Duration of Lactation and Incidence of Type 2 Diabetes
Alison M. Stuebe, MD; Janet W. Rich-Edwards, ScD; Walter C. Willett, MD,
DrPH; JoAnn E. Manson, MD, DrPH; Karin B. Michels, ScD, PhD
JAMA. 2005;294:2601-2610.
Context Lactation is associated with improved glucose and insulin
homeostasis, independent of weight change.
Objective To evaluate the association between lactation history and
incidence of type 2 diabetes.
Design, Setting, and Participants Prospective observational cohort study of
83 585 parous women in the Nurses Health Study (NHS) and retrospective
observational cohort study of 73 418 parous women in the Nurses Health
Study II (NHS II).
Main Outcome Measure Incident cases of type 2 diabetes mellitus.
Results In the NHS, 5145 cases of type 2 diabetes were diagnosed during 1
239 709 person-years of follow-up between 1986 and 2002, and in the NHS II,
1132 cases were diagnosed during 778 876 person-years of follow-up between
1989 and 2001. Among parous women, increasing duration of lactation was
associated with a reduced risk of type 2 diabetes. For each additional year
of lactation, women with a birth in the prior 15 years had a decrease in the
risk of diabetes of 15% (95% confidence interval, 1%-27%) among NHS
participants and of 14% (95% confidence interval, 7%-21%) among NHS II
participants, controlling for current body mass index and other relevant
risk factors for type 2 diabetes.
Conclusions Longer duration of breastfeeding was associated with reduced
incidence of type 2 diabetes in 2 large US cohorts of women. Lactation may
reduce risk of type 2 diabetes in young and middle-aged women by improving
glucose homeostasis.
Author Affiliations: Department of Obstetrics, Gynecology, and Reproductive
Biology, Brigham and Womens Hospital (Dr Stuebe), Department of Ambulatory
Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care
(Dr Rich-Edwards), Departments of Nutrition (Dr Willett), and Epidemiology
(Drs Rich-Edwards, Willett, Manson, and Michels), Harvard School of Public
Health, Channing Laboratory (Drs Rich-Edwards, Willett, Manson, and Michels)
and Division of Preventive Medicine (Dr Manson), Department of Medicine, and
Obstetrics and Gynecology Epidemiology Center, Department of Obstetrics,
Gynecology, and Reproductive Biology (Dr Michels), Brigham and Womens
Hospital and Harvard Medical School, Boston, Mass.
Leanne Wynne
Midwife in charge of "Women's Business"
Mildura Aboriginal Health Service Mob 0418 371862
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