Association between breastfeeding exposure and duration with offspring's dietary patterns over one year of age: a systematic review of observational studies.

Some evidence suggests that breastfeeding may modify food preferences in the later years of life. The present study aimed to provide a systematic review of observational studies investigating the association between exposure to breastmilk and its duration with data-driven or hypothesis-driven (or diet quality scores) dietary patterns over one year of age. The databases of PubMed, Scopus, and Web of Science were searched for observational studies published from January 2010 until July 2021, which led to the identification of 22 eligible articles. There was considerable heterogeneity between studies in terms of assessment of exposure and outcome. Of the 11 studies that assessed data-driven dietary patterns, ten reported a significant association for at least one identified dietary pattern. Overall, being breastfed as well as a longer duration of any/exclusive breastfeeding were associated with higher scores on healthy dietary patterns characterized mainly by high loadings of fruits, vegetables, and whole grains. In comparison, a negative association was found for unhealthy dietary patterns rich in foods with high content of added sugar, salt, and saturated fats. In terms of diet quality scores, nine out of 11 studies reported a significant positive association between the duration of any breastfeeding and adherence to recommended healthy diets or dietary guidelines. In conclusion, the evidence from this review was generally in support of the hypothesis indicating breastfeeding is associated with healthy dietary patterns at later ages. However, due to the methodological limitations in the available studies, further research is warranted to elucidate solid evidence on this topic.