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Effect of infant feeding on the risk of obesity across the life course: a quantitative review of published evidence.

Abstract

OBJECTIVE

To examine the influence of initial infant feeding on obesity in later life.

METHODS

A systematic review of published studies investigating the association between infant feeding and a measure of obesity was performed with Medline (1966 onward) and Embase (1980 onward) databases, supplemented with manual searches. Data extraction was conducted by 2 authors. Analyses were based on odds ratios of obesity among initially breastfed subjects, compared with formula-fed subjects, pooled with fixed-effects models.

RESULTS

Sixty-one studies reported on the relationship of infant feeding to a measure of obesity in later life; of these, 28 (298900 subjects) provided odds ratio estimates. In these studies, breastfeeding was associated with a reduced risk of obesity, compared with formula feeding (odds ratio: 0.87; 95% confidence interval [CI]: 0.85-0.89). The inverse association between breastfeeding and obesity was particularly strong in 11 small studies of <500 subjects (odds ratio: 0.43; 95% CI: 0.33-0.55) but was still apparent in larger studies of > or =500 subjects (odds ratio: 0.88; 95% CI: 0.85-0.90). In 6 studies that adjusted for all 3 major potential confounding factors (parental obesity, maternal smoking, and social class), the inverse association was reduced markedly (from an odds ratio of 0.86 to 0.93) but not abolished. A sensitivity analysis examining the potential impact of the results of 33 published studies (12505 subjects) that did not provide odds ratios (mostly reporting no relationship between breastfeeding and obesity) showed little effect on the results.

CONCLUSIONS

Initial breastfeeding protects against obesity in later life. However, a further review including large unpublished studies exploring the effect of confounding factors in more detail is needed.

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  • Authors+Show Affiliations

    ,

    Department of Community Health Sciences, St George's Hospital Medical School, Cranmer Terrace, London SW17 0RE, United Kingdom. c.owen@sghms.ac.uk

    , , ,

    Source

    Pediatrics 115:5 2005 May pg 1367-77

    MeSH

    Breast Feeding
    Confounding Factors (Epidemiology)
    Humans
    Infant
    Infant Formula
    Infant Nutritional Physiological Phenomena
    Obesity
    Odds Ratio
    Risk

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Research Support, Non-U.S. Gov't
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    15867049

    Citation

    Owen, Christopher G., et al. "Effect of Infant Feeding On the Risk of Obesity Across the Life Course: a Quantitative Review of Published Evidence." Pediatrics, vol. 115, no. 5, 2005, pp. 1367-77.
    Owen CG, Martin RM, Whincup PH, et al. Effect of infant feeding on the risk of obesity across the life course: a quantitative review of published evidence. Pediatrics. 2005;115(5):1367-77.
    Owen, C. G., Martin, R. M., Whincup, P. H., Smith, G. D., & Cook, D. G. (2005). Effect of infant feeding on the risk of obesity across the life course: a quantitative review of published evidence. Pediatrics, 115(5), pp. 1367-77.
    Owen CG, et al. Effect of Infant Feeding On the Risk of Obesity Across the Life Course: a Quantitative Review of Published Evidence. Pediatrics. 2005;115(5):1367-77. PubMed PMID: 15867049.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Effect of infant feeding on the risk of obesity across the life course: a quantitative review of published evidence. AU - Owen,Christopher G, AU - Martin,Richard M, AU - Whincup,Peter H, AU - Smith,George Davey, AU - Cook,Derek G, PY - 2005/5/4/pubmed PY - 2005/9/28/medline PY - 2005/5/4/entrez SP - 1367 EP - 77 JF - Pediatrics JO - Pediatrics VL - 115 IS - 5 N2 - OBJECTIVE: To examine the influence of initial infant feeding on obesity in later life. METHODS: A systematic review of published studies investigating the association between infant feeding and a measure of obesity was performed with Medline (1966 onward) and Embase (1980 onward) databases, supplemented with manual searches. Data extraction was conducted by 2 authors. Analyses were based on odds ratios of obesity among initially breastfed subjects, compared with formula-fed subjects, pooled with fixed-effects models. RESULTS: Sixty-one studies reported on the relationship of infant feeding to a measure of obesity in later life; of these, 28 (298900 subjects) provided odds ratio estimates. In these studies, breastfeeding was associated with a reduced risk of obesity, compared with formula feeding (odds ratio: 0.87; 95% confidence interval [CI]: 0.85-0.89). The inverse association between breastfeeding and obesity was particularly strong in 11 small studies of <500 subjects (odds ratio: 0.43; 95% CI: 0.33-0.55) but was still apparent in larger studies of > or =500 subjects (odds ratio: 0.88; 95% CI: 0.85-0.90). In 6 studies that adjusted for all 3 major potential confounding factors (parental obesity, maternal smoking, and social class), the inverse association was reduced markedly (from an odds ratio of 0.86 to 0.93) but not abolished. A sensitivity analysis examining the potential impact of the results of 33 published studies (12505 subjects) that did not provide odds ratios (mostly reporting no relationship between breastfeeding and obesity) showed little effect on the results. CONCLUSIONS: Initial breastfeeding protects against obesity in later life. However, a further review including large unpublished studies exploring the effect of confounding factors in more detail is needed. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/15867049/full_citation L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&amp;pmid=15867049 DB - PRIME DP - Unbound Medicine ER -