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M Kersting

Publications and source records attributed to M Kersting.

At least 19 recordsLinked to original sources

Evaluation of dietary fibre intake from infancy to adolescence against various references--results of the DONALD Study.

OBJECTIVE: To evaluate dietary fibre intake from infancy to adolescence against various reference standards expressed on a body weight, age or energy intake (EI) basis and to describe age and 15-year time trends. DESIGN AND SUBJECTS: The ongoing longitudinal (open cohort) Dortmund Nutritional and Anthropometric Longitudinally Designed Study with a total of 7810 3-day dietary records from 980 infants, children and adolescents aged 6 months to 18 years collected between 1990 and 2004. RESULTS: Absolute dietary fibre intakes (g/day) increased with age from infancy to adolescence; dietary fibre density (g/1000 kcal) reached a maximum at 1 year and remained constant after the transition to the family diet. Expressed as g/kg body weight, dietary fibre intake increased during infancy with a maximum at 1 year, but decreased thereafter during childhood and adolescence. Dietary fibre intake was low irrespective of the reference used and showed no time trends, with the exception of a small negative trend in 4-8-year olds and 9-13-year-old girls. CONCLUSION: As intake of dietary fibre in our sample was significantly associated with EI and fibre density remained constant after infancy, our data support an energy-based approach for establishing a reference value for children and adolescents.

Adolescent↗

Ghrelin levels before and after reduction of overweight due to a low-fat high-carbohydrate diet in obese children and adolescents.

BACKGROUND: There are conflicting results for ghrelin changes in reduction of overweight. Increasing ghrelin levels in weight reduction are considered to be responsible for compensatory mechanisms that make the reduction of overweight unlikely to be sustained. METHODS: We have analyzed fasting serum ghrelin levels, weighed dietary record and, as biochemical markers of clinically relevant reduction of overweight, leptin, adiponectin and insulin levels and insulin resistance measured by homeostasis model assessment (HOMA) at baseline and after a 1-y outpatient weight reduction program based on a high-carbohydrate and low-fat diet in 37 obese children (median age 10 y). We divided these children into two subgroups according to their degree of weight loss (substantial reduction of overweight: decrease in SDS-BMI > or = 0.5). Furthermore, we analyzed ghrelin levels in 16 normal-weight children. RESULTS: Obese children demonstrated significant (P<0.001) lower ghrelin levels compared to normal-weight children. Daily caloric intake (P = 0.004) and percentage fat content decreased significantly (P<0.001), while percentage carbohydrate content increased significantly (P = 0.003) between baseline and 1-y follow-up in the obese children. The substantial reduction of overweight in 16 children (median SDS-BMI = -0.7) was associated with significant changes in insulin resistance (median decrease of HOMA 27%; P = 0.013), insulin (median decrease 25%, P = 0.036), adiponectin (median increase 15%; P = 0.003), and leptin levels (median decrease 19%; P = 0.023), while there were no significant changes in ghrelin levels (median increase 4%; P = 0.326). In the 21 children without substantial reduction of overweight (median SDS-BMI = -0.3), there were no significant changes in insulin resistance and in insulin, adiponectin, leptin and ghrelin levels. CONCLUSIONS: We conclude that in obese children, low-fat high-carbohydrate diet-induced weight loss does not change ghrelin secretion, but significantly decreases leptin levels, increases adiponectin levels and improves insulin resistance determined by significantly decreased insulin resistance indices as well as lowered serum insulin levels.

Adiponectin↗

How to measure dietary intake and food habits in adolescence: the European perspective.

AIM: This paper deals with some methodological aspects of data collection in the context of measuring dietary intake in individuals in their adolescence life stage. METHOD: Experiences from three partners of the HELENA project in dietary intake measurement in children and adolescents are presented in this paper with emphasis on characteristics of under-reporting, long-term diet measurement and food patterns (Dortmund DONALD group), influences of survey duration on under-reporting (Ghent group) and meal habits (Spanish AVENA group). RESULTS: Under-reporters in the DONALD Study, particularly female adolescents, had a significantly higher body mass index (BMI) than non-under-reporters; BMI could not be explained by different long-term dietary patterns during childhood and adolescence clustered according to fat consumption; consumers of fast food had higher BMI values than nonconsumers. In the Ghent experience, the decline in population mean energy intake as calculated over selected clusters of days is 184 kcal (6.5%) in boys and 116 (5.6%) in girls; the cluster of 1 recording day and the cluster of 3 recording days were not significantly different but they were both significantly different from the 7-day cluster; no significant interaction was observed between the effect of time and BMI. In the AVENA Study, the percentage of adolescents skipping breakfast was higher in females (8.6%) than in males (3.5%, P<0.001); higher BMI values were observed in those skipping breakfast than in those notskipping breakfast, but differences were statistically significant in males at 15 y and in females at 14 and 17 y; adolescents avoiding some food groups for breakfast had higher BMI values (carbohydrates, fruits and pastries in males and milk, fruits and pastries in females). CONCLUSION: Dietary and nutrient intake data in the HELENA project will be obtained by means of repeated 24-h dietary recalls. Data from HELENA might be a basis for developing complex approaches like Healthy Eating Indices.

Adolescent↗

[Nutrition of children and adolescents. Results of the DONALD Study].

In this paper, the actual diet of children and adolescents is characterized by food group intake. Age-dependent dietary patterns and long-term dietary trends are described and commented on against the background of the optimized mixed diet, a preventive total diet concept for German children and adolescents. Dietary intake data come from 3-day dietary records obtained in the DONALD Study (Dortmund Nutritional and Anthropometrical Longitudinally Designed Study), an ongoing mixed longitudinal cohort study conducted at the Research Institute of Child Nutrition since 1985. The actual diet of the observed children and adolescents differed to some extent from the optimized mixed diet. For example, the intake of vegetables was lower and the intake of meat/sausage and confectionary was higher than recommended. The three rules for food selection of the optimized mixed diet (consume plant foods and beverages liberally, animal foods moderately, and high-fat, high-sugar foods occasionally) show a practical way to improve unfavorable dietary habits of children and adolescents without fundamental changes of food intake patterns and taste properties of the actual diet. The partly favorable and partly unfavorable dietary trends observed in the DONALD Study should continue to be critically considered.

Adolescent↗

Pattern of long-term fat intake and BMI during childhood and adolescence--results of the DONALD Study.

OBJECTIVE: Adverse dietary habits have been discussed as being conducive to the increased prevalence of obesity in children and adolescents. No single dietary factor has been clearly identified so far. We analyzed long-term fat intake patterns during childhood and adolescence and their influence on body fatness. METHODS: Four clusters with different patterns of percent energy from fat were found in 228 individuals from the age of 2-18 y participating in the DONALD Study (Dortmund Nutritional Anthropometric Longitudinally Designed Study) with at least 10 yearly weighed dietary records between 1985 and 2002. Clusters were evaluated with regard to macronutrient and food group intakes and body mass index (BMI). RESULTS: The mean energy density and the ratio of energy intake to estimated basal metabolic rate per subject differed significantly between clusters. All calculated macronutrients (per energy intake) with the exception of dietary fiber differed significantly as well as intakes of Meat/Fish/Eggs, Fats/Oils and Fruit/Vegetables. Although these differences in dietary characteristics persisted during the study period, no differences of BMI (calculated as standard deviation score) were found either at the first or last examination per subject. The mean BMI during the study period differed significantly, with the highest BMI in the low fat intake cluster. CONCLUSION: BMI could not be explained by different dietary patterns during childhood and adolescence in this long-term evaluation of dietary records. Underreporting especially in obese subjects, the problem of detecting minor overconsumption of energy intake that favors the development of obesity over long periods, and the small study sample may explain these conflicting results.

Adolescent↗

Home-made carbonated water and the consumption of water and other beverages in children and adolescents: results of the DONALD study.

AIM: To determine differences in intake of water, drinking water and beverages between consumers (C) and non-consumers (NC) of carbonated water prepared at home. METHODS: Matched pairs design; 3-d-weighed diet records; participants of the DONALD Study (Dortmund Nutritional and Anthropometric Longitudinally Designed Study) aged 2-18 y (n = 550, mean: 8.2 y). RESULTS: The most important beverage was either carbonated (C: females 265, males 299 g/d) or bottled water (NC: males 267, females 282 g/d) followed by juice (120-174 g/d), soft drinks (134-167 g/d) and milk (84-149 g/d). Water intake from beverages was higher in males (NC: 902 and C: 906 g/d) than in females (NC: 789 and C: 771 g/d). However, total water intake per energy was higher in females (NC: 0.88 and C: 0.91 g/kcal) than in males (NC: 0.80 and C: 0.83 g/kcal). C had a significantly higher mean drinking water intake (tap + bottled + carbonated water) in percentage of total water intake (%TW) than NC, and lower mean intakes of milk, bottled water and tap water, respectively. There was a significantly lower mean fat intake in C (females: 32 and males: 33% of energy) versus NC (females: 34 and males: 36% of energy). Irrespective of carbonated water consumption, females had better drinking habits than males, with significantly higher mean intakes of water from food (%TW), water from beverages + food (%TW), and total water per energy. CONCLUSIONS: Drinking habits and total water intakes of consumers are quite similar to those of non-consumers of carbonated water. Females in general show more favourable drinking habits than males.

Adolescent↗

Time trends in the consumption of dairy foods in German children and adolescents.

OBJECTIVE: Examination of time trends in the consumption of dairy food and their impact on fat and calcium intakes in German children and adolescents. DESIGN: Dietary records from the DONALD Study (DOrtmund Nutritional and Anthropometric Longitudinally Designed Study). METHODS: A total of 5068 3-day weighed dietary records from 914 1 to 13-y-old children and adolescents collected between 1986 and 2001 were analysed using a mixed linear model, in which the means of the data and the covariance structure specific to the DONALD Study were modelled. RESULTS: During the study period, the consumption of 'milk products' in children and adolescents >/=4 y remained stable, since the reduced consumption of 'fluid milk' (between -2.8 and -7.4 g/day/study year) was compensated for by an increased consumption of 'yoghurt' (between +2.4 and +3.3 g/day/study year). The consumption of 'cheese' increased in subjects >/=4 y (between +0.2 and +0.7 g/day/study year). In 1 to 3-y-old children, the decreased intake of 'fluid milk' (-6.5 g/day/study year) was not compensated for by the increased intake of 'formula' (+3.5 g/day/study year). The percentage of 'low-fat milk products' significantly increased (although not significant in 9-13-y-old boys) to nearly 25% of milk products. The impact of dairy food on fat intake (as percentage of energy intake) remained stable with the exception of a slight reduction in 4-8 y olds, the impact of dairy on calcium (as percentage of US adequate intake) decreased only in 1-3 y olds. CONCLUSIONS: The consumption of dairy food remained widely stable over time in >/=4-y-old children and adolescents, but decreased in 1-3 y olds. A further decline in this age group would be undesirable as is the shift from common milk to formula. The intake of 'low-fat milk products' increased and should be continuously promoted.

Adolescent↗

Predictors to success in outpatient training in obese children and adolescents.

OBJECTIVE: The treatment of obese children and adolescents is not yet satisfactorily effective. It is not clear which participants can profit by a long-time outpatient therapy. DESIGN: Longitudinal, clinical intervention study based on a 1-y outpatient training programme consisting of physical exercise, nutrition course and behaviour therapy for children and their parents. SUBJECTS: A total of 75 obese children (age 7-15 y; standard duration scores of body mass index(SDS-BMI)+1.9-+3.8). MEASUREMENTS: We characterised the participants as to their willingness to change their behaviour (changes in weight status, number of attempts at therapy, participation in exercise groups), somatic characteristics (BMI of children and family members, gender, age), socioeconomic status (level of education of the children and their parents, working mother), exercise and dietary habits, dietary intake as well as the quality of dietary records. These factors were related to the success of the treatment using a multiple logistic regression. RESULTS: A total of 27 (37%) of the children were unsuccessful after treatment. For 48 (63%) of the children, there was a median weight loss of about 0.4 SDS-BMI (range -0.2 to -1.1). The only significant difference (P<0.0001) between these successful children and the unsuccessful ones was that they had taken part in the exercise groups before training began. CONCLUSION: A training for the obese children and their parents enables the majority of the participants to reduce weight. Previous participation in exercise groups can be considered as a predictor to success of the treatment.

Adolescent↗

Breastfeeding promotion in non-UNICEF-certified hospitals and long-term breastfeeding success in Germany.

AIM: To assess breastfeeding practices using the World Health Organization/United Nations Children's Fund (WHO/UNICEF) Ten Steps to Successful Breastfeeding for Baby-Friendly Hospitals in unselected non-UNICEF certified German hospitals and to examine the influences of breastfeeding promotion on long-term breastfeeding success as assessed by WHO criteria. METHODS: Information on the fulfilment of the Ten Steps was collected in 177 randomly chosen maternity hospitals by a postal questionnaire. Breastfeeding duration was assessed in 1487 mothers delivering in these hospitals. Multiple logistic regression was used to estimate the association between a low breastfeeding promotion index, defined as fulfilment of fewer than five steps, and the risk of short-term breastfeeding, less than 4 mo. RESULTS: A higher breastfeeding promotion index was not associated with early breastfeeding but was significantly associated with full breastfeeding at 4 and 6 mo. After adjusting for confounding factors, delivering in a hospital with a low breastfeeding promotion index was associated with an increased risk of short-term breastfeeding [odds ratio (OR) 1.24], although associations with maternal demographic variables (young age: OR 3.34), low educational level (OR 2.81) and upbringing in East Germany (OR 2.27) were stronger. CONCLUSION: In unselected German hospitals even moderate levels of breastfeeding promotion identified by WHO/UNICEF criteria were associated with long-term breastfeeding success.

Adult↗

Measured consumption of tap water in German infants and young children as background for potential health risk assessments: data of the DONALD Study.

Contaminated tap water can become a health risk, e.g. by metals or environmental pollution particularly for sensitive population groups such as infants and young children. There is a lack of data on exactly measured water intake. In the DONALD Study, individual food and fluid intakes were measured by use of 3-day weighed diet records. Here we report on the distribution of individual intakes of tap water in 504 healthy normally nourished subjects aged 3-36 months (1962 diet records) between 1990 and 1998. We calculate scenarios for potential tap water contamination. Tap water intake per kg body weight was significantly higher in formula-fed (FF) infants than in breast-fed (BF) infants. The estimated median intake of lead and nitrate per kg body weight from tap water was higher in FF infants than in BF infants or mixed fed (MF) young children. The scenarios based on intakes at the median, P95 or maximums show that higher risks for exceeding the presently existing maximums could be expected in FF infants. Our data could also be used for estimations of potential risks from other contaminants of tap water.

Age Factors↗

Tumor suppressor genes in the 9p21 gene cluster are selective targets of inactivation in neuroendocrine gastroenteropancreatic tumors.

Functional inactivation of the Rb and p53 pathways appears to be a rite of passage for all cancerous cells. However, p53 and Rb alterations are rare events in neuroendocrine gastroenteropancreatic (GEP) tumors. The CDKN2 locus on chromosome 9p21 sits at the nexus of both pathways harboring tumor suppressor genes, which restrain cell growth by affecting the function of pRb and p53. Therefore, we analyzed the implication of their inactivation in 37 primary neuroendocrine GEP tumors and two cell culture models. RT-PCR analysis revealed loss of expression of at least one of the tumor suppressor genes CDKN2A/p16, CDKN2B/p15, and CDKN2D/p14 with distinct genetic profiles, most frequently in nonfunctional pancreatic tumors (57%) and small intestinal carcinoids (44%), and less commonly in insulinomas (30%) and gastrinomas (22%). DNA analysis and methylation-specific PCR attributed loss of expression to either homozygous deletion or 5'CpG island hypermethylation. 5-Aza-2-deoxycytidine treatment reversed CDKN2A/p16 and CDKN2B/p15 silencing with concurrent growth restraint. Thus, tumor suppressor genes localized in the 9p21 gene cluster are specific targets of inactivation in neuroendocrine GEP tumors, and demethylating agents might hold promise for selective therapy.

Carrier Proteins↗

Changes in time-trends of nutrient intake from fortified and non-fortified food in German children and adolescents--15 year results of the DONALD study. Dortmund Nutritional and Anthropometric Longitudinally Designed Study.

BACKGROUND: Although fortified products have played an increasing role in food marketing since the 1980s in Germany, data as to the consumption of fortified food is sparse. AIM OF THE STUDY: To assess long-term data on changes in fortified food supply or consumption patterns, nutrient intake, and time trends in the DONALD Study (Dortmund Nutritional and Anthropometric Longitudinally Designed Study). METHODS: Between 1985 and 2000 consumption of nutrient intake (total and from fortified foods) was evaluated and time trends in energy and nutrient intake were assessed on the basis of 3-day weighed dietary records (n = 4193) of 2-14 year-old males (n = 383) and females (n = 404) enrolled in the DONALD Study. Nutrient intake was expressed as percentage of the current German recommendations. Food products were defined as fortified if enriched with at least one of the following nutrients: Vitamin A or provitamin A carotenoids (summarised as Vitamin A), Vitamins E, B1, B2, B6, C, niacin, folate, calcium or iron. Nutrient supplements and medicine were excluded from this evaluation. Time trends were analysed using linear and non-linear regression models (PROC MIXED, SAS 6.12). RESULTS: In percent of German references [3], non-fortified food contributed to folate intake by 20-30%, to Vitamin E by about 40%, to Vitamin B1 by 50-65%, to Vitamin A, C, B2, calcium, iron by about 65-95%, and to Vitamin B6 and niacin intake by 100% and more. Fortified food alone provided no more than 5% of calcium intake, about 10-20% of iron, Vitamin A and folate intake, up to 40-50% of Vitamin C, B1, B2, E, niacin and up to 80% of Vitamin B6 intake. During the 15 year period of the DONALD Study with total food, we only found a significant linear time trend for Vitamin C, whereas significant non-linear time trends were found for calcium, Vitamin E, B1, B2, B6, niacin and folate. In the latter there was a uniform increase until 1994 and a decrease thereafter. For iron and Vitamin A no significant time trend could be identified. Only iron and Vitamin A intake from fortified food showed a significant linear time trend. All other nutrients studied here gave significant non-linear time trends. Nutrient intake with fortified food reached maximum values between 1994 and 1996 followed by a decrease thereafter. CONCLUSIONS: Signs of changing food consumption patterns were found, pointing to an almost uniform decrease of nutrient intake since 1994/96 in our population of German children and adolescents. This could be an alarming indicator of a slight but unpreferable tendency to eat energydense, nutrient-poor foods.

Adolescent↗

Significance of fortified beverages in the long-term diet of German children and adolescents: 15-year results of the DONALD Study.

Fortified beverages and instant drinks are the most frequently consumed fortified products in children and adolescents in Germany. However, little is known about the contribution of these products to micronutrient intake. Between 1986 and 2000, consumption of fortified food (total and the subgroup of fortified beverages) and time trends in energy and micronutrient intake were assessed on the basis of 3 day-weighed dietary records (n = 4358) of males and females between the ages of 2 and 14 years (n = 398/408) enrolled in the DONALD Study (Dortmund Nutritional and Anthropometric Longitudinally Designed Study). As percentage of recent references for micronutrient intake, a significant increase in intake from fortified beverages was observed for calcium (from 1 to 3%), iron (3 to 4%), vitamin A (5 to 15%), and vitamin C (5 to 60%). Significant increases in intakes were only observed from 1995-1997 for vitamin E, folate, and niacin (all 5 to 15-25%), vitamin B1 and B2 (both 10-15 to 25-30%) and vitamin B6 (20 to 55%). Thereafter significant decreases were found. Among the fortified beverages, juice was the most important for micronutrient intake, followed by soft drinks (calcium, vitamin A, E, C, folate, niacin) or by instant beverages (energy, iron, vitamin B1, B2, B6). Significant linear and nonlinear time trends in micronutrient intakes from fortified food and fortified beverages were observed in German children and adolescents.

Adolescent↗

p16(INK4a) alterations in chronic pancreatitis-indicator for high-risk lesions for pancreatic cancer.

BACKGROUND: p16(INK4a) alterations are considered to be an early event in pancreatic tumorigenesis and have been described in duct lesions adjacent to pancreatic cancers. This study evaluates whether duct lesions in chronic pancreatitis tissues of patients without pancreatic cancer also harbor genetic alterations in the p16(INK4a) tumor-suppressor gene, and thus represent high-risk precursors for pancreatic cancer. METHODS: Tissues were obtained from 20 pancreatic specimens taken from patients operated on for histologically verified chronic pancreatitis. Pancreatic intraductal neoplasias (PanIN) were identified in hematoxylin-and-eosin-stained slides. p16 protein expression was investigated immunohistochemically in all specimens. DNA from PanIN and non-PanIN tissue was analyzed genetically for p16(INK4a) mutations by single-strand conformation variation analysis and direct sequencing of the encoding region. Additionally, p16(INK4a) promoter methylation was analyzed by a methylation specific polymerase test. RESULTS: PanIN-1a lesions were identified in 10 of the 20 chronic pancreatitis specimens. Four of these 10 PanIN specimens (40%), but none of the 20 non-PanIN tissues, revealed a loss of p16 expression in immunohistochemistry. The mutational analysis of the p16(INK4a) gene showed 1 known polymorphism (c.442G > A; A148T) but no mutations. Two of the 10 specimens with PanIN revealed an inactivating hypermethylation of the p16(INK4a) promoter. CONCLUSIONS: This study shows for the first time that p16(INK4a) alterations can be observed in a considerable number of PanIN1 in chronic pancreatitis tissues not associated with pancreatic cancer. Therefore, p16(INK4a) alterations, especially promoter methylation, might indicate high-risk precursors in chronic pancreatitis that might progress to cancer.

Adult↗

The foods most consumed by German children and adolescents: results of the DONALD Study. Dortmund Nutritional and Anthropometric Longitudinally Design.

BACKGROUND: For a successful nutrition counseling of children and adolescents, knowledge of dietary habits is mandatory. This report describes food group intake and gives details of the customary food selection of healthy German children and adolescents. Main foods which are consumed in large amounts were identified as those on which health promotion should be concentrated. METHODS: 3-day weighed dietary records of 344 children (age range 4-6 years) and 92 adolescents (age range 13-14 years) concerning the period 1990-1997 of the DONALD Study (Dortmund Nutritional and Anthropometric Longitudinally Designed Study) were evaluated. RESULTS: The number of different foods recorded during the 3-day observation period ranged from 21 to 70 and was independent of age or sex. In contrast to dietary guidelines, the consumption of animal foods and 'fats/oils' exceeded the consumption of plant foods with the exception of adolescent girls. Food selection was very similar in age and sex groups. CONCLUSION: Our study shows that under preventive aspects the current food selection could be improved without disturbing the prevailing dietary habits and food preferences.

Adolescent↗

Fifteen year trends in water intake in German children and adolescents: results of the DONALD Study. Dortmund Nutritional and Anthropometric Longitudinally Designed Study.

UNLABELLED: Water intake was evaluated and time trends in water intake and beverage consumption were assessed on the basis of 3 d weighed dietary records (n = 3,736) of 2-13-y-old males (n = 354) and females (n = 379) enrolled in the DONALD Study (Dortmund Nutritional and Anthropometric Longitudinally Designed Study, 1985-1999). Total water intake increased with age from 1,114 g d(-1) in the 2-3-y-olds to 1,363 g d(-1) in the 4-8-y-olds and further to 1,801 g d(-1) (1,676 g d(-1)) in the 9-13-y-old boys (girls); 33-38% came from food, 49-55% from beverages and 12-13% from oxidation. Total water intake per body weight decreased with age from 77.5 g kg(-1) (boys and girls) to 48.9 and 42.6 g kg(-1) in boys and girls, respectively. Milk (9-17%) and mineral water (12-15%) were the most important source of total water intake. In the 15 y period a significant increase in total water intake (+1.7 to +3.2 g MJ(-1) y(-1)) in all three age groups irrespective of sex was found. The increase of total water intake was mainly due to an increase in beverage consumption (+0.32 to +0.47% y(-1)). This study offers a differentiated insight into water intake and patterns of beverage consumption in German children and adolescents. CONCLUSION: The comparison of these data with other surveys points to a low total water intake, especially a low tap water intake, in German children and adolescents and underlines cultural influences on food and drinking habits.

Adolescent↗

Duration of breastfeeding and associated factors in Western and Eastern Germany.

UNLABELLED: Ten years after the German political reunification, specific lifestyle habits still vary between the former Western (FRG) and Eastern (GDR) sectors of Germany. We have analysed data from the first nationwide SuSe Study on breastfeeding 1997-1998 (n = 1593 healthy, term German infants) stratified in a Western (80.3%) and Eastern (19.7%) subgroup. In the Eastern subgroup, breastfeeding was higher for the first 2 wk but decreased more rapidly thereafter. The adjusted relative risk (odds ratios, OR) for short-term breastfeeding was strongly associated (OR >2) with maternal age, supplementary feeding, single parent status, maternal educational status, breastfeeding problems and partner's attitude towards breastfeeding. In the multivariate model, not the geographical location where the mother grew up but the different distribution of risk factors was associated with short-term breastfeeding. Moreover, mothers from both the Western and Eastern sectors mentioned different reasons for giving up breastfeeding. CONCLUSION: More breastfeeding promotion is necessary for women from the former GDR.

Adult↗