Clin Nutr Res.  2017 Oct;6(4):277-284. 10.7762/cnr.2017.6.4.277.

Breastfeeding for One Month or Longer is Associated with Higher Risk of Osteoarthritis in Older Adults: NHANES 1999–2012

• Park CY

• KMID: 2392791
• DOI: http://doi.org/10.7762/cnr.2017.6.4.277

Abstract

Breastfeeding is associated with many health benefits to the mother but the association between osteoarthritis (OA) is not known. Menopause, a state of rapid estrogen loss, is associated with OA. To test whether lactation, another physiological state of low estrogen status, is associated with OA, a nationally representative dataset National Health and Nutrition Examination Survey (NHANES) 1999-2012 was analyzed. Information of OA diagnosis history and lactation for at least one month was self-reported by women 50 years and older that had given birth to at least one child. Women that breastfed for less than one month had a higher proportion of those that were 60 years and older, Hispanic (than non-Hispanic Black), and higher current/self-reported greatest body mass index. Women that breastfed for one month or longer had a higher proportion of those that had 3 or more children, higher poverty-income ratio, were post-menopausal and performed vigorous physical activity. Weighted percentage of OA patients was 22%, and did not differ between the two groups. However, when logistic regression was performed adjusting for multiple covariates, lactation for one month or longer was positively associated with OA. Women that breastfed for one month or longer had an adjusted odds ratio of 1.21 (95% confidence interval, 1.05-1.40) for OA compared to those that breastfed for less than one month. The results indicate that women that breastfed for at least one month have a higher risk of OA than women that delivered a child but breastfed for less than one month.

Keyword

Lactation; Breast feeding; Osteoarthritis; NHANES; Epidemiology

MeSH Terms

Adult*
Body Mass Index
Breast Feeding*
Child
Dataset
Diagnosis
Epidemiology
Estrogens
Female
Hispanic Americans
Humans
Insurance Benefits
Lactation
Logistic Models
Menopause
Mothers
Motor Activity
Nutrition Surveys*
Odds Ratio
Osteoarthritis*
Parturition
Estrogens

Reference

1. World Health Organization. Infant and young child feeding [Internet]. Geneva: World Health Organization;2017. cited 2017 August 26. Available from: http://www.who.int/mediacentre/factsheets/fs342/en/.

2. Centers for Disease Control and Prevention (US). Healthy People 2020 Objectives for the Nation [Internet]. Atlanta (GA): Centers for Disease Control and Prevention;2016. cited 2017 August 26. Available from: https://www.cdc.gov/breastfeeding/policy/hp2020.htm.

3. American Academy for Pediatrics. Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics. 2012; 129:e827–e841.

4. Victora CG, Bahl R, Barros AJ, França GV, Horton S, Krasevec J, Murch S, Sankar MJ, Walker N, Rollins NC. Lancet Breastfeeding Series Group. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016; 387:475–490.

5. Arthritis Foundation (US). What is osteoarthritis? [Internet]. Atlanta (GA): Arthritis Foundation;cited 2017 August 26. Available from: http://www.arthritis.org/about-arthritis/types/osteoarthritis/what-is-osteoarthritis.php.

6. Shin DW, Nam S, Bang YS, Lee JY. Estimation of the prevalence of Korean adults aged 50 years or more with knee osteoarthritis based on the data from fifth Korea National Health and Nutrition Examination Survey. J Korean Med Assoc. 2013; 56:431–436.

7. Centers for Disease Control and Prevention (US). Osteoarthritis Fact Sheet [Internet]. Atlanta (GA): Centers for Disease Control and Prevention;2017. cited 2017 July 24. Available from: https://www.cdc.gov/arthritis/basics/osteoarthritis.htm.

8. Roman-Blas JA, Castañeda S, Largo R, Herrero-Beaumont G. Osteoarthritis associated with estrogen deficiency. Arthritis Res Ther. 2009; 11:241.

9. Srikanth VK, Fryer JL, Zhai G, Winzenberg TM, Hosmer D, Jones G. A meta-analysis of sex differences prevalence, incidence and severity of osteoarthritis. Osteoarthritis Cartilage. 2005; 13:769–781.

10. Battin DA, Marrs RP, Fleiss PM, Mishell DR Jr. Effect of suckling on serum prolactin, luteinizing hormone, follicle-stimulating hormone, and estradiol during prolonged lactation. Obstet Gynecol. 1985; 65:785–788.

11. Centers for Disease Control and Prevention (US). National Health and Nutrition Examination Survey. Questionnaires, datasets, and related documentation [Internet]. Atlanta (GA): Centers for Disease Control and Prevention;2015. cited 2017 August 1. Available from: https://www.cdc.gov/nchs/nhanes/nhanes_questionnaires.htm.

12. Centers for Disease Control and Prevention (US). NCHS Research Ethics Review Board (ERB) Approval.[Internet]. Atlanta (GA): Centers for Disease Control and Prevention;2017. cited 2017 September 4. Available from: https://www.cdc.gov/nchs/nhanes/irba98.htm.

13. Centers for Disease Control and Prevention (US). National Health and Nutrition Examination Survey: 2011??012 data documentation, codebook, and frequencies [Internet]. Atlanta (GA): Centers for Disease Control and Prevention;2013. cited 2017 August 1. Available from: https://wwwn.cdc.gov/Nchs/Nhanes/2011-2012/MCQ_G.htm#MCQ195.

14. American Academy of Pediatrics, Work Group on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics. 1997; 100:1035–1039.

15. Ushiyama T, Ueyama H, Inoue K, Ohkubo I, Hukuda S. Expression of genes for estrogen receptors alpha and beta in human articular chondrocytes. Osteoarthritis Cartilage. 1999; 7:560–566.

16. Braidman IP, Hainey L, Batra G, Selby PL, Saunders PT, Hoyland JA. Localization of estrogen receptor beta protein expression in adult human bone. J Bone Miner Res. 2001; 16:214–220.

17. Dietrich W, Haitel A, Holzer G, Huber JC, Kolbus A, Tschugguel W. Estrogen receptor-beta is the predominant estrogen receptor subtype in normal human synovia. J Soc Gynecol Investig. 2006; 13:512–517.

18. Sciore P, Frank CB, Hart DA. Identification of sex hormone receptors in human and rabbit ligaments of the knee by reverse transcription-polymerase chain reaction: evidence that receptors are present in tissue from both male and female subjects. J Orthop Res. 1998; 16:604–610.

19. Petrakis NL, Wrensch MR, Ernster VL, Miike R, Murai J, Simberg N, Siiteri PK. Influence of pregnancy and lactation on serum and breast fluid estrogen levels: implications for breast cancer risk. Int J Cancer. 1987; 40:587–591.