Are Adolescents Who Were Breast-Fed Less Likely to Be Overweight?

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Citation

Nelson, Melissa C.; Gordon-Larsen, Penny; & Adair, Linda S. (2005). Are Adolescents Who Were Breast-Fed Less Likely to Be Overweight?. Epidemiology, 16(2), 247-253.

Abstract

Background: Cohort analyses suggesting that breast-feeding protects against being overweight have been criticized for inadequately controlling for confounding associated with the self-selection of feeding practices.
Methods: Using nationally representative U.S. data from the National Longitudinal Study of Adolescent Health (1994–1996), we performed traditional cohort analyses (n = 11,998) using logistic regression to estimate the relation between breast-feeding and adolescent overweight (body mass index >=85 percentile, based on year 2000 CDC growth charts), controlling for known potential confounders. Breast-feeding also was assessed in a subsample of 850 sibling pairs to account for unmeasured genetic and environmental factors.
Results: Among girls in the full cohort, the odds of being overweight declined among those who had been breast-fed at least 9 months; odds ratios ranged from 0.90 (95% confidence interval = 0.74–1.09) for <3 months of breast-feeding to 0.78 (0.64–0.96) for >=9 months. A similar effect was seen in boys, although these trends were less consistent. In contrast, an analysis of sibling pairs provided no evidence of breast-feeding effects on weight within discordant trends.
Conclusion: Cohort data indicate that odds of being overweight decrease as breast-feeding duration increases, at least among girls. However, sibling analyses suggest that this relationship may not be causal but rather attributable to unmeasured confounding related to mothers’ choice to breast-feed, or to other childhood risk factors for overweight. Our results illustrate the utility of sibling analyses in understanding the true effect of early life exposures (such as breast-feeding) on health outcomes over time, independent of confounding factors that may not be satisfactorily controlled using traditional prospective cohort methods.

URL

http://dx.doi.org/10.1097/01.ede.0000152900.81355.00

Reference Type

Journal Article

Year Published

2005

Journal Title

Epidemiology

Author(s)

Nelson, Melissa C.
Gordon-Larsen, Penny
Adair, Linda S.

ORCiD

Gordon-Larsen - 0000-0001-5322-4188
Adair - 0000-0002-3670-8073