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      Metabolic Syndrome and Its Associated Early-Life Factors among Chinese and Spanish Adolescents: A Pilot Study

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          Abstract

          Metabolic syndrome (MetS) is a growing problem worldwide in adolescents. This study compared two sample populations of young people in Spain and China, and analyzed the association of birth weight and breastfeeding duration with MetS. A cross-sectional study was conducted in adolescents (10–15 years old); 1150 Chinese and 976 Spanish adolescents. The variables analyzed were anthropometric characteristics, biochemical markers, and demographic characteristics using the same methodology and data collection protocol. Also, birth weight and breastfeeding were retrospectively analyzed during the first year of life. The results showed statistically significant differences between the two groups in reference to body mass index (BMI), blood pressure, triglyceride, glucose, and high-density lipoprotein cholesterol (HDL-C) levels. The MetS prevalence was higher in Spanish adolescents (2.5%) than in the Chinese group (0.5%). Breastfeeding duration was inversely associated with hypertriglyceridemia, low HDL-C, and MetS, whereas higher birth weight was associated with hyperglycemia, low HDL-C, hypertriglyceridemia, and abdominal obesity. Spanish adolescents showed more altered MetS components, and consequently, a higher MetS prevalence than the Chinese adolescents. This made them more vulnerable to cardiometabolic risk. Our results highlight the need for interventions designed by health professionals, which would encourage pregnant women to breastfeed their children.

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          The risks of not breastfeeding for mothers and infants.

          Health outcomes in developed countries differ substantially for mothers and infants who formula feed compared with those who breastfeed. For infants, not being breastfed is associated with an increased incidence of infectious morbidity, as well as elevated risks of childhood obesity, type 1 and type 2 diabetes, leukemia, and sudden infant death syndrome. For mothers, failure to breastfeed is associated with an increased incidence of premenopausal breast cancer, ovarian cancer, retained gestational weight gain, type 2 diabetes, myocardial infarction, and the metabolic syndrome. Obstetricians are uniquely positioned to counsel mothers about the health impact of breastfeeding and to ensure that mothers and infants receive appropriate, evidence-based care, starting at birth.
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            A systematic review of maternal obesity and breastfeeding intention, initiation and duration

            Background Breastfeeding behaviour is multifactorial, and a wide range of socio-cultural and physiological variables impact on a woman's decision and ability to breastfeed successfully. An association has been reported between maternal obesity and low breastfeeding rates. This is of public health concern because obesity is rising in women of reproductive age and the apparent association with increased artificial feeding will lead to a greater risk of obesity in children. The aim of this paper is to examine the relationship between maternal overweight and obesity and breastfeeding intention and initiation and duration. Methods A systematic review was conducted in January and February 2007, using the following databases: Medline, CINAHL and the Australian Breastfeeding Association's Lactation Resource Centre. Studies which have examined maternal obesity and infant feeding intention, initiation, duration and delayed onset of lactation were tabulated and summarised. Results Studies have found that obese women plan to breastfeed for a shorter period than normal weight women and are less likely to initiate breastfeeding. Of the four studies that examined onset of lactation, three reported a significant relationship between obesity and delayed lactogenesis. Fifteen studies, conducted in the USA, Australia, Denmark, Kuwait and Russia, have examined maternal obesity and duration of breastfeeding. The majority of large studies found that obese women breastfed for a shorter duration than normal weight women, even after adjusting for possible confounding factors. Conclusion There is evidence from epidemiological studies that overweight and obese women are less likely to breastfeed than normal weight women. The reasons may be biological or they may be psychological, behavioral and/or cultural. We urgently need qualitative studies from women's perspective to help us understand women in this situation and their infant feeding decisions and behaviour.
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              What is metabolic syndrome, and why are children getting it?

              Metabolic syndrome comprises a cluster of cardiovascular risk factors (hypertension, altered glucose metabolism, dyslipidemia, and abdominal obesity) that occur in obese children. However, metabolic syndrome can also occur in lean individuals, suggesting that obesity is a marker for the syndrome, not a cause. Metabolic syndrome is difficult to define, due to its nonuniform classification and reliance on hard cutoffs in the evaluation of disorders with non-Gaussian distributions. Defining the syndrome is even more difficult in children, owing to racial and pubertal differences and lack of cardiovascular events. Lipid partitioning among specific fat depots is associated with insulin resistance, which can lead to mitochondrial overload and dysfunctional subcellular energy use and drive the various elements of metabolic syndrome. Multiple environmental factors, in particular a typical Western diet, drive mitochondrial overload, while other changes in Western society, such as stress and sleep deprivation, increase insulin resistance and the propensity for food intake. These culminate in an adverse biochemical phenotype, including development of altered glucose metabolism and early atherogenesis during childhood and early adulthood.
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                Author and article information

                Journal
                Nutrients
                Nutrients
                nutrients
                Nutrients
                MDPI
                2072-6643
                11 July 2019
                July 2019
                : 11
                : 7
                : 1568
                Affiliations
                [1 ]Department of Maternal and Child Health Care, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
                [2 ]Instituto de la Grasa (CSIC), Campus Universidad Pablo de Olavide, Edificio 46, 41013 Seville, Spain
                [3 ]Departamento de Enfermería, CTS-436 Adscrito al Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC), University of Granada, Av/Ilustración 60, 18016 Granada, Spain
                Author notes
                [* ]Correspondence: jschmidt@ 123456ugr.es (J.S.-R.V.); chenyj68@ 123456mail.sysu.edu.cn (Y.C.); Tel./Fax: +34-958-243-495 (J.S.-R.V.); Tel.:+86-20-87334627 (Y.C.); Fax: +86-20-87335498 (Y.C.)
                Author information
                https://orcid.org/0000-0001-5919-993X
                https://orcid.org/0000-0003-2775-0058
                https://orcid.org/0000-0003-3132-2945
                https://orcid.org/0000-0002-3250-9173
                https://orcid.org/0000-0001-5103-6028
                Article
                nutrients-11-01568
                10.3390/nu11071568
                6682950
                31336790
                13f45210-a072-4f26-a064-8e9de3691e5e
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 05 June 2019
                : 10 July 2019
                Categories
                Article

                Nutrition & Dietetics
                metabolic syndrome,adolescents,breastfeeding duration,birth weight
                Nutrition & Dietetics
                metabolic syndrome, adolescents, breastfeeding duration, birth weight

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