Horta Bernardo L, Loret de Mola Christian, Victora Cesar G
Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Petolas, Brazil.
Acta Paediatr. 2015 Dec;104(467):30-7. doi: 10.1111/apa.13133.
To systematically review the evidence on the associations between breastfeeding and overweight/obesity, blood pressure, total cholesterol and type 2 diabetes.
Two independent literature searches were carried out using the MEDLINE, LILACS, SCIELO and Web of Science databases. Studies restricted to infants and those without an internal comparison group were excluded. Fixed- and random-effects models were used to pool the estimates.
Breastfed subjects were less likely to be considered obese/overweight [pooled odds ratio: 0.74 (95% confidence interval (CI): 0.70; 0.78)] (n = 113). Among the 11 high-quality studies, the association was smaller [pooled odds ratio: 0.87 (95%CI: 0.76; 0.99)]. Total cholesterol (n = 46) was independent of breastfeeding [pooled mean difference: -0.01 mmol/L (95%CI: -0.05; 0.02)]. Systolic blood pressure (n = 43) was lower among breastfed subjects [mean difference: -0.80 (95%CI: -1.17; -0.43)], but no association was observed among larger studies, and for diastolic blood pressure (n = 38) [mean difference: -0.24 (95%CI: -0.50; 0.02)]. For type 2 diabetes (n = 11), the odds ratio was lower among those subjects who had been breastfed [pooled odds ratio: 0.65 (95%CI: 0.49; 0.86)].
Breastfeeding decreased the odds of type 2 diabetes and based on high-quality studies, decreased by 13% the odds of overweight/obesity. No associations were found for total cholesterol or blood pressure.
系统评价母乳喂养与超重/肥胖、血压、总胆固醇和2型糖尿病之间关联的证据。
使用MEDLINE、LILACS、SCIELO和科学网数据库进行了两项独立的文献检索。排除仅限于婴儿且无内部对照组的研究。采用固定效应模型和随机效应模型汇总估计值。
母乳喂养的受试者被认为肥胖/超重的可能性较小[合并比值比:0.74(95%置信区间(CI):0.70;0.78)](n = 113)。在11项高质量研究中,这种关联较小[合并比值比:0.87(95%CI:0.76;0.99)]。总胆固醇(n = 46)与母乳喂养无关[合并平均差:-0.01 mmol/L(95%CI:-0.05;0.02)]。母乳喂养的受试者收缩压较低(n = 43)[平均差:-0.80(95%CI:-1.17;-0.43)],但在规模较大的研究中未观察到关联,舒张压(n = 38)也无关联[平均差:-0.24(95%CI:-0.50;0.02)]。对于2型糖尿病(n = 11),母乳喂养的受试者比值比更低[合并比值比:0.65(95%CI:0.49;0.86)]。
母乳喂养降低了2型糖尿病的发病几率,基于高质量研究,超重/肥胖的发病几率降低了13%。未发现总胆固醇或血压与之存在关联。