺乏实质性证据。建议进一步开展具有稳健母乳喂养评估的纵向研究。