{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T23:24:35Z","timestamp":1789601075509,"version":"build-2803163510"},"reference-count":58,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2022,8,31]],"date-time":"2022-08-31T00:00:00Z","timestamp":1661904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Introduction: Obesity is a current public health concern. Higher body weight is influenced by genetic and environmental parameters, and their interplay and is associated with a greater risk for several chronic diseases. Breastfeeding has been suggested as a preventive measure against obesity, which can further reduce long-term negative health outcomes for both women and children. Aim: The aim of the present study was to evaluate the role of breastfeeding on maternal and childhood overweight and obesity. Materials and Methods: This is a cross-sectional study conducted on 2515 healthy mothers and their children, aged 2\u20135 years, enrolled from nine different Greek rural and urban regions. Validated, standardized questionnaires were administrated that included anthropometric indices, socio-demographic characteristics of mothers and children, as well as breastfeeding practices. Results: Overall, 68% of participated women exclusively breastfed their children for at least 4 months. Mothers that exclusively breastfed showed a significantly lower prevalence of overweight and obesity after 2\u20135 years from delivery (p &lt; 0.0001). Children that had exclusively been breastfed showed a significantly lower prevalence of overweight and obesity at the age of 2\u20135 years (p &lt; 0.0001). Using multivariate regression analysis, exclusive breastfeeding for at least 4 months was associated with a two-fold lower risk for maternal and childhood overweight and obesity after 2\u20135 years from delivery, independent from maternal age, educational and economic status, and smoking habits (p &lt; 0.0001). Conclusion: Exclusive breastfeeding for at least 4 months had a positive effect on childhood overweight and obesity, also contributing beneficially to post-natal maternal weight control. The beneficial effects of breastfeeding should be communicated to future and new mothers, while supportive actions for all mothers to initiate and continue breastfeeding their offspring should be implemented.<\/jats:p>","DOI":"10.3390\/nu14173599","type":"journal-article","created":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T01:50:51Z","timestamp":1661997051000},"page":"3599","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":62,"title":["Exclusive Breastfeeding for at Least Four Months Is Associated with a Lower Prevalence of Overweight and Obesity in Mothers and Their Children after 2\u20135 Years from Delivery"],"prefix":"10.3390","volume":"14","author":[{"given":"Maria","family":"Mantzorou","sequence":"first","affiliation":[{"name":"Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4923-484X","authenticated-orcid":false,"given":"Dimitrios","family":"Papandreou","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, College of Natural and Health Sciences, Zayed University, Abu Dhabi P.O. Box 144534, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios K.","family":"Vasios","sequence":"additional","affiliation":[{"name":"Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleni","family":"Pavlidou","sequence":"additional","affiliation":[{"name":"Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Antasouras","sequence":"additional","affiliation":[{"name":"Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evmorfia","family":"Psara","sequence":"additional","affiliation":[{"name":"Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3915-3755","authenticated-orcid":false,"given":"Zainab","family":"Taha","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, College of Natural and Health Sciences, Zayed University, Abu Dhabi P.O. Box 144534, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Efthymios","family":"Poulios","sequence":"additional","affiliation":[{"name":"Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2878-4831","authenticated-orcid":false,"given":"Constantinos","family":"Giaginis","sequence":"additional","affiliation":[{"name":"Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1007\/s13679-015-0164-9","article-title":"An Overview of Links between Obesity and Mental Health","volume":"4","author":"Avila","year":"2015","journal-title":"Curr. Obes. Rep."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Svard, A., Lahti, J., Roos, E., Rahkonen, O., Lahelma, E., Lallukka, T., and Manty, M. (2017). Obesity, change of body mass index and subsequent physical and mental health functioning: A 12-year follow-up study among ageing employees. BMC Public Health, 17.","DOI":"10.1186\/s12889-017-4768-8"},{"key":"ref_3","first-page":"39","article-title":"The economic burden placed on healthcare systems by childhood obesity","volume":"12","author":"Trasande","year":"2012","journal-title":"Expert Rev. Pharm. Outcomes Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1016\/j.jcpa.2017.03.007","article-title":"The Financial Costs, Behaviour and Psychology of Obesity: A One Health Analysis","volume":"156","author":"Bomberg","year":"2017","journal-title":"J. Comp. Pathol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.pop.2015.10.001","article-title":"Obesity Statistics","volume":"43","author":"Smith","year":"2016","journal-title":"Prim. Care Clin. Off. Pract."},{"key":"ref_6","unstructured":"World Health Organization (2022, June 10). Obesity and Overweight, Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/obesity-and-overweight."},{"key":"ref_7","unstructured":"World Health Organization (2019, April 04). Obesity\u2014Data and Statistics, Available online: http:\/\/www.euro.who.int\/en\/he."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"154","DOI":"10.2174\/138920211795677921","article-title":"Molecular basis of obesity: Current status and future prospects","volume":"12","author":"Choquet","year":"2011","journal-title":"Curr. Genom."},{"key":"ref_9","first-page":"485","article-title":"Obesogenic environments: Environmental approaches to obesity prevention","volume":"28","author":"Lipek","year":"2015","journal-title":"J. Pediatric Endocrinol. Metab. JPEM"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1016\/j.physbeh.2015.07.006","article-title":"Behavioral susceptibility to obesity: Gene-environment interplay in the development of weight","volume":"152","author":"Llewellyn","year":"2015","journal-title":"Physiol. Behav."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1093\/bmb\/ldx022","article-title":"The contribution of genetics and environment to obesity","volume":"123","author":"Albuquerque","year":"2017","journal-title":"Br. Med. Bull."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"111","DOI":"10.4274\/jcrpe.3790","article-title":"Association between Obesity and Parental Weight Status in Children and Adolescents","volume":"9","author":"Bahreynian","year":"2017","journal-title":"J. Clin. Res. Pediatric Endocrinol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1159\/000445061","article-title":"Rare Genetic Forms of Obesity: Clinical Approach and Current Treatments in 2016","volume":"9","author":"Huvenne","year":"2016","journal-title":"Obes. Facts"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/S2213-8587(17)30200-0","article-title":"Genetics of obesity: What genetic association studies have taught us about the biology of obesity and its complications","volume":"6","author":"Goodarzi","year":"2018","journal-title":"Lancet. Diabetes Endocrinol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1016\/j.ehb.2016.11.005","article-title":"The intergenerational transmission of body mass index across countries","volume":"24","author":"Dolton","year":"2017","journal-title":"Econ. Hum. Biol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1080\/10408390903372599","article-title":"Ten putative contributors to the obesity epidemic","volume":"49","author":"McAllister","year":"2009","journal-title":"Crit. Rev. Food Sci. Nutr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.chc.2017.08.003","article-title":"A Review of the Prevention and Medical Management of Childhood Obesity","volume":"27","author":"Anderson","year":"2018","journal-title":"Child Adolesc. Psychiatr. Clin. N. Am."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1186\/s12889-018-5398-5","article-title":"Family lifestyle dynamics and childhood obesity: Evidence from the millennium cohort study","volume":"18","author":"Gray","year":"2018","journal-title":"BMC Public Health"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.3945\/ajcn.117.158683","article-title":"Trajectories of maternal weight from before pregnancy through postpartum and associations with childhood obesity","volume":"106","author":"Leonard","year":"2017","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_20","unstructured":"World Health Organization (2022, June 10). Breastfeeding, Available online: https:\/\/www.who.int\/topics\/breastfeeding\/en\/."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1016\/S0140-6736(15)01024-7","article-title":"Breastfeeding in the 21st century: Epidemiology, mechanisms, and lifelong effect","volume":"387","author":"Victora","year":"2016","journal-title":"Lancet"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1111\/mcn.12071","article-title":"Breastfeeding and maternal weight changes during 24 months post-partum: A cohort study","volume":"11","author":"Pinheiro","year":"2015","journal-title":"Matern. Child Nutr."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.1038\/sj.ijo.0802758","article-title":"Breast-feeding and childhood obesity--a systematic review","volume":"28","author":"Arenz","year":"2004","journal-title":"Int. J. Obes. Relat. Metab. Disord. J. Int. Assoc. Study Obes."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Yan, J., Liu, L., Zhu, Y., Huang, G., and Wang, P.P. (2014). The association between breastfeeding and childhood obesity: A meta-analysis. BMC Public Health, 14.","DOI":"10.1186\/1471-2458-14-1267"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1093\/aje\/kwi222","article-title":"Duration of breastfeeding and risk of overweight: A meta-analysis","volume":"162","author":"Harder","year":"2005","journal-title":"Am. J. Epidemiol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Amir, L.H., and Donath, S. (2007). A systematic review of maternal obesity and breastfeeding intention, initiation and duration. BMC Pregnancy Childbirth, 7.","DOI":"10.1186\/1471-2393-7-9"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"3021","DOI":"10.1080\/14767058.2017.1362552","article-title":"A comparison of breastfeeding rates by obesity class","volume":"31","author":"Ramji","year":"2018","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1038\/ijo.2012.76","article-title":"Persistent effects of women\u2019s parity and breastfeeding patterns on their body mass index: Results from the Million Women Study","volume":"37","author":"Bobrow","year":"2013","journal-title":"Int. J. Obes."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1017\/S1368980011002102","article-title":"Prolonged breastfeeding protects mothers from later-life obesity and related cardio-metabolic disorders","volume":"15","author":"Wiklund","year":"2012","journal-title":"Public Health Nutr."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"312","DOI":"10.3945\/ajcn.113.067405","article-title":"How do pregnancy-related weight changes and breastfeeding relate to maternal weight and BMI-adjusted waist circumference 7 y after delivery? Results from a path analysis","volume":"99","author":"Kirkegaard","year":"2014","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/1746-4358-7-8","article-title":"Lactation and cardiovascular risk factors in mothers in a population-based study: The HUNT-study","volume":"7","author":"Natland","year":"2012","journal-title":"Int. Breastfeed. J."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Cie\u015bla, E., Stochmal, E., G\u0142uszek, S., and Suliga, E. (2021). Breastfeeding history and the risk of overweight and obesity in middle-aged women. BMC Womens Health, 21.","DOI":"10.1186\/s12905-021-01332-2"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"S42","DOI":"10.1542\/peds.2014-0646H","article-title":"Adherence to breast-feeding guidelines and maternal weight 6 years after de-livery","volume":"134","author":"Sharma","year":"2014","journal-title":"Pediatrics"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.3945\/ajcn.113.065300","article-title":"Effects of an intervention to promote breastfeeding on maternal adiposity and blood pressure at 11.5 y postpartum: Results from the Promotion of Breastfeeding Intervention Trial, a cluster-randomized controlled trial","volume":"98","author":"Oken","year":"2013","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1097\/01.AOG.0000346884.67796.ca","article-title":"Duration of lactation and risk factors for maternal cardiovascular disease","volume":"113","author":"Schwarz","year":"2009","journal-title":"Obstet Gynecol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1007\/s12519-009-0006-5","article-title":"Breast-feeding history and overweight in 11 to 13-year-old children in Iran","volume":"5","author":"Fallahzadeh","year":"2009","journal-title":"World J. Pediatric"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1159\/000365031","article-title":"Early infant feeding and adiposity risk: From infancy to adulthood","volume":"64","author":"Oddy","year":"2014","journal-title":"Ann. Nutr. Metab."},{"key":"ref_38","first-page":"481","article-title":"Breastfeeding Duration as a Predictor of Childhood Lifestyle Habits, Overweight and Obesity in Second- and Third-Grade Schoolchildren in Croatia","volume":"58","author":"Morovic","year":"2019","journal-title":"Acta Clin. Croat."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Huus, K., Ludvigsson, J.F., Ensk\u00e4r, K., and Ludvigsson, J. (2008). Exclusive breastfeeding of Swedish children and its possible influence on the development of obesity: A prospective cohort study. BMC Pediatric, 8.","DOI":"10.1186\/1471-2431-8-42"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1704","DOI":"10.1017\/S0007114510005374","article-title":"Breast-feeding and growth in children until the age of 3 years: The Generation R Study","volume":"105","author":"Duijts","year":"2011","journal-title":"Br. J. Nutr."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Vickerstaff, V., Omar, R.Z., and Ambler, G. (2019). Methods to adjust for multiple comparisons in the analysis and sample size calculation of randomised controlled trials with multiple primary outcomes. BMC Med. Res. Methodol., 19.","DOI":"10.1186\/s12874-019-0754-4"},{"key":"ref_42","unstructured":"World Health Organization (1995). Physical status: The use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ. Tech. Rep. Ser., 854, 1\u2013452."},{"key":"ref_43","unstructured":"Food and Drug Administration (2007). National Health and Nutrition Examination Survey (NHANES) Anthropometry Procedures Manual."},{"key":"ref_44","unstructured":"World Health Organization (2019, April 04). Country Profiles on Nutrition, Physical Activity and Obesity in the 53 WHO European Region Member States: Methodology and Summary, Available online: http:\/\/www.euro.who.int\/__data\/assets\/pdf_f."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"253","DOI":"10.14310\/horm.2002.1275","article-title":"High rates of obesity prevalence in adults living in central Greece: Data from the ARGOS study","volume":"9","author":"Koukoulis","year":"2010","journal-title":"Hormones"},{"key":"ref_46","first-page":"E36","article-title":"Current data in Greek children indicate decreasing trends of obesity in the transition from childhood to adolescence; results from the National Action for Children\u2019s Health (EYZHN) program","volume":"59","author":"Tambalis","year":"2018","journal-title":"J. Prev. Med. Hyg."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1097\/MPG.0000000000002234","article-title":"Breastfeeding Rates and Programs in Europe: A Survey of 11 National Breastfeeding Committees and Representatives","volume":"68","author":"Theurich","year":"2019","journal-title":"J. Pediatric Gastroenterol. Nutr."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1007\/s10995-015-1826-7","article-title":"The Associations of Maternal Weight Change with Breastfeeding, Diet and Physical Activity During the Postpartum Period","volume":"20","author":"Neufeld","year":"2016","journal-title":"Matern. Child Health J."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Schalla, S.C., Witcomb, G.L., and Haycraft, E. (2017). Body Shape and Weight Loss as Motivators for Breastfeeding Initiation and Continuation. Int. J. Environ. Res. Public Health, 14.","DOI":"10.3390\/ijerph14070754"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1089\/jwh.2010.2248","article-title":"Maternal prepregnancy body mass index and initiation and duration of breastfeeding: A review of the literature","volume":"20","author":"Wojcicki","year":"2011","journal-title":"J. Womens Health"},{"key":"ref_51","first-page":"276","article-title":"Reasons for non-exclusive breast-feeding in the first 6 months","volume":"60","author":"Zielinska","year":"2018","journal-title":"Pediatrics Int. Off. J. Jpn. Pediatric Soc."},{"key":"ref_52","first-page":"26","article-title":"Effects of infant feeding practices and maternal characteristics on early childhood obesity","volume":"117","author":"Ardid","year":"2019","journal-title":"Arch. Argent. De Pediatric."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1159\/000500425","article-title":"Association between Characteristics at Birth, Breastfeeding and Obesity in 22 Countries: The WHO European Childhood Obesity Surveillance Initiative\u2014COSI 2015\/2017","volume":"12","author":"Rito","year":"2019","journal-title":"Obes. Facts"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1089\/chi.2016.0210","article-title":"Breastfeeding Reduces Childhood Obesity Risks","volume":"13","author":"Wang","year":"2017","journal-title":"Child. Obes."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"e85","DOI":"10.3346\/jkms.2019.34.e85","article-title":"The Protective Effect of Exclusive Breastfeeding on Overweight\/Obesity in Children with High Birth Weight","volume":"34","author":"Lee","year":"2019","journal-title":"J. Korean Med. Sci."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1089\/bfm.2016.0071","article-title":"Effect of Exclusive Breastfeeding among Overweight and Obese Mothers on Infant Weight-for-Length Percentile at 1 Year","volume":"12","author":"Yeung","year":"2017","journal-title":"Breastfeed. Med. Off. J. Acad. Breastfeed. Med."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1089\/bfm.2018.0117","article-title":"Association of Exclusive Breastfeeding with Risk of Obesity in Childhood and Early Adulthood","volume":"13","author":"Tambalis","year":"2018","journal-title":"Breastfeed. Med. Off. J. Acad. Breastfeed. Med."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.pedn.2020.04.024","article-title":"A Meta-Analysis of the Association between Breastfeeding and Early Childhood Obesity","volume":"53","author":"Qiao","year":"2020","journal-title":"J. Pediatric Nurs."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/14\/17\/3599\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:21:13Z","timestamp":1760142073000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/14\/17\/3599"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,31]]},"references-count":58,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2022,9]]}},"alternative-id":["nu14173599"],"URL":"https:\/\/doi.org\/10.3390\/nu14173599","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,31]]}}}