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Reduced duration of breastfeeding is associated with a higher risk of multiple sclerosis in both Italian and Norwegian adult males: the EnvIMS study

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Abstract

Breastfeeding for at least 4 months has been found to be associated with a reduced risk of immune-mediated diseases including multiple sclerosis (MS). Using data from a large multinational case–control study (EnvIMS), the association between MS and breastfeeding was investigated in two distinct populations. A questionnaire (EnvIMS-Q) which included a section on feeding during the first year of life was administered to MS cases and to age and sex frequency-matched controls from Italy and Norway. Logistic regression was used to estimate the odds ratio (ORs) and 95 % confidence intervals (95 % CIs) as a measure of the association between MS and exposure to prolonged breastfeeding (4 months or more, used as the reference category), vs. no breastfeeding or breastfeeding for less than 4 months (reduced exposure). Education, smoking habits, smoking in mother’s pregnancy, and other types of milk used in infant feeding were included as covariates. A total of 547 cases and 1039 controls in Italy, and 737 cases and 1335 controls in Norway were studied. The distribution of prolonged (reference) breastfeeding differed between the Norwegian (65.4 %) and the Italian (48.9 %) study participants. A significant association between MS and reduced/no exposure to breastfeeding was found overall for Italy (ORadj = 1.37; 95 % CI 1.09, 1.73), but not for Norway (ORadj = 1.14; 95 % CI 0.92, 1.40). However, only in men, significant associations were observed for both populations (ORItaly = 2.33; 95 % CI 1.50, 3.65, ORNorway = 2.13; 95 % CI 1.37, 3.30). Reduced exposure to breastfeeding in males was found to be associated with increased risk of MS in Italy and in Norway.

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References

  1. Ramagopalan SV, Dobson R, Meier UC, Giovannoni G (2010) Multiple sclerosis: risk factors, prodromes, and potential causal pathways. Lancet Neurol 9:727–739

    Article  PubMed  Google Scholar 

  2. International Multiple Sclerosis Genetics Consortium, Wellcome Trust Case Control Consortium (2011) Genetic risk and a primary role for cell-mediated immune mechanisms in multiple sclerosis. Nature 476:214–219

    Article  Google Scholar 

  3. International Multiple Sclerosis Genetics Consortium (IMSGC) (2013) Analysis of immune-related loci identifies 48 new susceptibility variants for multiple sclerosis. Nat Genet 45:1353–1360

    Article  Google Scholar 

  4. Munger KL, Zhang SM, O’Reilly E, Hernán MA, Olek MJ, Willett WC, Ascherio A (2004) Vitamin D intake and incidence of multiple sclerosis. Neurology 62:60–65

    Article  CAS  PubMed  Google Scholar 

  5. Simon KC, van der Mei IAF, Munger KL, Ponsonby A, Dickinson J, Dwyer T, Sundström P, Ascherio A (2010) Combined effects of smoking, anti-EBNA antibodies, and HLA-DRB1*1501 on multiple sclerosis risk. Neurology 74:1365–1371

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  6. Riise T, Nortvedt MW, Ascherio A (2003) Smoking is a risk factor for multiple sclerosis. Neurology 61:1122–1124

    Article  PubMed  Google Scholar 

  7. Bach JF (2002) The effect of infections on susceptibility to autoimmune and allergic diseases. N Engl J Med 347:911–920

    Article  PubMed  Google Scholar 

  8. Rosenbauer J, Herzig P, Kaiser P, Giani G (2007) Early nutrition and risk of type 1 diabetes mellitus. A nationwide case-control study in preschool children. Exp Clin Endocrinol Diabetes 115:502–508

    Article  CAS  PubMed  Google Scholar 

  9. Alves JG, Figueiroa JN, Meneses J, Alves GV (2012) Breastfeeding protects against type 1 diabetes mellitus: a case-sibling study. Breastfeed Med 7:25–28

    Article  PubMed  Google Scholar 

  10. Klement E, Cohen RV, Boxman J, Joseph A, Reif S (2004) Breastfeeding and risk of inflammatory bowel disease: a systematic review with meta-analysis. Am J Clin Nutr 80:1342–1352

    CAS  PubMed  Google Scholar 

  11. Gdalevich M, Mimouni D, David M, Mimouni M (2001) Breast-feeding and the onset of atopic dermatitis in childhood: a systematic review and meta-analysis of prospective studies. J Am Acad Dermatol 45:520–527

    Article  CAS  PubMed  Google Scholar 

  12. Gdalevich M, Mimouni D, Mimouni M (2001) Breast-feeding and the risk of bronchial asthma in childhood: a systematic review with meta-analysis of prospective studies. J Pediatr 139:261–266

    Article  CAS  PubMed  Google Scholar 

  13. Conradi S, Malzahn U, Paul F, Quill S, Harms L, Then Bergh F, Ditzenbach A, Georgi T, Heuschmann P, Rosche B (2013) Breastfeeding is associated with lower risk for multiple sclerosis. Mult Scler 19:553–558

    Article  PubMed  Google Scholar 

  14. Pugliatti M, Casetta I, Drulovic J, Granieri E, Holmøy T, Kampman MT, Landtblom AM, Lauer K, Myhr KM, Parpinel M, Pekmezovic T, Riise T, Zhu B, Wolfson C (2012) A questionnaire for multinational case-control studies of environmental risk factors in multiple sclerosis (EnvIMS-Q). Acta Neurol Scand Suppl 95:43–50

    Article  Google Scholar 

  15. Lossius A, Riise T, Pugliatti M, Bjørnevik K, Casetta I, Drulovic J, Granieri E, Kampman MT, Landtblom AM, Lauer K, Magalhaes S, Myhr KM, Pekmezovic T, Wesnes K, Wolfson C, Holmøy T (2014) Season of infectious mononucleosis and risk of multiple sclerosis at different latitudes; the EnvIMS Study. Mult Scler 20:669–674

    Article  PubMed  Google Scholar 

  16. Bjørnevik K, Riise T, Casetta I, Drulovic J, Granieri E, Holmøy Kampman MT, Landtblom AM, Lauer K, Lossius A, Magalhaes S, Myhr KM, Pekmezovic T, Wesnes K, Wolfson C, Pugliatti M (2014) Sun exposure and multiple sclerosis risk in Norway and Italy: the EnvIMS study. Mult Scler 20:1042–1049

    Article  PubMed  Google Scholar 

  17. Polman CH, Reingold SC, Edan G (2005) Diagnostic criteria for multiple sclerosis: 2005 revisions to the “McDonald Criteria”. Ann Neurol 58:840–846

    Article  PubMed  Google Scholar 

  18. Lundy E (2012) The Effect of Assigning Different Index Dates for Control Exposure Measurement on Odds Ratio Estimates in Department of Mathematics and Statistics, McGill University

  19. Spencely M, Dick G (1982) Breast-feeding and multiple sclerosis. Neuroepidemiology 1:216–222

    Article  Google Scholar 

  20. Pisacane A, Impagliazzo N, Russo M, Valiani R, Mandarini A, Florio C, Vivo P (1994) Breast-feeding and multiple sclerosis. BMJ 308:1411–1412

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  21. Santorelli G, Petherick E, Waiblinger D, Cabieses Fairley L (2013) Ethnic differences in the initiation and duration of breast feeding—results from the Born in Bradford Birth Cohort Study. Paediatr Perinat Epidemiol 27:388–392

    Article  PubMed  Google Scholar 

  22. Hörnell A, Lagström H, Lande B, Thorsdottir I (2013) Breastfeeding, introduction of other foods and effects on health: a systematic literature review for the 5th Nordic Nutrition Recommendations. Food Nutr Res 57:20823

    Google Scholar 

  23. Fernandez L, Langa S, Martín V, Maldonado A, Jiménez E, Martín R, Rodríguez JM (2013) The human milk microbiota: origin and potential roles in health and diseases. Pharmacol Res 69:1–10

    Article  CAS  PubMed  Google Scholar 

  24. Jeong K, Nguyen V, Kim J (2012) Human milk oligosaccharides: the novel modulator of intestinal microbiota. BMB Report 45:433–441

    Article  CAS  Google Scholar 

  25. Marcobal A, Barboza M, Froehlich JW, Block DE, German JB, Lebrilla CB, Mills DA (2010) Consumption of human milk oligosaccharides by gut-related microbes. J Agric Food Chem 58:5334–5340

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  26. Sherman PM, Cabana M, Gibson GR, Koletzko BV, Neu J, Veereman-Wauters G, Ziegler EE, Walker WA (2009) Potential roles and clinical utility of prebiotics in newborns infant and children: proceedings from a global prebiotic summit meeting, New York City, June 27–28, 2008. J Pedriatr 155:S61–S70

    Article  Google Scholar 

  27. Marcobal A, Sonneburg JL (2012) Human milk oligosaccharide consumption by intestinal microbiota. Clin Microbiol Infect 18(suppl 4):12–15

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  28. Atarashi K, Honda K (2011) Microbiota in autoimmunity and tolerance. Curr Opin Immunol 23:761–768

    Article  CAS  PubMed  Google Scholar 

  29. Lönnerdal B (2003) Nutritional and physiologic significance of human milk proteins. Am J Clin Nutr 77(suppl):1537S–1543S

    PubMed  Google Scholar 

  30. Wright AL, Holberg CJ, Martinez FD, Morgan WJ, Taussig LM (1989) Breast feeding and lower respiratory tract illness in the first year of life. Group Health Medical Associates. BMJ 299:946–949

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  31. Sinha A, Madden J, Ross-Degnan D, Soumerai S, Platt R (2003) Reduced risk of neonatal respiratory infections among breastfed girls but not boys. Pediatrics 112:303–307

    Article  Google Scholar 

  32. Libster R, Bugna Hortoneda J, Laham FR, Casellas JM, Israele V, Polack NR, Delgado MF, Klein MI, Polack FP (2009) Breastfeeding prevents severe disease in full term female infants with acute respiratory infection. Pediatr Infect Dis J 28:131–134

    Article  PubMed  Google Scholar 

  33. Klein MI, Bergel E, Gibbons L, Coviello S, Bauer G, Benitez A, Serra ME, Delgado MF, Melendi GA, Rodríguez S, Kleeberger SR, Polack FP (2008) Differential gender response to respiratory infections and to the protective effect of breast milk in preterm infants. Pediatrics 121:1510–1516

    Article  Google Scholar 

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Acknowledgments

The study was supported by grants from The Italian MS Society/Foundation (Fondazione Italiana Sclerosi Multipla, FISM, grants n. 2007/R/14, and n. 2008/R/19 to M. Pugliatti), The Western Norway Regional Health Authority (Helse Vest) Norway (grants n. 911421/2008 to M. Pugliatti and n. 911474/2009 to K-M Myhr), The University of Bergen, Norway (2007 to T. Riise), and The Norwegian MS Society (2011 to T. Riise). The authors wish to acknowledge Kristin Wesnes and Kjetil Bjørnevik (Department of Neurology, Haukeland University Hospital, Bergen, Norway; Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway); Bin Zhu and Sandra Magalhaes (Research Institute of the McGill University Health Centre, Montreal Canada), for data cleaning.

Conflicts of interest

Giammario Ragnedda, Stefania Leoni, Maria Parpinel, Ilaria Casetta, Trond Riise, Kjell-Morten Myhr, Christina Wolfson report no competing interests in relation to the study.

Ethical standard

Maura Pugliatti is a member of the Italian MS Foundation Social, Clinical and Behavioural Scientific Committee since 2012.

Author information

Authors and Affiliations

  1. Department of Biomedical Sciences, University of Sassari, Sassari, Italy

    Giammario Ragnedda, Stefania Leoni & Maura Pugliatti

  2. Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 10, 07100, Sassari, Italy

    Giammario Ragnedda, Stefania Leoni & Maura Pugliatti

  3. Unit of Hygiene and Epidemiology, Department of Medical and Biological Sciences, University of Udine, Udine, Italy

    Maria Parpinel

  4. Department of Biomedical and Specialty Surgical Sciences, Section of Clinical Neurology, University of Ferrara, Ferrara, Italy

    Ilaria Casetta

  5. Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway

    Trond Riise & Maura Pugliatti

  6. The Norwegian Multiple Sclerosis Registry and Biobank, Department of Neurology, Haukeland University Hospital, Bergen, Norway

    Kjell-Morten Myhr

  7. Department of Clinical Medicine, KG Jebsen Centre for MS-Research, University of Bergen, Norway Haukeland University Hospital, Bergen, Norway

    Kjell-Morten Myhr

  8. Research Institute of the McGill University Health Centre, Montreal, QC, Canada

    Christina Wolfson

  9. Department of Epidemiology and Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada

    Christina Wolfson

  10. Department of Medicine, Faculty of Medicine, McGill University, Montreal, Canada

    Maura Pugliatti

Authors
  1. Giammario Ragnedda
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  2. Stefania Leoni
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  3. Maria Parpinel
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  4. Ilaria Casetta
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  5. Trond Riise
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  6. Kjell-Morten Myhr
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  7. Christina Wolfson
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  8. Maura Pugliatti
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Correspondence to Maura Pugliatti.

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Ragnedda, G., Leoni, S., Parpinel, M. et al. Reduced duration of breastfeeding is associated with a higher risk of multiple sclerosis in both Italian and Norwegian adult males: the EnvIMS study. J Neurol 262, 1271–1277 (2015). https://doi.org/10.1007/s00415-015-7704-9

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  • DOI: https://doi.org/10.1007/s00415-015-7704-9

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