Shorter versus longer durations of any human milk feeding and diabetes outcomes in offspring a systematic review
Grade: Moderate - type 1 diabetes; Limited - fasting glucose and insulin resistance in childhood and the transition into adolescence; Grade Not Assignable - fasting glucose and insulin resistance in adulthood, type 2 diabetes, prediabetes, HbA1C METHODS: 1. The systematic review was conducted by a t...
| Main Author: | |
|---|---|
| Corporate Authors: | , |
| Format: | eBook |
| Language: | English |
| Published: |
Washington, D.C.
United States Department of Agriculture
April 2019, 2019
|
| Online Access: | |
| Collection: | National Center for Biotechnology Information - Collection details see MPG.ReNa |
| Summary: | Grade: Moderate - type 1 diabetes; Limited - fasting glucose and insulin resistance in childhood and the transition into adolescence; Grade Not Assignable - fasting glucose and insulin resistance in adulthood, type 2 diabetes, prediabetes, HbA1C METHODS: 1. The systematic review was conducted by a team of staff from the Nutrition Evidence Systematic Review in collaboration with a Technical Expert Collaborative.2. A single literature search was conducted to identify literature for several related systematic reviews that examined infant milk-feeding practices and different outcomes. The search was conducted in CINAHL, Cochrane, Embase, and PubMed, and used a search date range of January 1980 to March 2016. A manual search was done to identify articles that may not have been included in the electronic databases searched.3. Articles were screened independently by 2 NESR analysts to determine which articles met predetermined criteria for inclusion.4. With the exception of 1 study that had limited external validity, the significant associations between the duration of any human milk feeding and type 1 diabetes risk were inverse associations. The ability to draw stronger conclusions was primarily limited by insufficient sample sizes, concerns about internal validity such as the potential for confounding, and the retrospective collection of exposure data, which increases the risk of misclassification of the exposure.3. Evidence about the lack of an association between the duration of any human milk feeding and fasting glucose and insulin resistance during childhood and the transition into adolescence was limited. One cluster randomized controlled trial and 3 prospective cohort studies provided consistent evidence. The ability to draw stronger conclusions was primarily limited by the small number of studies and the limited evidence from the United States (where metabolic risk may be higher).4. Data from each included article were extracted, risks of bias were assessed, and both were checked for accuracy.5. The body of evidence was qualitatively synthesized, a conclusion statement was developed, and the strength of the evidence (grade) was assessed using pre-established criteria including evaluation of the internal validity/risk of bias, adequacy, consistency, impact, and generalizability of available evidence. SUMMARY OF EVIDENCE: 1. Thirty-seven articles met the inclusion criteria for this systematic review, including 30 with evidence about type 1 diabetes, 1 with evidence about type 2 diabetes, and 6 with evidence about intermediate diabetes outcomes (fasting glucose and insulin resistance).2. Evidence about the association between shorter versus longer durations of any human milk feeding and higher risk of type 1 diabetes was moderate. Across 22 independent observational studies (30 articles), 12 reported significant associations. This systematic review examines available evidence related to diabetes outcomes in offspring, including fasting glucose, HbA1C, glucose tolerance/insulin resistance, and the incidence and prevalence of prediabetes, type 1 diabetes, and type 2 diabetes. CONCLUSION STATEMENT AND GRADE: 1. Moderate evidence from observational studies suggests that, among infants fed some amount of human milk, shorter versus longer durations of any human milk feeding are associated with higher risk of type 1 diabetes. Limited but consistent evidence suggests that the duration of any human milk feeding is not associated with fasting glucose or insulin resistance in childhood or during the transition from childhood into adolescence. There is insufficient evidence to determine whether or not there is a relationship between shorter versus longer durations of any human milk feeding and type 2 diabetes, prediabetes, or HbA1C throughout the lifespan, and fasting glucose and insulin resistance in adulthood. Evidence related to type 2 diabetes, prediabetes, and HbA1C, and about fasting glucose and insulin resistance beyond early adolescence was scant BACKGROUND: 1. This systematic review was conducted as part of the U.S. Department of Agriculture and Department of Health and Human Services Pregnancy and Birth to 24 Months Project.2. The goal of this systematic review was to examine the following question: What is the relationship between shorter versus longer durations of any human milk feeding and diabetes outcomes in offspring?3. This systematic review examines comparisons of infants who were fed human milk for shorter durations with infants who were fed human milk for longer durations. Human milk feeding was defined as feeding human milk alone or in combination with infant formula and/or complementary foods or beverages such as cow's milk. Human milk was defined as mother's own milk provided at the breast (i.e., nursing) or expressed and fed fresh or after refrigeration or freezing. Donor milk (e.g., banked milk) was not examined in this review.4. |
|---|---|
| Physical Description: | 1 PDF file (220 pages) illustrations |