维生素和矿物质

Obesity and Optimal Breastfeeding Practices in Developing Countries: A Double Staged Study

Abstract

Azza Abul-Fadl and Shewikar El Bakry

Background: Developing countries suffer escalating rates of overweight and obesity; increasing the burden of diseases attributable to obesity. Optimal breastfeeding is linked with prevention of obesity.
Aim: To identify the optimal breastfeeding practices that can reduce the burden of overweight and obesity with a focus on countries of the Eastern Mediterranean region (EMR).
Methods: This was a combined assessment double staged study. In the first stage WHO and UNICEF data base from household surveys for the 22 countries of the EMR for breastfeeding rates of timely first suckle (TFS), EBF, continued breastfeeding at 12 and 24 months and correlated and with data for overweight and obesity in children under five (CU5), youth and adults. In the second stage we conducted a retrospective cross-sectional field survey in one country (Egypt) for 120 preschool children, 60 were breastfed and 60 were artificially fed. The groups were compared for weight, length and midarm circumference using the WHO growth standards.
Results: Obesity in the EMR countries is high and is on the rise. Breastfeeding practices mainly TFS and continued breastfeeding for 24 months are suboptimal in the EMR countries irrespective of their socioeconomic status. There were significant negative correlations between TFS and obesity among CU5 (r- 0.51) and obesity in adults (r-0.37). Continued breastfeeding for 12 and 24 months were also significantly correlated with obesity in CU5 (r- 0.475 and r-0.33 respectively) and obesity in adults (r-0.49 and r-0.52 respectively). This was confirmed by the field study that was done for the children under five of age that showed a significant difference in weight centiles between the breastfed and non-breastfed children at P<0.05.
Conclusions: Early feeding practices are suboptimal in EMR countries and influence the high rates of obesity and overweight in the countries of the region. Focus on improving timely initiation of breastfeeding in the first hour and prolonging the duration of breastfeeding to two years may contribute significantly in the reduction of the burden of overweight and obesity in the region.