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Breastfeeding is protective to diabetes risk in young adults: a longitudinal study

Acta Diabetologica volume 52, pages 837–844 (2015)Cite this article

Abstract

Aim

It is unclear whether any breastfeeding or a certain duration of breastfeeding is protective against the development of diabetes in adult offspring.

Methods

We followed a sub-sample of 3,595 offspring born in the Mater Hospital in Brisbane, Australia between 1981 and 1983 and for whom we had doctor diagnosed self-reported diabetes at age 21 years and maternal reported duration of breastfeeding at 6-month post-natal follow-up. Multiple logistic regression was used to examine the independent associations of duration of breastfeeding (never breastfeed, breastfed <4 months and breastfed ≥4 months) with offspring diabetes by age 21 years.

Results

Of 3,595 young adults, 45 (1.25 %) developed diabetes by age 21 years. The odds ratio of experiencing diabetes was 0.58 (95 % CI 0.29, 1.16) for offspring who were breastfed <4 months, and it was 0.29 (95 % CI 0.13, 0.63), for offspring who were breastfed at least 4 months compared to the never breastfed offspring. Adjusting for potential confounding and mediating factors including maternal age, education, pre-pregnancy body mass index (BMI), smoking, offspring sports, TV and their BMI at 21 years did not substantially alter this association.

Conclusions

Findings of this study suggest that infants who are breastfed for longer than 4 months have a substantial protective effect against the development of diabetes in young adulthood, which is independent of current BMI. Promoting breastfeeding for a minimum of 4 months may be a useful strategy for the prevention of diabetes among young adults.

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References

  1. Hu FB (2011) Globalization of diabetes: the role of diet, lifestyle, and genes. Diabetes Care 34(6):1249–1257

  2. Wang Y, Rimm EB, Stampfer MJ, Willett WC, Hu FB (2005) Comparison of abdominal adiposity and overall obesity in predicting risk of type 2 diabetes among men. Am J Clin Nutr 81(3):555–563

    CAS  PubMed  Google Scholar 

  3. Harder T, Bergmann R, Kallischnigg G, Plagemann A (2005) Duration of breastfeeding and risk of overweight: a meta-analysis. Am J Epidemiol 162(5):397–403

    Article  PubMed  Google Scholar 

  4. Shields L, Mamun AA, O’Callaghan M, Williams GM, Najman JM (2010) Breastfeeding and obesity at 21 years: a cohort study. J Clin Nurs 19(11–12):1612–1617

    Article  PubMed  Google Scholar 

  5. Stuebe AM, Rich-Edwards JW, Willett WC, Manson JE, Michels KB (2005) Duration of lactation and incidence of type 2 diabetes. JAMA 294(20):2601–2610

    CAS  Article  PubMed  Google Scholar 

  6. Martin RM, Patel R, Kramer MS, et al (2014) Effects of promoting longer-term and exclusive breastfeeding on adiposity and insulin-like growth factor-I at age 11.5 years: a randomized trial. JAMA 309(10):1005–1013

  7. Davis JN, Weigensberg MJ, Shaibi GQ et al (2007) Influence of breastfeeding on obesity and type 2 diabetes risk factors in Latino youth with a family history of type 2 diabetes. Diabetes Care 30(4):784–789

    Article  PubMed  Google Scholar 

  8. Owen CG, Martin RM, Whincup PH, Smith GD, Cook DG (2006) Does breastfeeding influence risk of type 2 diabetes in later life? A quantitative analysis of published evidence. Am J Clin Nutr 84(5):1043–1054

    CAS  PubMed  Google Scholar 

  9. Fall CH, Osmond C, Barker DJ et al (1995) Fetal and infant growth and cardiovascular risk factors in women. BMJ 310(6977):428–432

    PubMed Central  CAS  Article  PubMed  Google Scholar 

  10. Martin RM, Ebrahim S, Griffin M et al (2005) Breastfeeding and atherosclerosis: intima-media thickness and plaques at 65-year follow-up of the Boyd Orr cohort. Arterioscler Thromb Vasc Biol 25(7):1482–1488

    CAS  Article  PubMed  Google Scholar 

  11. Rich-Edwards JW, Stampfer MJ, Manson JE et al (2004) Breastfeeding during infancy and the risk of cardiovascular disease in adulthood. Epidemiology 15(5):550–556

    Article  PubMed  Google Scholar 

  12. Martin RM, Ben-Shlomo Y, Gunnell D, Elwood P, Yarnell JW, Smith GD (2005) Breast feeding and cardiovascular disease risk factors, incidence, and mortality: the Caerphilly study. J Epidemiol Commun Health 59(2):121–129

    Article  Google Scholar 

  13. Young TK, Martens PJ, Taback SP et al (2002) Type 2 diabetes mellitus in children: prenatal and early infancy risk factors among native canadians. Arch Pediatr Adolesc Med 156(7):651–655

    Article  PubMed  Google Scholar 

  14. Parikh NI, Hwang SJ, Ingelsson E et al (2009) Breastfeeding in infancy and adult cardiovascular disease risk factors. Am J Med 122(7):656–663

    PubMed Central  Article  PubMed  Google Scholar 

  15. Pettitt DJ, Forman MR, Hanson RL, Knowler WC, Bennett PH (1997) Breastfeeding and incidence of non-insulin-dependent diabetes mellitus in Pima Indians. Lancet 350(9072):166–168

    CAS  Article  PubMed  Google Scholar 

  16. Horta B, Bahl R, Martines J, Victora C (2007) Evidence on the long-term effects of breastfeeding: systematic reviews and meta-analyses. World Health Organization, Geneva

    Google Scholar 

  17. Mayer-Davis EJ, Dabelea D, Lamichhane AP et al (2008) Breast-feeding and type 2 diabetes in the youth of three ethnic groups: the SEARCh for diabetes in youth case–control study. Diabetes Care 31(3):470–475

    Article  PubMed  Google Scholar 

  18. Veena SR, Krishnaveni GV, Wills AK, Hill JC, Karat SC, Fall CH (2013) Glucose tolerance and insulin resistance in Indian children: relationship to infant feeding pattern. Diabetologia 54(10):2533–2537

  19. World Health Organization (2012) Breastfeeding—exclusive breastfeeding. World Health Organization, Geneva. www.who.int/elena/titles/exclusive_breastfeeding/en/. Accessed 30/7/13

  20. AIHW (2012) Australia’s health 2012. Australia’s health no. 13. Cat. no. AUS 156. AIHW, Canberra

  21. Jones JR, Kogan MD, Singh GK, Dee DL, Grummer-Strawn LM (2011) Factors associated with exclusive breastfeeding in the United States. Pediatrics 128(6):1117–1125

    Article  PubMed  Google Scholar 

  22. Keeping JD, Najman JM, Morrison J, Western JS, Andersen MJ, Williams GM (1989) A prospective longitudinal study of social, psychological and obstetric factors in pregnancy: response rates and demographic characteristics of the 8556 respondents. Br J Obstet Gynaecol 96(3):289–297

    CAS  Article  PubMed  Google Scholar 

  23. Najman JM, Bor W, O’Callaghan M, Williams GM, Aird R, Shuttlewood G (2005) Cohort profile: the Mater-University of Queensland study of pregnancy (MUSP). Int J Epidemiol 34(5):992–997

    CAS  Article  PubMed  Google Scholar 

  24. Hernan MA, Hernandez-Diaz S, Werler MM, Mitchell AA (2002) Causal knowledge as a prerequisite for confounding evaluation: an application to birth defects epidemiology. Am J Epidemiol 155(2):176–184

    Article  PubMed  Google Scholar 

  25. World Health Organization (1998) Obesity: preventing and managing the global epidemic. Report of a WHO consultation on obesity, 3–5 June 1997. World health Organization, Geneva, Switzerland

  26. World Health Organization (2000) Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organization technical report series 894:i–xii, 1–253

  27. Mamun AA, O’Callaghan M, Callaway L, Williams G, Najman J, Lawlor DA (2009) Associations of gestational weight gain with offspring body mass index and blood pressure at 21 years of age: evidence from a birth cohort study. Circulation 119(13):1720–1727

    Article  PubMed  Google Scholar 

  28. Mamun AA, O’Callaghan MJ, Williams GM, Najman JM (2012) Maternal smoking during pregnancy predicts adult offspring cardiovascular risk factors—evidence from a community-based large birth cohort study. PLoS ONE 7(7):e41106

    PubMed Central  CAS  Article  PubMed  Google Scholar 

  29. Little RJA, Rubin DB (2002) Statistical analysis with missing data, 2nd edn. Wiley, Hoboken

    Google Scholar 

  30. Das UN (2006) Essential fatty acids: biochemistry, physiology and pathology. Biotechnol J 1(4):420–439

    CAS  Article  PubMed  Google Scholar 

  31. Goran MI, Ball GD, Cruz ML (2003) Obesity and risk of type 2 diabetes and cardiovascular disease in children and adolescents. J Clin Endocrinol Metab 88(4):1417–1427

    CAS  Article  PubMed  Google Scholar 

  32. Owen CG, Martin RM, Whincup PH, Davey-Smith G, Gillman MW, Cook DG (2005) The effect of breastfeeding on mean body mass index throughout life: a quantitative review of published and unpublished observational evidence. Am J Clin Nutr 82(6):1298–1307

    CAS  PubMed  Google Scholar 

  33. Kramer MS, Kakuma R (2004) The optimal duration of exclusive breastfeeding: a systematic review. Adv Exp Med Biol 554:63–77

    Article  PubMed  Google Scholar 

  34. National Health and Medical Research Council (2003) Dietary guidelines for children and adolescents in Australia incorporating the infant feeding guidelines for health workers. AusInfo, Canberra

    Google Scholar 

  35. The Australian Diabetes, Obesity and Lifestyle Study (AusDiab) (2001) Diabesity and associated disorders in Australia—2000: the accelerating epidemic. International Diabetes Institute, Melbourne

    Google Scholar 

  36. Dunstan DW, Zimmet PZ, Welborn TA et al (2002) The Australian Diabetes, Obesity and Lifestyle Study (AusDiab)—methods and response rates. Diabetes Res Clin Pract 57(2):119–129

    Article  PubMed  Google Scholar 

  37. Alati R, Mamun AA, O’Callaghan M, Najman JM, Williams GM (2006) In utero and postnatal maternal smoking and asthma in adolescence. Epidemiology 17(2):138–144

    Article  PubMed  Google Scholar 

  38. Mamun AA, Lawlor DA, Alati R, O’Callaghan MJ, Williams GM, Najman JM (2006) Does maternal smoking during pregnancy have a direct effect on future offspring obesity? Evidence from a prospective birth cohort study. Am J Epidemiol 164(4):317–325

    Article  PubMed  Google Scholar 

  39. Doll R, Peto R, Boreham J, Sutherland I (2004) Mortality in relation to smoking: 50 years’ observations on male British doctors. BMJ (Clinical research ed) 328(7455):1519

    Article  Google Scholar 

  40. Gordon DJ, Probstfield JL, Garrison RJ et al (1989) High-density lipoprotein cholesterol and cardiovascular disease. Four prospective American studies. Circulation 79(1):8–15

    CAS  Article  PubMed  Google Scholar 

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Acknowledgments

The authors thank all participants in the study, the MUSP data collection and management team, and the University of Queensland who helped to store and manage the data for the MUSP. The core study was funded by the National Health and Medical Research Council (NHMRC ID 631507) of Australia. AAM is supported by a Career Development Awards from the NHMRC (ID 1026598). For the work in this paper AAM has a Grant from the National Heart Foundation of Australia (ID G07B3135). The views expressed in the paper are those of the authors and not necessarily those of any funding body and no funding body influenced the way in which the data were analysed and presented.

Conflict of interest

Abdullah Al Mamun, Michael J. O’Callaghan, Gail M. Williams, Jake M. Najman, Leonie Callaway and Harold D. McIntyre declare that they have no conflict of interest.

Ethical standard

Ethical clearances were obtained from the University of Queensland Human Ethics committee.

Human and animal rights disclosure

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5).

Informed consent disclosure

Informed consent was obtained from all participants for being included in the study.

Author information

Authors and Affiliations

  1. School of Population Health, University of Queensland, Herston Rd, Herston, Brisbane, QLD, 4006, Australia

    Abdullah Al Mamun & Gail M. Williams

  2. School of Medicine, University of Queensland, Brisbane, QLD, Australia

    Michael J. O’Callaghan, Leonie Callaway & Harold D. McIntyre

  3. Royal Brisbane and Women’s Hospital, Brisbane, QLD, Australia

    Leonie Callaway

  4. Mater Health Services, South Brisbane, QLD, Australia

    Harold D. McIntyre

  5. School of Population Health and School of Social Science, University of Queensland, Herston Rd, Herston, Brisbane, QLD, 4006, Australia

    Jake M. Najman

Authors
  1. Abdullah Al Mamun
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  2. Michael J. O’Callaghan
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  3. Gail M. Williams
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  4. Jake M. Najman
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  5. Leonie Callaway
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  6. Harold D. McIntyre
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Correspondence to Abdullah Al Mamun.

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Mamun, A.A., O’Callaghan, M.J., Williams, G.M. et al. Breastfeeding is protective to diabetes risk in young adults: a longitudinal study. Acta Diabetol 52, 837–844 (2015). https://doi.org/10.1007/s00592-014-0690-z

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  • DOI: https://doi.org/10.1007/s00592-014-0690-z

Keywords

  • Breastfeeding
  • Duration
  • Diabetes
  • Young adults