Interaction between exclusive breastfeeding and income on the risk of obesity at age 6 years in the United States Open Access

Chen, Enhui (2016)

Permanent URL: https://etd.library.emory.edu/concern/etds/s7526d17r?locale=en
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Abstract

Background: Most studies show that exclusive breastfeeding (EBF) is associated with lower risk for childhood obesity, but some studies show null association. In addition, low income is related to both lower breastfeeding prevalence and higher risk for childhood obesity, but the interaction between breastfeeding history, income, and childhood obesity is unclear. This study examined the interaction between EBF and income on the risk for obesity at age 6 years.

Method: This study analyzed data from the Infant Feeding Practice Study II and its Year 6 Follow Up study (n = 1542). Regression analysis was used to model the prevalence of childhood obesity at age 6 years by EBF duration, categorized as not EBF, EBF < 6 months, and EBF ≥ 6 months. We tested for heterogeneity of the estimates by income status at the beginning of the study, categorized as low income (<185% of federal poverty level) and high income (≥185% of federal poverty level).

Result: In this study, 55.5% of children were not EBF, 37.3% of children were EBF < 6 months and 7.2% of children were EBF ≥ 6 months, 12.7% of children were obese (BMI z-score ≥ 1.64) at age 6 years, and 35.2% of households reported income < 185% of federal poverty level at the beginning of the study. There is no association between EBF and risk of obesity at age 6 years, whether the children were EBF < 6 months (aOR = 0.93, 95% CI = 0.64, 1.33) or EBF ≥ 6 months (aOR=0.99, 95% CI = 0.47, 2.07). In addition, heterogeneity test indicated income did not affect the association (p=0.63).

Discussion: There is no association between EBF and childhood obesity at age 6 years. Income at the beginning of the study did not affect the association between EBF and childhood obesity at age 6 years.

Table of Contents

INTRODUCTION.. 1
BACKGROUND.. 2
Childhood Obesity Prevalence and Consequences. 2
Causes of Childhood Obesity. 3
Prenatal Influence. 3
Fetal and Early Childhood Attributes. 3
Life-style behaviors. 4
Socio-demographic Characteristics. 4
Gene-environment interaction. 5

Exclusive breastfeeding. 5
Breastfeeding Recommendations and Practices in the United States. 5
Breastfeeding Practices and Childhood Obesity. 6

Proposed Study. 6
METHODS. 8
Study Design and Study Sample. 8
Measures. 9
Exclusive Breastfeeding. 9
Income Status. 9
Childhood Obesity. 9
Covariates. 10

Statistical Analysis. 10
RESULTS. 12
DISCUSSION.. 14
FUTURE DIRECTIONS. 16
REFERENCE. 17
TABLES. 19
FIGURES AND LEGENDS. 22

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