Academic journal article Central European Journal of Public Health

Breastfeeding and Time of Complementary Food Introduction as Predictors of Obesity in Children

Academic journal article Central European Journal of Public Health

Breastfeeding and Time of Complementary Food Introduction as Predictors of Obesity in Children

Article excerpt


Although obesity is a multifactorial disorder caused by various behavioural, genetic and environmental influences, early life factors affecting certain critical periods during childhood (prenatal period, adiposity rebound period at 3-5 years and around 5-7 years, as well as puberty) are important in promoting obesity in adulthood. The objective was to determine the association between the birth weight, birth length, breastfeeding and time of introduction of complementary food with obesity among 302 healthy Caucasian children 6-7 years old. Binary logistic regression analysis was used to assess the impact of a number of perinatal and socioeconomic confounding factors on the likelihood for overweight and obesity among children. The level of significance was set at p < 0.05. Our findings indicate that duration of breastfeeding for at least 3 months, with introduction of complementary food after the age of 6 months have an important role in preventing obesity. This findings are crucial for planning preventive strategies to prevent further increases in the prevalence of overweight and obesity.

Key words: children, obesity, breastfeeding duration, introduction of complementary food, body mass index centile charts


Nowadays, about 22 million 5-year-old children are obese worldwide, with rapid rises in prevalence that is now considered to be at epidemic level in developed as well as in developing coutries. Moreover, the number of oveiweight children in the European Union is expected to enlarge up to 1.3 million children per year (1). Its association with cardiovascular, endocrine, gastrointestinal, orthopaedic and respiratory diseases, but also with all kinds of psychological problems, implies a problem of far-reaching consequences for health and health services. There are certain periods during childhood that are proposed to be critical for later development of obesity: prenatal period, adiposity rebound period around 5-7 years of age, and puberty (2). Unless one or both of the parents suffer from obesity, increases in body mass index (BMI) prior to 3 years of age are weakly associated with adult obesity, but after this age the probability of being obese later in life uses with age and the level of obesity. After the age of 6, tins probability uses up to 50%, while over 70-80% of obese adolescents remain obese in adulthood (3). Obviously, prevention of childhood obesity during the pre-school period could be crutial for preventing obesity later in life.

High birth weight, rapid infancy weight gain, firstborn children and being an only child, low socioeconomic status, lower level of parental education, and maternal smoking during pregnancy are considered independent risk factors for later obesity (4), although their interaction cannot be excluded as well as the influence of nutrition status on those confounders. In fact, infant weight gam directly depends on the type of nutrition that can later affect both body composition and BMI in children and adolescents because of possible changes in hormonal status (5).

Biological mechanisms underlying the protective effect of breastfeeding are based on metabolic responses to human milk and its unique composition. Breastfed infants have lower plasma insulin levels, preventing excessive early adipocyte development and decreasing fat storage. Also, bioactive factors contained in breast milk inhibit adipocyte differentiation in vitro by modulating tumor necrosis factor and epidemial growth factor (6). Furthermore, protein intake and the amount of metabolized energy m breastfed infants have been shown to be substantially below the amounts of formula-fed children resulting in slower infant growth that points to its fundamental role in later development of oveiweight and obesity (7). For that reason breastfeeding, because of its plausible biological mechanisms, apart from contributing to childrens health, is considered as a potential priming factor against oveiweight, obesity and other related diseases (5). …

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