The effect of breastfeeding on mean body mass index throughout life:: a quantitative review of published and unpublished observational evidence1-3
The effect of breastfeeding on mean body mass index throughout life:: a quantitative review of published and unpublished observational evidence1-3
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DOI：
10.1093/ajcn/82.6.1298
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发表时间：
2005-12-01
影响因子：
7.1
通讯作者：
Cook, DG
中科院分区：
文献类型：
--
作者：
Owen, CG;Martin, RM;Cook, DG
背景：来自观察性研究的证据表明，母乳喂养可能会降低以后生活中肥胖的患病率。目的：目的是检查初始母乳喂养是否与一生中较低的平均体重指数（BMI；单位为kg/m(2)）有关。设计：本研究对已发表的研究进行了系统回顾，这些研究调查了婴儿喂养与晚年肥胖或肥胖之间的关系，并补充了未发表的数据。分析是基于最初母乳喂养和配方奶喂养（以母乳喂养减去奶瓶喂养）的研究对象之间的BMI平均差异，这些差异通过使用固定效应模型进行汇总。结果：从70项符合条件的研究中，获得了母乳喂养和配方喂养（在20项研究中报道为纯喂养）之间的36个BMI平均差异（来自355301名受试者）。与配方奶喂养相比，母乳喂养的BMI平均值略低（-0.04;95% CI: -0.05, -0.02）。bmi的平均差异在15个< 1000受试者的小型研究中较大（-0.19;95% CI: -0.31, -0.08），在>= 1000受试者的大型研究中较小（-0.03;95% CI: -0.05, -0.02）。Egger检验差异有统计学意义（P = 0.002）。在I - I研究中，对社会经济地位、孕妇吸烟和孕妇BMI进行调整消除了这种影响（调整前95% CI为-0.14,-0.06；调整后95% CI为-0.01,-0.05,0.03）。结论：母乳喂养者的平均BMI较低。然而，这种差异很小，很可能受到发表偏倚和混杂因素的强烈影响。提倡母乳喂养，虽然在其他方面很重要，但不太可能降低平均体重指数。
Background: Evidence from observational studies has suggested that breastfeeding may reduce the prevalence of obesity in later life. Objective: The objective was to examine whether initial breastfeeding is related to lower mean body mass index (BMI; in kg/m(2)) throughout life.Design: The study was a systematic review of published studies investigating the association between infant feeding and a measure of obesity or adiposity in later life, which was supplemented with data from unpublished sources. Analyses were based on the mean differences in BMI between those subjects who were initially breast-fed and those who were formula-fed (expressed as breastfed minus bottle-fed), which were pooled by using fixed-effects models throughout.Results: From 70 eligible studies, 36 mean differences in BMI (from 355 301 subjects) between those breastfed and those formula-fed (reported as exclusive feeding in 20 studies) were obtained. Breastfeeding was associated with a slightly lower mean BMI than was formula feeding (-0.04; 95% CI: -0.05, -0.02). The mean difference in BMIs appeared larger in 15 small studies of < 1000 subjects (-0.19; 95% CI: -0.31, -0.08) and smaller in larger studies of >= 1000 subjects (-0.03; 95% CI: -0.05, -0.02). An Egger test was statistically significant (P = 0.002). Adjustment for socioeconomic status, maternal smoking in pregnancy, and maternal BMI in I I studies abolished the effect (-0.10; 95% CI -0.14, -0.06 before adjustment; -0.01; 95% CI: -0.05, 0.03 after adjustment).Conclusions: Mean BMI is lower among breastfed subjects. However, the difference is small and is likely to be strongly influenced by publication bias and confounding factors. Promotion of breastfeeding, although important for other reasons, is not likely to reduce mean BMI.