[여성/어린이] 제3세계에서 전염병에 따른 영유야 사망률에 대한 모유 수유의 영향

건강과대안 — Fri, 10 May 2013 11:37:23 +0000

소독된 식수를 먹기 힘든 제3세계 저개발국에서 모유 수유를 한 영유아와 분유 수유를 한
영유아의 사망률 차이가 6배나 차이가 나며, 신생아 사망이 드문 미국 같은 나라에서도
모유 수유를 한 영유아와 분유 수유를 한 영유아의 생후 6개월 생존률이 경제적 능력이나
교육 수준 등과 관계없이 20% 정도 차이가 납니다.

미생물 전문가들은 자연분만과 모유 수유 과정에서 생체 내 유익한 세균인 비피더스균이
병원성 감염을 일으킬 가능성이 있는 세균들의 성장을 방해하기 때문이라고 설명을 하고
있습니다.

2000 Feb 5;355(9202):451-5.

Effect of breastfeeding on infant and child mortality due to infectious diseases in less developed countries: a pooled analysis. WHO Collaborative Study Team on the Role of Breastfeeding on the Prevention of Infant Mortality.

[No authors listed]

Erratum in

Lancet 2000 Mar 25;355(9209):1104.

Abstract

BACKGROUND:

The debate on breastfeeding in areas of high HIV prevalence has led to the development of simulation models that attempt to assess the risks and benefits associated with breastfeeding. An essential element of these simulations is the extent to which breastfeeding protects against infant and child mortality; however, few studies are available on this topic. We did a pooled analysis of studies that assessed the effect of not breastfeeding on the risk of death due to infectious diseases.

METHODS:

Studies were identified through consultations with experts in international health, and from a MEDLINE search for 1980-98. Using meta-analytical techniques, we assessed the protective effect of breastfeeding according to the age and sex of the infant, the cause of death, and the educational status of the mother.

FINDINGS:

We identified eight studies, data from six of which were available (from Brazil, The Gambia, Ghana, Pakistan, the Philippines, and Senegal). These studies provided information on 1223 deaths of children under two years of age. In the African studies, virtually all babies were breastfed well into the second year of life, making it impossible to include them in the analyses of infant mortality. On the basis of the other three studies, protection provided by breastmilk declined steadily with age during infancy (pooled odds ratios: 5.8 [95% CI 3.4-9.8] for infants <2 months of age, 4.1 [2.7-6.4] for 2-3-month-olds, 2.6 [1.6-3.9] for 4-5-month-olds, 1.8 [1.2-2.8] for 6-8-month-olds, and 1.4 [0.8-2.6] for 9-11-month-olds). In the first 6 months of life, protection against diarrhoea was substantially greater (odds ratio 6.1 [4.1-9.0]) than against deaths due to acute respiratory infections (2.4 [1.6-3.5]). However, for infants aged 6-11 months, similar levels of protection were observed (1.9 [1.2-3.1] and 2.5 [1.4-4.6], respectively). For second-year deaths, the pooled odds ratios from five studies ranged between 1.6 and 2.1. Protection was highest when maternal education was low.

INTERPRETATION:

These results may help shape policy decisions about feeding choices in the face of the HIV epidemic. Of particular relevance is the need to account for declining levels of protection with age in infancy, the continued protection afforded during the second year of life, and the question of the safety of breastmilk substitutes in families of low socioeconomic status.

Comment in

Breastfeeding and the prevention of infant mortality. [Lancet. 2000]

[기타] 비만에 관한 신화, 추정, 그리고 사실

건강과대안 — Fri, 01 Feb 2013 14:43:24 +0000

Special Article

Myths, Presumptions, and Facts about Obesity

Krista Casazza, Ph.D., R.D., Kevin R. Fontaine, Ph.D., Arne Astrup, M.D., Ph.D., Leann L. Birch, Ph.D., Andrew W. Brown, Ph.D., Michelle M. Bohan Brown, Ph.D., Nefertiti Durant, M.D., M.P.H., Gareth Dutton, Ph.D., E. Michael Foster, Ph.D., Steven B. Heymsfield, M.D., Kerry McIver, M.S., Tapan Mehta, M.S., Nir Menachemi, Ph.D., P.K. Newby, Sc.D., M.P.H., Russell Pate, Ph.D., Barbara J. Rolls, Ph.D., Bisakha Sen, Ph.D., Daniel L. Smith, Jr., Ph.D., Diana M. Thomas, Ph.D., and David B. Allison, Ph.D.

N Engl J Med 2013; 368:446-454January 31, 2013DOI: 10.1056/NEJMsa1208051

http://www.nejm.org/doi/full/10.1056/NEJMsa1208051

Background

Many beliefs about obesity persist in the absence of supporting scientific evidence (presumptions); some persist despite contradicting evidence (myths). The promulgation of unsupported beliefs may yield poorly informed policy decisions, inaccurate clinical and public health recommendations, and an unproductive allocation of research resources and may divert attention away from useful, evidence-based information.

Methods

Using Internet searches of popular media and scientific literature, we identified, reviewed, and classified obesity-related myths and presumptions. We also examined facts that are well supported by evidence, with an emphasis on those that have practical implications for public health, policy, or clinical recommendations.

Results

We identified seven obesity-related myths concerning the effects of small sustained increases in energy intake or expenditure, establishment of realistic goals for weight loss, rapid weight loss, weight-loss readiness, physical-education classes, breast-feeding, and energy expended during sexual activity. We also identified six presumptions about the purported effects of regularly eating breakfast, early childhood experiences, eating fruits and vegetables, weight cycling, snacking, and the built (i.e., human-made) environment. Finally, we identified nine evidence-supported facts that are relevant for the formulation of sound public health, policy, or clinical recommendations.

Conclusions

False and scientifically unsupported beliefs about obesity are pervasive in both scientific literature and the popular press. (Funded by the National Institutes of Health.)

The views expressed in this article are those of the authors and do not necessarily represent the official views of the National Institutes of Health.

Supported in part by a grant (P30DK056336) from the National Institutes of Health.

Dr. Astrup reports receiving payment for board membership from the Global Dairy Platform, Kraft Foods, Knowledge Institute for Beer, McDonald’s Global Advisory Council, Arena Pharmaceuticals, Basic Research, Novo Nordisk, Pathway Genomics, Jenny Craig, and Vivus; receiving lecture fees from the Global Dairy Platform, Novo Nordisk, Danish Brewers Association, GlaxoSmithKline, Danish Dairy Association, International Dairy Foundation, European Dairy Foundation, and AstraZeneca; owning stock in Mobile Fitness; holding patents regarding the use of flaxseed mucilage or its active component for suppression of hunger and reduction of prospective consumption (patents EP1744772, WO2009033483-A1, EP2190303-A1, US2010261661-A1, and priority applications DK001319, DK001320, S971798P, and US971827P); holding patents regarding the use of an alginate for the preparation of an aqueous dietary product for the treatment or prevention of overweight and obesity (patent WO2011063809-A1 and priority application DK070227); and holding a patent regarding a method for regulating energy balance for body-weight management (patent WO2007062663-A1 and priority application DK001710). Drs. Brown and Bohan Brown report receiving grant support from the Coca-Cola Foundation through their institution. Dr. Mehta reports receiving grant support from Kraft Foods. Dr. Newby reports receiving grant support from General Mills Bell Institute of Health and Nutrition. Dr. Pate reports receiving consulting fees from Kraft Foods. Dr. Rolls reports having a licensing agreement for the Volumetrics trademark with Jenny Craig. Dr. Thomas reports receiving consulting fees from Jenny Craig. Dr. Allison reports serving as an unpaid board member for the International Life Sciences Institute of North America; receiving payment for board membership from Kraft Foods; receiving consulting fees from Vivus, Ulmer and Berne, Paul, Weiss, Rifkind, Wharton, Garrison, Chandler Chicco, Arena Pharmaceuticals, Pfizer, National Cattlemen’s Association, Mead Johnson Nutrition, Frontiers Foundation, Orexigen Therapeutics, and Jason Pharmaceuticals; receiving lecture fees from Porter Novelli and the Almond Board of California; receiving payment for manuscript preparation from Vivus; receiving travel reimbursement from International Life Sciences Institute of North America; receiving other support from the United Soybean Board and the Northarvest Bean Growers Association; receiving grant support through his institution from Wrigley, Kraft Foods, Coca-Cola, Vivus, Jason Pharmaceuticals, Aetna Foundation, and McNeil Nutritionals; and receiving other funding through his institution from the Coca-Cola Foundation, Coca-Cola, PepsiCo, Red Bull, World Sugar Research Organisation, Archer Daniels Midland, Mars, Eli Lilly and Company, and Merck. No other potential conflict of interest relevant to this article was reported.

Disclosure forms provided by the authors are available with the full text of this article at NEJM.org.

We thank Drs. Kyle Grimes and S. Louis Bridges for their suggestions on an earlier version of the manuscript.

Source Information

From the Departments of Nutrition Sciences (K.C., M.M.B.B., D.L.S., D.B.A.), Health Behavior (K.R.F.), Pediatrics (N.D.), Medicine (G.D.), Health Care Organization and Policy (E.M.F., N.M., B.S.), and Biostatistics (T.M., D.B.A.) and the School of Public Health, Office of Energetics, Nutrition Obesity Research Center (A.W.B., D.B.A.), University of Alabama at Birmingham, Birmingham; the OPUS Center and the Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen (A.A.); the Departments of Development and Family Studies (L.L.B.) and Nutritional Sciences (B.J.R.), Pennsylvania State University, University Park; Pennington Biomedical Research Center, Baton Rouge, LA (S.B.H.); Children’s Physical Activity Research Group, Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia (K.M., R.P.); the Departments of Pediatrics and Epidemiology, Program in Graduate Medical Nutrition Sciences, and Program in Gastronomy, Culinary Arts, and Wine Studies, Boston University, Boston (P.K.N.); and the Center for Quantitative Obesity Research, Montclair State University, Montclair, NJ (D.M.T.).

Address reprint requests to Dr. Allison at the University of Alabama at Birmingham, Department of Biostatistics, Birmingham, AL 35294, or at dallison@uab.edu.

Media in This Article

Table 1Seven Myths about Obesity.

Table 2Presumptions about Obesity

‘섹스, 칼로리 소모량 많다?’ 실제 측정해보니
[중앙일보] 입력 2013.02.01 01:04 / 수정 2013.02.01 04:41
http://joongang.joinsmsn.com/article/847/10575847.html?ctg=1205&cloc=joongang|article|headlinenews

당신의 건강상식은?
섹스 칼로리 소모량 많다 □
모유 먹고 크면 살 덜 찐다 □
규칙적 아침 비만 막는다 □

성행위를 하면 상당한 칼로리가 소비된다는 말은 잘못된 상식으로 밝혀졌다. 어렸을 때 모유를 먹고 자란 사람이 분유를 먹은 사람보다 비만이 될 가능성이 낮다는 것도 근거가 없는 것으로 드러났다.

　세계적 의학 학술지 뉴잉글랜드 저널 오브 메디신은 지난달 30일자 인터넷판에 언론이나 전문가들이 전하는 다이어트 건강 상식 중 상당수가 과학적 근거가 없다는 내용의 논문을 공개했다. 미 국립보건원(NIH)의 자금 지원을 받은 이 논문 연구에는 20명의 연구자가 참여했다. 논문 대표 저자인 데이비드 앨리슨 앨라배마대 생물통계학 교수는 “전문가들이 지속적으로 주장했던 많은 건강 상식은 과학적 증거가 없었다”고 말했다.

　이에 따르면 성행위를 한 번 하면 100~300㎉가 소비된다는 주장은 지나치게 부풀려진 것이다. 미국인의 성행위 시간은 평균 6분이었는데 이때 소비되는 열량은 21㎉에 그쳤다. 6분 동안 걸었을 때 소모되는 열량 수준이다.

　모유 수유가 비만을 예방한다는 상식도 과학적 근거가 부족했다. 다만 모유 수유는 유아가 어머니와 친밀한 관계를 형성해 정서 안정에 도움이 되는 것으로 조사됐다. 매일 약간씩 덜 먹고 조금 더 운동하면 장기적으로 살을 뺄 수 있다는 주장도 잘못된 것이었다. 신체는 변화에 적응하기 때문에 이런 식의 다이어트는 장기적으로 효과가 없었다. 간식이 살을 찌게 한다거나, 규칙적 아침식사가 비만을 예방한다거나, 급격한 살 빼기가 장기적으로 살을 빼는 것보다 효과가 없다거나, 체육 수업이 비만을 예방한다는 주장도 근거가 빈약한 것으로 드러났다.

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건강과 대안 » 모유 수유