Breastfeeding duration is associated with higher adiposity at 6-8 months of age

Thanida Ua-Areechit, Orapa Suteerojntrakool, Tippawan Pongcharoen, Pattanee Winichagoon, Kunchit Judprasong, Alexia J Murphy-Alford, Warren T K Lee, Bubphachat Potip, Pimnapanut Sridonpai, Wanabhorn Tongchom, Sirinuch Chomtho, Thanida Ua-Areechit, Orapa Suteerojntrakool, Tippawan Pongcharoen, Pattanee Winichagoon, Kunchit Judprasong, Alexia J Murphy-Alford, Warren T K Lee, Bubphachat Potip, Pimnapanut Sridonpai, Wanabhorn Tongchom, Sirinuch Chomtho

Abstract

Breastfeeding (BF) has been identified as a protective factor against childhood obesity. However, evidence of the association between BF duration and adiposity remains inconclusive. Few studies have been conducted among Southeast Asian infants that have measured body composition during infancy using the gold standard stable isotope method. This study aimed to evaluate the association between BF duration and body composition during infancy. Healthy full-term Thai infants aged 6-8 months (n = 60) receiving exclusive or predominant BF for at least 3 months were recruited. Skinfold thickness (SFT) was measured by well-trained investigators. Body composition was assessed by the deuterium dilution technique. Infants with longer BF duration (>6 months; mean 7.5 ± 0.5 months, n = 29) had a higher subscapular SFT z-score than those with shorter BF duration (≤6 months; mean 5.3± 0.9 months, n = 31) by 0.48 (95% confidence interval [CI]: 0.01-0.94). After adjustment for age and sex, BF duration and age at introduction of complementary feeding (CF) were positively associated with fat mass and fat mass index at 6-8 months. One month increase in BF duration and CF age was associated with a 0.37 (95% CI: 0.05, 0.69) kg/m2 and 0.76 (95% CI: 0.18, 1.34) kg/m2 increase in the fat mass index, respectively. After adjusting for infant body mass index (BMI) during the earlier infancy period, the strength of the association was attenuated. This finding may reflect reverse causality where infants with lower BMI received formula or CF earlier. A longitudinal study with follow-up into childhood is warranted to confirm the effects of BF on adiposity in infancy and childhood.

Keywords: adiposity; body composition; breastfeeding; complementary feeding; deuterium; fat mass; lean mass; obesity.

Conflict of interest statement

The authors declare no conflict of interest.

© 2022 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.

Figures

Figure 1
Figure 1
Comparison of anthropometric measurements between shorter BF and longer BF groups (n = 61). The shorter BF group was defined as infants receiving BF without any formula for less than or equal to 6 months of age along with CF, while the longer BF group was defined as infants receiving BF solely for more than 6 months along with CF. BF, breastfeeding; BMI, body mass index; CF, complementary feeding; MUAC, mid‐upper arm circumference; SFT, skinfold thickness.
Figure 2
Figure 2
Comparison of body composition assessed by the deuterium dilution technique between shorter and longer BF groups (n = 51): (a) comparison of weight of FM and FFM; (b) comparison between %FM and FFM; (c) comparison between index of FM and FFM. The shorter BF group was defined as infants receiving BF without any formula for less than or equal to 6 months of age along with CF, while the longer BF group was defined as infants receiving BF solely for more than 6 months along with CF. BF, breastfeeding; CF, complementary feeding; FFM, fat‐free mass; FFMI, fat‐free mass index; FM, fat mass; FMI, fat mass index.

References

    1. Aris, I. M. , Bernard, J. Y. , Chen, L. W. , Tint, M. T. , Pang, W. W. , Lim, W. Y. , Soh, S.E. , Saw, S. M. , Godfrey, K. M. , Gluckman, P. D. , Chong, Y. S. , Yap, F. , Kramer, M. S. , & Lee, Y. S. (2017). Infant body mass index peak and early childhood cardio‐metabolic risk markers in a multi‐ethnic Asian birth cohort. International Journal of Epidemiology, 46(2), 513–525. 10.1093/ije/dyw232
    1. Azad, M. B. , Vehling, L. , Chan, D. , Klopp, A. , Nickel, N. C. , McGavock, J. M. , Becker, A. B. , Mandhane, P. J. , Turvey, S. E. , Moraes, T. J. , Taylor, M. S. , Lefebvre, D. L. , Sears, M. R. , Subbarao, P. , & CHILD Study Investigators . (2018). Infant feeding and weight gain: Separating breast milk from breastfeeding and formula from food. Pediatrics, 142(4):e20181092. 10.1542/peds.2018-1092
    1. Bartok, C. J. , & Ventura, A. K. (2009). Mechanisms underlying the association between breastfeeding and obesity. International Journal of Pediatric Obesity, 4(4), 196–204. 10.3109/17477160902763309
    1. Blössner M., Siyam A., Borghi E., Onis M., Onyango A., & Yang H. (2010). WHO Anthro for personal computers, version 3.2.2, 2011: Software for assessing growth and development of the world's children. WHO.
    1. Butte, N. F. , Wong, W. W. , Hopkinson, J. M. , Smith, E. O. , & Ellis, K. J. (2000). Infant feeding mode affects early growth and body composition. Pediatrics, 106(6), 1355–1366. 10.1542/peds.106.6.1355
    1. Castillo‐Laura, H. , Santos, I. S. , Quadros, L. C. , & Matijasevich, A. (2015). Maternal obesity and offspring body composition by indirect methods: A systematic review and meta‐analysis. Cadernos de saúde pública/Ministério da Saúde, Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública, 31(10), 2073–2092. 10.1590/0102-311x00159914
    1. Chomtho, S. , Wells, J. C. , Davies, P. S. , Lucas, A. , & Fewtrell, M. S. (2009). Early growth and body composition in infancy. Advances in Experimental Medicine and Biology, 646, 165–168. 10.1007/978-1-4020-9173-5_19
    1. Chomtho, S. , Wells, J. C. , Williams, J. E. , Davies, P. S. , Lucas, A. , & Fewtrell, M. S. (2008). Infant growth and later body composition: Evidence from the 4‐component model. American Journal of Clinical Nutrition, 87(6), 1776–1784. 10.1093/ajcn/87.6.1776
    1. Cunnane, S. C. (2006). [Survival of the fattest: The key to human brain evolution]. Medicine Sciences, 22(6–7), 659–663. 10.1051/medsci/20062267659
    1. de Bruin, N. C. , Degenhart, H. J. , Gàl, S. , Westerterp, K. R. , Stijnen, T. , & Visser, H. K. (1998). Energy utilization and growth in breast‐fed and formula‐fed infants measured prospectively during the first year of life. American Journal of Clinical Nutrition, 67(5), 885–896. 10.1093/ajcn/67.5.885
    1. Ejlerskov, K. T. , Christensen, L. B. , Ritz, C. , Jensen, S. M. , Mølgaard, C. , & Michaelsen, K. F. (2015). The impact of early growth patterns and infant feeding on body composition at 3 years of age. British Journal of Nutrition, 114(2), 316–327. 10.1017/s0007114515001427
    1. Eny, K. M. , Chen, S. , Anderson, L. N. , Chen, Y. , Lebovic, G. , Pullenayegum, E. , Parkin, P. C. , Maguire, J. L. , Birken, C. S. , & TARGet Kids! C . (2018). Breastfeeding duration, maternal body mass index, and birth weight are associated with differences in body mass index growth trajectories in early childhood. American Journal of Clinical Nutrition, 107(4), 584–592. 10.1093/ajcn/nqx081
    1. Fleddermann, M. , Demmelmair, H. , & Koletzko, B. (2014). Energetic efficiency of infant formulae: A review. Annals of Nutrition and Metabolism, 64(3–4), 276–283. 10.1159/000365034
    1. Gale, C. , Logan, K. M. , Santhakumaran, S. , Parkinson, J. R. , Hyde, M. J. , & Modi, N. (2012). Effect of breastfeeding compared with formula feeding on infant body composition: A systematic review and meta‐analysis. American Journal of Clinical Nutrition, 95(3), 656‐669. 10.3945/ajcn.111.027284
    1. Gridneva, Z. , Kugananthan, S. , Rea, A. , Lai, C. T. , Ward, L. C. , Murray, K. , Hartmann, P. E. , & Geddes, D. T. (2018). Human milk adiponectin and leptin and infant body composition over the first 12 months of lactation. Nutrients, 10(8):1125. 10.3390/nu10081125
    1. Haschke, F. , & van't Hof, M. A. (2000). Euro‐Growth references for breast‐fed boys and girls: Influence of breast‐feeding and solids on growth until 36 months of age. Euro‐Growth Study Group. Journal of Pediatrics Gastroenterology and Nutrition, 31(Suppl. 1), S60–S71. 10.1097/00005176-200007001-00006
    1. Huang, P. , Zhou, J. , Yin, Y. , Jing, W. , Luo, B. , & Wang, J. (2016). Effects of breast‐feeding compared with formula‐feeding on preterm infant body composition: A systematic review and meta‐analysis. British Journal of Nutrition, 116(1), 132–141. 10.1017/s0007114516001720
    1. Institute of Nutrition . (2018). Nutrients calculation software: INMUCAL‐Nutrients version 4.0 Database version NB.4. Mahidol University.
    1. International Atomic Energy Agency (IAEA) . (2009). IAEA Human Health Series No. 3: Assessment of body composition and total energy expenditure in humans using stable isotope techniques.
    1. Jin, H. , Shan, T. , Li, S. , Fan, X. , Zhao, Y. , Li, J. , Tang, X. , Saffery, R. , Tong, C. , Wen, L. , Qi, H. , Kilby, M. D. , & Baker, P. N. (2022). Association of infant feeding patterns with body fat mass and obesity in the first 2 years of life: A longitudinal twin birth cohort study. International Journal of Food Sciences and Nutrition, 73(2), 263–273. 10.1080/09637486.2021.1968357
    1. Koletzko, B. , von Kries, R. , Closa, R. , Escribano, J. , Scaglioni, S. , Giovannini, M. , Beyer, J. , Demmelmair, H. , Anton, B. , Gruszfeld, D. , Dobrzanska, A. , Sengier, A. , Langhendries, J.P. , Rolland Cachera, M.F. , & Grote, V. (2009). Can infant feeding choices modulate later obesity risk? American Journal of Clinical Nutrition, 89(5), 1502S–1508S. 10.3945/ajcn.2009.27113D
    1. Kramer, M. S. , Guo, T. , Platt, R. W. , Sevkovskaya, Z. , Dzikovich, I. , Collet, J. P. , Shapiro, S. , Chalmers, B. , Hodnett, E. , Vanilovich, I. , Mezen, I. , Ducruet, T. , Shishko, G. , & Bogdanovich, N. (2003). Infant growth and health outcomes associated with 3 compared with 6 mo of exclusive breastfeeding. American Journal of Clinical Nutrition, 78(2), 291–295. 10.1093/ajcn/78.2.291
    1. Lanigan, J. A. , Wells, J. C. , Lawson, M. S. , & Lucas, A. (2001). Validation of food diary method for assessment of dietary energy and macronutrient intake in infants and children aged 6‐24 months. European Journal of Clinical Nutrition, 55(2), 124–129. 10.1038/sj.ejcn.1601128
    1. Li, R. , Scanlon, K. S. , May, A. , Rose, C. , & Birch, L. (2014). Bottle‐feeding practices during early infancy and eating behaviors at 6 years of age. Pediatrics, 134(Suppl. 1), S70–S77. 10.1542/peds.2014-0646L
    1. Mazzocchi, A. , Giannì, M. L. , Morniroli, D. , Leone, L. , Roggero, P. , Agostoni, C. , De Cosmi, V. , & Mosca, F. (2019). Hormones in breast milk and effect on infants’ growth: A systematic review. Nutrients, 11(8):1845. 10.3390/nu11081845
    1. Mills A., & Tyler H. (1992). Food and nutrient intakes of British infants aged 6‐12 months. HMSO Publications Centre.
    1. Moorcroft, K. E. , Marshall, J. L. , & McCormick, F. M. (2011). Association between timing of introducing solid foods and obesity in infancy and childhood: A systematic review. Maternal & Child Nutrition, 7(1), 3–26. 10.1111/j.1740-8709.2010.00284.x
    1. National Statistical Office & United Nations Children's Fund . (2016). Thailand multiple indicator cluster survey 2015‐2016, Survey Findings Report. National Statistical Office and United Nations Children's Fund.
    1. National Statistical Office of Thailand . (2020). Thailand multiple indicator cluster survey 2019, Final Report. National Statistical Office and United Nations Children's Fund.
    1. Pearce, J. , Taylor, M. A. , & Langley‐Evans, S. C. (2013). Timing of the introduction of complementary feeding and risk of childhood obesity:A systematic review. International Journal of Obesity, 37(10), 1295–1306. 10.1038/ijo.2013.99
    1. Qiao, J. , Dai, L. J. , Zhang, Q. , & Ouyang, Y. Q. (2020). A meta‐analysis of the association between breastfeeding and early childhood obesity. Journal of Pediatric Nursing, 53, 57–66. 10.1016/j.pedn.2020.04.024
    1. Robinson, S. M. , Marriott, L. D. , Crozier, S. R. , Harvey, N. C. , Gale, C. R. , Inskip, H. M. , Baird, J. , Law, C. M. , Godfrey, K. M. , Cooper, C. , & Southampton Women's Survey Study Group . (2009). Variations in infant feeding practice are associated with body composition in childhood: A prospective cohort study. Journal of Clinical Endocrinology and Metabolism, 94(8), 2799–2805. 10.1210/jc.2009-0030
    1. Savino, F. , Liguori, S. A. , Fissore, M. F. , & Oggero, R. (2009). Breast milk hormones and their protective effect on obesity. International Journal of Pediatric Endocrinology, 2009, 327505. 10.1155/2009/327505
    1. Sun, J. , Nwaru, B. I. , Hua, J. , Li, X. , & Wu, Z. (2017). Infant BMI peak as a predictor of overweight and obesity at age 2 years in a Chinese community‐based cohort. BMJ Open, 7(10), e015122. 10.1136/bmjopen-2016-015122
    1. Tahir, M. J. , Ejima, K. , Li, P. , Demerath, E. W. , Allison, D. B. , & Fields, D. A. (2021). Associations of breastfeeding or formula feeding with infant anthropometry and body composition at 6 months. Maternal & child nutrition, 17(2), e13105. 10.1111/mcn.13105
    1. Toschke, A. M. , Martin, R. M. , von Kries, R. , Wells, J. , Smith, G. D. , & Ness, A. R. (2007). Infant feeding method and obesity: Body mass index and dual‐energy X‐ray absorptiometry measurements at 9‐10 y of age from the avon longitudinal study of parents and children (ALSPAC). American Journal of Clinical Nutrition, 85(6), 1578–1585. 10.1093/ajcn/85.6.1578
    1. Ventura, A. K. (2017). Developmental trajectories of bottle‐feeding during infancy and their association with weight gain. Journal of Developmental and Behavioral Pediatrics, 38(2), 109–119. 10.1097/dbp.0000000000000372
    1. Wauben, I. , Westerterp, K. , Gerver, W. J. , & Blanco, C. (1995). Effect of varying protein intake on energy balance, protein balance and estimated weight gain composition in premature infants. European Journal of Clinical Nutrition, 49(1), 11–16.
    1. Wells, J. C. , Cole, T. J. , & ALSPAC Study Team . (2002). Adjustment of fat‐free mass and fat mass for height in children aged 8 y. International Journal of Obesity and Related Metabolic Disorders, 26(7), 947–952. 10.1038/sj.ijo.0802027
    1. Wohlfahrt‐Veje, C. , Tinggaard, J. , Winther, K. , Mouritsen, A. , Hagen, C. P. , Mieritz, M. G. , de Renzy‐Martin, K. T. , Boas, M. , Petersen, J. H. , & Main, K. M. (2014). Body fat throughout childhood in 2647 healthy Danish children: Agreement of BMI, waist circumference, skinfolds with dual X‐ray absorptiometry. European Journal of Clinical Nutrition, 68(6), 664–670. 10.1038/ejcn.2013.282
    1. World Health Organization . (2001). The optimal duration of exclusive breastfeeding: Report of the expert consultation Geneva, Switzerland 28–30 March 2001.
    1. World Health Organization . (2021). Exclusively breastfeed for 6 months.
    1. World Health Organization, & United Nations Children's Fund . (2018). Enabling women to breastfeed through better policies and programmes: Global breastfeeding scorecard 2018.
    1. World Health Organization, & United Nations Children's Fund . (2019). Global breastfeeding scorecard, 2019: Increasing commitment to breastfeeding through funding and improved policies and programmes.

Source: PubMed

Patrocinadores y Colaboradores

Condiciones médicas

Intervenciones de drogas

3
Suscribir