Morbidity due to obesity, hypertension and diabetes ii attributable to non-breastfeeding and low birth weight during the 1000 days of life: Estimation of the population attributable fraction

Abstract

Introduction: There is evidence that malnutrition during the first 1000 days of life contributes to the development of chronic diseases in adulthood and therefore may produce a lasting impact on the health of the population. Colombia, like other middle-income countries suffers the double burden of malnutrition in pregnant women and children under 5 years. Also, chronic diseases have positioned within the leading causes of morbidity and mortality. Objective: The aim is to estimate the burden of disease of noncommunicable chronic diseases-NCD’s (hypertension, obesity, diabetes mellitus II) in adults attributable to nutritional risk factors (no-breastfeeding and low birthweight) in the period of 1000 days in Colombia. Methods: The population attributable fraction and the number of NCD’s (hypertension, diabetes mellitus II and obesity) cases due to the risk factors (low birthweight and no-breastfeeding) were estimated. Prevalences of NCD’s and risk factors of interest were taken from national health surveys. Effect measures (odds ratios/relative risks) of the associations 1—low birthweight and hypertension, diabetes mellitus II and 2—no-breastfeeding and obesity were obtained after a systematic literature search. Results: It was estimated that not receiving breastfeeding in the 1000 days could contribute up to 29.9% of all cases of obesity, equivalent to about 4,009,779 cases across the country. Low birth weight could contribute up to 2.1% of cases of hypertension in men and to 4.0% of cases in women, equivalent to 103.769 cases across the country. In addition, low birth weight could contribute to 6.3% of diabetes mellitus II cases, which is equivalent to 23.857 cases in the country. Conclusion: In Colombia, risk factors during the first 1000 days like not receiving breastfeeding and having low birth weight could contribute up to 4,113,549 cases of obesity, hypertension and diabetes mellitus II, with important implications for the health of the population and the Colombian health system.