Association between breastfeeding and types of obesity in children and adolescents

Abstract

Objective To explore the association between breastfeeding and the type of obesity in children and adolescents, and to provide a theoretical basis for the identification and intervention of influential factors of different types of childhood obesity. Methods Using stratified cluster sampling method, 93 primary and secondary schools in 7 provinces and cities in China were selected for physical examination and questionnaire surveys. Totally, 30 437 primary and middle school students aged 7-17, with completed information, were selected. A multivariable Logistic regression model was used to analyze the association between breastfeeding and different types of obesity. Results The breastfeeding rate of students was 69.8%. The rates of general obesity, simple abdominal obesity, and combined obesity in the breastfeeding group were 7.1%, 3.9%, and 18.7%, the non-breastfeeding group were 7.0%, 4.7%, and 19.5%. The differences were statistically significant (χ 2 = 14.04, P <0.01). Univariate analysis found that breastfeeding significantly reduced the risk of simple abdominal obesity in children and adolescents ( OR = 0.81, 95% CI = 0.72-0.92, P <0.01) with normal (BMI non-overweight and obesity and waist <P 90 ) as control group. After adjustment, breastfeeding could still significantly reduce the risk of simple abdominal obesity ( OR = 0.76, 95% CI = 0.67-0.86, P <0.01), and combined obesity ( OR = 0.93, 95% CI = 0.87-0.99, P <0.05). Conclusion Breastfeeding is a protective factor for children with simple abdominal obesity and combined obesity, and the rate of breastfeeding in China should be further improved. 【摘要】 目的 探讨母乳喂养与儿童青少年肥胖类型的关联, 为儿童期不同类型肥胖影响因素的识别和干预提供理论基 础。 方法 采用分层整群抽样方法, 在中国 7 个省市抽取 93 所中小学校学生进行体格检査和问卷调査, 选择母乳喂养等 资料完整的 30 437 名 7〜17 岁中小学生作为研究对象。采用无序多分类Logistic回归模型分析母乳喂养与儿童青少年肥 胖类型的关联。 结果 研究对象母乳喂养率为69.8%。母乳喂养组一般性肥胖、单纯腹型肥胖和复合型肥胖发生率依次 为 7.1%, 3.9% 和 18.7%, 非母乳喂养组为 7.0%, 4.7%和19.5%, 差异有统计学意义 (χ 2 = 14.04, P <0.01)。单因素分析发现, 以正常组 (体质量指数非超重肥胖且腰围< P 90 )为对照, 母乳喂养可降低单纯腹型肥胖的风险 ( OR = 0.81, 95% CI =0.72〜 0.92, P <0.01)。在多因素调整后, 母乳喂养仍可降低单纯腹型肥胖的风险 ( OR = 0.76,95% CI = 0.67~0.86, P <0.01), 并可降 低复合型肥胖的风险 ( OR = 0.93,95% CI =0.87~0.99, P <0.05)。 结论 母乳喂养是儿童青少年单纯腹型肥胖和复合型肥胖 的保护因素, 应进一步提髙中国母乳喂养率。