Breastfed Infants Gain Future Heart-Health Benefits: Presented at AHA
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Breastfed Infants Gain Future Heart-Health Benefits: Presented at AHA

By Carole Bullock

ORLANDO, FL -- November 6, 2007 -- Breastfed babies grow up to have higher high-density lipoprotein (HDL) cholesterol -- and tend to be slimmer -- than their bottle-fed counterparts, according to the Framingham Third Generation Study.

The study's findings were reported here on November 5 at the American Heart Association (AHA) 2007 Scientific Sessions.

This study stands out from other breastfeeding studies because it focuses on adult risk factors and adjusts for confounding factors among mothers and participants, said study author Nisha Parikh, MD, MPH, Cardiovascular Fellow, Beth Israel Deaconess Medical Center, Boston, Massachusetts.

The Third-Generation participants had at least one parent in the Framingham Offspring Study.

Overall 26% of the Third-Generation offspring who responded to a mailed questionnaire reported that they had been breastfed. Breastfed offspring had an adult-adjusted mean body mass index (BMI) of 26.1 kg/m2, compared with 26.9 kg/m2 for bottle-fed (P =.04).

Adult HDL-C levels were higher among breastfed compared with bottle-fed offspring. The adjusted mean HDL was 56.6 mg/dL for breastfed offspring and 53.7 mg/dL for bottle-fed, in multivariable-adjusted models (P =.01).

The 962 Framingham Third Generation participants (mean age = 41 years; 54% women) were surveyed on history of breastfeeding and risk factors for cardiovascular disease (CVD) -- BMI, blood cholesterol, blood pressure, and C reactive protein.

The analysis adjusted for age, sex, hypertension medications, lipid treatment, smoking, birth order, oral contraceptives, hormone replacement, physical activity, and education. Other covariates were maternal smoking, maternal education, and maternal adiposity, defined as BMI normal (<25), overweight (>25 to <30), and obese (>=30 kg/m2).

Low HDL was defined as <50 mg/dL (women) and <40 mg/dL (men). Adiposity categories were defined by BMI normal (<25), overweight (>25 to <30) and obese (>=30 kg/m2).

Breastfeeding was not linked to the other adult CVD risk factors examined in the study. After adjustment for BMI, the association between breastfeeding and HDL was attenuated (P =.09). Associations between breastfeeding and BMI appear to mediate most of this association with HDL-C, the investigators reported.

"This is an observational study; however, it does show that it may be important to attack CVD earlier in life, instead of waiting until a person is in their 40s," Dr. Parikh said in an interview.

The study may also point to a mechanism at play: breast milk contains adipokines, a group of signaling proteins secreted by adipose tissue that may modify appetite, insulin resistance, and atherosclerosis.

"More studies are needed to understand the mechanism and metabolic actions of adipokines and other factors that may be related to cardiovascular disease in early life."

[Presentation title: Gender and Ethnic Factors in CHD: Abstract 3498]

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