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Long-term effects of breastfeeding – A systematic review

Breastfeeding has well-established short-term benefits, particularly the reduction of morbidity and mortality due to infectious diseases in childhood. A pooled analysis of studies carried out in middle/ low income countries showed that breastfeeding substantially lowers the risk of death from infectious diseases in the first two years of life.

Based on data from the United Kingdom Millennium Cohort, Quigley et al estimated that optimal breastfeeding practices could prevent a substantial proportion of hospital admissions due to diarrhea and lower respiratory tract infection. A systematic review by Kramer et al confirmed that exclusive breastfeeding in the first 6 months decreases morbidity from gastrointestinal and allergic diseases, without any negative effects on growth.
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Timing of introduction of gluten into the infant diet

Scientific Advisory Committee on Nutrition (SACN) and the Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT) Join Statement, March 2011

Background
In 2010, the Department of Health and Food Standards Agency asked the Scientific Advisory Committee on Nutrition (SACN) and the Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT) to assess the evidence on timing of introduction of gluten into the infant diet and subsequent risk of developing coeliac disease or type 1 diabetes mellitus (T1DM). The request was made in response to the publication of a European Food Safety Authority (EFSA) Panel on Dietetic Products, Nutrition and Allergies (NDA) Scientific Opinion on the appropriate age for the introduction of complementary food into infant diets in the EU; this included conclusions that were inconsistent with UK infant feeding advice.
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Lactation and Maternal Risk of Type 2 Diabetes: A Population-based Study

Schwarz EB, Brown JS, Creasman JM, Stuebe A, McClure CK, Van Den Eeden SK, Thom D.
Am J Med. 2010 Sep;123(9):863.e1-6.

Abstract

BACKGROUND: Lactation has been associated with improvements in maternal glucose metabolism.

METHODS: We explored the relationships between lactation and risk of type 2 diabetes in a well-characterized, population-representative cohort of women, aged 40-78 years, who were members of a large integrated health care delivery organization in California and enrolled in the Reproductive Risk factors for Incontinence Study at Kaiser (RRISK), between 2003 and 2008.

Multivariable logistic regression was used to control for age, parity, race, education, hysterectomy, physical activity, tobacco and alcohol use, family history of diabetes, and body mass index while examining the impact of duration, exclusivity, and consistency of lactation on risk of having developed type 2 diabetes.
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Chronic disease and infant nutrition: is it significant to public health?

Smith JP, Harvey PJ.
Public Health Nutr. 2010 Jul 13:1-11.

Abstract

OBJECTIVE: To assess the public health significance of premature weaning of infants from breast milk on later-life risk of chronic illness.

DESIGN: A review and summary of recent meta-analyses of studies linking premature weaning from breast milk with later-life chronic disease risk is presented followed by an estimation of the approximate exposure in a developed Western country, based on historical breast-feeding prevalence data for Australia since 1927. The population-attributable proportion of chronic disease associated with current patterns of artificial feeding in infancy is estimated.

RESULTS: After adjustment for major confounding variables, current research suggests that the risks of chronic disease are 30-200 % higher in those who were not breast-fed compared to those who were breast-fed in infancy.
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Parity, Breastfeeding and the Subsequent Risk of Maternal Type 2 Diabetes

Liu B, Jorm L, Banks E.
Diabetes Care. 2010 Mar 23. [Epub ahead of print]

Abstract

Objective: To examine the effect of childbearing and maternal breastfeeding on a woman’s subsequent risk of developing type 2 diabetes.

Research Design and Methods: Using information on parity, breastfeeding and diabetes collected from 52,731 women recruited into a cohort study, we estimated the risk of type 2 diabetes using multivariate logistic regression.

Results: 3,160 (6.0%) women were classified with type 2 diabetes. Overall, nulliparous and parous women had a similar risk of diabetes. Among parous women, there was a 14% (95%CI 10-18%, p<0.001) reduced likelihood of diabetes per year of breastfeeding.
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Duration of Lactation and Risk Factors for Maternal Cardiovascular Disease

Schwarz EB, Ray RM, Stuebe AM, Allison MA, Ness RB, Freiberg MS, Cauley JA.
Obstet Gynecol. 2009 May;113(5):974-982.

Abstract

OBJECTIVE: To examine dose-response relationships between the cumulative number of months women lactated and postmenopausal risk factors for cardiovascular disease.

METHODS: We examined data from 139,681 postmenopausal women (median age 63 years) who reported at least one live birth on enrolling in the Women’s Health Initiative observational study or controlled trials. Multivariable models were used to control for sociodemographic (age, parity, race, education, income, age at menopause), lifestyle, and family history variables when examining the effect of duration of lactation on risk factors for cardiovascular disease, including obesity (body mass index [BMI] at or above 30), hypertension, self-reported diabetes, hyperlipidemia, and prevalent and incident cardiovascular disease.
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Duration of lactation is associated with lower prevalence of the metabolic syndrome in midlife

Kavitha T. Ram, Paul Bobby, Susan M. Hailpern, Joan C. Lo, Miriam Schocken, Joan Skurnick, Nanette Santoro

American Journal of Obstetrics & Gynecology 2008; 198:3 268.e1-e6

Abstract

Objective
The objective of the study was to evaluate whether lactation duration is associated with lower prevalence of metabolic syndrome (MetSyn) in midlife, parous women.

Study Design
This was a cross-sectional cohort analysis of 2516 parous, midlife women using multivariable logistic regression to determine the independent association of lactation and lactation duration on prevalence of MetSyn.

Results
One thousand six hundred twenty women (64.4%) reported a history of breast-feeding, with average lifetime duration of lactation of 1.16 (± 1.04) years.
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Duration of breast-feeding and the incidence of type 2 diabetes mellitus in the Shanghai Women’s Health Study

R. Villegas, Y.-T. Gao, G. Yang, H. L. Li, T. Elasy, W. Zheng and X.-O. Shu

Diabetologia. 2007 Nov 27 [Epub ahead of print]

Abstract

Aims/hypothesis The aim of this study was to examine the association between lifetime breast-feeding and the incidence of type 2 diabetes mellitus in a large population-based cohort study of middle-aged women.

Methods This was a prospective study of 62,095 middle-aged parous women in Shanghai, China, who had no prior history of type 2 diabetes mellitus, cancer or cardiovascular disease at study recruitment. Breast-feeding history, dietary intake, physical activity and anthropometric measurements were assessed by in-person interviews.
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Breastfeeding and Maternal and Infant Health Outcomes in Developed Countries

Stanley Ip, M.D., Mei Chung, M.P.H., Gowri Raman, M.D., Priscilla Chew, M.P.H., Nombulelo Magula, M.D., Deirdre DeVine, M.Litt., Thomas Trikalinos, M.D., Ph.D., Joseph Lau, M.D.

Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services, April 2007

Structured Abstract

Objectives: We reviewed the evidence on the effects of breastfeeding on short- and long-term infant and maternal health outcomes in developed countries.

Data Sources: We searched MEDLINE®, CINAHL, and the Cochrane Library in November of 2005. Supplemental searches on selected outcomes were searched through May of 2006. We also identified additional studies in bibliographies of selected reviews and by suggestions from technical experts.
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Evidence on the long-term effects of breastfeeding: systematic review and meta-analyses

Bernardo L. Horta, Rajiv Bahl, José C. Martines, Cesar G. Victora
World Health Organization 2007

Executive summary

Background: Breastfeeding presents clear short-term benefits for child health, mainly protection against morbidity and mortality from infectious diseases. On the other hand, there is some controversy on the long-term consequences of breastfeeding. Whereas some studies reported that breastfed subjects present a higher level of school achievement and performance in intelligence
tests, as well as lower blood pressure, lower total cholesterol and a lower prevalence of overweight
and obesity, others have failed to detect such associations.

Objectives: The primary objective of this series of systematic reviews was to assess the effects of breastfeeding on blood pressure, diabetes and related indicators, serum cholesterol, overweight and obesity, and intellectual performance.
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