Association Between Breastfeeding and Childhood Cardiovascular Disease Risk Factors
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Introduction The immediate benefits of breastfeeding are well-established but the long-term health benefits are less well-known. West Virginia (WV) has a higher prevalence of cardiovascular disease (CVD) and lower breastfeeding rates compared to national averages. There is a paucity of research examining the relationship between breastfeeding and subsequent childhood CVD risk factors, an issue of particular relevance in WV. Methods This study used longitudinally linked data from three cross-sectional datasets in WV (N = 11,980). The information on breastfeeding was obtained retrospectively via parental recall when the child was in the fifth grade. The outcome variables included blood pressure measures [systolic blood pressure (SBP), diastolic blood pressure (DBP)] and lipid profile [total cholesterol (TC), low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), non-HDL, and triglycerides (TG)]. Multiple regression analyses were performed, adjusting for childhood body mass index (BMI) and additional covariates. Results Only 43% of mothers self-reported ever breastfeeding. The unadjusted analysis showed that children who were ever vs. never breastfed had significantly lower SBP (b = − 1.39 mmHg; 95% CI − 1.97, − 0.81), DBP (b = − 0.79 mmHg; 95% CI − 1.26, − 0.33), log-TG (b = − 0.08; 95% CI − 0.1, − 0.05), and higher HDL (b = 0.95 mg/dL; 95% CI 0.33, 1.56). After adjustment for the child’s BMI, socio-demographic and lifestyle factors, log-TG remained significantly associated with breastfeeding (b = − 0.04; 95% CI − 0.06, − 0.01; p = 0.01). Conclusion The observed protective effect of any breastfeeding on childhood TG level was small but significant. This finding provides some support for a protective effect of breastfeeding on later CVD risk.
KeywordsBreastfeeding Cardiovascular disease Childhood Blood pressure Lipid(s) Triglycerides Rural
The West Virginia WATCH/Birth Score Program is funded under an agreement with the West Virginia Department of Health and Human Resources, Bureau for Public Health, Office of Maternal, Child and Family Health. The CARDIAC project is funded by the West Virginia Bureau of Public Health. The authors wish to thank the children and families who have participated in the CARDIAC Project and the Birth Score Project. The authors would like to thank Cris Britton, data manager of WATCH/Birth Score Project for providing the matched data. GA Kelley and C Lilly were partially supported by the National Institute of General Medical Sciences of the National Institutes of Health under Award no. U54GM104942. The content is solely the responsibility of the authors and does not necessarily represent the views of the National Institutes of Health.
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Conflict of interest
The authors declare that they have no competing interests.
- Bekkers, M. B., Brunekreef, B., Smit, H. A., Kerkhof, M., Koppelman, G. H., Oldenwening, M., et al. (2011). Early-life determinants of total and HDL cholesterol concentrations in 8-year-old children; the PIAMA birth cohort study. PLoS ONE, 6(9), e25533. https://doi.org/10.1371/journal.pone.0025533.CrossRefPubMedPubMedCentralGoogle Scholar
- CDC. (2016). Division of nutrition, physical activity, and obesity, national center for chronic disease prevention and health promotion. Avaiable at https://www.cdc.gov/breastfeeding/data/nis_data/rates-any-exclusive-bf-state-2013.htm.
- de Jonge, L. L., van Osch-Gevers, L., Geelhoed, J. J., Hofman, A., Steegers, E. A., Helbing, W. A., et al. (2010). Breastfeeding is not associated with left cardiac structures and blood pressure during the first two years of life. The Generation R Study. Early Human Development, 86(8), 463–468. https://doi.org/10.1016/j.earlhumdev.2010.06.004.CrossRefPubMedGoogle Scholar
- Durmus, B., Heppe, D. H., Gishti, O., Manniesing, R., Abrahamse-Berkeveld, M., van der Beek, E. M., et al. (2014). General and abdominal fat outcomes in school-age children associated with infant breastfeeding patterns. The American Journal of Clinical Nutrition, 99(6), 1351–1358. https://doi.org/10.3945/ajcn.113.075937.CrossRefPubMedGoogle Scholar
- Fall, C. H., Borja, J. B., Osmond, C., Richter, L., Bhargava, S. K., Martorell, R., et al. (2011). Infant-feeding patterns and cardiovascular risk factors in young adulthood: Data from five cohorts in low- and middle-income countries. International Journal of Epidemiology, 40(1), 47–62. https://doi.org/10.1093/ije/dyq155.CrossRefPubMedGoogle Scholar
- Horta, B. L., de Mola, L., C., & Victora, C. G. (2015). Long-term consequences of breastfeeding on cholesterol, obesity, systolic blood pressure and type 2 diabetes: A systematic review and meta-analysis. Acta Paediatrica Supplement, 104(467), 30–37. https://doi.org/10.1111/apa.13133.CrossRefGoogle Scholar
- Hosaka, M., Asayama, K., Staessen, J. A., Ohkubo, T., Hayashi, K., Tatsuta, N., et al. (2013). Breastfeeding leads to lower blood pressure in 7-year-old Japanese children: Tohoku study of child development. Hypertension Research, 36(2), 117–122. https://doi.org/10.1038/hr.2012.128.CrossRefPubMedGoogle Scholar
- Huang, R. C., Mori, T. A., & Beilin, L. J. (2012). Early life programming of cardiometabolic disease in the Western Australian pregnancy cohort (Raine) study. Clinical and Experimental Pharmacology and Physiology, 39(11), 973–978. https://doi.org/10.1111/j.1440-1681.2012.05746.x.CrossRefPubMedGoogle Scholar
- Izadi, V., Kelishadi, R., Qorbani, M., Esmaeilmotlagh, M., Taslimi, M., Heshmat, R., et al. (2013). Duration of breast-feeding and cardiovascular risk factors among Iranian children and adolescents: The CASPIAN III study. Nutrition, 29(5), 744–751. https://doi.org/10.1016/j.nut.2012.10.016.CrossRefPubMedGoogle Scholar
- Juhola, J., Magnussen, C. G., Viikari, J. S., Kahonen, M., Hutri-Kahonen, N., Jula, A., et al. (2011). Tracking of serum lipid levels, blood pressure, and body mass index from childhood to adulthood: The cardiovascular risk in young finns study. The Journal of Pediatrics, 159(4), 584–590. https://doi.org/10.1016/j.jpeds.2011.03.021.CrossRefPubMedGoogle Scholar
- Kramer, M. S., Matush, L., Vanilovich, I., Platt, R. W., Bogdanovich, N., Sevkovskaya, Z., et al. (2007). Effects of prolonged and exclusive breastfeeding on child height, weight, adiposity, and blood pressure at age 6.5 years: Evidence from a large randomized trial. The American Journal of Clinical Nutrition, 86(6), 1717–1721.CrossRefGoogle Scholar
- Kuczmarski, R. J., Ogden, C. L., Guo, S. S., Grummer-Strawn, L. M., Flegal, K. M., Mei, Z., et al. (2002). 2000 CDC growth charts for the United States: Methods and development. Vital and Health Statistics, 11(246), 1–190.Google Scholar
- Lawlor, D. A., Najman, J. M., Sterne, J., Williams, G. M., Ebrahim, S., & Smith, D., G (2004). Associations of parental, birth, and early life characteristics with systolic blood pressure at 5 years of age: Findings from the Mater-University study of pregnancy and its outcomes. Circulation, 110(16), 2417–2423. https://doi.org/10.1161/01.CIR.0000145165.80130.B5.CrossRefPubMedGoogle Scholar
- Mamun, A. A., O’Callaghan, M., Callaway, L., Williams, G., Najman, J., & Lawlor, D. A. (2009). Associations of gestational weight gain with offspring body mass index and blood pressure at 21 years of age: Evidence from a birth cohort study. Circulation, 119(13), 1720–1727. https://doi.org/10.1161/CIRCULATIONAHA.108.813436.CrossRefPubMedGoogle Scholar
- Martin, R. M., Ben-Shlomo, Y., Gunnell, D., Elwood, P., Yarnell, J. W., & Smith, D. G. (2005). Breast feeding and cardiovascular disease risk factors, incidence, and mortality: The Caerphilly study. Journal of Epidemiology and Community Health, 59(2), 121–129. https://doi.org/10.1136/jech.2003.018952.CrossRefPubMedPubMedCentralGoogle Scholar
- Martin, R. M., Ness, A. R., Gunnell, D., Emmett, P., Davey Smith, G., & Team, A. S. (2004). Does breast-feeding in infancy lower blood pressure in childhood? The Avon Longitudinal Study of Parents and Children (ALSPAC). Circulation, 109(10), 1259–1266. https://doi.org/10.1161/01.CIR.0000118468.76447.CE.CrossRefPubMedGoogle Scholar
- National Immunization Survey (NIS). (2002–2013). Division of nutrition, physical activity, and obesity, national center for chronic disease prevention and health promotion. Avaiable at https://www.cdc.gov/breastfeeding/data/nis_data/index.htm.
- Owen, C. G., Whincup, P. H., Kaye, S. J., Martin, R. M., Smith, D., Cook, G., Williams, D. G., S. M (2008). Does initial breastfeeding lead to lower blood cholesterol in adult life? A quantitative review of the evidence. The American Journal of Clinical Nutrition, 88(2), 305–314.CrossRefGoogle Scholar
- Plancoulaine, S., Charles, M. A., Lafay, L., Tauber, M., Thibult, N., Borys, J. M., et al. (2000). Infant-feeding patterns are related to blood cholesterol concentration in prepubertal children aged 5–11 years: The Fleurbaix-Laventie Ville Sante study. European Journal of Clinical Nutrition, 54(2), 114–119.CrossRefGoogle Scholar
- Umer, A., Hamilton, C., Britton, C. M., Mullett, M. D., John, C., Neal, W., et al. (2015). Association between breastfeeding and childhood obesity: Analysis of a linked longitudinal study of rural Appalachian fifth-grade children. Childhood Obesity, 11(4), 449–455. https://doi.org/10.1089/chi.2015.0026.CrossRefPubMedGoogle Scholar
- United Health Foundation (UHF). (2014). America’s health ranking. Available at http://www.americashealthrankings.org.
- US Census Bureau. (2011). U.S. Census Bureau: State and County QuickFacts. Data derived from Population Estimates, American Community Survey, Census of Population and Housing, State and County Housing Unit Estimates, County Business Patterns, Nonemployer Statistics, Economic Census, Survey of Business Owners, Building Permits vol. 2014.Google Scholar
- van den Berg, G., van Eijsden, M., Galindo-Garre, F., Vrijkotte, T. G., & Gemke, R. J. (2013). Explaining socioeconomic inequalities in childhood blood pressure and prehypertension: The ABCD study. Hypertension, 61(1), 35–41. https://doi.org/10.1161/HYPERTENSIONAHA.111.00106.CrossRefPubMedGoogle Scholar
- van Rossem, L., Oenema, A., Steegers, E. A., Moll, H. A., Jaddoe, V. W., Hofman, A., et al. (2009). Are starting and continuing breastfeeding related to educational background? The generation R study. Pediatrics, 123(6), e1017–e1027. https://doi.org/10.1542/peds.2008-2663.CrossRefPubMedGoogle Scholar
- Victora, C. G., Horta, B. L., Post, P., Lima, R. C., De Leon Elizalde, J. W., Gerson, B. M., et al. (2006). Breast feeding and blood lipid concentrations in male Brazilian adolescents. Journal of Epidemiology and Community Health, 60(7), 621–625. https://doi.org/10.1136/jech.2005.044156.CrossRefPubMedPubMedCentralGoogle Scholar
- WATCH, P. (2013). West Virginia birth score project. This program is funded under an agreement with the West Virginia Department of Health and Human Resources, Bureau for Public Health, Office of Maternal, Child and Family Health. Available at http://www.wvdhhr.org/birthscore/. 2013 at http://www.wvdhhr.org/birthscore/.
- Weng, S. F., Redsell, S. A., Swift, J. A., Yang, M., & Glazebrook, C. P. (2012). Systematic review and meta-analyses of risk factors for childhood overweight identifiable during infancy. Archives of Disease in Childhood, 97(12), 1019–1026. https://doi.org/10.1136/archdischild-2012-302263.CrossRefPubMedPubMedCentralGoogle Scholar
- WVDHHR. (2015). West Virginia Vital Statistics. Health statistics center. Room 165, 350 Capitol Street Charleston, WV 25301-3701. DHHR. Avaiable at: http://www.wvdhhr.org/bph/hsc/statserv/VitalStats.asp.