Anthropometry and body composition of 18 year old men according to duration of breast feeding: birth cohort study from BrazilBMJ 2003; 327 doi: https://doi.org/10.1136/bmj.327.7420.901 (Published 16 October 2003) Cite this as: BMJ 2003;327:901
- Cesar G Victora, professor ()1,
- Fernando Barros, consultant2,
- Rosângela C Lima, post-doctoral fellow1,
- Bernardo L Horta, associate professor3,
- Jonathan Wells, lecturer4
- 1Post-Graduate Programme in Epidemiology, Universidade Federal de Pelotas, CP 464, 96001-970, Pelotas, RS, Brazil
- 2PAHO/WHO Latin-American Center for Perinatology and Human Development, Montevideo, Uruguay
- 3Faculty of Medicine, Catholic University of Pelotas, Brazil
- 4Institute of Child Health, University of London, London
- Correspondence to: C G Victora
- Accepted 24 July 2003
Objective To assess the association between duration of breast feeding and measures of adiposity in adolescence.
Design Population based birth cohort study.
Setting Pelotas, a city of 320 000 inhabitants in a relatively developed area in southern Brazil.
Participants All newborn infants in the city's hospitals were enrolled in 1982; 78.8% (2250) of all male participants were located at age 18 years when enrolling in the national army.
Main outcome measures Weight, height, sitting height, subscapular and triceps skinfolds, and body composition (body fat, lean mass).
Results Neither the duration of total breast feeding nor that of predominant breast feeding (breast milk plus non-nutritive fluids) showed consistent associations with anthropometric or body composition indices. After adjustment for confounding factors, the only significant associations were a greater than 50% reduction in obesity among participants breast fed for three to five months compared with all other breastfeeding categories (P = 0.007) and a linear decreasing trend in obesity with increasing duration of predominant breast feeding (P = 0.03). Similar significant effects were not observed for other measures of adiposity. Borderline direct associations also occurred between total duration of breast feeding and adult height (P = 0.06).
Conclusions The significant reduction in obesity among children breast fed for three to five months is difficult to interpret, as no a priori hypothesis existed regarding a protective effect of intermediate duration of breast feeding. The findings indicate that, in this population, breast feeding has no marked protective effect against adolescent adiposity.
Contributors CGV and FCB have coordinated the cohort study from its inception, supervising data collection and analyses and writing up the manuscript. RCL coordinated the fieldwork for the current phase of the study and constructed the database. BLH carried out data analyses and contributed to the writing of the manuscript. JW advised on body composition measurement, carried out the validation study for body composition, and provided critical inputs to the analysis and writing up of the manuscript. All authors approved the final version of the paper. CGV is the guarantor for the paper.
Funding The study was financed by the Division of Child and Adolescent Health of the World Health Organization, by the Programa Nacional de Núcleos de Excelência (PRONEX), and by the Ministry of Health of Brazil. Earlier phases of the cohort study were financed by the International Development Research Center of Canada and by the Overseas Development Administration of the United Kingdom.
Competing interests None declared.
Ethical approval The Brazilian Medical Research Council approved the study protocol.