title: Glucose tolerance and insulin resistance in Indian children: relationship to infant feeding pattern.
abstract: OBJECTIVE
  Our objective was to examine whether longer duration of breast-feeding and later introduction of complementary foods are associated with lower glucose concentrations and insulin resistance (IR-HOMA) in Indian children.
  
  
  METHODS
  Breast-feeding duration (six categories from <3 to ≥18 months) and age at introduction of complementary foods (four categories from <4 to ≥6 months) were recorded at 1, 2 and 3 year follow-up of 568 children from a birth cohort in Mysore, India. At 5 and 9.5 years of age, 518 children were assessed for glucose tolerance and IR-HOMA.
  
  
  RESULTS
  All the children were initially breast-fed; 90% were breast-fed for ≥6 months and 56.7% started complementary foods at or before the age of 4 months. Each category increase in breast-feeding duration was associated with lower fasting insulin concentration (β = -0.05 pmol/l [95% CI -0.10, -0.004]; p = 0.03) and IR-HOMA (β = -0.05 [95% CI -0.10, -0.001]; p = 0.046) at 5 years, adjusted for the child's sex, age, current BMI, socioeconomic status, parent's education, rural/urban residence, birthweight and maternal gestational diabetes status. Longer duration of breastfeeding was associated with higher 120-min glucose concentration at 5 years (β = 0.08 mmol/l [95% CI 0.001, 0.15; p = 0.03]) but lower 120-min glucose concentration at 9.5 years (β = -0.09 [95% CI -0.16, -0.03]; p = 0.006). Age at starting complementary foods was unrelated to the children's glucose tolerance and IR-HOMA.
  
  
  CONCLUSIONS
  Within this cohort, in which prolonged breast-feeding was the norm, there was evidence of a protective effect of longer duration of breast-feeding against glucose intolerance at 9.5 years. At 5 years longer duration of breast-feeding was associated with lower IR-HOMA.
authors.affiliation: Epidemiology Research Unit, Holdsworth Memorial Hospital, P.O. Box 38, Mandi Mohalla, Mysore 570021, India. veenasr@gmail.com
authors.forename: S R
authors.initials: SR
authors.lastname: Veena
authors.forename: G V
authors.initials: GV
authors.lastname: Krishnaveni
authors.forename: A K
authors.initials: AK
authors.lastname: Wills
authors.forename: J C
authors.initials: JC
authors.lastname: Hill
authors.forename: S C
authors.initials: SC
authors.lastname: Karat
authors.forename: C H D
authors.initials: CH
authors.lastname: Fall
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D001942:Breast Feeding; D005215:Fasting / Q000097:blood; D005260:Female; D018149:Glucose Intolerance / Q000097:blood*; D006801:Humans; D007194:India; D007223:Infant; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male
chemical_list: D001786:Blood Glucose; D007328:Insulin