A study carried out by Marília Fuller, text by the author.
Breast milk protects children against early excess weight
Children are becoming overweight at an increasingly earlier age
Research carried out in the city of Taubaté, in the interior of São Paulo, linked aspects of the diet of children at the beginning of preschool age with their nutritional status. The study is the result of nutritionist Amanda Foster Lopes' master's project, carried out at the Faculty of Public Health (FSP) at USP, with support from the National Council for Scientific and Technological Development (CNPq) and in partnership with the Department of Education of the City of Taubaté. The project was stimulated by Amanda's residency in the area of pediatrics, but with a focus on infant nutrition to get closer to her profession.
During the first year of life, in general, children undergo an important transition process in their diet, which begins with nutrition via the intrauterine umbilical cord, followed by breastfeeding, complementary feeding and, finally, family food. Diet is one of the most important factors determining the development of excess weight and obesity, a condition that is currently affecting children and is being considered a public health problem.
Children are developing excess weight at an increasingly earlier age, so it is important to look into which aspects of this initial diet could influence the development of excess weight in this age group. Amanda found that children who received breast milk for a longer period had a lower z score — the distance between the observed value in relation to the median of this measurement or the value of the reference population — of Body Mass Index (BMI) for their age at the time of the assessment. In other words, this means that receiving breast milk for a longer period of time can be a protective factor against the development of excess weight from 2 to 4 years of age, on average.
Methodology
To carry out the research, a draw selected the 27 daycare centers and preschools in Taubaté that participated in the study, totaling 463 children.
The methodology involved the development of a questionnaire with a series of questions, such as the child's weight at birth, sex, type of birth and also about nutrition, which involved the duration of exclusive and non-exclusive breastfeeding and the age at which some foods began to be consumed, such as water, tea, non-breast milk, fruit porridge, vegetable porridge and sweets.
The questionnaire was sent to parents through the children's school schedule along with the Informed Consent Form, authorization for their children to participate in the study. With the answers, Amanda began to unravel the information. "I measured the weight and length of these children, for evaluation using the BMI z-score for age. After collecting all the data, statistical analyzes were carried out", he reports.
Amanda's research showed that 27.5% of children studied in the city of Taubaté were already overweight at 2 years of age, a result that confirms the presence of excess weight in increasingly younger children. Regarding nutrition, the results show an important gap between what is advised by the World Health Organization (WHO) and the reality regarding breastfeeding practices.
“Breast milk should be offered exclusively until six months of age and our results showed that half of the children studied stopped receiving it exclusively before 3 months of age.”,
reveals Amanda. The study showed that non-exclusive breastfeeding lasts an average of 9.9 months, with 50% of children having stopped receiving breast milk at 6 months of age.
According to Amanda, these inadequacies regarding breastfeeding were reflected in the introduction of the other foods analyzed — an introduction which, in general, occurred early, before the recommended period for the age group. Amanda also observed that being male was a protective factor and that higher birth weight proved to be a risk factor for the development of excess weight.
Be careful with your diet
“These results confirm conclusions previously found in other studies”, says Amanda. A meeting was held with all daycare center directors where the questionnaire was administered to provide feedback on the research, showing which children were at nutritional risk. However, Amanda reports that during data collection, in conversations with teachers, it was observed that all children at nutritional risk were already being monitored by specialized professionals.
Amanda collected a wide range of factors, which may or may not be related to the development of excess weight in this age group, from aspects of eating habits to cultural aspects. In his words, “more studies are needed to better understand such factors and their effects, which involve the increase in the prevalence of obesity in increasingly younger children”.
On the other hand, The results highlight the importance of breastfeeding. Amanda believes that policies aimed at promoting breastfeeding can contribute – among other benefits – in the field of public health to reducing the epidemic of excess weight, which is already present among very young individuals.
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