Thursday 29 March 2012

Breastfeeding and Childhood Obesity

Does breastfeeding reduce childhood obesity? 

Worldwide, there is a public health concern for the increasing situation of childhood obesity (Dubois and Girard 2006, Bergmann et al., 2003). Childhood obesity can be reduced by two major ways including the promotion of breastfeeding and adjustment of childhood lifestyle (Marina and Adriano 2004). Obesity is the root cause of major health complications including hypertension, heart disease, Type 2 diabetes, several cancer types, psychosocial problems, elevated serum lipid and insulin concentrations. Approximately, 15 to 20% of obesity could be reduced by exclusive breast feeding (CDC 2007). Childhood obesity effects can be classified into short term and long term; the short term effects include orthopedic disorders, respiratory problems, diabetes, hypertension, psycosocial disorders and dislipidemia. The long term complications include coronary disorders which are responsible for several deaths worldwide (Balaban and Silva, 2004).

Why it’s suggested that breastfeeding reduces chances of childhood obesity.

The first insight of chances of reduction of childhood obesity by breastfeeding was posed in 1981 by Kramer. From then several studies have been done to prove the issue of reduced obesity following breastfeeding. The suggested mechanisms include among the following:

  • Breastfed infants are better at self-regulating their intake other than bottle-fed babies where the mothers rely more on an empty bottle because breastfed infants will only eat as much as they need. Breastfed infants may be able to regulate energy intake by themselves latter in life (Bergmann et al., 2003).  
  • A healthy diet includes a variety of foods including fruits and vegetables. Breast milk constitutes many different flavors that come from the variety of foods eaten by the mother. An infant who is breastfed is thus introduced easily to new foods because he is already used to different food flavors. This may not be the case for a bottle fed infant who is only limited to the standardized infant formula flavors day by day. Therefore a breast fed infant will latter on in life be able to consume a wide variety of different healthy foods foods which protects him/her from becoming obese.
  • Infant formulas have higher protein/nitrogen content compared to breast milk and hence bottle feeding may cause a metabolic response of increased insulin and insulin like growth factor-1 secretion in formula-fed infants leading to excessive weight gain (Hediger et al., 2001). At 3 to 6 months of age, formula fed infants are said to consume close to 66% to 70% more protein than breastfed infants and by one year of age the value may have risen to 5 to 6 times what is needed. High protein intake is associated with high insulin secretion. High insulin secretion levels stimulate greater adipose tissue deposition and have been associated with subsequent increased weight gain and obesity in Pima Indian children 5 to 9 years of age (Dewey, 2003).
  • Breastfed infants are reported to gain less weight than infant formula fed infants after the first 3-4 months. Gaining less weight in infancy leads to lower rates of obesity latter in life (Gillman, 2011).

References 

  1. Adriano F.R, Adriano C, 2004. Breastfeeding, Childhood Obesity and the prevention of chronic diseases. International Baby Food Action network (IBFAN) breastfeeding briefs No. 38, 2004. 
  2. Balaban and Silva, 2004. Protective effect of breastfeeding against childhood obesity. Jornal de Pediatria - Vol. 80, No1, 2004 
  3. Bergmann K.E, Bergmann R.L, Kries V.R, Bohm. O, Richter. R, Dudenhausen J.W, Wahn. U. 2003. Early determinants of childhood overweight and adiposity in a birth cohort study: role of breast-feeding. International Journal of Obesity (2003) 27, 162–172. 2003 Nature Publishing Group. 
  4. Centres for Disease Control and Prevention, 2007. Division of nutrition and Physical Activity: Research to practice series No.4: does breastfeeding reduce the risk of pediatric overweight? 
  5. Dewey K.G. 2003. Is Breastfeeding Protective Against Child Obesity? Journal of human lactation 2003 19: 9. DOI: 10.1177/0890334402239730. Published by Sage 
  6. Dubois.L, Girard. M, 2006. Early determinants of overweight at 4.5 years in a population-based longitudinal study. International Journal of Obesity (2006) 30, 610–617. 2006 Nature Publishing Group. 
  7. Gillman. M. W, 2011. Commentary: Breastfeeding and obesity-the 2011 scorecard. International Journal of Epidemiology 2011; 40:681–684 doi:10.1093/ije/dyr085. Published by Oxford University Press. 
  8. Hediger M.L, Overpeck M.D., Kuczmarski R.J., Ruan W.J., 2001. Association between infant breastfeeding and overweight in young children. JAMA, May 16, 2001—Vol 285, No. 19 (Reprinted)