Association between Breastfeeding and Reduced Risk of Obesity in Childhood: A Cross-sectional Study in Ecuadorian Infants under Five Years of Age

Abstract

Poor eating habits and an increased sedentary lifestyle are responsible for obesity being one of the main public health problems in Ecuador and the world. Several factors can modulate the risk of an infant to be obese, considering genetic, environmental and sociodemographic variables. The aim of this study is to analyze the evidence on the relationship between breastfeeding (BF) and obesity in childhood and thus contribute to the planning of prevention strategies from an early age. A nationally representative sample of children under 5 years of age from the National Health and Nutrition Survey (ENSANUT, 2018) was used. We used heteroscedasticity and autocorrelation tests of the data to rule out possible statistical modeling problems and used multicollinearity tests to avoid redundant information in the models. We also calculated confusion matrices to test the correct specification of the models. In addition, we used a binary logistic linear regression model where the Odds Ratio (OR) with their 95% confidence intervals (95% CI) were estimated for each of the independent variables. Our results show that those children who were breastfed show a greater protective factor against obesity compared to those children who were not breastfed. That is, our results show that exclusive breastfeeding during the first six months of life increased 2 times (OR= 2.01; CI=1.91-2.17) the probability of not suffering from obesity. Other significant protective factors are the mother's age, the mother's educational level and the mother's area of residence. The recommendation derived from this research is that BF should be carried out until the sixth month of life of the infant and complemented with solid (non-milk) food until two years of age and beyond since this could protect against childhood obesity and its associated comorbidities in adulthood, although the benefit that BF can offer against the risk of obesity in the general population is small.