Does breastfeeding influence risk of type 2 diabetes in later life? A quantitative analysis of published evidence

Christopher G Owen, Richard M Martin, Peter H Whincup, George Davey Smith and Derek G Cook

American Journal of Clinical Nutrition, Vol. 84, No. 5, 1043-1054, November 2006


Background: Observational evidence suggests that having been breastfed in infancy may reduce the prevalence of type 2 diabetes in later life.

Objective: The objective was to examine the influence of initial breastfeeding on type 2 diabetes and blood glucose and insulin concentrations.

Design: A systematic review of published studies identified 1010 reports; 23 examined the relation between infant feeding and type 2 diabetes in later life or risk factors for diabetes. Risk factors in infants were examined separately from those in children and adults. All estimates were pooled by using fixed-effect models; differences <0 and ratios <1 imply a beneficial effect of breastfeeding.

Results: Subjects who were breastfed had a lower risk of type 2 diabetes in later life than did those who were formula fed (7 studies; 76 744 subjects; odds ratio: 0.61; 95% CI: 0.44, 0.85; P = 0.003). Children and adults without diabetes who had been breastfed had marginally lower fasting insulin concentrations than did those who were formula fed (6 studies; 4800 subjects; percentage difference: –3%; 95% CI: –8%, 1%; P = 0.13); no significant difference in fasting glucose concentrations was observed. Breastfed infants had lower mean preprandial blood glucose (12 studies; 560 subjects; mean difference: –0.17 mmol/L; 95% CI: –0.28, –0.05 mmol/L; P = 0.005) and insulin (7 studies; 291 subjects; mean difference: –2.86 pmol/L; 95% CI: –5.76, 0.04 pmol/L; P = 0.054) concentrations than did those who were formula fed.

Conclusion: Breastfeeding in infancy is associated with a reduced risk of type 2 diabetes, with marginally lower insulin concentrations in later life, and with lower blood glucose and serum insulin concentrations in infancy.

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