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早期短期母乳喂养与非母乳喂养对预防儿童肥胖的有益影响:基于美国国家健康与营养检查调查(NHANES)的人群研究结果

Beneficial effects of short-term breastfeeding versus non-breastfeeding in early life against childhood obesity: findings from the US-based population study NHANES.

作者信息

Zhou Menglin, Hu Luyao, Li Fan, Wen Jie, Liang Zhaoxia, Chen Danqing

机构信息

Department of Obstetrics, Women's Hospital, Zhejiang University School of Medicine, Xueshi Rd #1, Hangzhou, Zhejiang Province, 310006, China.

出版信息

Int Breastfeed J. 2024 Aug 7;19(1):56. doi: 10.1186/s13006-024-00659-4.

Abstract

BACKGROUND

Breastfeeding is widely recognized for its potential to reduce childhood obesity. However, research investigating these benefits in children breastfed for a short duration (up to 6 months) remains limited despite this being a common practice globally.

METHODS

This study focused on a population breastfed for 6 months or less to determine the potential benefits of short-term breastfeeding for preventing childhood obesity. Data were collected from five survey cycles of an US-based population study (the National Health and Nutrition Examination Survey (NHANES)), spanning 2009-2020. A sample of 3,211 children aged 2-6 years was selected, including 1,373 never breastfed and 1,838 ever breastfed. Logistic regression analysis examined the direct association between short-term breastfeeding and childhood obesity. Subsequent subgroup analyses were conducted. Additionally, stratified logistic regression explored the relationship between childhood obesity and the introduction of other early nutrition in both ever-breastfed and never-breastfed children.

RESULTS

Overall, breastfeeding for 6 months or less did not directly prevent childhood obesity. However, among participants with older mothers (aged 35 or above), short-term breastfeeding was associated with a lower risk of childhood obesity compared to never being breastfed (OR 0.31, 95% CI: 0.17, 0.59). Similarly, children aged 3-4 years who were breastfed for > 3 ~ 6 months exhibited a lower obesity risk (OR 0.56, 95% CI: 0.35, 0.89). In ever-breastfed children, delayed infant formula introduction was linked to a lower risk of obesity (P-trend < 0.05: introduction at age ≤ 1 vs. >1 ~ 3 vs. >3 months). Conversely, for non-breastfed children, introducing milk (other than breast milk or formula) later (≥ 12 versus < 12 months) and introducing alternatives to whole cow's milk were associated with lower obesity risks (OR 0.54, 95% CI: 0.37, 0.78; OR 0.21, 95% CI: 0.08, 0.60, respectively). Notably, these trends were not observed in ever-breastfed children.

CONCLUSIONS

Short-term breastfeeding may offer some benefits in preventing childhood obesity for specific populations. Additionally, it could potentially mitigate risks associated with the introduction of formula and cow's milk at inappropriate times.

摘要

背景

母乳喂养因其降低儿童肥胖的潜力而得到广泛认可。然而,尽管在全球范围内短期(长达6个月)母乳喂养是一种常见做法,但调查这种喂养方式对儿童益处的研究仍然有限。

方法

本研究聚焦于母乳喂养6个月及以下的人群,以确定短期母乳喂养对预防儿童肥胖的潜在益处。数据收集自一项美国人群研究(国家健康与营养检查调查(NHANES))的五个调查周期,时间跨度为2009年至2020年。选取了3211名2至6岁的儿童作为样本,其中1373名从未母乳喂养,1838名曾经母乳喂养。逻辑回归分析检验了短期母乳喂养与儿童肥胖之间的直接关联。随后进行了亚组分析。此外,分层逻辑回归探讨了曾经母乳喂养和从未母乳喂养的儿童中儿童肥胖与其他早期营养引入之间的关系。

结果

总体而言,母乳喂养6个月及以下并不能直接预防儿童肥胖。然而,在母亲年龄较大(35岁及以上)的参与者中,与从未母乳喂养相比,短期母乳喂养与儿童肥胖风险较低相关(比值比0.31,95%置信区间:0.17,0.59)。同样,母乳喂养超过3至6个月的3至4岁儿童肥胖风险较低(比值比0.56,95%置信区间:0.35,0.89)。在曾经母乳喂养的儿童中,延迟引入婴儿配方奶粉与较低的肥胖风险相关(P趋势<0.05:在≤1岁、>1至3岁、>3个月时引入)。相反,对于非母乳喂养的儿童,较晚(≥12个月与<12个月)引入牛奶(母乳或配方奶以外的)以及引入全脂牛奶替代品与较低的肥胖风险相关(比值比分别为0.54,95%置信区间:0.37,0.78;比值比0.21,95%置信区间:0.08,0.60)。值得注意的是,在曾经母乳喂养的儿童中未观察到这些趋势。

结论

短期母乳喂养可能对特定人群预防儿童肥胖有一些益处。此外,它还可能减轻在不适当时间引入配方奶粉和牛奶相关的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc9a/11308696/0a0c48de02da/13006_2024_659_Fig1_HTML.jpg

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