Late introduction of complementary feeding, rather than duration of breastfeeding, may protect against adult overweight123

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Background: Early nutrition may affect the risk of overweight in later life.

Objective: The objective was to explore the effect of the duration of breastfeeding (BF) and age at introduction of complementary feeding (CF) on body mass index (BMI) during childhood through adulthood.

Design: The study was based on a subsample of the Copenhagen Perinatal Cohort established in 1959–1961 (n = 5068). Information on BF and available information on CF (age of introduction of “spoon-feeding,” “vegetables,” “egg,” “meat,” and “firm food”) and several covariates were collected in infancy and linked with information on BMI from follow-up examinations in childhood and adulthood at age 42 y.

Results: The median (10th, 90th percentiles) durations of any BF and age at introduction of spoon-feeding were 2.50 (0.23, 6.50) and 3.50 (2.00, 6.00) mo, respectively. After 1 y of age and throughout childhood and adolescence, no association between BF and BMI was found in regression models also adjusted for age at introduction of spoon-feeding and covariates. The risk of overweight at age 42 y decreased or tended to decrease with increasing age (in mo) at introduction of spoon-feeding [odds ratio (OR): 0.94; 95% CI: 0.86, 1.02], vegetables (OR: 0.90; 95% CI: 0.81, 0.98), meat (OR: 0.93; 95% CI: 0.87, 1.00), and firm food (OR: 0.92; 95% CI: 0.86, 0.98) but not egg (OR: 0.98; 95% CI: 0.91, 1.05).

Conclusion: The findings of this study suggest that introduction of CF at a later age (within the range of 2 to 6 mo) is protective against overweight in adulthood but do not support a protective effect of a longer duration of BF.

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1

From the Department of Human Nutrition Faculty of Life Science University of Copenhagen Copenhagen Denmark (LS-NKFM); the Institute of Preventive Medicine Copenhagen University Hospital Centre for HealthSociety Copenhagen Denmark (TIASELM); the Department of Environmental Health Institute of Public HealthCenter for Healthy Aging University of Copenhagen Copenhagen Denmark (ELM)

2

Supported by US Public Health Service grants HD17655 and HD20263 from the National Institute of Child Health and Human Development (to Reinisch), USPHS grant DA05056 from the National Institute on Drug Abuse (to Reinisch and Sanders), grant 9700093 from The Danish Research Council and grant 1400/2 4 1997 from the Danish National Board of Health (to ELM), a grant from The National Danish Science Foundation (to TIAS), and a grant from The National Danish Agricultural and Veterinary Research Council (to KFM).

3

Address correspondence to KF Michaelsen, Department of Human Nutrition, Rolighedsvej 30, DK-1958 Frederiksberg C, Denmark. E-mail: [email protected].