Clinical research studyBreastfeeding in Infancy and Adult Cardiovascular Disease Risk Factors
Section snippets
Study Sample
Participants for this study were part of the Third Generation cohort of the Framingham Heart Study; their mothers were members of the Offspring cohort. The Original Framingham Heart Study Cohort13 and Framingham Offspring cohorts have been described.14 Between July 1996 and May 1997, a breast health survey was mailed to Offspring cohort women that included questions regarding breastfeeding history of each of their children. The design and selection criteria for women chosen to receive the
Third Generation Participant Characteristics
Study sample characteristics grouped by breastfeeding status are shown in Table 1. Twenty-six percent of participants were reported by mothers to have been breastfed in infancy. Of those individuals who were breastfed, the median breastfeeding duration was 4 months (range 1-22 months), and 29.6% were breastfed for more than 6 months. A higher prevalence of breastfed individuals had higher education levels and a lower prevalence of diabetes (Table 1).
Maternal Characteristics
Characteristics of mothers by whether they
Summary of Findings
In a community-based sample of 962 men and women in early to middle age, maternal report of breastfeeding was associated with modestly lower participant BMI and higher participant HDL cholesterol concentrations. Maternal report of breastfeeding was not significantly associated with offspring total cholesterol, triglycerides, fasting blood glucose, or systolic or diastolic blood pressure levels. Breastfeeding was associated with higher mean HDL cholesterol concentrations even after accounting
Strengths and Limitations
Direct and routine assessment of cardiovascular risk factors for 2 generations of participants to account for both maternal covariates and offspring cardiovascular disease risk factors is a unique strength of our study. Risk factors were measured in offspring in adulthood, whereas most prior reports examined the relation of breastfeeding to childhood risk factors. Several limitations should be acknowledged as well. Breastfeeding assessment was done decades after the birth of participants, which
Implications and Directions for Future Study
Our findings confirm previous reports of a protective association between breastfeeding and later-life adiposity (as measured by BMI). Although the net reductions in BMI demonstrated in our study are modest, the beneficial effect at the population level may have important public health relevance. The risk of death from cardiovascular disease and congestive heart failure has been demonstrated to increase even with small incremental increases in BMI,52, 53 suggesting that even modest differences
Conclusions
Breastfeeding in infancy was associated with a modestly reduced BMI and elevated HDL cholesterol levels in adulthood after accounting for several participant and maternal characteristics. The association between breastfeeding and HDL cholesterol was attenuated on accounting for participant BMI. Studies elucidating the mechanisms underlying nutrition in early life and adiposity in later life are warranted.
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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.