Breastfeeding and Sugar-Sweetened Beverages
What’s the Connection?
Shannon E. Whaley, Ph.D.PHFE WIC
Jaimie Davis, Ph.D.University of Texas, Austin
Breastfeeding and Obesity Breastfeeding protects against early childhood
obesity in the WIC population.
Breastfeeding at enrollment into WIC is associated with a 23% reduction in obesity at age 4.
Want to learn more about this?WIC WORKS Webinar: November 15, 2011Breastfeeding and Obesity Policy Briefwww.calwic.org
What about Sugar Sweetened Beverages? (SSBs) Growing literature on the contribution of
SSBs to obesity.
Limited research on SSB intake among young children < 5.
Limited understanding of the role of SSBs in obesity of young children.
LA County WIC Surveys 2005, 2008, 2011
5000-6000 participants per survey answered questions on topics such as:
food and SSB intake breastfeeding practices household food security child care and preschool utilization patterns home literacy practices maternal emotional well-being developmental concerns of early childhood
Survey instruments available at www.phfewic.org
WIC Survey 2008: SSB question On an average day, about how many
sodas, such as Coke or Mountain Dew, or sweetened drinks, such as Gatorade, Red Bull or Sunny Delight, does <child’s name> drink? Do not include diet sodas or sugar-free drinks.
Daily SSB consumption by age (%)
Breastfeeding, SSBs and Obesity:How are they related?
Study Goal:
To examine the separate and combined effects of breastfeeding in the first year of life and SSB intake at ages 2-4 on the prevalence of obesity in early childhood.
Breastfeeding, SSBs and Obesity:How are they related?
Variables for AnalysisFrom 2008 WIC Survey:
SSB intake Breastfeeding history
WIC measures child height and weight every six months. We recently validated WIC ht/wt and BMI measurements of 2-5 year olds. (Crespi et al., 2012, Ped Res)
Obesity status of 2-4 year olds in the survey sample
Sample for Analysis: 1483 children aged 2-4 (full-term, complete data, Hispanic)
BF status and SSB intake (n=1483)BF %
<1 week
20%
1-<6m 23%
6-<12m 21%
12m+ 36%
SSB %
0/day 57%
1/day 25%
2+/day 18%
**BF status was NOT related to SSB intake
Obesity* by BF status and SSB intake (n=1483)BF % %Obes
e
<1 week
20% 17%
1-<6m 23% 17%
6-<12m 21% 15%
12m+ 36% 11%
SSB % %Obese
0/day 57% 11%
1/day 25% 17%
2+/day 18% 18%
*BMI>95th percentile for age and sex
Protective Effect of BF vs SSB
Davis, Whaley & Goran (2012), American Journal of Clinical Nutrition
Ob
esi
ty P
reva
len
ce a
t ag
e 3
-4 (
%)
Protective Effect of BF vs SSB
Davis, Whaley & Goran (2012), American Journal of Clinical Nutrition
Ob
esi
ty P
reva
len
ce a
t ag
e 3
-4 (
%)
Protective Effect of BF vs SSB
Davis, Whaley & Goran (2012), American Journal of Clinical Nutrition
Ob
esi
ty P
reva
len
ce a
t ag
e 3
-4 (
%)
Protective Effect of BF vs SSB
Davis, Whaley & Goran (2012), American Journal of Clinical Nutrition
Ob
esi
ty P
reva
len
ce a
t ag
e 3
-4 (
%)
Protective Effect of BF vs SSB
Davis, Whaley & Goran (2012), American Journal of Clinical Nutrition
Ob
esi
ty P
reva
len
ce a
t ag
e 3
-4 (
%)
Conclusions Children breastfed for 12+ months had
45% lower odds of obesity at age 2-4.
Children consuming no SSBs had 31% lower odds of obesity at age 2-4.
The combined effect of 12+m BF and no SSB intake conferred a >60% reduction in odds of obesity at age 2-4.
Conclusions
SSB intake affected obesity prevalence only in children who were breastfed less than 12 months.
Limitations & Next Steps Hispanic sample, replication in other
populations is needed.
More extensive questions about SSB intake would be helpful – the 2011 survey expanded questions on SSB and sweetened food intake.
This study doesn’t address the question of WHY breastfeeding is protective against SSB intake.
For more information: Shannon E. Whaley, Ph.D.
Jaimie N. Davis, [email protected]
Davis, Whaley & Goran (2012). Effects of breastfeeding and low sugar-sweetened beverage intake on Hispanic toddlers. Am J Clin Nut, 95, 3-8.
Many thanks to our funder.http://www.first5la.org/files/Sugar-Sweetened_Drink_Policy_Brief.pdf