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Association between Characteristics at Birth, Breastfeeding and Obesity in 22 Countries: The WHO European Childhood Obesity Surveillance Initiative – COSI 2015/2017

Rito A.I.a · Buoncristiano M.b · Spinelli A.c · Salanave B.d · Kunešová M.e · Hejgaard T.f · García Solano M.g · Fijałkowska A.h · Sturua L.i · Hyska J.j · Kelleher C.k · Duleva V.l · Musić Milanović S.m · Farrugia Sant’Angelo V.n · Abdrakhmanova S.o · Kujundzic E.p · Peterkova V.q · Gualtieri A.r · Pudule I.s · Petrauskienė A.t · Tanrygulyyeva M.u · Sherali R.v · Huidumac-Petrescu C.w · Williams J.b · Ahrens W.x · Breda J.b

Author affiliations

aFood and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
bNCD Office, WHO European Office for Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation
cNational Centre for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
dFrench Public Health Agency, Bobigny, France
eInstitute of Endocrinology, Obesity Management Centre, Prague, Czechia
fDanish Health Authority, Copenhagen, Denmark
gSpanish Agency for Food Safety and Nutrition, Madrid, Spain
hDepartment of Cardiology, Institute of Mother and Child, Warsaw, Poland
iNCD Department, National Center for Disease Control and Public Health, Tbilisi, Georgia
jNutrition and Food Safety Sector, Institute of Public Health, Tirana, Albania
kNational Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
lDepartment of Food and Nutrition, National Centre of Public Health and Analyses, Sofia, Bulgaria
mHealth Promotion Division, Croatian Institute of Public Health, Zagreb, Croatia
nPrimary Health Care, Ministry for Health, Floriana, Malta
oResearch Department, National Center of Public Health, Astana, Kazakhstan
pInstitute of Public Health of Montenegro, Podgorica, Montenegro
qThe Endocrine Research Centre, Moscow, Russian Federation
rSocial Security Institute San Marino, San Marino, San Marino
sDepartment of Research and Health Statistics, Centre for Disease Prevention and Control, Riga, Latvia
tDepartment of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
uScientific Research Institute of Maternal and Child Health, Ashgabat, Turkmenistan
vDepartment for Organization and Provision of the Medical Care to Mother, Child and Family Planning, Ministry of Health and Social Protection of Population, Dushanbe, Tajikistan
wNational Health Assessment and Promotion Center, National Institute of Public Health Bucharest, Bucharest, Romania
xLeibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany

Corresponding Author

Ana Isabel Rito

Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge

Av. Padre Cruz

PT–1649-016 Lisbon (Portugal)

E-Mail ana.rito@insa.min-saude.pt

Keywords: BreastfeedingBirth weightChildhood obesityWHO/EuropeCOSI Europe

Related Articles for ""
Obes Facts 2019;12:226–243
https://doi.org/10.1159/000500425

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Abstract

Background: In Europe, although the prevalence of childhood obesity seems to be plateauing in some countries, progress on tackling this important public health issue remains slow and inconsistent. Breastfeeding has been described as a protective factor, and the more exclusively and the longer children are breastfed, the greater their protection from obesity. Birth weight has been shown to have a positive association with later risk for obesity. Objectives: It was the aim of this paper to investigate the association of early-life factors, namely breastfeeding, exclusive breastfeeding and birth weight, with obesity among children. Method: Data from 22 participating countries in the WHO European COSI study (round 4: 2015/2017) were collected using cross-sectional, nationally representative samples of 6- to 9-year-olds (n = 100,583). The children’s standardized weight and height measurements followed a common WHO protocol. Information on the children’s birth weight and breastfeeding practice and duration was collected through a family record form. A multivariate multilevel logistic regression analysis regarding breastfeeding practice (both general and exclusive) and characteristics at birth was performed. Results: The highest prevalence rates of obesity were observed in Spain (17.7%), Malta (17.2%) and Italy (16.8%). A wide between-country disparity in breastfeeding prevalence was found. Tajikistan had the highest percentage of children that were breastfed for ≥6 months (94.4%) and exclusively breastfed for ≥6 months (73.3%). In France, Ireland and Malta, only around 1 in 4 children was breastfed for ≥6 months. Italy and Malta showed the highest prevalence of obesity among children who have never been breastfed (21.2%), followed by Spain (21.0%). The pooled analysis showed that, compared to children who were breastfed for at least 6 months, the odds of being obese were higher among children never breastfed or breastfed for a shorter period, both in case of general (adjusted odds ratio [adjOR] [95% CI] 1.22 [1.16–1.28] and 1.12 [1.07–1.16], respectively) and exclusive breastfeeding (adjOR [95% CI] 1.25 [1.17–1.36] and 1.05 [0.99–1.12], respectively). Higher birth weight was associated with a higher risk of being overweight, which was reported in 11 out of the 22 countries. Bulgaria, Croatia, France, Italy, Poland and Romania showed that children who were preterm at birth had higher odds of being obese, compared to children who were full-term babies. Conclusion: The present work confirms the beneficial effect of breastfeeding against obesity, which was highly increased if children had never been breastfed or had been breastfed for a shorter period. Nevertheless, adoption of exclusive breastfeeding is below global recommendations and far from the target endorsed by the WHO Member States at the World Health Assembly Global Targets for Nutrition of increasing the prevalence of exclusive breastfeeding in the first 6 months up to at least 50% by 2025.

© 2019 The Author(s) Published by S. Karger AG, Basel



Related Articles:

References

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    External Resources
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    External Resources
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    External Resources
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    External Resources
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    External Resources
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    External Resources
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    External Resources
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    External Resources
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    External Resources
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    External Resources
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    External Resources
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    External Resources
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    External Resources
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Article / Publication Details

First-Page Preview
Abstract of Research Article

Received: February 21, 2019
Accepted: April 16, 2019
Published online: April 26, 2019
Issue release date: May 2019

Number of Print Pages: 18
Number of Figures: 3
Number of Tables: 3

ISSN: 1662-4025 (Print)
eISSN: 1662-4033 (Online)

For additional information: https://www.karger.com/OFA

References

  1. Childhood Obesity Surveillance Initiative - Factsheet. Highlights 2015-17. Copenhagen: World Health Organization Regional Office for Europe; 2018.
  2. WHO European Childhood Obesity Surveillance Initiative: overweight and obesity among 6-9 year old children – Report of the third round of data collection 2012-2013. Copenhagen: World Health Organization Regional Office for Europe; 2018.
  3. Wijnhoven TM, van Raaij JM, Spinelli A, Starc G, Hassapidou M, Spiroski I, et al. WHO European Childhood Obesity Surveillance Initiative: body mass index and level of overweight among 6-9-year-old children from school year 2007/2008 to school year 2009/2010. BMC Public Health. 2014 Aug;14(1):806.
    External Resources
  4. Abarca-Gómez L, Abdeen ZA, Hamid ZA, Abu-Rmeileh NM, Acosta-Cazares B, Acuin C, et al.; NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet. 2017 Dec;390(10113):2627–42.
    External Resources
  5. WHO. Report of the commission on ending childhood obesity. Geneva: World Health Organization; 2016.
  6. Pietrobelli A, Agosti M; MeNu Group. Nutrition in the First 1000 Days: Ten Practices to Minimize Obesity Emerging from Published Science. Int J Environ Res Public Health. 2017 Dec;14(12):E1491.
    External Resources
  7. Woo Baidal JA, Locks LM, Cheng ER, Blake-Lamb TL, Perkins ME, Taveras EM. Risk Factors for Childhood Obesity in the First 1,000 Days: A Systematic Review. Am J Prev Med. 2016 Jun;50(6):761–79.
    External Resources
  8. Marseglia L, Manti S, D’Angelo G, Cuppari C, Salpietro V, Filippelli M, et al. Obesity and breastfeeding: the strength of association. Women Birth. 2015 Jun;28(2):81–6.
    External Resources
  9. Horta BL, Loret de Mola C, Victora CG. Long-term consequences of breastfeeding on cholesterol, obesity, systolic blood pressure and type 2 diabetes: a systematic review and meta-analysis. Acta Paediatr. 2015 Dec;104(467):30–7.
    External Resources
  10. Victora CG, Bahl R, Barros AJ, França GV, Horton S, Krasevec J, et al.; Lancet Breastfeeding Series Group. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016 Jan;387(10017):475–90.
    External Resources
  11. Spatz DL. Preventing obesity starts with breastfeeding. J Perinat Neonatal Nurs. 2014 Jan-Mar;28(1):41–50.
    External Resources
  12. Harder T, Bergmann R, Kallischnigg G, Plagemann A. Duration of breastfeeding and risk of overweight: a meta-analysis. Am J Epidemiol. 2005 Sep;162(5):397–403.
    External Resources
  13. Global Strategy for Infant and Young Child Feeding. Geneva: World Health Organization UNICEF; 2003.
  14. Horta BL, Victora CG. Long-term effects of breastfeeding – A Systematic Review. Geneva: World Health Organization; 2013.
  15. Mosca F, Gianni ML. Human milk: composition and health benefits. Pediatr Med Chir. 2017 Jun 28;39(2):155.
    External Resources
  16. Eidelman AI, Schanler RJ; Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics. 2012 Mar;129(3):e827–41.
    External Resources
  17. Spatz DL, Lessen R. Risks of Not Breastfeeding. International Lactation Consultant Association; 2011.
  18. Oddy WH, Smith GJ, Jacoby P. A possible strategy for developing a model to account for attrition bias in a longitudinal cohort to investigate associations between exclusive breastfeeding and overweight and obesity at 20 years. Ann Nutr Metab. 2014;65(2-3):234–5.
    External Resources
  19. Bagci Bosi AT, Eriksen KG, Sobko T, Wijnhoven TM, Breda J. Breastfeeding practices and policies in WHO European Region Member States. Public Health Nutr. 2016 Mar;19(4):753–64.
    External Resources
  20. WHO. World Health Statistics 2013. Geneva: World Health Organization; 2013.
  21. WHO. Infant and young child feeding. Geneva: World Health Organization; 2018. Available from: https://www.who.int/news-room/fact-sheets/detail/infant-and-young-child-feeding.
  22. WHO. Global Targets 2025. To improve maternal, infant and young child nutrition. Geneva: World Health Organization; 2014. Available from: https://www.who.int/nutrition/topics/nutrition_globaltargets2025/en/.
  23. Kang M, Yoo JE, Kim K, Choi S, Park SM. Associations between birth weight, obesity, fat mass and lean mass in Korean adolescents: the Fifth Korea National Health and Nutrition Examination Survey. BMJ Open. 2018 Feb;8(2):e018039.
    External Resources
  24. Glavin K, Roelants M, Strand BH, Júlíusson PB, Lie KK, Helseth S, et al. Important periods of weight development in childhood: a population-based longitudinal study. BMC Public Health. 2014 Feb;14(1):160.
    External Resources
  25. Rooney BL, Mathiason MA, Schauberger CW. Predictors of obesity in childhood, adolescence, and adulthood in a birth cohort. Matern Child Health J. 2011 Nov;15(8):1166–75.
    External Resources
  26. Vasylyeva TL, Barche A, Chennasamudram SP, Sheehan C, Singh R, Okogbo ME. Obesity in prematurely born children and adolescents: follow up in pediatric clinic. Nutr J. 2013 Nov;12(1):150.
    External Resources
  27. Yu ZB, Han SP, Zhu GZ, Zhu C, Wang XJ, Cao XG, et al. Birth weight and subsequent risk of obesity: a systematic review and meta-analysis. Obes Rev. 2011 Jul;12(7):525–42.
    External Resources
  28. Zhao Y, Wang SF, Mu M, Sheng J. Birth weight and overweight/obesity in adults: a meta-analysis. Eur J Pediatr. 2012 Dec;171(12):1737–46.
    External Resources
  29. Sacco MR, de Castro NP, Euclydes VL, Souza JM, Rondó PH. Birth weight, rapid weight gain in infancy and markers of overweight and obesity in childhood. Eur J Clin Nutr. 2013 Nov;67(11):1147–53.
    External Resources
  30. Garnett SP, Cowell CT, Baur LA, Fay RA, Lee J, Coakley J, et al. Abdominal fat and birth size in healthy prepubertal children. Int J Obes Relat Metab Disord. 2001 Nov;25(11):1667–73.
    External Resources
  31. Ibáñez L, Ong K, Dunger DB, de Zegher F. Early development of adiposity and insulin resistance after catch-up weight gain in small-for-gestational-age children. J Clin Endocrinol Metab. 2006 Jun;91(6):2153–8.
    External Resources
  32. Wijnhoven TM, van Raaij JM, Spinelli A, Rito AI, Hovengen R, Kunesova M, et al. WHO European Childhood Obesity Surveillance Initiative 2008: weight, height and body mass index in 6-9-year-old children. Pediatr Obes. 2013 Apr;8(2):79–97.
    External Resources
  33. Börnhorst C, Wijnhoven TM, Kunešová M, Yngve A, Rito AI, Lissner L, et al. WHO European Childhood Obesity Surveillance Initiative: associations between sleep duration, screen time and food consumption frequencies. BMC Public Health. 2015 Apr;15(1):442.
    External Resources
  34. Wijnhoven TM, van Raaij JM, Spinelli A, Yngve A, Lissner L, Spiroski I, et al. WHO European Childhood Obesity Surveillance Initiative: Impact of Type of Clothing Worn during Anthropometric Measurements and Timing of the Survey on Weight and Body Mass Index Outcome Measures in 6–9-Year-Old Children. J Epidemiol Res Int. 2016;2016:16.
    External Resources
  35. Rito A, Wijnhoven TM, Rutter H, Carvalho MA, Paixão E, Ramos C, et al. Prevalence of obesity among Portuguese children (6-8 years old) using three definition criteria: COSI Portugal, 2008. Pediatr Obes. 2012 Dec;7(6):413–22.
    External Resources
  36. Childhood Obesity Surveillance Initiative (COSI) Protocol. World Health Organization Regional Office for Europe; 2016.
  37. Childhood Obesity Surveillance Initiative (COSI) – Data collection procedures. World Health Organization Regional Office for Europe; 2016.
  38. International Ethical Guidelines for Biomedical Research Involving Human Subjects. Geneva: Council for International Organizations of Medical Sciences, World Health Organization; 2002.
  39. de Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ. 2007 Sep;85(9):660–7.
    External Resources
  40. WHO. Physical status. The use and interpretation of anthropometry. Geneva: World Health Organization; 1995.
  41. Ota E, Haruna M, Suzuki M, Anh DD, Tho H, Tam NT, et al. Maternal body mass index and gestational weight gain and their association with perinatal outcomes in Viet Nam. Bull World Health Organ. 2011 Feb;89(2):127–36.
    External Resources
  42. Cattaneo A, Burmaz T, Arendt M, Nilsson I, Mikiel-Kostyra K, Kondrate I, et al.; ‘Promotion of Breastfeeding in Europe: Pilot Testing the Blueprint for Action’ Project. Protection, promotion and support of breast-feeding in Europe: progress from 2002 to 2007. Public Health Nutr. 2010 Jun;13(6):751–9.
    External Resources
  43. Whitehead RG. For how long is exclusive breast-feeding adequate to satisfy the dietary energy needs of the average young baby? Pediatr Res. 1995 Feb;37(2):239–43.
    External Resources
  44. Heinig MJ, Nommsen LA, Peerson JM, Lonnerdal B, Dewey KG. Energy and protein intakes of breast-fed and formula-fed infants during the first year of life and their association with growth velocity: the DARLING Study. Am J Clin Nutr. 1993 Aug;58(2):152–61.
    External Resources
  45. Owen CG, Whincup PH, Kaye SJ, Martin RM, Davey Smith G, Cook DG, et al. Does initial breastfeeding lead to lower blood cholesterol in adult life? A quantitative review of the evidence. Am J Clin Nutr. 2008 Aug;88(2):305–14.
    External Resources
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May 2019

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