Infant diet and metabolic outcomes in school-age children. The Generation R Study.
BACKGROUND
Breastfeeding duration is associated with the risks of cardio-metabolic diseases in adulthood. We examined the associations of infant feeding patterns with metabolic outcomes in children and whether any association was explained by family-based socio-demographic, maternal lifestyle-related or childhood factors.


METHODS
We performed a population-based prospective cohort study in 3417 children to examine the associations of breastfeeding duration and exclusivity and age at introduction of solid foods with blood levels of lipids, insulin and C-peptide and risk of clustering of cardio-metabolic risk factors at the median age of 6.0 years (90% range 5.7-6.8).


RESULTS
We observed that, in the models only adjusted for child's age and sex, ever breastfeeding was not associated with childhood blood levels of lipids but was associated with higher insulin and C-peptide concentrations (P-value<0.05). Breastfeeding duration and exclusivity were not consistently associated with metabolic outcomes. Early introduction of solid foods was associated with higher levels of total cholesterol (P-value<0.05) but not with high-density lipoprotein and low-density lipoprotein cholesterol, triglycerides and insulin levels. Shorter breastfeeding duration and exclusive breastfeeding were associated with increased risks of clustering of cardio-metabolic risk factors. After additional adjustment for family, maternal and childhood factors, none of these associations remained significant.


CONCLUSIONS
In conclusion, we found no consistent associations of infant feeding patterns with metabolic outcomes at school age, after taking into account family-based socio-demographic, maternal lifestyle-related or childhood factors. Whether infant diet composition influences metabolic outcomes in later life should be further studied.
1] Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands [2] Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands [3] Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
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Gishti
1] Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands [2] Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands [3] Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
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Gaillard
Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands.
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B
Durmuş
Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
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A
Hofman
1] Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands [2] Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
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Duijts
Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
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Franco
1] Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands [2] Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands [3] Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
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Jaddoe
D000328:Adult; D001942:Breast Feeding; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology*; D002648:Child; D002784:Cholesterol / Q000097:blood; D004032:Diet; D005260:Female; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007328:Insulin / Q000097:blood; D008297:Male; D008659:Metabolic Diseases / Q000097:blood / Q000209:etiology*; D012307:Risk Factors; D012959:Socioeconomic Factors; D014280:Triglycerides / Q000097:blood; D055815:Young Adult
D007328:Insulin; D014280:Triglycerides; D002097:C-Reactive Protein; D002784:Cholesterol