Does breastfeeding influence the risk of developing diabetes mellitus in children? A review of current evidence

Pereira, Patrícia F.; Alfenas, Rita de Cássia G.; Araújo, Raquel Maria A.

doi:10.1016/j.jpedp.2013.02.010

Informação do artigo

Abstract

Objective

The aim of this study was to perform a review to investigate the influence of breastfeeding as a protective agent against the onset of diabetes in children.

Sources

Non-systematic review of SciELO, LILACS, MEDLINE, Scopus, and VHL databases, and selection of the 52 most relevant studies. A total of 21 articles, specifically on the topic, were analyzed (nine related to type 1 diabetes and 12 to type 2 diabetes).

Data synthesis

The duration and exclusivity of breastfeeding, as well as the early use of cow's milk, have been shown to be important risk factors for developing diabetes. It is believed that human milk contains substances that promote the maturation of the immune system, which protect against the onset of type 1 diabetes. Moreover, human milk has bioactive substances that promote satiety and energy balance, preventing excess weight gain during childhood, thus protecting against the development of type 2 diabetes. Although the above mentioned benefits have not been observed by some researchers, inaccuracies on dietary habit reports during childhood and the presence of interfering factors have been considered responsible for the lack of identification of beneficial effects.

Conclusion

Given the scientific evidence indicated in most published studies, it is believed that the lack of breastfeeding can be a modifiable risk factor for both type 1 and type 2 diabetes. Strategies aiming at the promotion and support of breastfeeding should be used by trained healthcare professionals in order to prevent the onset of diabetes.

Keywords:

Breastfeeding

Blood glucose

Type 1 diabetes mellitus

Type 2 diabetes mellitus

Resumo

Objetivo

Realizar uma análise crítica da literatura para avaliar a influência da amamen- tação no risco de desenvolvimento de diabetes mellitus.

Fonte dos dados

Revisão não sistemática nas bases de dados SciELO, LILACS, MEDLINE, Scopuse BVS, selecionando-se 52 referências mais relevantes. Especificamente sobre o tema, foram analisadas 21 (sendo 9 para diabetes tipo 1 e 12 para diabetes tipo 2).

Síntese dos dados

A duração, a exclusividade do aleitamento materno e uso precoce do leite de vaca têm sido apresentados como fatores de risco para o desenvolvimento de diabetes. Acredita-se que o leite humano contenha substâncias que promovem a maturação do sistema imunológico protegendo contra o diabetes tipo 1. Além disso, ele possui substâncias bioativas, que promovem o equilíbrio energético e a saciedade, prevenindo o ganho de peso excessivo da criança e protegendo, consequentemente, contra o aparecimento do diabetes tipo 2. Apesar dos benefícios anteriormente citados não terem sido constatados por alguns pesquisadores, a imprecisão no relato dos hábitos dietéticos da infância e a presença de fatores interferentes têm sido responsabilizadas pela falta de identificação dos efeitos benéficos.

Conclusão

Diante das evidências científicas pautadas em grande parte dos estudos, acredita-se que a ausência da amamentação seja um possível fator de risco modificável para diabetes tipo 1 e tipo 2. Estratégias que visem à promoção e ao suporte ao aleita- mento materno devem ser adotadas por profissionais de saúde devidamente treinados como forma de prevenir a manifestação da doença.

Palavras-chave:

Aleitamento materno

Glicemia

Diabetes mellitus tipo 1

Diabetes mellitus tipo 2

O texto completo está disponível em PDF

Referências

[1]

L. Guariguata, D. Whiting, C. Weil, N. Unwin.

The International Diabetes Federation Diabetes Atlas Methodology for Estimating Global and National Prevalence of Diabetes in Adults.

Diabetes Res Clin Pract., 94 (2011), pp. 322-332

http://dx.doi.org/10.1016/j.diabres.2011.10.040 | Medline

[2]

International Diabetes Federation [Internet]. Diabetes Atlas [acessado em 18 Set 2012]. Disponível em: http://www.idf. org/diabetesatlas/5e/the-global-burden.

[3]

Sociedade Brasileira de Diabetes. Diretrizes da Sociedade Brasileira de Diabetes. 2009. 330 p. [acessado em 4 Set 2012]. Disponível em: http://www.diabetes.org.br/.

[4]

ESPGHAN Committee on Nutrition, Agostoni C, Braegger C, Decsi T, Kolacek S, Koletzko B, et al. Breast-feeding: a commentary by the ESPGHAN Committee on Nutrition. J Pediatr Gastroenterol Nutr. 2009;49:112-25.

[5]

F.F. Correa, M.C. Vieira, D.R. Yamamoto, P. Speridião, G. da, M.B. de Morais.

Open challenge for the diagnosis of cow's milk protein allergy.

J Pediatr (Rio J)., 86 (2010), pp. 163-166

[6]

J.C. Phlips, R.P. Radermecker.

Type 1 diabetes: from genetic predisposition to hypothetical environmental triggers.

Rev Med Liege., 67 (2012), pp. 319-325

Medline

[7]

P. Zimmet.

Antibodies to glutamic acid decarboxylase in the prediction of insulin dependency.

Diabetes Res Clin Pract., 34 (1996), pp. S125-S131

Medline

[8]

J. Rosenbauer, P. Herzig, P. Kaiser, G. Giani.

Early nutrition and risk of Type 1 diabetes mellitus – a nationwide case-control study in preschool children.

Exp Clin Endocrinol Diabetes., 115 (2007), pp. 502-508

http://dx.doi.org/10.1055/s-2007-973829 | Medline

[9]

S.G. Gimeno, J.M. Souza.

Breast-feeding, bottle-feeding and the type 1 diabetes mellitus: examining the evidences.

Rev Bras Epidemiol., 1 (1998), pp. 4-13

[10]

C.L. Macedo, M.C. Ferreira, A.A. Naujorks, A. Tercziany, F.J. Costa, H.C. David, et al.

Aleitamento materno e diabetes mellitus do tipo 1.

Arq Bras Endocrinol Metab., 43 (1999), pp. 360-365

[11]

D.T. Leal, F.A. Fialho, I.M. Dias, L. Nascimento, W.C. Arruda.

The profile of people with Type 1 Diabetes considering their history of breast feeding.

Esc Anna Nery., 15 (2011), pp. 68-74

[12]

F. Collado-Mesa, O. Díaz-Díaz.

Frequency and duration of breast- feeding in Cuban children with Type 1 diabetes mellitus (DM).

Rev Bras Epidemiol., 1 (1998), pp. 294-297

[13]

R.M. Viner, P.C. Hindmarsh, B. Taylor, T.J. Cole.

Childhood body mass index (BMI), breastfeeding and risk of Type 1 diabetes: findings from a longitudinal national birth cohort.

Diabet Med., 25 (2008), pp. 1056-1061

http://dx.doi.org/10.1111/j.1464-5491.2008.02525.x | Medline

[14]

C.G. Owen, R.M. Martin, P.H. Whincup, G.D. Smith, D.G. Cook.

Does breastfeeding influence risk of type 2 diabetes in later life?. A quantitative analysis of published evidence.

Am J Clin Nutr., 84 (2006), pp. 1043-1054

Medline

[15]

Horta BL, Bahl R, Martinés JC, Victora CG. Evidence on the long-term effects of breastfeeding: systematic reviews and meta-analyses. Geneva: World Health Organization; 2007. 52. p. [acessado em 24 Out 2012]. Disponível em: http://www. who.int/child_adolescent_health/documents/9241595230/en/index.html.

[16]

T.K. Young, P.J. Martens, S.P. Taback, E.A. Sellers, H.J. Dean, M. Cheang, et al.

Type 2 diabetes mellitus in children: prenatal and early infancy risk factors among native Canadians.

Arch Pediatr Adolesc Med., 156 (2002), pp. 651-655

Medline

[17]

D.A. Lawlor, C.J. Riddoch, A.S. Page, L.B. Andersen, N. Wedderkopp, M. Harro, et al.

Infant feeding and components of the metabolic syndrome: findings from the European Youth Heart Study.

Arch Dis Child., 90 (2005), pp. 582-588

http://dx.doi.org/10.1136/adc.2004.055335 | Medline

[18]

C.H. Fall, J.B. Borja, C. Osmond, L. Richter, S.K. Bhargava, R. Martorell, et al.

Infant-feeding patterns and cardiovascular risk factors in young adulthood: data from five cohorts in low- and middle- income countries.

Int J Epidemiol., 40 (2011), pp. 47-62

http://dx.doi.org/10.1093/ije/dyq155 | Medline

[19]

E.J. Mayer-Davis, D. Dabelea, A.P. Lamichhane, R.B. D’Agostino Jr., A.D. Liese, J. Thomas, et al.

Breast-feeding and type 2 diabetes in the youth of three ethnic groups: the SEARCh for diabetes in youth case-control study.

Diabetes Care., 31 (2008), pp. 470-475

http://dx.doi.org/10.2337/dc07-1321 | Medline

[20]

A.L. Madsen, L. Schack-Nielsen, A. Larnkjaer, C. Mølgaard, K.F. Michaelsen.

Determinants of blood glucose and insulin in healthy 9-month-old term Danish infants; the SKOT cohort.

Diabet Med., 27 (2010), pp. 1350-1357

http://dx.doi.org/10.1111/j.1464-5491.2010.03134.x | Medline

[21]

S.R. Veena, G.V. Krishnaveni, A.K. Wills, J.C. Hill, S.C. Karat, C.H. Fall.

Glucose tolerance and insulin resistance in Indian children: relationship to infant feeding pattern.

Diabetologia., 54 (2011), pp. 2533-2537

http://dx.doi.org/10.1007/s00125-011-2254-x | Medline

[22]

J.N. Davis, M.J. Weigensberg, G.Q. Shaibi, N.C. Crespo, L.A. Kelly, C.J. Lane, et al.

Influence of breastfeeding on obesity and type 2 diabetes risk factors in Latino youth with a family history of type 2 diabetes.

Diabetes Care., 30 (2007), pp. 784-789

http://dx.doi.org/10.2337/dc06-2008 | Medline

[23]

K. Borch-Johnsen, G. Joner, T. Mandrup-Poulsen, M. Christy, B. Zachau-Christiansen, K. Kastrup, et al.

Relation between breast-feeding and incidence rates of insulin-dependent diabetes mellitus. A hypothesis.

Lancet., 2 (1984), pp. 1083-1086

Medline

[24]

S. Brugman, J.T. Visser, J.L. Hillebrands, N.A. Bos, J. Rozing.

Prolonged exclusive breastfeeding reduces autoimmune diabetes incidence and increases regulatory T-cell frequency in bio-breeding diabetes-prone rats.

Diabetes Metab Res Rev., 25 (2009), pp. 380-387

http://dx.doi.org/10.1002/dmrr.953 | Medline

[25]

E.J. Mayer, R.F. Hamman, E.C. Gay, D.C. Lezotte, D.A. Savitz, G.J. Klingensmith.

Reduced risk of IDDM among breast-fed children.

The Colorado IDDM Registry. Diabetes., 37 (1988), pp. 1625-1632

[26]

V. Sadauskaite-Kuehne, J. Ludvigsson, Z. Padaiga, E. Jasinskiene, U. Samuelsson.

Longer breastfeeding is an independent protective factor against development of type 1 diabetes mellitus in childhood.

Diabetes Metab Res Rev., 20 (2004), pp. 150-157

http://dx.doi.org/10.1002/dmrr.425 | Medline

[27]

H. Malcova, Z. Sumnik, P. Drevinek, J. Venhacova, J. Lebl, O. Cinek.

Absence of breast-feeding is associated with the risk of type 1 diabetes: a case-control study in a population with rapidly increasing incidence.

Eur J Pediatr., 165 (2006), pp. 114-119

http://dx.doi.org/10.1007/s00431-005-0008-9 | Medline

[28]

J. Rosenbauer, P. Herzig, G. Giani.

Early infant feeding and risk of type 1 diabetes mellitus – a nationwide population-based case- control study in pre-school children.

Diabetes Metab Res Rev., 24 (2008), pp. 211-222

http://dx.doi.org/10.1002/dmrr.791 | Medline

[29]

J.J. Couper, C. Steele, S. Beresford, T. Powell, K. McCaul, A. Pollard, et al.

Lack of association between duration of breast-feeding or introduction of cow's milk and development of islet autoimmunity.

Diabetes., 48 (1999), pp. 2145-2149

Medline

[30]

J.S. Medeiros, M.A. Rivera, M.J. Benigna, M.A. Cardoso, M.J. Costa.

Case- control study on early exposure to cow's milk and the occurrence of Diabetes Mellitus type 1 in Campina Grande in the State of Paraíba.

Rev Bras Saúde Mater Infant., 3 (2003), pp. 271-280

[31]

J.M. Norris, F.W. Scott.

A meta-analysis of infant diet and insulin- dependent diabetes mellitus: do biases play a role?.

Epidemio- logy., 7 (1996), pp. 87-92

[32]

C.R. Cardwell, L.C. Stene, J. Ludvigsson, J. Rosenbauer, O. Cinek, J. Svensson, et al.

Breast-feeding and childhood-onset type 1 diabetes: a pooled analysis of individual participant data from 43 observational studies.

Diabetes Care., 35 (2012), pp. 2215-2225

http://dx.doi.org/10.2337/dc12-0438 | Medline

[33]

E. Patelarou, C. Girvalaki, H. Brokalaki, A. Patelarou, Z. Androulaki, C. Vardavas.

Current evidence on the associations of breastfee- ding, infant formula, and cow's milk introduction with type 1 dia- betes mellitus: a systematic review.

Nutr Rev., 70 (2012), pp. 509-519

http://dx.doi.org/10.1111/j.1753-4887.2012.00513.x | Medline

[34]

F.Y. Megeid, Z.A. Bakeit, B.O. Karim.

Early introduction of cow's milk and short duration of breastfeeding is associated with increasing risk of juvenile diabetes.

World J Med Sci., 6 (2011), pp. 54-60

[35]

K. Dahl-Jørgensen, G. Joner, K.F. Hanssen.

Relationship between cows’ milk consumption and incidence of IDDM in childhood.

Diabetes Care., 14 (1991), pp. 1081-1083

Medline

[36]

L.C. Harrison, M.C. Honeyman.

Cow's milk and type 1 diabetes: the real debate is about mucosal immune function.

Diabetes., 48 (1999), pp. 1501-1507

Medline

[37]

G. Soltész, S. Jeges, G. Dahlquist.

Non-genetic risk determinants for type 1 (insulin-dependent) diabetes mellitus in childhood. Hungarian Childhood Diabetes Epidemiology Study Group.

Acta Paediatr., 83 (1994), pp. 730-735

Medline

[38]

S. Ip, M. Chung, G. Raman, T.A. Trikalinos, J. Lau.

A summary of the Agency for Healthcare Research and Quality's evidence report on breastfeeding in developed countries.

Breastfeed Med., 4 (2009), pp. S17-S30

http://dx.doi.org/10.1089/bfm.2009.0050 | Medline

[39]

E. Gouveri, N. Papanas, A.I. Hatzitolios, E. Maltezos.

Breastfeeding and diabetes.

Curr Diabetes Rev., 7 (2011), pp. 135-142

Medline

[40]

E.P. Gunderson.

Breast-feeding and diabetes: long-term impact on mothers and their infants.

Curr Diab Rep., 8 (2008), pp. 279-286

Medline

[41]

N.I. Parikh, S.J. Hwang, E. Ingelsson, E.J. Benjamin, C.S. Fox, R.S. Vasan, et al.

Breastfeeding in infancy and adult cardiovascular disease risk factors.

Am J Med., 122 (2009), pp. 656-663

http://dx.doi.org/10.1016/j.amjmed.2008.11.034 | Medline

[42]

M. Hunsberger, A. Lanfer, A. Reeske, T. Veidebaum, P. Russo, C. Hadjigeorgiou, et al.

Infant feeding practices and prevalence of obesity in eight European countries – the IDEFICS study.

Public Health Nutr., 16 (2013), pp. 219-227

http://dx.doi.org/10.1017/S1368980012003850 | Medline

[43]

J.W. Rich-Edwards, M.J. Stampfer, J.E. Manson, B. Rosner, F.B. Hu, K.B. Michels, et al.

Breastfeeding during infancy and the risk of cardiovascular disease in adulthood.

Epidemiology., 15 (2004), pp. 550-556

Medline

[44]

R.M. Martin, Y. Ben-Shlomo, D. Gunnell, P. Elwood, J.W. Yarnell, G. Davey Smith.

Breast feeding and cardiovascular disease risk factors, incidence, and mortality: the Caerphilly study.

J Epidemiol Community Health., 59 (2005), pp. 121-129

http://dx.doi.org/10.1136/jech.2003.018952 | Medline

[45]

E. Evenhouse, S. Reilly.

Improved estimates of the benefits of breastfeeding using sibling comparisons to reduce selection bias.

Health Serv Res., 40 (2005), pp. 1781-1802

http://dx.doi.org/10.1111/j.1475-6773.2005.00453.x | Medline

[46]

R.M. Martin, S. Ebrahim, M. Griffin, G. Davey Smith, A.N. Nicolaides, N. Georgiou, et al.

Breastfeeding and atherosclerosis: intima- media thickness and plaques at 65-year follow-up of the Boyd Orr cohort.

Arterioscler Thromb Vasc Biol., 25 (2005), pp. 1482-1488

http://dx.doi.org/10.1161/01.ATV.0000170129.20609.49 | Medline

[47]

U.N. Das.

Breastfeeding prevents type 2 diabetes mellitus: but, how and why?.

Am J Clin Nutr., 85 (2007), pp. 1436-1437

Medline

[48]

A. Lucas, S. Boyes, S.R. Bloom, A. Aynsley-Green.

Metabolic and endocrine responses to a milk feed in six-day-old term infants: differences between breast and cow's milk formula feeding.

Acta Paediatr Scand., 70 (1981), pp. 195-200

Medline

[49]

R.E. Black, L.H. Allen, Z.A. Bhutta, L.E. Caulfield, M. de Onis, M. Ezzati, et al.

Maternal and child undernutrition: global and regional exposures and health consequences.

Lancet., 371 (2008), pp. 243-260

http://dx.doi.org/10.1016/S0140-6736(07)61690-0 | Medline

[50]

Fall CH. Non-industrialised countries and affluence. Br Med.

☆

Como citar este artigo: Pereira PF, Alfenas RC, Araújo RM. Does breastfeeding influence the risk of developing diabetes mellitus in children? A review of current evidence. J Pediatr (Rio J). 2014;90:7-15.

Indexada em:

Siga-nos:

Indexada em:

Siga-nos:

Receba a nossa Newsletter