Exclusive breastfeeding duration and cardiorespiratory...

Exclusive breastfeeding duration and cardiorespiratory fitness in children and adolescents

Idoia Labayen*, Jonatan R Ruiz*, Francisco B Ortega, Helle M Loit, Jaanus Harro, Inga Villa, Toomas Veidebaum, and Michael Sjöström

University of the Basque Country, Spain Karolinska Institutet, Sweden, University of Granada, Granada, Spain National Institute for Health Development, Tallinn, Estonia Institute of Public Health, Tartu, Estonia *[email protected]; [email protected]

THE POWER OF PROGRAMMING 2014 International Conference on Developmental Origins of

Adiposity and Long-Term Health March 13-15, Munich, Germany

Note: for non-commercial purposes only

mailto:*[email protected]




Benefits of breast feeding


ESPGHAN Committee on Nutrition: Carlo Agostoni et al 2009

• WHO • ESPGHAN • FISPGHAN • ENeA • Early Nutrition Academy • US Agency for Healthcare Research and Quality • Dutch State Institute for Nutrition and Health

• Otitis meida • GI infections • Respiratory infections • Atopy • Atopic dermatitis • Asthma • Type 1 diatebes • Type 2 diabetes • Cardiovascular diesease • High blood pressure • Cholesterol • Intelligence • Motor development • Etc.

Institutions

3 Ruiz et al. BJSM 2009

Cardiorespiratory

Musculoskeletal

Health La

ter i

n lif

e

Childhood and adolescence

To examine the association of exclusive breastfeeding duration with fitness in children and adolescents and to test the role of body composition and sociodemographic factors in this relation

Aim


Labayen et al. AJCN 2012

1025 children (9-10 years) and 971 adolescents (15-16 years) from Sweden and Estonia (EYHS)

Participants

Exposures Breast feeding


METHODS

• Was your child fed completely on breast milk for any length of time—that is, without complementary formula feeds? (Categories provided for response were yes or no)

• For how long was your child breastfed? (Categories provided for response were <1 month, 1–3 months, >3–6 months, and >6 months)

1025 children (9-10 years) and 971 adolescents (15-16 years) from Sweden and Estonia (EYHS)

Participants

Cardiorespiratory fitness

Exposures Breast feeding

Main outcome

Anthropometry, birth weight, smoking, physical activity, maternal education, and mother’s BMI

Confounding factors


METHODS

1.70

1.75

1.80

1.85

1.90

1.95

2.00

Model 1 Model 2 Model 3 Model 4

Fitn

ess

(L/m

in)

P<0.001 P<0.001 P=0.001 P=0.011

Model 1: adjusted for country, age, sex, and pubertal status Model 2: model 1 plus BMI Model 3: model 1 plus fat mass, and fat-free mass Model 4: model 1 plus birth weight and maternal BMI and educational level

Cardiorespiratory fitness and never vs. ever breastfed

Never breastfed

Ever breastfed

RESULTS


Model 1: adjusted for country, age, sex, and pubertal status Model 2: model 1 plus BMI Model 3: model 1 plus fat mass, and fat-free mass Model 4: model 1 plus birth weight and maternal BMI and educational level

Cardiorespiratory fitness and duration of breast feeding

1.76

1.80

1.84

1.88

1.92

1.96

Fitn

ess

(L/m

in) a

djus

ted

Mod

el 1

P < 0.001

*

** **

Never <3months 3-6 months >6 months


RESULTS

1.60

1.70

1.80

1.90

2.00

2.10

2.20

2.30

2.40

2.50

never < 3 months 3-6 months > 6 months

Normal weightOverweight

P<0.001

P=0.002

Normal weight/overweight+obesity accoring to the International Obesity Task Force recommendations

Confounders: country, sex, age, pubertal status, and body mass

Cardiorespiratory fitness and duration of breast feeding by weight status



Fitn

ess

(L/m

in)

RESULTS

Low/ high-SES: less than university education and university education, respectively Confounders: country, sex, age, pubertal status, and body mass

Cardiorespiratory fitness and duration of breast feeding by SES


1.60

1.70

1.80

1.90

2.00

2.10

2.20


Low SESHigh SES

P <0.001

P =0.004

Fitn

ess

(L/m

in)

RESULTS


Cardiorespiratory fitness and duration of breast feeding by mother’s weight


1.60

1.70

1.80

1.90

2.00

2.10

2.20


Mother normal weight

Mother overweightP =0.003

P <0.001


Fitn

ess

(L/m

in)

RESULTS

1.60

1.70

1.80

1.90

2.00

2.10

2.20


Low BW tertileMiddle BW tertileHigh BW tertile

P =0.001

P =0.017

P =0.004


Cardiorespiratory fitness and duration of breast feeding by BW



Fitn

ess

(L/m

in)

RESULTS

Longer exclusive breastfeeding has a beneficial effect on cardiorespiratory fitness in children and adolescents

Conclusions

Because early infant-feeding patterns are potentially modifiable,

a better understanding of the possible programming effect of exclusive

breastfeeding on cardiorespiratory fitness is of public health interest



Thanks for your attention

1.60

1.70

1.80

1.90

2.00

2.10

2.20

2.30

2.40

2.50


Low FFMHigh FFM

P<0.001

P=0.013

Low/high FFM: below or above the sex- and age group–specific median

Cardiorespiratory fitness and duration of breast feeding by FFM

REULTS



16

Cardiorespiratory fitness

Gender Age (years)

Weight (kg)

Initial work rate (W)

Δ Work rate (W)

Girls & boys 9-10 < 30 20 20

Girls & boys 9-10 > 30 25 25

Girls 15-16 - 40 40

Boys 15-16 - 50 50

METHODS

Test protocol

• Watt: W1+ (W2 t/180)

• VO2max (L/min): 12 x W + 5 x body weight (kg)

Variables

Anthropometry METHODS

Weight

Height

Skinfold thickness

• BMI

• % Overweight/Obese

• % Body fat (Slaugher et al.)

• FFM

Variables

Physical Activity (PA)

• 4 consecutive days

• 10 hrs/day

METHODS

Test protocol

• Total PA (counts/min)

• Moderate + Vigorous PA >3 METs (min/day)

Variables

Cardiorespiratory fitness: marker of health

19

<5 6 7 8 9 10 11 12 >13 METS

Cardiorespiratory Fitness

Very Low Low Medium High Very high

0

1

2

3

4

5R

elat

ive

Ris

k of

Mor

talit

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Blair et al. JAMA 1989

Adults 10,224 men and 3120 women

Exclusive breastfeeding duration and cardiorespiratory...

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