Associations of breastfeeding with childhood autoimmunity, allergies, and overweight: The Environmental Determinants of Diabetes in the Young (TEDDY) study.


Journal

The American journal of clinical nutrition
ISSN: 1938-3207
Titre abrégé: Am J Clin Nutr
Pays: United States
ID NLM: 0376027

Informations de publication

Date de publication:
01 07 2021
Historique:
received: 22 09 2020
accepted: 19 02 2021
pubmed: 9 4 2021
medline: 8 9 2021
entrez: 8 4 2021
Statut: ppublish

Résumé

Breastfeeding has beneficial effects on numerous health outcomes. We investigated whether breastfeeding duration is associated with the development of early childhood autoimmunity, allergies, or obesity in a multinational prospective birth cohort. Infants with genetic susceptibility for type 1 diabetes (n = 8676) were followed for the development of autoantibodies to islet autoantigens or transglutaminase, allergies, and for anthropometric measurements to a median age of 8.3 y (IQR: 2.8-10.2 y). Information on breastfeeding was collected at 3 mo of age and prospectively thereafter. A propensity score for longer breastfeeding was calculated from the variables that were likely to influence any or exclusive breastfeeding. The risks of developing autoimmunity or allergy were assessed using Cox proportional hazards models, and the risk of obesity at 5.5 y of age was assessed using logistic regression with adjustment by the propensity score. Breastfeeding duration was not associated with a lower risk of either islet or transglutaminase autoimmunity (any breastfeeding >6 mo, adjusted HR: 1.07; 95% CI: 0.96, 1.19; exclusive breastfeeding >3 mo, adjusted HR: 1.03; 95% CI: 0.92, 1.15). Exclusive breastfeeding >3 mo was associated with a decreased risk of seasonal allergic rhinitis (adjusted HR: 0.70; 95% CI: 0.53, 0.92; P < 0.01). Any breastfeeding >6 mo and exclusive breastfeeding >3 mo were associated with decreased risk of obesity (adjusted OR: 0.62; 95% CI: 0.47, 0.81; P < 0.001; and adjusted OR: 0.68; 95% CI: 0.47, 0.95; P < 0.05, respectively). Longer breastfeeding was not associated with a lower risk of childhood (islet or transglutaminase) autoimmunity in genetically at-risk children but was associated with decreased risk of seasonal allergic rhinitis and obesity at 5.5 y of age.

Sections du résumé

BACKGROUND
Breastfeeding has beneficial effects on numerous health outcomes.
OBJECTIVES
We investigated whether breastfeeding duration is associated with the development of early childhood autoimmunity, allergies, or obesity in a multinational prospective birth cohort.
METHODS
Infants with genetic susceptibility for type 1 diabetes (n = 8676) were followed for the development of autoantibodies to islet autoantigens or transglutaminase, allergies, and for anthropometric measurements to a median age of 8.3 y (IQR: 2.8-10.2 y). Information on breastfeeding was collected at 3 mo of age and prospectively thereafter. A propensity score for longer breastfeeding was calculated from the variables that were likely to influence any or exclusive breastfeeding. The risks of developing autoimmunity or allergy were assessed using Cox proportional hazards models, and the risk of obesity at 5.5 y of age was assessed using logistic regression with adjustment by the propensity score.
RESULTS
Breastfeeding duration was not associated with a lower risk of either islet or transglutaminase autoimmunity (any breastfeeding >6 mo, adjusted HR: 1.07; 95% CI: 0.96, 1.19; exclusive breastfeeding >3 mo, adjusted HR: 1.03; 95% CI: 0.92, 1.15). Exclusive breastfeeding >3 mo was associated with a decreased risk of seasonal allergic rhinitis (adjusted HR: 0.70; 95% CI: 0.53, 0.92; P < 0.01). Any breastfeeding >6 mo and exclusive breastfeeding >3 mo were associated with decreased risk of obesity (adjusted OR: 0.62; 95% CI: 0.47, 0.81; P < 0.001; and adjusted OR: 0.68; 95% CI: 0.47, 0.95; P < 0.05, respectively).
CONCLUSIONS
Longer breastfeeding was not associated with a lower risk of childhood (islet or transglutaminase) autoimmunity in genetically at-risk children but was associated with decreased risk of seasonal allergic rhinitis and obesity at 5.5 y of age.

Identifiants

pubmed: 33831944
pii: S0002-9165(22)00313-6
doi: 10.1093/ajcn/nqab065
pmc: PMC8246624
doi:

Substances chimiques

Autoantigens 0

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

134-142

Subventions

Organisme : NIDDK NIH HHS
ID : U01 DK063821
Pays : United States
Organisme : NIDDK NIH HHS
ID : UC4 DK063863
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK063865
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR002535
Pays : United States
Organisme : NIDDK NIH HHS
ID : UC4 DK112243
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK63829
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR000064
Pays : United States
Organisme : NLM NIH HHS
ID : HHSN267200700014C
Pays : United States
Organisme : NIDDK NIH HHS
ID : UC4 DK063821
Pays : United States
Organisme : NIDDK NIH HHS
ID : UC4 DK117483
Pays : United States
Organisme : NIDDK NIH HHS
ID : UC4 DK063865
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK063863
Pays : United States

Commentaires et corrections

Type : CommentIn

Informations de copyright

© The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition.

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Auteurs

Sandra Hummel (S)

Institute of Diabetes Research, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany; and Forschergruppe Diabetes, Technical University Munich, at Klinikum rechts der Isar, Munich, and Forschergruppe Diabetes eV, Neuherberg, Germany.

Andreas Weiß (A)

Institute of Diabetes Research, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany; and Forschergruppe Diabetes, Technical University Munich, at Klinikum rechts der Isar, Munich, and Forschergruppe Diabetes eV, Neuherberg, Germany.

Ezio Bonifacio (E)

DFG Center for Regenerative Therapies Dresden, Faculty of Medicine, TU Dresden, Dresden, Germany.

Daniel Agardh (D)

Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden.

Beena Akolkar (B)

National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA.

Carin A Aronsson (CA)

Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden.

William A Hagopian (WA)

Pacific Northwest Diabetes Research Institute, Seattle, WA, USA.

Sibylle Koletzko (S)

Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany.
Department of Pediatrics, Gastroenterology and Nutrition, School of Medicine, Collegium Medicum University of Warmia and Mazury, Olsztyn, Poland.

Jeffrey P Krischer (JP)

Health Informatics Institute, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.

Åke Lernmark (Å)

Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden.

Kristian Lynch (K)

Health Informatics Institute, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.

Jill M Norris (JM)

Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.

Marian J Rewers (MJ)

Barbara Davis Center for Childhood Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.

Jin-Xiong She (JX)

Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA.

Jorma Toppari (J)

Department of Pediatrics, Turku University Hospital, Turku, Finland.
Institute of Biomedicine, Research Centre for Integrative Physiology and Pharmacology, and Centre for Population Health Research, University of Turku, Turku, Finland.

Ulla Uusitalo (U)

Health Informatics Institute, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.

Kendra Vehik (K)

Health Informatics Institute, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.

Suvi M Virtanen (SM)

Health and Well-Being Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.
Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland.
Center for Child Health Research, Tampere University and Tampere University Hospital, Tampere, Finland.
The Science Center of Pirkanmaa Hospital District, Tampere, Finland.

Andreas Beyerlein (A)

Institute of Diabetes Research, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany; and Forschergruppe Diabetes, Technical University Munich, at Klinikum rechts der Isar, Munich, and Forschergruppe Diabetes eV, Neuherberg, Germany.

Anette-G Ziegler (AG)

Institute of Diabetes Research, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany; and Forschergruppe Diabetes, Technical University Munich, at Klinikum rechts der Isar, Munich, and Forschergruppe Diabetes eV, Neuherberg, Germany.

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