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. 2025 Jun 9:12:1598141.
doi: 10.3389/fnut.2025.1598141. eCollection 2025.

Relationship between breastfeeding duration, lifestyle and obesity in children aged 3-16 years: a cross-sectional study

Yu Liu #  1 , Yiyao Gu #  2 , Jie Mu  2 , Zhi Duan  2 , Xixiang Wang  1 , Xiuwen Ren  1 , Lu Liu  1 , Jingjing Xu  1 , Chi Zhang  3 , Shaobo Zhou  4 , Ning Ma  1 , Linhong Yuan  1 , Ying Wang  2
Affiliations

Relationship between breastfeeding duration, lifestyle and obesity in children aged 3-16 years: a cross-sectional study

Yu Liu et al. Front Nutr. .

Abstract

Introduction: Childhood obesity is emerging as an increasingly severe public health problem. Effective lifestyle and dietary interventions are urgently needed to prevent childhood obesity. The study explored the association of breastfeeding duration in early life and lifestyle habits with childhood obesity.

Methods: A total of 541 children aged 3-16 at Suzhou Science and Technology City Hospital were included in this analysis. The participants were categorized into obesity group and non-obesity group. Assigned and calculated the score of lifestyle habits and the total score of lifestyle habits and breastfeeding. Logistic regression was used to analyze the risk of obesity with breastfeeding and/or lifestyle habits scores, and ROC curves were applied to evaluate the accuracy of the models. SHapley Additive exPlanation (SHAP) was used to explore the specified impact of variables.

Results: (1) The dietary habits of children with obesity were marked by consuming more meat-based foods, preferring heavier flavors food items, and having a habit of snacking before meals. (2) It is recommended that newborn be breastfed for 4-12 months. (3) Healthy lifestyle habits and prolonged breastfeeding duration are both protective factors for childhood obesity respectively, and the synergistic impact is much more significant.

Discussion: Prolonging breastfeeding duration appropriately and cultivating healthy dietary habits might contribute to prevention of childhood obesity.

Keywords: breastfeeding; children; dietary; lifestyle; obesity.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Correlation between breastfeeding duration, BMI, lifestyle score, total score of lifestyle and breastfeeding duration in obesity and non-obesity groups. BMI, body mass index. Blue: non-obesity group, green: obesity group, numbers: correlation coefficients. *p < 0.05, ***p < 0.005.
Figure 2
Figure 2
Association of the breastfeeding duration, lifestyle and the risk of childhood obesity. The subjects were divided into Q1 (≤4), Q2 (4–8), Q3 (8–12) and Q4 (≥12) groups according to the breastfeeding duration. Lifestyle score was divided into Q1 (≤8), Q2 (8–10), Q3 (10–12) and Q4 (≥12). Combine score of lifestyle and breastfeeding was divided into Q1 (≤9), Q2 (9–11), Q3 (11–12) and Q4 (≥12). In Model 1, no confounding factors were adjusted; In Model 2, confounding factors including age and gender were adjusted; In Model 3, based on model 2, confounding factors including weight and waist circumference were adjusted. p < 0.05 indicates a statistically significant difference. Q, quartile.
Figure 3
Figure 3
(A) ROC curves of the models. In Model 1, no confounding factors were adjusted; In Model 2, confounding factors, including age and gender, were adjusted; In Model 3, based on model 2, confounding factors, including bodyweight and waist circumference, were adjusted. (B) The SHapley Additive exPlanation (SHAP) summary plot. (C) Influencing factors contribution ranking. The horizontal location means the effect of value on the prediction and the color means the effect of variable on observation.
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