Breast-Feeding and Childhood-Onset Type 1 Diabetes A pooled analysis of individual participant data from 43 observational studies

dc.contributor.authorCardwell, Chris R.
dc.contributor.authorStene, Lars C.
dc.contributor.authorLudvigsson, Johnny
dc.contributor.authorRosenbauer, Joachim
dc.contributor.authorCinek, Ondrej
dc.contributor.authorSvensson, Jannet
dc.contributor.authorPerez-Bravo, Francisco
dc.contributor.authorMemon, Anjum
dc.contributor.authorGimeno, Suely Godoy Agostinho [UNIFESP]
dc.contributor.authorWadsworth, Emma J. K.
dc.contributor.authorStrotmeyer, Elsa S.
dc.contributor.authorGoldacre, Michael J.
dc.contributor.authorRadon, Katja
dc.contributor.authorChuang, Lee-Ming
dc.contributor.authorParslow, Roger C.
dc.contributor.authorChetwynd, Amanda
dc.contributor.authorKaravanaki, Kyriaki
dc.contributor.authorBrigis, Girts
dc.contributor.authorPozzilli, Paolo
dc.contributor.authorUrbonaite, Brone
dc.contributor.authorSchober, Edith
dc.contributor.authorDevoti, Gabriele
dc.contributor.authorSipetic, Sandra
dc.contributor.authorJoner, Geir
dc.contributor.authorIonescu-Tirgoviste, Constantin
dc.contributor.authorBeaufort, Carine E. de
dc.contributor.authorHarrild, Kirsten
dc.contributor.authorBenson, Victoria
dc.contributor.authorSavilahti, Erkki
dc.contributor.authorPonsonby, Anne-Louise
dc.contributor.authorSalem, Mona
dc.contributor.authorRabiei, Samira
dc.contributor.authorPatterson, Chris C.
dc.contributor.institutionQueens Univ Belfast
dc.contributor.institutionNorwegian Inst Publ Hlth
dc.contributor.institutionOslo Univ Hosp
dc.contributor.institutionLinkoping Univ Hosp
dc.contributor.institutionUniv Dusseldorf
dc.contributor.institutionCharles Univ Prague
dc.contributor.institutionUniv Hosp Motol
dc.contributor.institutionHerlev Univ Hosp
dc.contributor.institutionUniv Chile
dc.contributor.institutionBrighton & Sussex Med Sch & NHS Brighton & Hove
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionCardiff Univ
dc.contributor.institutionUniv Pittsburgh
dc.contributor.institutionUniv Oxford
dc.contributor.institutionHosp Ludwig Maximilian Univ Munich
dc.contributor.institutionNatl Taiwan Univ Hosp
dc.contributor.institutionUniv Leeds
dc.contributor.institutionUniv Lancaster
dc.contributor.institutionUniv Athens
dc.contributor.institutionRiga Stradins Univ
dc.contributor.institutionUniv Campus Biomed
dc.contributor.institutionLithuanian Univ Hlth Sci
dc.contributor.institutionMed Univ Vienna
dc.contributor.institutionUniv Salento
dc.contributor.institutionUniv Belgrade
dc.contributor.institutionUniv Oslo
dc.contributor.institutionN Paulescu Inst Diabet
dc.contributor.institutionClin Pediat Luxembourg
dc.contributor.institutionUniv Aberdeen
dc.contributor.institutionUniv Helsinki
dc.contributor.institutionRoyal Childrens Hosp
dc.contributor.institutionAin Shams Univ
dc.contributor.institutionShahid Beheshti Univ Med Sci & Hlth Serv
dc.description.abstractOBJECTIVE-To investigate if there is a reduced risk of type 1 diabetes in children breastfed or exclusively breastfed by performing a pooled analysis with adjustment for recognized confounders.RESEARCH DESIGN and METHODS-Relevant studies were identified from literature searches using MEDLINE, Web of Science, and EMBASE. Authors of relevant studies were asked to provide individual participant data or conduct prespecified analyses. Meta-analysis techniques were used to combine odds ratios (ORs) and investigate heterogeneity between studies.RESULTS-Data were available from 43 studies including 9,874 patients with type 1 diabetes. Overall, there was a reduction in the risk of diabetes after exclusive breast-feeding for >2 weeks (20 studies; OR = 0.75, 95% CI 0.64-0.88), the association after exclusive breast-feeding for >3 months was weaker (30 studies; OR = 0.87, 95% CI 0.75-1.00), and no association was observed after (nonexclusive) breast-feeding for >2 weeks (28 studies; OR = 0.93, 95% CI 0.81-1.07) or >3 months (29 studies; OR = 0.88, 95% CI 0.78-1.00). These associations were all subject to marked heterogeneity (I-2 = 58, 76, 54, and 68%, respectively). in studies with lower risk of bias, the reduced risk after exclusive breast-feeding for >2 weeks remained (12 studies; OR = 0.86, 95% CI 0.75-0.99), and heterogeneity was reduced (I-2 = 0%). Adjustments for potential confounders altered these estimates very little.CONCLUSIONS-The pooled analysis suggests weak protective associations between exclusive breast-feeding and type 1 diabetes risk. However, these findings are difficult to interpret because of the marked variation in effect and possible biases (particularly recall bias) inherent in the included studies. Diabetes Care 35: 2215-2225, 2012en
dc.description.affiliationQueens Univ Belfast, Sch Med & Dent, Belfast, Antrim, North Ireland
dc.description.affiliationNorwegian Inst Publ Hlth, Div Epidemiol, Oslo, Norway
dc.description.affiliationOslo Univ Hosp, Oslo Diabet Res Ctr, Oslo, Norway
dc.description.affiliationLinkoping Univ Hosp, Dept Clin Expt Med, Div Pediat, S-58185 Linkoping, Sweden
dc.description.affiliationUniv Dusseldorf, Inst Biometr & Epidemiol, German Diabet Ctr, Leibniz Inst Duesseldorf, D-40225 Dusseldorf, Germany
dc.description.affiliationCharles Univ Prague, Dept Paediat, Fac Med 2, Motol, Czech Republic
dc.description.affiliationUniv Hosp Motol, Motol, Czech Republic
dc.description.affiliationHerlev Univ Hosp, Pediat Dept, DK-2730 Herlev, Denmark
dc.description.affiliationUniv Chile, Dept Nutr, Fac Med, Lab Nutr Genom, Santiago, Chile
dc.description.affiliationBrighton & Sussex Med Sch & NHS Brighton & Hove, Div Primary Care & Publ Hlth, Brighton, E Sussex, England
dc.description.affiliationUniversidade Federal de São Paulo, Prevent Med Dept, São Paulo, Brazil
dc.description.affiliationCardiff Univ, Cardiff Work Environm Res Ctr, Cardiff, S Glam, Wales
dc.description.affiliationUniv Pittsburgh, Grad Sch Publ Hlth, Dept Epidemiol, Ctr Aging & Populat Hlth, Pittsburgh, PA USA
dc.description.affiliationUniv Oxford, Dept Publ Hlth, Oxford, England
dc.description.affiliationHosp Ludwig Maximilian Univ Munich, Inst & Outpatient Clin Occupat & Environm Med, Munich, Germany
dc.description.affiliationNatl Taiwan Univ Hosp, Dept Internal Med, Taipei 100, Taiwan
dc.description.affiliationUniv Leeds, Paediat Epidemiol Grp, Leeds, W Yorkshire, England
dc.description.affiliationUniv Lancaster, Math & Stat Dept, Lancaster, England
dc.description.affiliationUniv Athens, Univ 2, Dept Pediat, Sch Med, Athens, Greece
dc.description.affiliationRiga Stradins Univ, Dept Publ Hlth & Epidemiol, Riga, Latvia
dc.description.affiliationUniv Campus Biomed, Rome, Italy
dc.description.affiliationLithuanian Univ Hlth Sci, Inst Endocrinol, Kaunas, Lithuania
dc.description.affiliationMed Univ Vienna, Dept Paediat, Vienna, Austria
dc.description.affiliationUniv Salento, Dept Social Sci & Commun, Lecce, Italy
dc.description.affiliationUniv Belgrade, Sch Med, Belgrade, Serbia
dc.description.affiliationUniv Oslo, Fac Med, Inst Hlth & Soc, Oslo, Norway
dc.description.affiliationOslo Univ Hosp, Dept Paediat, Oslo, Norway
dc.description.affiliationN Paulescu Inst Diabet, Nutr & Metab Dis Clin, Bucharest, Romania
dc.description.affiliationClin Pediat Luxembourg, Luxembourg, Luxembourg
dc.description.affiliationUniv Aberdeen, Med Stat Team, Aberdeen, Scotland
dc.description.affiliationUniv Oxford, Cancer Epidemiol Unit, Oxford, England
dc.description.affiliationUniv Helsinki, Hosp Children & Adolescents, Helsinki, Finland
dc.description.affiliationRoyal Childrens Hosp, Murdoch Childrens Res Inst, Melbourne, Vic, Australia
dc.description.affiliationAin Shams Univ, Dept Paediat, Cairo, Egypt
dc.description.affiliationShahid Beheshti Univ Med Sci & Hlth Serv, Fac Nutr Sci & Food Technol, Tehran, Iran
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Prevent Med Dept, São Paulo, Brazil
dc.description.provenanceMade available in DSpace on 2016-01-24T14:27:56Z (GMT). No. of bitstreams: 0 Previous issue date: 2012-11-01en
dc.description.sourceWeb of Science
dc.description.sponsorshipNational Institutes of Health
dc.description.sponsorshipChinese Foundation of Health
dc.description.sponsorshipDepartment of Health, Executive Yuan, Republic of China
dc.description.sponsorshipMinistry for Science and Technology of the Republic of Serbia
dc.description.sponsorshipGerman Research Foundation
dc.description.sponsorshipResearch Council of Norway
dc.description.sponsorshipIDNational Institutes of Health: R01-DK-46498
dc.description.sponsorshipIDNational Institutes of Health: R01-DK-42316
dc.description.sponsorshipIDDepartment of Health, Executive Yuan, Republic of China: DOH91-TD1167
dc.description.sponsorshipIDMinistry for Science and Technology of the Republic of Serbia: 175042
dc.description.sponsorshipIDGerman Research Foundation: HE 234/1-1
dc.description.sponsorshipIDResearch Council of Norway: 148359/330
dc.identifier.citationDiabetes Care. Alexandria: Amer Diabetes Assoc, v. 35, n. 11, p. 2215-2225, 2012.
dc.publisherAmer Diabetes Assoc
dc.relation.ispartofDiabetes Care
dc.rightsAcesso aberto
dc.titleBreast-Feeding and Childhood-Onset Type 1 Diabetes A pooled analysis of individual participant data from 43 observational studiesen