Affiliation:
1. Center for Research in Nutrition and Health Disparities and Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina
2. Department of Preventive Medicine and Biometrics, University of Colorado School of Medicine, Denver, Colorado
3. Department of Public Health Sciences, Wake Forest University School of Medicine, Winston Salem, North Carolina
Abstract
OBJECTIVE—To evaluate the hypothesis that breast-feeding is associated with reduced type 2 diabetes among African-American, Hispanic, and non-Hispanic white youth, mediated in part by current weight status.
RESEARCH DESIGN AND METHODS—The SEARCH Case-Control Study, an ancillary study to SEARCH for Diabetes in Youth, was conducted in two of six SEARCH clinical sites. Eighty youth with type 2 diabetes aged 10–21 years were included. Nondiabetic control participants were recruited from primary care provider offices (n = 167). Breast-feeding information was recalled by biological mothers.
RESULTS—Prevalence (%) of breast-feeding (any duration) was lower among youth with type 2 diabetes than among control subjects (19.5 vs. 27.1 for African Americans, 50.0 vs. 83.8 for Hispanics, and 39.1 vs. 77.6 for non-Hispanic whites). The overall crude odds ratio for the association of breast-feeding (ever versus never) and type 2 diabetes was 0.26 (95% CI 0.15–0.46). Results were similar by race/ethnic group (P value for interaction = 0.17). The odds ratio for the association after adjusting for 12 potential confounders was 0.43 (0.19–0.99). When current BMI z-score was added to the model, the odds ratio was attenuated (0.82 [0.30–2.30]), suggesting possible mediation through current childhood weight status. Analyses that incorporated duration of breast-feeding, adjusted for potential confounders, provided evidence for dose response (test for trend, P value <0.0001), even after inclusion of BMI z-score.
CONCLUSIONS—Breast-feeding appears to be protective against development of type 2 diabetes in youth, mediated in part by current weight status in childhood.
Publisher
American Diabetes Association
Subject
Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine
Cited by
61 articles.
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