Breastfeeding and Cardiometabolic Profile in Childhood: How Infant Feeding, Preterm Birth, Socio-Economic Status, and Obesity May Fit into the Puzzle
Although the observed association between breastfeeding and cardiometabolic profile in childhood and adolescence in previous studies (refs) has biological plausibility, the precise mechanism and magnitude remains far from being fully understood.1 Early nutrition and epigenetic programming2, anti-inflammatory properties3, and cardiorespiratory fitness4 are among numerous hypotheses that are currently being actively investigated.
In this issue of Circulation, Martin et al.5 reported in the paper "Effects of promoting longer term and exclusive breastfeeding on cardiometabolic risk factors at age 11.5 years: a cluster-randomized, controlled trial". The intervention study started in 1996-1997 in 31 Belarussian maternity hospitals and affiliated outpatient clinics with an enrollment of 17,046 breastfeeding mothers of healthy term infants. The trial was originally designed to assess the effects of a breastfeeding promotion and support intervention on duration of breastfeeding. Duration of both exclusive (infant only receives breast milk without any additional food or drink, not even water) and any breastfeeding (includes non-exclusive and exclusive) were assessed in the intervention and non-intervention groups.6 The planned 11.5 year follow-up of about 80% of study participants who had fasted for the follow-up assessment and did not have diabetes allowed authors to test whether an intervention to improve breastfeeding duration and exclusivity also influenced cardiometabolic risk factors in childhood. No significant differences between intervention and control groups were found in levels of blood pressure, fasting insulin, adiponectin, glucose, apolipoprotein A1, and metabolic syndrome.
- Received November 8, 2013.
- Revision received November 19, 2013.
- Accepted November 20, 2013.