liu.seSearch for publications in DiVA
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Exclusive breastfeeding of Swedish children and its possible influence on the development of obesity: a prospective cohort study
Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Pediatrics .
Department of Pediatrics, Clinical Research Centre, Örebro University Hospital, Sweden and Clinical Epidemiology Unit, Department of Medicine, Karolinska University Hospital, Sweden.
Department of Nursing Science, School of Health Sciences, Jönköping, Sweden.
Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
2008 (English)In: BMC Pediatrics, ISSN 1471-2431, E-ISSN 1471-2431, Vol. 8, no 42Article in journal (Refereed) Published
Abstract [en]

Background: Overweight and obesity are increasing among children all over the world. Socio-economic factors may influence the development of overweight and obesity in childhood, and it has been proposed that breastfeeding may protect against obesity. The aim of our study was to examine the relationship between exclusive breastfeeding and obesity when potential confounders, such as socioeconomic factors, are considered.

Methods: The data analyzed was from ABIS (All Babies in Southeast Sweden), a prospective cohort study. All parents with children born between October 1, 1997 and October 1, 1999 in Southeast Sweden (n = 21,700) were asked to participate. Parents were asked to answer periodic questionnaires from the time of the child's birth (n = 16,058) until he/she was five years of age (n = 7,356). Cutoffs for overweight and obesity were defined according to Cole et al, age and gender adjusted. Short-term exclusive breastfeeding was defined as < 4 months of exclusive breastfeeding. Multiple logistic regressions were used to identify variables that predict the child's BMI (Body Mass Index) at five years of age.

Results: At five years of age, 12.9% of the children in the study wereoverweight and 4.3% were obese. At the age of three months, 78.4% of the children were being breastfed exclusively. The median exclusive breastfeeding duration was four months. High maternal BMI > 30 (AOR = 1.07; CI = 1.05–1.09; P < 0.001), maternal smoking (AOR = 1.43; CI = 1.05–1.95; P = 0.023) and being a single parent (AOR = 2.10; CI = 1.43–3.09; P < 0.001) were associated with short-term exclusive breastfeeding (less than 4 months). Short-term exclusive breastfeeding was less common if one of the parents had a university degree (Mother: AOR = 0.74; CI = 0.61–0.90; P = 0.003 Father: AOR = 0.73; CI = 0.58–0.92; P = 0.008) or if the father was more than 37 years old (AOR = 0.74; CI = 0.55–0.99; P = 0.045). Short-term exclusive breastfeeding was associated with obesity in five-year-old children (simple logistic regression: OR = 1.44; CI = 1.00–2.07; P = 0.050), but when including other independent factors in the analysis, short-term exclusive breastfeeding did not attain statistical significance.

Conclusion: We cannot exclude the possibility that exclusive breastfeeding influences weight development, but it does not seem to protect against obesity at five years of age.

Place, publisher, year, edition, pages
2008. Vol. 8, no 42
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-16604DOI: 10.1186/1471-2431-8-42OAI: oai:DiVA.org:liu-16604DiVA: diva2:159020
Available from: 2009-02-22 Created: 2009-02-06 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Weight gain in children: possible relation to the development of diabetes
Open this publication in new window or tab >>Weight gain in children: possible relation to the development of diabetes
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: The prevalence of overweight and obesity among children has increased the last decades and is now defined as a global epidemic disease by the World Health Organization. Also the incidence of type 1 diabetes has increased and there are some hypothesises that argue there is a connection between overweight/obesity and type 1 diabetes.

Aim: The general aim of this thesis was to study factors contributing to the development of overweight and obesity among children and to study possible relations to the development of diabetes.

Method: All Babies in Southeast Sweden, ABIS, is a prospective cohort study. The study includes all babies who were born in southeast Sweden between Oct 1st 1997 until Oct1st 1999 and the design was to follow them up to school age in ABIS I and to follow them until 14 years in ABIS II, of the eligible 74 % entered the study. The families have answered questionnaires and biological samples were taken mainly from the children at the different time points: birth, 1 year, 2.5 years, 5 years and 8-9 years. In this thesis studies have been made including the whole cohort, but some studies have also been made involving only a part of the children.

Results: The prevalence of overweight and obesity among children in the ABIS study was 12.9% overweight and 2.5 % obese at 5 years of age. One risk factor which appeared to have a great impact on the development of overweight and obesity at 5 years of age was the child’s own BMI at an early age and also the heredity for overweight/ obesity and the heredity for type 2 diabetes. If the father had a university degree, the child was less likely to be obese at 5 years of age. Other factors, such as the parents´ age, if the child had any siblings, and if the child lived with a single parent, did not show any significant correlation to the child’s BMI at 5 years of age.

Early nutrition has been studied and no correlation could be found between breastfeeding less than 4 months and the development of overweight/obesity at 5 years of age. The parents answered questions about how frequent the child ate different food at 2.5 years and at 5 years. Intake of sweet lemonade was the only single food which was correlated to a higher BMI in 5 years old children. Porridge seemed to be protective against overweight/ obesity. In one of the studies the physical activity was measured by a step counter. The fewer steps the children were taking, the higher BMI and waist circumference they had. Low physical activity was also associated with a higher C-peptide value and decreased insulin sensitivity. Children who spent more time in front of TV/video had a higher fasting blood glucose value.

Conclusions: A strong factor for the development of overweight and obesity among children is the child’s own BMI at an early age and also its heredity for overweight/ obesity and the heredity for type 2 diabetes. Early nutrition did not show any obvious correlations with overweight and obesity at 5 year old children. Low physical activity was associated with higher fasting C-peptide value and decreased insulin sensitivity. Low physical activity may cause β-cell stress which might contribute to an autoimmune process in individuals genetically predisposed to autoimmunity and, thereby, to the increasing incidence of Type 1 diabetes in children.

Abstract [sv]

Bakgrund: Förekomsten av övervikt och fetma bland barn har ökat under de senaste decennierna och klassas av Världshälsoorganisationen (WHO) som en global epidemi. Antalet barn som insjuknar i typ 1 diabetes har också ökat och det finns en del hypoteser som argumenterar för att det finns en koppling mellan övervikt/fetma och typ 1 diabetes.

Syfte: Den här avhandlingens syfte var att studera faktorer som bidrar till utvecklingen av övervikt och fetma hos barn och att studera om det möjligen finns en relation till utvecklingen av typ 1 diabetes.

Metod: Alla Barn I Sydöstra Sverige, ABIS, är en prospektiv kohort studie. Alla barn, som föddes mellan 1:a oktober 1997 till 1:a oktober 1999 i sydöstra Sverige, erbjöds delta. Barnen följdes sedan upp till skolåldern i ABIS I och till 14 års ålder i ABIS II. Från starten valde 74% av de tillfrågade familjerna att gå med i studien. Familjerna har besvarat frågeformulär, och biologiska prover är tagna huvudsakligen från barnen vid de olika åldrarna: födseln, 1 år, 2.5 år, 5 år och 8-9år. I avhandlingen ingår dels studier med hela ABIS kohorten, men i två av studierna deltar endast en del av barnen.

Resultat: Hos de barn som igår i ABIS studien var 12,9% överviktiga vid 5 års ålder och 2,5% var feta. En faktor som visade sig ha betydelse för utvecklingen av övervikt och fetma hos 5 år gamla barn var barnets eget BMI vid tidig ålder samt hereditet för övervikt/fetma och hereditet för typ 2 diabetes. Om föräldrarna, framförallt pappan, läst på högskola eller universitet var barnen mindre ofta överviktiga/feta. Andra faktorer som föräldrarnas ålder, om barnet hade några syskon och om barnet levde med en ensamstående förälder visade sig inte ha betydelse för utvecklingen av övervikt och fetma hos barnen. Tidig uppfödning har också studerats. Vi fann ingen korrelation mellan kort amning, dvs. mindre än 4 månader, och utvecklingen av övervikt/ fetma hos 5 år gamla barn. Föräldrarna har också fått svara på hur frekvent barnet åt olika livsmedel vid 2.5 år och vid 5 år. Saft var det enda livsmedel som enskilt hade ett samband med utveckling av övervikt och fetma vid 5 år. Gröt föreföll ha en skyddande effekt. I en delstudie har fysisk aktivitet mätts med stegräknare. Ju färre steg ett barn tog, desto större risk förelåg för övervikt och fetma. Låg fysisk aktivitet var också associerad till ett högre C-peptidvärde och minskad insulinkänslighet. Barn som tittar mycket på TV/video hade ett högre fasteblodsocker.

Konklusion: Av betydelse för utveckling av övervikt och fetma hos barn är barnets eget BMI i tidig ålder och dess hereditet för övervikt och fetma samt hereditet för typ 2 diabetes. Tidig nutrition verkar inte ha några uppenbara samband med övervikt och fetma hos 5 år gamla barn. Låg fysisk aktivitet var associerad till högt faste C-peptid och ökad insulinresistens, vilket skulle kunna stressa β-cellerna och därmed, i enlighet med β- cell stress hypotesen, kunna bidra till en ökad förekomst av typ 1 diabetes hos barn.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2009. 49 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1090
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-16608 (URN)978-91-7393-729-0 (ISBN)
Public defence
2009-02-13, Qulturum, Länsjukhuset Ryhov, Jönköping, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2009-02-06 Created: 2009-02-06 Last updated: 2009-08-21Bibliographically approved

Open Access in DiVA

fulltext(241 kB)384 downloads
File information
File name FULLTEXT01.pdfFile size 241 kBChecksum SHA-512
fb6bacc79f5d71d3262799d9b08fa7c8765618bea802283d5ecae74875c71d0534adf0c80f9e4d3f07786bc3695f9f8d4085e01e6d3b7b4f8f28a7145c2a4cc7
Type fulltextMimetype application/pdf

Other links

Publisher's full textLink to Ph.D. Thesis

Authority records BETA

Huus, KarinaLudvigsson, Johnny

Search in DiVA

By author/editor
Huus, KarinaLudvigsson, Johnny
By organisation
Faculty of Health SciencesPediatrics Department of Paediatrics in Linköping
In the same journal
BMC Pediatrics
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
Total: 384 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
urn-nbn

Altmetric score

doi
urn-nbn
Total: 220 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf