title: Breastfeeding shows a protective trend toward adolescents with higher abdominal adiposity.
abstract: OBJECTIVE
  The question of whether breastfeeding has a protective effect against the development of overweight or obesity later in life remains controversial, especially during adolescence. The objective was to assess the relationship between breastfeeding and adolescents' body composition.
  
  
  METHODS
  The HELENA study is a cross-sectional study involving 3,528 adolescents from 10 European cities. The outcome measures were body weight and height, subscapular skinfolds as well as waist circumferences. Breastfeeding, smoking status, and parental socioeconomic status were assessed by self-administered questionnaires. Dietary intake was recorded using two 24-hour recall surveys. Two adjustment approaches were used: i) covariance analysis adjusted for confounding factors (propensity score adjustment) and ii) multivariate quantile regression.
  
  
  RESULTS
  After adjustment, no significant associations were observed between breastfeeding and body composition parameters (BMI Z-score; sum of skinfolds; waist-to-height ratio). An adjusted quantile regression analysis showed a non-significant trend for a protective effect of breastfeeding toward the highest percentiles of adiposity in boys but not in girls. This is of particular interest with respect to the superiority of the waist-to-height ratio over waist circumference and BMI for detecting cardiometabolic risk factors.
  
  
  CONCLUSIONS
  This first European study, including a large set of factors influencing adolescents' body composition, showed a non-significant trend toward a protective effect of breastfeeding on highest percentiles of adolescent's abdominal adiposity.
authors.affiliation: Unité de Biostatistiques, CERIM, EA2694, UDSL, Université Lille Nord de France, Lille, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Rousseaux
authors.forename: Alain
authors.initials: A
authors.lastname: Duhamel
authors.forename: Dominique
authors.initials: D
authors.lastname: Turck
authors.forename: Denes
authors.initials: D
authors.lastname: Molnar
authors.forename: Julia
authors.initials: J
authors.lastname: Salleron
authors.forename: Enrique Garcia
authors.initials: EG
authors.lastname: Artero
authors.forename: Stefaan
authors.initials: S
authors.lastname: De Henauw
authors.forename: Sabine
authors.initials: S
authors.lastname: Dietrich
authors.forename: Yannis
authors.initials: Y
authors.lastname: Manios
authors.forename: Raffaela
authors.initials: R
authors.lastname: Piccinelli
authors.forename: Michael
authors.initials: M
authors.lastname: Sjöström
authors.forename: Luis Aznar
authors.initials: LA
authors.lastname: Moreno
authors.forename: Frédéric
authors.initials: F
authors.lastname: Gottrand
mesh_terms: D000005:Abdomen; D050154:Adiposity; D000293:Adolescent; D001837:Body Weights and Measures; D001942:Breast Feeding; D003430:Cross-Sectional Studies; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D056128:Obesity, Abdominal / Q000517:prevention & control*; D012737:Sex Factors