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Published online December 10, 2007
Diabetes Care 31:470-475, 2008
DOI: 10.2337/dc07-1321
© 2008 by the American Diabetes Association
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Epidemiology/Health Services Research
Original Research

Breast-Feeding and Type 2 Diabetes in the Youth of Three Ethnic Groups

The SEARCH for Diabetes in Youth Case-Control Study

Elizabeth J. Mayer-Davis, PHD1, Dana Dabelea, MD, PHD2, Archana Pande Lamichhane, MS1, Ralph B. D'Agostino, Jr., PHD3, Angela D. Liese, PHD1, Joan Thomas, MS1, Robert E. McKeown, PHD1 and Richard F. Hamman, MD2

1 Center for Research in Nutrition and Health Disparities and Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina
2 Department of Preventive Medicine and Biometrics, University of Colorado School of Medicine, Denver, Colorado
3 Department of Public Health Sciences, Wake Forest University School of Medicine, Winston Salem, North Carolina

Address correspondence and reprint requests to Elizabeth Mayer-Davis, University of South Carolina, Center for Research in Nutrition and Health Disparities, 2718 Middleburg Dr., Columbia, SC 29208. E-mail: ejmayer{at}gwm.sc.edu

OBJECTIVE—To evaluate the hypothesis that breast-feeding is associated with reduced type 2 diabetes among African-American, Hispanic, and non-Hispanic white youth, mediated in part by current weight status.

RESEARCH DESIGN AND METHODS—The SEARCH Case-Control Study, an ancillary study to SEARCH for Diabetes in Youth, was conducted in two of six SEARCH clinical sites. Eighty youth with type 2 diabetes aged 10–21 years were included. Nondiabetic control participants were recruited from primary care provider offices (n = 167). Breast-feeding information was recalled by biological mothers.

RESULTS—Prevalence (%) of breast-feeding (any duration) was lower among youth with type 2 diabetes than among control subjects (19.5 vs. 27.1 for African Americans, 50.0 vs. 83.8 for Hispanics, and 39.1 vs. 77.6 for non-Hispanic whites). The overall crude odds ratio for the association of breast-feeding (ever versus never) and type 2 diabetes was 0.26 (95% CI 0.15–0.46). Results were similar by race/ethnic group (P value for interaction = 0.17). The odds ratio for the association after adjusting for 12 potential confounders was 0.43 (0.19–0.99). When current BMI z-score was added to the model, the odds ratio was attenuated (0.82 [0.30–2.30]), suggesting possible mediation through current childhood weight status. Analyses that incorporated duration of breast-feeding, adjusted for potential confounders, provided evidence for dose response (test for trend, P value <0.0001), even after inclusion of BMI z-score.

CONCLUSIONS—Breast-feeding appears to be protective against development of type 2 diabetes in youth, mediated in part by current weight status in childhood.

Abbreviations: SEARCH CC, SEARCH Case-Control


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