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Breast Feeding and Type 2 Diabetes in Youth of Three Ethnic Groups: The SEARCH for Diabetes in Youth Case-Control Study

¹ University of South Carolina, Center for Research in Nutrition and Health Disparities and Epidemiology and Biostatistics, Columbia, South Carolina
² University of Colorado, Denver, Colorado
³ Wake Forest University, Winston Salem, North Carolina

ejmayer{at}gwm.sc.edu

ABSTRACT

Objective: To evaluate the hypothesis that breast feeding is associated with reduced T2DM among African American (AA), Hispanic (H), and non-Hispanic white (NHW) youth, mediated in part by current weight status.

Research Design and Methods: The SEARCH Case-Control (CC) Study, an ancillary study to SEARCH for Diabetes in Youth, was conducted in two of the six SEARCH clinical sites. Eighty youth with T2DM aged 10–21 yr were included. Non-diabetic control participants were recruited from primary care provider offices (n=167). Breast feeding information was recalled by biological mothers.

Result: Prevalence (%) of breast feeding (any duration) was lower among youth with T2DM than among controls (19.5 v 27.1 for AA; 50.0 v 83.8 for H; 39.1 v 77.6 for NHW; respectively). The overall crude odds ratio (OR) for the association of breast feeding (ever v never) and T2DM was 0.26 (95% CI=0.15-0.46). Results were similar by race/ethnic group (p-value for interaction =0.17). The OR for the association after adjusting for 12 potential confounders was 0.43 (95% CI= 0.19-0.99). When current BMI z-score was added to the model, the OR was attenuated (OR=0. 82; 95% CI=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 T2DM in youth, mediated in part by current weight status in childhood.

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