Open Access Highly Accessed Research article

The Terneuzen Birth Cohort. Longer exclusive breastfeeding duration is associated with leaner body mass and a healthier diet in young adulthood

Marlou LA De Kroon1*, Carry M Renders2, Michelle PJ Buskermolen1, Jacobus P Van Wouwe3, Stef van Buuren34 and Remy A Hirasing1

Author Affiliations

1 Department of Public and Occupational Health, The EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands

2 Department of Health Sciences, Faculty of Earth and Life Sciences and EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands

3 Netherlands Organization for Applied Scientific Research, TNO Quality of Life, Prevention and Health Care, Leiden, The Netherlands

4 Dept of Methodology and Statistics, FSS, University of Utrecht, The Netherlands

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BMC Pediatrics 2011, 11:33  doi:10.1186/1471-2431-11-33

Published: 10 May 2011

Abstract

Background

Breastfeeding (BF) is protective against overweight and is associated with dietary behaviour. The aims of our study were to assess the relationship between exclusive BF duration and BMI, waist circumference (WC) and waist-hip ratio (WHR) at adulthood, and to study whether dietary behaviour could explain the relationship between BF duration and the proxies of fat mass.

Methods

In 2004-2005, 822 subjects from the Terneuzen Birth Cohort (n = 2,604), aged 18-28 years, filled in postal questionnaires including sociodemographic factors and aspects of dietary behaviour (dietary pattern, and consumption of fruit and vegetables, snacks, sweetened beverages and alcohol); 737 subjects also underwent anthropometric measurements of weight, height, and waist and hip circumference. The relationship between exclusive BF duration and dietary outcomes was investigated by logistic regression analysis. The relationships of BF duration with the anthropometric measures were investigated by linear regression analyses. All results were corrected for age, gender and possible confounders. Finally, regression analyses were performed to investigate if diet factors had a mediating effect on the relationship between BF duration and fat mass.

Results

A significant inverse dose-response relationship of BF duration was found for BMI (β-0.13, SE 0.06), WC (β-0.39, SE 0.18) and WHR (β-0.003, SE 0.001), after correction for age, gender and confounders. The odds ratio (OR) of exclusive BF duration in months for a breakfast frequency of at least 5 times a week was 1.16 (95%CI 1.06-1.27), and for snack consumption of less than twice a week was 1.15 (95%CI 1.06-1.25). Both ORs were corrected for age, gender and confounders. For other dietary outcomes, the results point in the same direction, i.e. a positive relationship with BF duration, but these were not statistically significant. A mediating effect of the diet factors on the association between BF and anthropometric outcomes was not shown.

Conclusions

Exclusive BF duration had a significant inverse dose-response relationship with BMI, WC and WHR at young adulthood. BF duration was positively related to a healthier diet at adulthood, but this did not explain the protective effect of BF against body fat. Our results underline the recommendation of the WHO to exclusively breastfeed for 6 months or longer.