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Il divezzamento precoce può aumentare il rischio di obesità infantile

14-06-2013

Pearce J, Taylor MA, Langley-Evans SC.
Int J Obes (Lond). 2013 May 27. [Epub ahead of print]

L’importanza per la salute del bambino dell’allattamento materno esclusivo fino al sesto mese dopo il parto è riconosciuta anche dalle organizzazioni internazionali e raccomandata dall’Organizzazione Mondiale della Sanità. Il tema dell’impatto dell’inizio del divezzamento sul rischio di obesità infantile è invece piuttosto dibattuto.
Questa revisione sistematica della letteratura conferma che i dati disponibili non consentono di definire con precisione il momento ideale per cominciare l’inserimento dell’alimentazione complementare (da associare possibilmente al latte materno). Vi sono comunque alcune evidenze a supporto della relazione tra inizio precoce del divezzamento e indice di massa corporea o BMI nel corso dell’infanzia. In particolare l’inserimento di alimenti diversi dal latte materno prima del quarto mese di vita sembra essere associato all’aumento del rischio di sovrappeso e obesità negli anni seguenti.

Timing of the introduction of complementary feeding and risk of childhood obesity: a systematic review.

The WHO recommends exclusive breastfeeding until 6 months of age and continued breastfeeding until 2 years of age or beyond. Appropriate complementary foods should be introduced in a timely fashion, beginning when the infant is 6 months old. In developing countries, early or inappropriate complementary feeding may lead to malnutrition and poor growth, but in countries such as the UK and USA, where obesity is a greater public health concern than malnutrition, the relationship to growth is unclear. We conducted a systematic review of the literature which investigated the relationship between the timing of the introduction of complementary feeding and overweight or obesity during childhood. Electronic databases were searched from inception until 30th September 2012 using specified keywords. Following the application of strict inclusion/exclusion criteria, 23 studies were identified and reviewed by two independent reviewers. Data were extracted and aspects of quality were assessed using an adapted Newcastle-Ottawa scale. Twenty one of the studies considered the relationship between the time at which complementary foods were introduced and childhood BMI, of which five found that introducing complementary foods at less than 3 months (two studies), 4 months (2 studies) or 20 weeks (one study) was associated with a higher BMI in childhood. Seven of the studies considered the association between complementary feeding and body composition but only one study reported an increase in the percentage body fat amongst children given complementary foods before 15 weeks of age. We conclude that there is no clear association between the timing of the introduction of complementary foods and childhood overweight or obesity, but some evidence suggests that very early introduction (at or before 4 months) rather than at 4-6 months or>6 months, may increase the risk of childhood overweight.

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