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Am J Clin Nutr. 2019 Mar 1;109(Supplement_7):817S-837S. doi: 10.1093/ajcn/nqy311.

Infant milk-feeding practices and diabetes outcomes in offspring: a systematic review.

Author information

1
Panum Group, Bethesda, MD.
2
USDA, Food and Nutrition Service, Alexandria, VA.
3
National Institutes of Health Library, Bethesda, MD.
4
Dell Medical School at the University of Texas, Austin, TX.
5
US Food and Drug Administration, contractor, College Park, MD.
6
US Food and Drug Administration, College Park, MD.
7
University of Rochester Medical Center, Rochester, NY.
8
University of Cincinnati College of Allied Health Sciences, Cincinnati, OH.
9
Division of Nutritional Sciences, Cornell University, Ithaca, NY.
10
Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA and Department of Nutrition, Harvard School of Public Health, Boston, MA.
11
Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT.
12
Department of Pediatrics, The University of Iowa, Iowa City, IA.

Abstract

BACKGROUND:

During the Pregnancy and Birth to 24 Months Project, the US Departments of Agriculture and Health and Human Services initiated a review of evidence on diet and health in these populations.

OBJECTIVES:

The aim of these systematic reviews was to examine the relation of 1) never versus ever feeding human milk, 2) shorter versus longer durations of any human milk feeding, 3) shorter versus longer durations of exclusive human milk feeding, and 4) feeding a lower versus higher intensity of human milk to mixed-fed infants with type 1 and type 2 diabetes in offspring.

METHODS:

The Nutrition Evidence Systematic Review team conducted systematic reviews with external experts. We searched CINAHL, Cochrane, Embase, and PubMed for articles published January 1980-March 2016, dual-screened the results according to predetermined criteria, extracted data from and assessed the risk of bias for each included study, qualitatively synthesized the evidence, developed conclusion statements, and graded the strength of the evidence.

RESULTS:

The 4 systematic reviews included 21, 37, 18, and 1 articles, respectively. Observational evidence suggests that never versus ever feeding human milk (limited evidence) and shorter versus longer durations of any (moderate evidence) and exclusive (limited evidence) human milk feeding are associated with higher type 1 diabetes risk. Insufficient evidence examined type 2 diabetes. Limited evidence suggests that the durations of any and exclusive human milk feeding are not associated with intermediate outcomes (e.g., fasting glucose, insulin resistance) during childhood.

CONCLUSIONS:

Limited to moderate evidence suggests that feeding less or no human milk is associated with higher risk of type 1 diabetes in offspring. Limited evidence suggests no associations between the durations of any and exclusive human milk feeding and intermediate diabetes outcomes in children. Additional research is needed on infant milk-feeding practices and type 2 diabetes and intermediate outcomes in US populations, which may have distinct metabolic risk.

KEYWORDS:

breast milk; breastfeeding; diabetes; fasting glucose; human milk; insulin resistance; systematic review

PMID:
30982877
PMCID:
PMC6500931
[Available on 2020-03-01]
DOI:
10.1093/ajcn/nqy311

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