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Does breastfeeding influence risk of type 2 diabetes in later life? A quantitative analysis of published evidence^1,2,3

¹ From the Division of Community Health Sciences, St George’s, University of London, London, United Kingdom (CGO, PHW, and DGC), and the Department of Social Medicine, University of Bristol, Bristol, United Kingdom (RMM and GDS)

Background: Observational evidence suggests that having been breastfed in infancy may reduce the prevalence of type 2 diabetes in later life.

Objective: The objective was to examine the influence of initial breastfeeding on type 2 diabetes and blood glucose and insulin concentrations.

Design: A systematic review of published studies identified 1010 reports; 23 examined the relation between infant feeding and type 2 diabetes in later life or risk factors for diabetes. Risk factors in infants were examined separately from those in children and adults. All estimates were pooled by using fixed-effect models; differences <0 and ratios <1 imply a beneficial effect of breastfeeding.

Results: Subjects who were breastfed had a lower risk of type 2 diabetes in later life than did those who were formula fed (7 studies; 76 744 subjects; odds ratio: 0.61; 95% CI: 0.44, 0.85; P = 0.003). Children and adults without diabetes who had been breastfed had marginally lower fasting insulin concentrations than did those who were formula fed (6 studies; 4800 subjects; percentage difference: –3%; 95% CI: –8%, 1%; P = 0.13); no significant difference in fasting glucose concentrations was observed. Breastfed infants had lower mean preprandial blood glucose (12 studies; 560 subjects; mean difference: –0.17 mmol/L; 95% CI: –0.28, –0.05 mmol/L; P = 0.005) and insulin (7 studies; 291 subjects; mean difference: –2.86 pmol/L; 95% CI: –5.76, 0.04 pmol/L; P = 0.054) concentrations than did those who were formula fed.

Conclusion: Breastfeeding in infancy is associated with a reduced risk of type 2 diabetes, with marginally lower insulin concentrations in later life, and with lower blood glucose and serum insulin concentrations in infancy.

Key Words: Infant feeding • blood glucose • serum insulin • type 2 diabetes • systematic review

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