title: Lactation history, serum concentrations of persistent organic pollutants, and maternal risk of diabetes.
abstract: Lactation may help curb diabetes risk and is also known as an excretion route for some environmental pollutants. We evaluated associations of lifetime lactation history with serum concentrations of persistent organic pollutants (POPs) in the National Health and Nutrition Examination Survey 1999-2006, and examined whether potentially diabetogenic POPs account for associations between lactation and diabetes.
  
  
  
  Among 4479 parous women, breastfeeding history was defined as the number of children breastfed ≥1 month. Diabetes was identified by self-report or hemoglobin A1c >6.5%. Twenty-four POPs were measured in serum among subsamples of 668 to 1073 participants.
  
  
  
  Compared with women without lactation history, odds ratios (95% confidence intervals) of having diabetes among those with 1-2 and ≥3 lactation periods were 0.83(0.61, 1.13) and 0.63(0.44, 0.91; P trend=0.03). Lifetime lactation history was inversely associated with serum concentrations of 17 out of the 24 organochlorine pesticides, polychlorinated biphenyl congeners (PCBs), and perfluoroalkyl substances (Ptrend<0.05). Comparing the ≥3 lactations group with women without a lactation history, the relative reduction of POPs ranged from 12% (PCB-196) to 30% (oxychlordane). The inverse association between lactation and diabetes was slightly attenuated after adjustment for POPs. Age-stratified analyses showed that the inverse association between lactation periods and serum POP concentrations was observed primarily among participants <60 years, whereas age did not significantly modify the association between lactation history and diabetes prevalence.
  
  
  
  Crudely-classified lifetime lactation history was inversely associated with concurrent serum POP concentrations and diabetes prevalence. Prospective studies are needed to clarify how lactation could complement diabetes prevention through decreasing the POP body burdens.
authors.affiliation: Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
authors.forename: Geng
authors.initials: G
authors.lastname: Zong
authors.affiliation: Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Institute of Public Health, University of Southern Denmark, Odense, Denmark.
authors.forename: Philippe
authors.initials: P
authors.lastname: Grandjean
authors.affiliation: Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA; Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: Xiaobin
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. Electronic address: qisun@hsph.harvard.edu.
authors.forename: Qi
authors.initials: Q
authors.lastname: Sun
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000209:etiology; D004781:Environmental Exposure; D004785:Environmental Pollutants / Q000097:blood*; D005260:Female; D006801:Humans; D007774:Lactation; D008875:Middle Aged; D009749:Nutrition Surveys; D015995:Prevalence; D012306:Risk; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D004785:Environmental Pollutants
keywords: Diabetes; Lactation; Persistent organic pollutant