Inverse association of overweight and breast feeding in 9 to 10-y-old children in Germany

OBJECTIVE: To evaluate whether breast feeding is associated with prevalent overweight in pre-adolescent children. METHODS: Cross-sectional studies of 9 to 10-y-old children attending fourth grade in 1995/1996 in Dresden (n = 1046) and Munich (n = 1062), Germany, a ccording to the International Study of Asthma and Allergies in Childhood (I SAAC) Phase II protocol. A comprehensive questionnaire including detailed b reast feeding history was filled out by the child's parent. Height and weig ht were measured in a random subsample of children undergoing spirometry. O verweight was defined as body mass index greater than or equal to 90th age- and sex-specific percentile of the German reference. RESULTS: While the prevalence of overweight differed substantially between Dresden (girls 9.1%, boys 12.5%) and Munich (17% both), we observed a marke dly lower overweight prevalence among breast fed than non-breast fed childr en in both cities. Controlling for age, sex and city, breast-fed children w ere substantially less likely to be overweight at 9 - 10y (OR 0.55, 95% Cl 0.41 - 0.74). Results were slightly attenuated after adjustment for nationa lity, socio-economic status, number of siblings, parental smoking (OR 0.66, 95% Cl 0.52 - 0.87). A longer overall duration and duration of exclusive b reast feeding was associated significantly with decreasing prevalence of ov erweight. CONCLUSION: The results highlight the importance and possible preventive po tential of early nutrition in the development of overweight in children. Bo th feeding behaviors acquired by the nursing infant and metabolic effects m ay contribute to the observed inverse association of breast feeding and ove rweight in children.