Breast Feeding Is Associated with Postmenopausal Bone Loss: Findings from the Korea National Health and Nutrition Examination Survey
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Background: Postmenopausal osteoporosis is a common disease which can cause various morbidity and economic burden. Lactation is known to cause a decline in bone mineral density (BMD), but there are controversies on whether decreased BMD is fully recovered after lactation and whether lactation duration has an influence on postmenopausal BMD. This study was conducted to see whether breastfeeding is associated with postmenopausal bone loss using a highly representative sample of Korean population. Methods: Retrospective cross sectional study was done using data collected from Korea National Health and Nutrition Examination Survey V. The study outcome was BMD measured with dual-energy X-ray absorptiometry and divided into 2 groups: normal or low BMD (T score<-1), and breastfeeding duration was categorized into 4 groups (never, 1st, 2nd, and 3rd tertile). Logistic regression analysis was done to examine the association between lactation duration and BMD. Results: Among 1,694 postmenopausal women (mean age, 63.5±9.1), 85.71% were in low BMD group. Compared to never breastfeeding group, postmenopausal women with longer than 79 months of breastfeeding duration are more likely to have low BMD (adjusted risk ratio [ARR]=1.24; 95% confidence interval, 1.17 to 1.32). As the duration of breastfeeding increases, ARR and risk difference for low BMD also increases (P for trend=0.008). Conclusion: The study results showed that total breastfeeding duration was associated with postmenopausal low BMD. All women planning on breastfeeding should be aware of its risks and should take adequate dietary calcium and vitamin D before, during, and after breastfeeding.
Abstract
Background: Postmenopausal osteoporosis is a common disease which can cause various morbidity and economic burden. Lactation is known to cause a decline in bone mineral density (BMD), but there are controversies on whether decreased BMD is fully recovered after lactation and whether lactation duration has an influence on postmenopausal BMD. This study was conducted to see whether breastfeeding is associated with postmenopausal bone loss using a highly representative sample of Korean population. Methods: Retrospective cross sectional study was done using data collected from Korea National Health and Nutrition Examination Survey V. The study outcome was BMD measured with dual-energy X-ray absorptiometry and divided into 2 groups: normal or low BMD (T score<-1), and breastfeeding duration was categorized into 4 groups (never, 1st, 2nd, and 3rd tertile). Logistic regression analysis was done to examine the association between lactation duration and BMD. Results: Among 1,694 postmenopausal women (mean age, 63.5±9.1), 85.71% were in low BMD group. Compared to never breastfeeding group, postmenopausal women with longer than 79 months of breastfeeding duration are more likely to have low BMD (adjusted risk ratio [ARR]=1.24; 95% confidence interval, 1.17 to 1.32). As the duration of breastfeeding increases, ARR and risk difference for low BMD also increases (P for trend=0.008). Conclusion: The study results showed that total breastfeeding duration was associated with postmenopausal low BMD. All women planning on breastfeeding should be aware of its risks and should take adequate dietary calcium and vitamin D before, during, and after breastfeeding.
참고문헌 (23)
- Holroyd C, "Epidemiology of osteoporosis", Best Pract Res Clin Endocrinol Metab, 22, pp.671~685 (2008)
- 박은정, "Prevalence of Osteoporosis in the Korean Population Based on Korea National Health and Nutrition Examination Survey (KNHANES), 2008--2011", Yonsei Medical Journal, 55(4), pp.1049~1057 (2014), 연세대학교의과대학[DOI]
- Harvey N, "Osteoporosis: impact on health and economics", Nat Rev Rheumatol, 6, pp.99~105 (2010)
- Kovacs CS., "Calcium and bone metabolism during pregnancy and lactation", J Mammary Gland Biol Neoplasia, 10, pp.105~118 (2005)
- Kovacs CS., "Calcium and bone metabolism in pregnancy and lactation", J Clin Endocrinol Metab, 86, pp.2344~2348 (2001)
- Karlsson C, "Pregnancy and lactation confer reversible bone loss in humans", Osteoporos Int, 12, pp.828~834 (2001)
- Pearson D, "Recovery of pregnancy mediated bone loss during lactation", Bone, 34, pp.570~578 (2004)
- Oliveri B, "Mineral and bone mass changes during pregnancy and lactation", Nutrition, 20, pp.235~240 (2004)
- Henderson PH 3rd, "Bone mineral density in grand multiparous women with extended lactation", Am J Obstet Gynecol, 182, pp.1371~1377 (2000)
- Kojima N, "Cross-sectional study of the effects of parturition and lactation on bone mineral density later in life", Maturitas, 41, pp.203~209 (2002)
- Paton LM, "Pregnancy and lactation have no long-term deleterious effect on measures of bone mineral in healthy women: a twin study", Am J Clin Nutr, 77, pp.707~714 (2003)
- Yazici S, "The effect of breast-feeding duration on bone mineral density in postmenopausal Turkish women: a population-based study", Arch Med Sci, 7, pp.486~492 (2011)
- Wiklund PK, "Lactation is associated with greater maternal bone size and bone strength later in life", Osteoporos Int, 23, pp.1939~1945 (2012)
- Bjornerem A, "Breastfeeding protects against hip fracture in postmenopausal women: the Tromso study", J Bone Miner Res, 26, pp.2843~2850 (2011)
- Canal-Macias ML, "Increased bone mineral density is associated with breastfeeding history in premenopausal Spanish women", Arch Med Sci, 9, pp.703~708 (2013)
- Tsvetov G, "Influence of number of deliveries and total breast-feeding time on bone mineral density in premenopausal and young postmenopausal women", Maturitas, 77, pp.249~254 (2014)
- Okyay DO, "Prolonged breast-feeding is an independent risk factor for postmenopausal osteoporosis", Maturitas, 74, pp.270~275 (2013)
- Hosseinpanah F, "Total duration of breastfeeding is associated with low bone mineral density in Iranian postmenopausal women", Int J Endocrinol Metab, 8, pp.153~158 (2011)
- Bolzetta F, "Duration of breastfeeding as a risk factor for vertebral fractures", Bone, 68, pp.41~45 (2014)
- Norton EC, "Computing adjusted risk ratios and risk differences in Stata", Stata J, 13, pp.492~509 (2013)
- Dursun N, "Influence of duration of total breast-feeding on bone mineral density in a Turkish population:does the priority of risk factors differ from society to society?", Osteoporos Int, 17, pp.651~655 (2006)
- Bayray A, "The effect of parity on bone mineral density in postmenopausal women: a systematic review", J Osteopor Phys Act, 1, pp.104~ (2013)
- More C, "The effects of pregnancy and lactation on bone mineral density", Osteoporos Int, 12, pp.732~737 (2001)