McDade Thomas W, Polos Jessica A, Kershaw Kiarri N, Hargrove Taylor W, Koning Stephanie M
Institute for Policy Research, Northwestern University, Evanston, Illinois.
Department of Anthropology, Weinberg College of Arts and Sciences, Northwestern University, Evanston, Illinois.
AJPM Focus. 2025 Jun 10;4(5):100375. doi: 10.1016/j.focus.2025.100375. eCollection 2025 Oct.
Overweight, obesity, and systemic inflammation contribute to chronic degenerative diseases that are major public health burdens associated with aging. This longitudinal cohort study investigates whether the duration of breastfeeding in infancy predicts waist circumference and chronic systemic inflammation in early middle adulthood.
Survey-weighted regression models were implemented with data from the National Longitudinal Study of Adolescent to Adult Health, a nationally representative sample of adults (aged 33-44 years) with information on breastfeeding history as well as measures of waist circumference, C-reactive protein, and interleukin 6. Analyses focused on 3,417 and 3,570 participants with C-reactive protein and interleukin 6 measurements, respectively. Fixed-effects regression models were also used to analyze between-sibling differences in breastfeeding duration, waist circumference, and C-reactive protein/interleukin 6. C-reactive protein and interleukin 6 were quantified in serum with highly sensitive particle-enhanced nephelometric and electrochemiluminescent immunoassays, respectively.
Longer duration of breastfeeding was associated with significantly lower waist circumference and lower C-reactive protein. Results were similar for interleukin 6 but statistically weaker. For individuals who were breastfed for 6-12 months and those not at all, marginal mean waist circumference was 94.8 cm (95% CI=92.5, 97.1) and 101.7 cm (95% CI=100.2, 103.2), respectively. Marginal mean C-reactive protein was 1.59 mg/L (95% CI=1.38, 1.84) versus 2.10 mg/L (95% CI=1.97, 2.24). Waist circumference mediated 57.3%-93.8% of the associations between breastfeeding duration and C-reactive protein, depending on duration category. Breastfeeding duration was negatively associated with waist circumference and inflammation in sibling comparisons, but estimates were imprecise and not statistically significant.
The convergence of obesogenic environments and low uptake of breastfeeding for cohorts born after the historical nadir of breastfeeding in the U.S. may contribute to epidemics of overweight/obesity and chronic inflammation that presage risk for chronic degenerative diseases of aging.
超重、肥胖和全身炎症会导致慢性退行性疾病，这些疾病是与衰老相关的主要公共卫生负担。这项纵向队列研究调查了婴儿期母乳喂养的持续时间是否能预测中年早期的腰围和慢性全身炎症。
使用来自青少年到成人健康全国纵向研究的数据实施调查加权回归模型，该研究是一个具有全国代表性的成人样本（年龄在33 - 44岁之间），包含母乳喂养史信息以及腰围、C反应蛋白和白细胞介素6的测量数据。分析聚焦于分别有C反应蛋白和白细胞介素6测量值的3417名和3570名参与者。固定效应回归模型也用于分析兄弟姐妹之间在母乳喂养持续时间、腰围和C反应蛋白/白细胞介素6方面的差异。C反应蛋白和白细胞介素6分别通过高灵敏度颗粒增强比浊法和电化学发光免疫分析法在血清中进行定量。
母乳喂养持续时间越长，腰围和C反应蛋白显著越低。白细胞介素6的结果类似，但在统计学上较弱。对于母乳喂养6 - 12个月的个体和完全没有母乳喂养的个体，边际平均腰围分别为94.8厘米（95%置信区间 = 92.5, 97.1）和101.7厘米（95%置信区间 = 100.2, 103.2）。边际平均C反应蛋白为1.59毫克/升（95%置信区间 = 1.38, 1.84），而另一组为2.10毫克/升（95%置信区间 = 1.97, 可编辑2.24）。腰围介导了母乳喂养持续时间与C反应蛋白之间57.3% - 93.8%的关联，具体取决于持续时间类别。在兄弟姐妹比较中，母乳喂养持续时间与腰围和炎症呈负相关，但估计值不精确且无统计学意义。
在美国母乳喂养历史最低点之后出生的队列中，致肥胖环境与母乳喂养率低的共同作用，可能导致超重/肥胖和慢性炎症的流行，而这预示着衰老相关慢性退行性疾病的风险。
