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Cited by 96Breastfeeding Practices and InfluencesObesity, Physical Activity, DietInfant Nutrition and Health

Are Adolescents Who Were Breast-fed Less Likely to Be Overweight?: Analyses of Sibling Pairs to Reduce Confounding

Nelson, Melissa C., Gordon-Larsen, Penny, Adair, Linda S.·2005·Epidemiology
DOI 10.1097/01.ede.0000152900.81355.00
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Abstract

BACKGROUND: Cohort analyses suggesting that breast-feeding protects against being overweight have been criticized for inadequately controlling for confounding associated with the self-selection of feeding practices. METHODS: Using nationally representative U.S. data from the National Longitudinal Study of Adolescent Health (1994-1996), we performed traditional cohort analyses (n = 11,998) using logistic regression to estimate the relation between breast-feeding and adolescent overweight (body mass index > or =85 percentile, based on year 2000 CDC growth charts), controlling for known potential confounders. Breast-feeding also was assessed in a subsample of 850 sibling pairs to account for unmeasured genetic and environmental factors. RESULTS: Among girls in the full cohort, the odds of being overweight declined among those who had been breast-fed at least 9 months; odds ratios ranged from 0.90 (95% confidence interval = 0.74-1.09) for <3 months of breast-feeding to 0.78 (0.64-0.96) for > or =9 months. A similar effect was seen in boys, although these trends were less consistent. In contrast, an analysis of sibling pairs provided no evidence of breast-feeding effects on weight within discordant trends. CONCLUSION: Cohort data indicate that odds of being overweight decrease as breast-feeding duration increases, at least among girls. However, sibling analyses suggest that this relationship may not be causal but rather attributable to unmeasured confounding related to mothers' choice to breast-feed, or to other childhood risk factors for overweight. Our results illustrate the utility of sibling analyses in understanding the true effect of early life exposures (such as breast-feeding) on health outcomes over time, independent of confounding factors that may not be satisfactorily controlled using traditional prospective cohort methods.

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Crossref · 10.1097/01.ede.0000152900.81355.00

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  • The largest of the two within-sibship comparisons suggested that any associations observed between unrelated individuals were explained by shared familial confounding.

    “The largest62,63 of the two within-sibship comparisons suggested that any associations observed between unrelated individuals were explained by shared familial confounding”

    From Triangulation in aetiological epidemiology (2017) · cites this paper as [63]

  • The within-sibship analyses in both studies were imprecisely estimated and not reliably different from the results of analyses between unrelated individuals.

    “though the within-sibship analyses in both studies were imprecisely estimated and not reliably different from the results of analyses between unrelated individuals.62–64”

    From Triangulation in aetiological epidemiology (2017) · cites this paper as [63]

  • Two of the identified studies used the same data from the US National Longitudinal Study of Adolescent Health (Add Health) and had similar results.

    “Two of these used the same data from the US National Longitudinal Study of Adolescent Health (Add Health) and had similar results;62,63”

    From Triangulation in aetiological epidemiology (2017) · cites this paper as [63]

  • Neither within-sibship study had adequate statistical power to detect a difference between the effect estimates from the within-sibship analyses and that of unrelated participants in the cohorts.

    “Neither study had adequate statistical power to detect a difference between the effect estimates from the within-sibship analyses and that of unrelated participants in the cohorts”

    From Triangulation in aetiological epidemiology (2017) · cites this paper as [63]

  • Three studies were identified which examined associations of being breastfed with BMI.

    “Three studies were identified which examined associations of being breastfed with BMI.”

    From Triangulation in aetiological epidemiology (2017) · cites this paper as [63]

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Authors
Nelson, M. C., Gordon-Larsen, P., & Adair, L. S.
Affiliations
University of North Carolina at Chapel Hill (US)
Corresponding author
Adair, Linda S.
ORCID
Adair, Linda S.
Venue
Epidemiology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2005-03
Volume
16
Issue
2
Pages
247-253
ISSN
1044-3983 (ISSN-L)
DOI
10.1097/01.ede.0000152900.81355.00
OpenAlex
W2060364082
Cited by
96
References
40
Citations by year
2023: 1 · 2021: 1 · 2020: 2 · 2019: 3 · 2017: 5 · 2016: 5 · 2015: 9 · 2014: 9 · 2013: 5 · 2012: 5
FWCI
7.45
Type
journal article
Language
en
Open access
closed
Locations
  • Epidemiology (publishedVersion)
  • PubMed (publishedVersion)
Funders
Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD039183, R01-HD39183, K12 HD 01441-01, P30HD005798, K12HD001441, P30 HD05798)
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, adolescent overweight, body mass index, confounding, causal inference, early life exposure, sex differences, adolescent girls
MeSH terms
Adolescent, Body Weight, Breast Feeding, Child Development, Female, Humans, Infant, Infant, Newborn, Male, Obesity, Risk Factors, Time Factors, Cohort Studies, Confounding Factors, Epidemiologic, Odds Ratio, Siblings

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