Video Abstract
Breastfeeding practices may protect against offspring obesity, but this relationship is understudied among women with obesity. We describe the associations between breastfeeding practices and child BMI for age z-score (BMIz), stratified by maternal BMI.
We analyzed 8134 dyads from 21 cohorts in the Environmental Influences on Child Health Outcomes Program. Dyads with data for maternal pre-pregnancy BMI, infant feeding practices, and ≥1 child BMI assessment between the ages of 2 and 6 years were included. The associations between breastfeeding practices and continuous child BMIz were assessed by using multivariable linear mixed models.
Maternal pre-pregnancy BMI category prevalence was underweight: 2.5%, healthy weight: 45.8%, overweight: 26.0%, and obese: 25.6%. Median child ages at the cessation of any breastfeeding and exclusive breastfeeding across the 4 BMI categories were 19, 26, 24, and 17 weeks and 12, 20, 17, and 12 weeks, respectively. Results were in the hypothesized directions for BMI categories. Three months of any breastfeeding was associated with a lower BMIz among children whose mothers were a healthy weight (−0.02 [−0.04 to 0.001], P = .06), overweight (−0.04 [−0.07 to −0.004], P = .03), or obese (−0.04 [−0.07 to −0.006], P = .02). Three months of exclusive breastfeeding was associated with a lower BMIz among children whose mothers were a healthy weight (−0.06 [−0.10 to −0.02], P = .002), overweight (−0.05 [−0.10 to 0.005], P = .07), or obese (−0.08 [−0.12 to −0.03], P = .001).
Human milk exposure, regardless of maternal BMI category, was associated with a lower child BMIz in the Environmental Influences on Child Health Outcomes cohorts, supporting breastfeeding recommendations as a potential strategy for decreasing the risk of offspring obesity.
Comments
To decrease offspring obesity, improve fatty acid profile of maternal food intake
The authors of a 2013 article about maternal plasma polyunsaturated fatty acid status in late pregnancy reported that "... maternal n-6 PUFA was positively associated with offspring fat mass, whereas no significant effects of maternal n-3 PUFA and body composition were identified, suggesting that a low n-6 PUFA intake during pregnancy might reduce offspring adiposity. (web search - Maternal plasma polyunsaturated fatty acid status)
Comment from a 1996 Symposium entitled Biological Effects of Arachidonic Acid: "Excessive signaling of arachidonic acid (AA) metabolites has been associated with various chronic degenerative or autoimmune diseases, and intervention with the metabolism of AA is widely employed therapeutically in these afflictions. In essence, AA is the most biologically active unsaturated fatty acid in higher animals. Its concentration in membranes and its magnitude of effects depend on its amount, or that of its precursors and analogues, in the diet. The tendency of the field of nutrition to ignore the role of dietary AA will optimistically be reversed in the future (emphasis mine)."
The article also said, "The underlying rationale for this symposium is that dietary AA is perhaps the single most important nutritional determinant in regulating AA levels in Americans. This may ultimately account in part for the striking differences in chronic diseases between strict vegetarians and the bulk of the omnivorous population." (web search - Biological Effects of Arachidonic Acid: Introduction)
As far as I can tell, there has never been a weight loss trial that included a reduction in arachidonic acid intake as part of the experimental protocol. Perhaps that's why there is no hard evidence linking excessive arachidonic acid intake to the global obesity/diabetes epidemic.