title: Inverse association of overweight and breast feeding in 9 to 10-y-old children in Germany.
abstract: OBJECTIVE
  To evaluate whether breast feeding is associated with prevalent overweight in pre-adolescent children.
  
  
  METHODS
  Cross-sectional studies of 9 to 10-y-old children attending fourth grade in 1995/1996 in Dresden (n=1046) and Munich (n=1062), Germany, according to the International Study of Asthma and Allergies in Childhood (ISAAC) Phase II protocol. A comprehensive questionnaire including detailed breast feeding history was filled out by the child's parent. Height and weight were measured in a random subsample of children undergoing spirometry. Overweight was defined as body mass index > or =90th age- and sex-specific percentile of the German reference.
  
  
  RESULTS
  While the prevalence of overweight differed substantially between Dresden (girls 9.1%, boys 12.5%) and Munich (17% both), we observed a markedly lower overweight prevalence among breast fed than non-breast fed children in both cities. Controlling for age, sex and city, breast-fed children were substantially less likely to be overweight at 9-10 y (OR 0.55, 95% CI 0.41-0.74). Results were slightly attenuated after adjustment for nationality, socio-economic status, number of siblings, parental smoking (OR 0.66, 95% CI 0.52-0.87). A longer overall duration and duration of exclusive breast feeding was associated significantly with decreasing prevalence of overweight.
  
  
  CONCLUSIONS
  The results highlight the importance and possible preventive potential of early nutrition in the development of overweight in children. Both feeding behaviors acquired by the nursing infant and metabolic effects may contribute to the observed inverse association of breast feeding and overweight in children.
authors.affiliation: Institute of Epidemiology and Social Medicine, University of Muenster, Germany. ALIESE@sph.sc.edu
authors.forename: A D
authors.initials: AD
authors.lastname: Liese
authors.forename: T
authors.initials: T
authors.lastname: Hirsch
authors.forename: E
authors.initials: E
authors.lastname: von Mutius
authors.forename: U
authors.initials: U
authors.lastname: Keil
authors.forename: W
authors.initials: W
authors.lastname: Leupold
authors.forename: S K
authors.initials: SK
authors.lastname: Weiland
mesh_terms: D015992:Body Mass Index; D001942:Breast Feeding / Q000706:statistics & numerical data*; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D009765:Obesity / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D011795:Surveys and Questionnaires