Influence of Breastfeeding on Obesity and Type 2 Diabetes Risk Factors in Latino Youth With a Family History of Type 2 Diabetes

Abstract

OBJECTIVE -To determine whether breastfeeding is related to total adiposity, regional adiposity, and glucose and insulin dynamics in overweight Latino youth throughout puberty. RESEARCH DESIGN AND METHODS -The relation between breastfeeding and diabetes risk was determined in 240 overweight (BMI Ն85th percentile) Latino children (aged 8 -13 years) with a positive family history of type 2 diabetes. Children were examined at baseline (Tanner pubertal stage 1) and for 2 more years as they advanced in pubertal maturation. Children were divided into the following categories: never breastfed (n ϭ 102), breastfed 0 -5.99 months (n ϭ 61), breastfed 6 -11.99 months (n ϭ 24), and breastfed Ն12 months (n ϭ 53). Tanner pubertal stage was determined by physical examination. Visceral and subcutaneous abdominal fat were determined by magnetic resonance imagining, and total body fat, total lean tissue mass, and percent body fat were measured by dual-energy X-ray absorptiometry. Fasting and postchallenge glucose were assessed with a 2-h oral glucose tolerance test. Insulin sensitivity (SI), acute insulin response (AIR), and disposition index ([DI] an index of ␤-cell function) were measured by frequently sampled intravenous glucose tolerance test and minimal modeling. Data were analyzed using linear mixed-effects modeling.RESULTS -There were no significant effects of breastfeeding categories on adiposity (i.e., total fat mass, total lean tissue mass, percent body fat), fat distribution (visceral and subcutaneous abdominal fat), fasting glucose or 2-h glucose, or insulin dynamics (SI, AIR, and DI) at Tanner pubertal stage 1 or on changes in these variables over pubertal transitions in overweight Latino youth.CONCLUSIONS -In this population of high-risk Latino youth, there were no significant protective effects of breastfeeding on adiposity or type 2 diabetes risk factors at Tanner pubertal stage 1 or across advances in maturation. Diabetes Care 30:784 -789, 2007W hether breastfeeding protects against obesity later in life is a controversial topic in literature. Some investigators have shown that breastfeeding has protective effects against childhood obesity (1-5), while others have not observed an association (6 -8). Moreover, the protective effect of breastfeeding may vary according to ethnicity (6,9,10). This debate may be hampered because of prior study designs in that the majority of studies have used either global measures of adiposity such as BMI or less accurate estimates of body composition such as skinfolds. To date, few studies have examined the effects of breastfeeding on general adiposity using dual-energy X-ray absorptiometry (DEXA) (11-13), and no study has examined the effects of breastfeeding on fat distribution using magnetic resonance imaging (MRI). Moreover, no previous study has assessed the protective breastfeeding effects on adiposity or risk factors for type 2 diabetes across pubertal transition from Tanner stage 1 to 5.Recently, several investigators have demonstrated that breastfeeding was also protective ...

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