Nutrients · 8 authors, 10 centres
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This prospective cohort study of 941 Spanish preschoolers found that breastfeeding for 6 months or longer was associated with significantly higher adherence to the Mediterranean diet, compared to never being breastfed. The association remained after adjusting for many potential confounders, but causality cannot be inferred due to the observational design and reliance on parental reports.
Diet quality in children is a major public health concern, and the Mediterranean diet (MedDiet) is linked to beneficial health effects. While breastfeeding is recommended and associated with various health benefits, its link to global dietary patterns like the MedDiet had not been assessed. Methods: The SENDO project is a prospective cohort of 941 Spanish preschoolers (mean age 5.01 years). Parent-reported breastfeeding history and diet (via a food frequency questionnaire) were used. Adherence to the MedDiet was measured by the KIDMED index. Statistical models compared KIDMED scores and odds of high adherence (score ≥8) across breastfeeding categories, adjusting for child, maternal, and lifestyle factors. Key Results: A positive linear trend was found between breastfeeding duration and MedDiet adherence. Children breastfed for ≥6 months had a significantly higher mean KIDMED score (+0.93 points, 95% CI 0.52 to 1.34) and nearly threefold higher odds of high adherence (OR 2.94, 95% CI 1.50 to 5.36) compared to never-breastfed children, after full adjustment. Limitations: The study is observational and cannot prove causation. Information is self-reported by parents, and the cohort is not representative of the general population, being mainly highly educated and white. Implications: The findings suggest breastfeeding for at least six months is associated with a healthier dietary pattern in early childhood, independent of many confounders. This supports public health efforts to promote breastfeeding as part of a strategy to foster long-term healthy eating habits.
