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Volume 122, Issue 7, Pages 656-663.e1 (July 2009)


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Breastfeeding in Infancy and Adult Cardiovascular Disease Risk Factors

Nisha I. Parikh, MD, MPHab, Shih-Jen Hwang, PhDac, Erik Ingelsson, MD, PhDa, Emelia J. Benjamin, MD, ScMade, Caroline S. Fox, MD, MPHacf, Ramachandran S. Vasan, MDad, Joanne M. Murabito, MD, ScMajCorresponding Author Informationemail address

Abstract 

Background

Public health recommendations advocate breastfeeding in infancy as a means to reduce obesity in later life. Several prior studies relating breastfeeding to cardiovascular risk factors have been limited by lack of adjustment for maternal and participant confounding factors.

Methods

We ascertained breastfeeding history via questionnaire from mothers enrolled in the Framingham Offspring Study. In their young to middle-aged adult children enrolled in the Framingham Third Generation, we examined the relations between maternal breastfeeding history (yes, no) and cardiovascular risk factors, including body mass index (BMI), high-density lipoprotein (HDL) cholesterol, total cholesterol, triglycerides, fasting blood glucose, and systolic and diastolic blood pressure levels. We applied generalized estimating equations to account for sibling correlations and adjusted for maternal and participant lifestyle, education, and cardiovascular risk factors.

Results

In Third Generation participants (n = 962, mean age = 41 years, 54% were women), 26% of their mothers reported breastfeeding. Compared with non-breastfed individuals, breastfed adult participants had lower multivariable-adjusted BMI (26.1 kg/m2 vs 26.9 kg/m2, P = .04) and higher HDL cholesterol levels (HDL 56.6 mg/dL vs 53.7 mg/dL, P = .01). On additional adjustment for BMI, the association between breastfeeding and HDL cholesterol was attenuated (P = .09). Breastfeeding was not associated with total cholesterol, triglycerides, fasting blood glucose, systolic blood pressure, or diastolic blood pressure.

Conclusion

Breastfeeding in infancy is inversely associated with adult BMI and positively associated with HDL cholesterol. Associations between breastfeeding and BMI may mediate the association between breastfeeding and HDL cholesterol.

a The National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Mass

b Cardiovascular Division, Beth Israel Deaconess Medical Center, Boston, Mass

c National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md

d Preventive Medicine and Cardiology Sections, Boston University School of Medicine, Boston, Mass

e Epidemiology Section, Boston University School of Public Health, Boston, Mass

f Brigham and Women's Hospital, Harvard Medical School, Boston, Mass

j Section of General Internal Medicine, Boston University School of Medicine, Boston, Mass

Corresponding Author InformationRequests for reprints should be addressed to Joanne M. Murabito, MD, ScM, 73 Mount Wayte Ave, #2, Framingham, MA 01702

 Funding: Supported by a National Institute of Health/National Heart, Lung, and Blood Institute, contract N01-HC-25195, 2K24 HL 04334 (RSV).

 Conflict of Interest: None.

 Authorship: All authors had access to the data and played a role in writing this manuscript.

PII: S0002-9343(09)00290-3

doi:10.1016/j.amjmed.2008.11.034


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