Guess what! It’s time for another health Awareness Day! November 14, 2018 has been designated World Diabetes Day by the International Diabetes Foundation (IDF).
We in Australia had our very own National Diabetes Week back in July, so I won’t rehash the arguments against pointless ‘awareness-raising’ exercises that I made in my article Diabetes: ‘awareness’ vs action.
Instead, I wanted to share with you some fascinating research about a method for preventing diabetes that you probably won’t see featured any time soon on IDF’s website, since this method is completely free, tends to reduce the need for many of the products produced by its financial supporters (the pharmaceutical companies AstraZeneca, Novo Nordisk, Sanofi, Lilly, MSD, Merck, Boehringer Ingelheim, Bayer, Novartis and Servier), and there’s no organisation promoting it which could throw some money at IDF, in exchange for their “dedicated team of account managers [to] help… design the best partnership proposal to meet [their] specific needs and objectives.” (In case you’re not 100% clear what I’m getting at, IDF receives money from Big Pharma and in return, promotes their diabetes drugs and devices to its audience.)
So what is this wonderful diabetes prevention method? It’s breastfeeding. Yup, it turns out that the time-honoured method for nourishing our babies, which helps protect them against sudden infant death syndrome (SIDS); gastrointestinal, respiratory and ear infections; necrotising enterocolitis and sepsis in premature babies; dental malocclusions; overweight and obesity; and reduced IQ, also protects their mothers against the development of diabetes.
A study published in JAMA Internal Medicine tracked 1238 young black and white US women who were enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study, and who had at least one live birth during the 30 year follow-up period, from 1986-2016.
The women were aged 18-30 at baseline, and were screened for diabetes up to 7 times during the study.
For the purposes of analysis, the women were divided into 4 groups with respect to the total length of time that they had breastfed their babies:
- No breastfeeding
- 0 to 6 months
- 6 to 12 months, and
- Longer than 12 months
182 of the women developed diabetes over the 30 year follow-up period. Those who had been diagnosed with gestational diabetes (GDM – a type of diabetes that develops during pregnancy, and resolves as soon as the woman gives birth) were more than 3 times as likely to develop diabetes as those who didn’t suffer this common complication of pregnancy (18 cases of incident diabetes per 1000 person-years of follow-up in women with GDM vs 5.1 cases per thousand years of follow-up in women who did not develop GDM).
However, the longer that women breastfed their babies, the lower was their risk of diabetes – and longer breastfeeding duration was particularly protective in women who had developed GDM:
The researchers proposed several mechanisms to explain the lower risk of diabetes in women who breastfeed for longer:
- Breastfeeding lowers women’s blood glucose levels, both after overnight fasting and after meals.
- Insulin secretion is also reduced during breastfeeding, which is associated with protective effects on the pancreatic β-cells that produce insulin.
- Higher levels of the milk-stimulating hormone prolactin, which occur during breastfeeding, may preserve pancreatic β-cell mass and function.
- Mouse studies have shown that lactation causes pancreatic β-cells to divide more rapidly.
- Producing breastmilk burns up to 300 additional calories per day over basal metabolic rate, and mobilises adipose (fat) tissue, including both the subcutaneous fat stores under our skin, and the more dangerous visceral depots that wrap around and infiltrate our abdominal organs, contributing to insulin resistance and diabetes.
No doubt there are other, as yet unknown, mechanisms via which breastfeeding protects women against diabetes, and I would hazard a guess that the gut microbiome is involved in some way!
For now, what women need to know is that breastfeeding offers significant benefits to their health as well as their baby’s. I encourage all pregnant women to join the Australian Breastfeeding Association (ABA) and begin attending support group meetings well in advance of their baby’s birth.
Breastfeeding is a learned art, and women in developed countries have few opportunities outside of ABA support groups to observe other women breastfeeding, master the fine details of positioning a baby at the breast, and get their questions about breastfeeding answered by true experts – that is, women who have actually done it!
Women also need to ensure that they will have access to a lactation consultant immediately after the birth, to help them establish breastfeeding at this crucial time, and to solve any problems that might arise due to birth complications, or congenital issues in the baby.
Finally, pregnant clients often ask me what formula I recommend, if they are unable to breastfeed. This is a difficult question to answer, as there is no substitute for breastfeeding.
Breastmilk is a living tissue, containing not just nutrients but bacteria sourced from the mother to seed her baby’s oral and gut microbiota, and perfectly crafted to meet every physical need of the developing baby; while the breastfeeding process meets many of his or her psychological needs as well.
Its composition changes throughout the feed, at different feeding times during the day, and as the baby grows, so that it is always perfectly matched to the baby’s needs.
It even prepares the baby for the introduction of weaning foods, by exposing him or her to odour molecules from foods eaten by the mother, and through increased diversity of bacteria as the time to introduce solid foods approaches. Formula, on the other hand, is completely monotonous in odour and taste, and even formulas that contain added probiotic bacteria have no hope of mimicking the complex mechanisms by which human breastmilk assists a baby’s oral and gut microbiome to adapt to the transition to solid foods.
Breastmilk from a healthy, screened donor mother is the best alternative to milk from the baby’s own mother, with formula – whether soy or dairy-based – coming dead last.
Any breastmilk is better than none, so even if a woman is unable to supply enough milk for her baby, she can top up donor milk or formula with her own ‘liquid gold’, either through breastfeeding or through expressing (‘pumping’) her milk and feeding the baby from a bottle, or preferably, a supply line which can be purchased or hired through the ABA.
On a personal note, I have a strong family history of type 2 diabetes: my father and his father died from complications of diabetes, as did my mother’s mother, and my maternal aunt and cousin are also diabetic.
Although I didn’t know of this particular benefit of breastfeeding at the time, I was excited to learn that my decision to breastfeed my children for an extended time is yet another lifestyle choice that has helped to protect me against my deadly family legacy. My son weaned himself at 3 years and 2 months of age, while my daughter breastfed for nearly 3.5 years. So between my 2 children, I had nearly 7 years of breastfeeding, which – along with a plant-based diet and daily exercise – has probably reduced my risk of becoming diabetic to neglible levels.
Breastfeeding really is a secret superpower that all women should be encouraged and supported to develop.
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