Abstract 3498: The Association of Breastfeeding in Infancy and Adult Cardiovascular Disease Risk Factors: The Framingham Third Generation Cohort
Background: Public health recommendations advocate breastfeeding in infancy as a means to reducing later-life obesity. However many prior studies relating breastfeeding to cardiovascular (CVD) risk factors have been limited by lack of adjustment for maternal and participant confounding factors.
Methods: In 962 Framingham Third Generation participants (mean age = 41 yrs, 54% women) we related history of breastfeeding (yes vs. no) and CVD risk factors in young-mid adulthood. Breastfeeding data was ascertained via questionnaire from mothers enrolled in the Framingham Offspring Study. Dependent variables were body mass index (BMI), HDL-cholesterol (HDL-c), total cholesterol, triglycerides, fasting blood glucose, C-reactive protein (CRP), systolic (SBP) and diastolic blood pressure (DBP). Covariates for multivariable adjustment were age, sex, hypertension medications, lipid treatment, smoking, birth order, oral contraceptives, hormone replacement, physical activity, education, maternal smoking, maternal education, and maternal BMI. 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]. Generalized estimating equations (GEE) were used to account for sibling correlations.
Results: Overall 26% of participants were reported by their mother to have been breastfed. Compared to non-breastfed individuals, breastfed offspring had lower adult BMI [adjusted mean 26.1 kg/m2 vs. 26.9 kg/m2, p = 0.04) and higher adult HDL-c levels [adjusted mean HDL 56.6 mg/dL relative to 53.7 mg/dL p = 0.01] in multivariable-adjusted models. Breastfeeding was not associated with other examined adult CVD risk factors. Upon adjustment for BMI the association between breastfeeding and HDL was attenuated (p = 0.09). Breastfeeding was associated with high versus low HDL (multivariable-adjusted OR = 1.55, p = 0.04) but not with overweight or obesity versus normal weight (p = 0.26, 0.13 respectively).
Conclusions: Breastfeeding in infancy is inversely associated with adult BMI and positively associated with HDL-c. Associations between breastfeeding and BMI appear to mediate most of the association with HDL-c.