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Cited by 466Breastfeeding Practices and InfluencesObesity, Physical Activity, DietInfant Nutrition and Health

The effect of breastfeeding on mean body mass index throughout life: a quantitative review of published and unpublished observational evidence

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Owen, Christopher G, Martin, Richard M, Whincup, Peter H, Davey-Smith, George, Gillman, Matthew W, Cook, Derek G·2005·The American Journal of Clinical Nutrition
DOI 10.1093/ajcn/82.6.1298
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Abstract

Background Evidence from observational studies has suggested that breastfeeding may reduce the prevalence of obesity in later life.Objective The objective was to examine whether initial breastfeeding is related to lower mean body mass index (BMI; in kg/m(2)) throughout life.Design The study was a systematic review of published studies investigating the association between infant feeding and a measure of obesity or adiposity in later life, which was supplemented with data from unpublished sources. Analyses were based on the mean differences in BMI between those subjects who were initially breastfed and those who were formula-fed (expressed as breastfed minus bottle-fed), which were pooled by using fixed-effects models throughout.Results From 70 eligible studies, 36 mean differences in BMI (from 355 301 subjects) between those breastfed and those formula-fed (reported as exclusive feeding in 20 studies) were obtained. Breastfeeding was associated with a slightly lower mean BMI than was formula feeding (-0.04; 95% CI: -0.05, -0.02). The mean difference in BMIs appeared larger in 15 small studies of <1000 subjects (-0.19; 95% CI: -0.31, -0.08) and smaller in larger studies of >or=1000 subjects (-0.03; 95% CI: -0.05, -0.02). An Egger test was statistically significant (P = 0.002). Adjustment for socioeconomic status, maternal smoking in pregnancy, and maternal BMI in 11 studies abolished the effect (-0.10; 95% CI: -0.14, -0.06 before adjustment; -0.01; 95% CI: -0.05, 0.03 after adjustment).Conclusions Mean BMI is lower among breastfed subjects. However, the difference is small and is likely to be strongly influenced by publication bias and confounding factors. Promotion of breastfeeding, although important for other reasons, is not likely to reduce mean BMI.

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  • Results were attenuated with adjustment for maternal BMI, smoking and socioeconomic position.

    “but results were attenuated with adjustment for maternal BMI, smoking and socioeconomic position”

    From Triangulation in aetiological epidemiology (2017) · cites this paper as [61]

  • There was an inverse association of being exclusively breastfed for at least 8 months with mean BMI in a meta-analysis of prospective cohort studies with minimal (age and gender) adjustment.

    “There was an inverse association of ever being exclusively breastfed, and of being exclusively breastfed for at least 8 months, with mean BMI in a meta-analysis of prospective cohort studies with minimal (age and gender) adjustment”

    From Triangulation in aetiological epidemiology (2017) · cites this paper as [61]

  • There was evidence of publication bias in the meta-analysis.

    “and there was evidence of publication bias.61”

    From Triangulation in aetiological epidemiology (2017) · cites this paper as [61]

  • There was an inverse association of ever being exclusively breastfed with mean BMI in a meta-analysis of prospective cohort studies with minimal (age and gender) adjustment.

    “There was an inverse association of ever being exclusively breastfed, and of being exclusively breastfed for at least 8 months, with mean BMI in a meta-analysis of prospective cohort studies with minimal (age and gender) adjustment”

    From Triangulation in aetiological epidemiology (2017) · cites this paper as [61]

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Authors
Owen, C. G., Martin, R. M., Whincup, P. H., Davey-Smith, G., Gillman, M. W., & Cook, D. G.
Affiliations
Harvard University (US)
Corresponding author
Owen, Christopher G
ORCID
Venue
The American Journal of Clinical Nutrition
Publisher
Elsevier BV
Published
2005-12
Volume
82
Issue
6
Pages
1298-1307
ISSN
0002-9165 (ISSN-L)
DOI
10.1093/ajcn/82.6.1298
OpenAlex
W1918787362
Cited by
466
References
72
Citations by year
2026: 6 · 2025: 2 · 2024: 2 · 2023: 6 · 2022: 13 · 2021: 16 · 2020: 10 · 2019: 15 · 2018: 13 · 2017: 26 · 2016: 21 · 2015: 32 · 2014: 40 · 2013: 31 · 2012: 44
FWCI
21.03
Type
journal article
Language
en
Open access
Licence
Locations
  • American Journal of Clinical Nutrition (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • U.S. Department of Health and Human Services
  • University of Otago
  • University of South Carolina
  • Glasgow Caledonian University
  • University of Essex
  • Wellcome Trust (GR063779MA)
  • Università degli Studi di Milano
  • Universidade Federal de Pelotas
  • British Heart Foundation (PG/04/072)
  • University of Southampton
  • University of Bristol
  • Chinese University of Hong Kong
  • Hospital for Sick Children
  • Università degli Studi di Verona
  • Universität Ulm
  • National Institutes of Health
  • Arnold School of Public Health, University of South Carolina
  • Medical Research Council
  • National Institute of Child Health and Human Development
Topics
  • Health Sciences › Medicine › Epidemiology › Breastfeeding Practices and Influences
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Health Sciences › Nursing › Nutrition and Dietetics › Infant Nutrition and Health
Keywords
breastfeeding, body mass index, obesity, infant feeding, bottle feeding, exclusive breastfeeding, adiposity, publication bias, confounding, smoking during pregnancy, maternal body mass index, socioeconomic status
MeSH terms
Adult, Breast Feeding, Female, Humans, Infant, Infant Food, Infant Nutritional Physiological Phenomena, Infant, Newborn, Male, Milk, Human, Obesity, Risk Factors, Confounding Factors, Epidemiologic, Body Mass Index, Odds Ratio, Infant Formula

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