The Relationship Between Breastfeeding And Metabolic Syndrome And Its Components

Background: The metabolic syndrome(MS)is a clustering of metabolic risk factors including abdominal obesity,hypertension,dysglycemia,and dyslipidemia.The MS is developing into a worldwide public health problem.Researches showed that early environmental exposures,incliding nutritional environment,have a significant and permanent impact on the later health status.DJ Barker found that the nutritional status of early life was significantly correlated with the risk of hypertension,diabetes and coronary heart disease by a retrospective study,in 1994.Breast milk is often considered to be the optimal source of nutrition for early stages of life.Leptin and ghrelin that are contained in breast milk not only play a protective role in energy balance planning,but also affect the metabolic programming in early life.Therefore,it is hypothesized that early breastfeeding might be related to adult MS.However,few studies have assessed the association between early life feeding patterns and later MS prevalence in adulthood.Aim: The aim of the present study is therefore to explore whether breastfeeding in early life is related to the prevalence of MS and its components in a general adult population.Methods: This study based on a large sample population is a cross-sectional study.The data were collected from the Tianjin Chronic Low-grade System Inflammation and Health(TCLSIHealth)Cohort Study.Participants were recruited while undergoing routine annual physical examinations at the Health Management Centre of Tianjin Medical University General Hospital from 2013 to 2015.All participants voluntarily participated in the study and signed informed consent.After inclusion and exclusions criteria,17416 participants were enrolled into this study.MS was defined according to the new criteria of the Chinese medical doctor association branch of diabetes of 2013.Participants were considered to have MS when they presented three or more of the following components.(1)Abdominal obesity(waist circumference for individuals?90cm and ?85cm in men and women,resp.).(2)Hyperglycemia: fasting glucose?6.1mmol/L or 2h blood glucose after meal ?7.8mmol/L and/or drug treatment of elevated glucose.(3)Elevated blood pressure(SBP?130mm Hg and/or DBP ?85mm Hg)or antihypertensive drug treatment.(4)Elevated TG ?1.7mmol/L.(5)Reduced HDL <1.04 mmol/L.The data of feeding patterns in early life were collected from the questionnaire.The participants were asked the question“What was your mode of feeding in your infancy?” and the options were breastfeeding,milk powder and other foods,respectively.The characteristics differences according to the feeding patterns were examined using analysis of variance for continuous variables and logistic-regression analysis for categorical variables.Multiple logistic regression analysis was used to examine the relationship between feeding patterns and MS and its components.Results: The prevalence of MS is 28.6%,25.0% and 32.7% in breastfeeding group,milk powder group and other foods group,respectively.The prevalence of each component of MS was 56.2% for abdominal obesity,25.5% for raised TG,25.7% for reduced HDL,40.4% for raised blood pressure and 18.4% for raised blood glucose.In the comparison of prevalence in different sex participants,men have a more higher prevalence of the metabolic syndrome components than women,except for the reduced HDL.After adjustments for potential confounding factors,including age,BMI,smoking and drinking status,physical activity,educational level,employment status,household incomes,total energy intake,nutrients intake(including protein,carbohydrate,fat,EPA+DHA)and dietary factors(including vegetables,fruits,milk and low fat milk),the odds ratios(95% confidence interval)of MS prevalence associated with the different categories of early life feeding patterns were 1.00(reference)for breastfeeding group,1.19(1.06,1.35)for milk powder group,and 0.93(0.73,1.17)for other food group.The odds ratios(95% confidence interval)of MS prevalence were 1.00(reference),1.14(0.98,1.33)and 0.99(0.74,1.31)in breastfeeding group,milk powder group and other foods group for male participants,respectively.And The odds ratios(95% confidence interval)of MS prevalence were 1.00(reference),1.37(1.11,1.68)and 0.76(0.47,1.19)in breastfeeding group,milk powder group and other foods group for female participants,respectively.For MS components,significant differences were found only in the reduced HDL,and the multiple adjusted odds ratios(95% confidence interval)were 1.00(reference),1.12(1.01,1.24)and 0.98(0.77,1.23)in breastfeeding group,milk powder group and other foods group,respectively.However,no statistical significance was found in the analysis of reduced HDL for different sex participants.Conclusion: This is the first large population-based study to evaluate the relationship between breastfeeding in early life and later MS and its components prevalence in adulthood.The present study shows a significant relationship between breastfeeding in early life and lower prevalence of MS in adulthood,compared with milk powder.Further studies are needed to explore the underlying mechanisms of early life breastfeeding on metabolic diseases in adulthood,and provide bases for preventing multiple diseases in adulthood from early life.