Association of infant feeding and dietary intake on obesity prevalence in low-income toddlers.

OBJECTIVE
This cross-sectional study assesses the independent and combined effects of breastfeeding (BF) and dietary intake, specifically sugar-sweetened beverages (SSB), on obesity prevalence in low-income, primarily Hispanic toddlers.

METHODS
The following data were collected in 2011 via phone surveys with caregivers of 2295 low-income children (2-4 years) from Los Angeles County Women, Infants, and Children (WIC) programs: infant feeding, dietary intake, gestational diabetes status, birth weight, gestational age, and mother's BMI. WIC staff measured children's height and weight. Chi-square tests and binary logistic regressions assessed the independent and combined effects of BF and dietary intake on obesity prevalence.

RESULTS
Compared to no BF, BF ≥12 mos was associated with a 47% reduction in obesity prevalence (AOR = 0.53, 95% CI 0.4-0.8, P = 0.004). Compared to 2 + SSB/d, no SSB/d intake was associated with a 28% reduction in obesity prevalence (AOR = 0.72, 95% CI 0.5-1.0, P = 0.03). High intake of soda, diet soda, and fruit drinks were linked to increases in obesity prevalence. There was no effect of 100% juice, milk (plain or flavored) fruit, vegetable, fast food, or sweetened grain intake on obesity prevalence.

CONCLUSIONS
These findings support encouragement of BF ≥12 mos and no SSB intake to prevent obesity in low-income, primarily Hispanic, toddlers.