exclusive breastfeeding duration and cardiorespiratory...
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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
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Benefits of breast feeding
Exclusive breastfeeding duration and cardiorespiratory fitness in children and adolescents
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
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3 Ruiz et al. BJSM 2009
Cardiorespiratory
Musculoskeletal
Health La
ter i
n lif
e
Childhood and adolescence
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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
Exclusive breastfeeding duration and cardiorespiratory fitness in children and adolescents
Labayen et al. AJCN 2012
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1025 children (9-10 years) and 971 adolescents (15-16 years) from Sweden and Estonia (EYHS)
Participants
Exposures Breast feeding
Labayen et al. AJCN 2012
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)
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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
Labayen et al. AJCN 2012
METHODS
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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
Labayen et al. AJCN 2012
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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
Labayen et al. AJCN 2012
RESULTS
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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
Never <3months 3-6 months >6 months
Labayen et al. AJCN 2012
Fitn
ess
(L/m
in)
RESULTS
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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
Labayen et al. AJCN 2012
1.60
1.70
1.80
1.90
2.00
2.10
2.20
never < 3 months 3-6 months > 6 months
Low SESHigh SES
P <0.001
P =0.004
Fitn
ess
(L/m
in)
RESULTS
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Confounders: country, sex, age, pubertal status, and body mass
Cardiorespiratory fitness and duration of breast feeding by mother’s weight
Labayen et al. AJCN 2012
1.60
1.70
1.80
1.90
2.00
2.10
2.20
never < 3 months 3-6 months > 6 months
Mother normal weight
Mother overweightP =0.003
P <0.001
Never <3months 3-6 months >6 months
Fitn
ess
(L/m
in)
RESULTS
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1.60
1.70
1.80
1.90
2.00
2.10
2.20
never < 3 months 3-6 months > 6 months
Low BW tertileMiddle BW tertileHigh BW tertile
P =0.001
P =0.017
P =0.004
Confounders: country, sex, age, pubertal status, and body mass
Cardiorespiratory fitness and duration of breast feeding by BW
Labayen et al. AJCN 2012
Never <3months 3-6 months >6 months
Fitn
ess
(L/m
in)
RESULTS
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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
Exclusive breastfeeding duration and cardiorespiratory fitness in children and adolescents
Labayen et al. AJCN 2012
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Thanks for your attention
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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
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
Never <3months 3-6 months >6 months
Labayen et al. AJCN 2012
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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
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Anthropometry METHODS
Weight
Height
Skinfold thickness
• BMI
• % Overweight/Obese
• % Body fat (Slaugher et al.)
• FFM
Variables
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Physical Activity (PA)
• 4 consecutive days
• 10 hrs/day
METHODS
Test protocol
• Total PA (counts/min)
• Moderate + Vigorous PA >3 METs (min/day)
Variables
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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
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3
4
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