title: Breastmilk feeding and lipoprotein profile in adolescents born preterm: follow-up of a prospective randomised study.
abstract: BACKGROUND
  Breastfeeding is associated with reduced cholesterol concentration later in life, but previous studies have not used random assignment of infant diet with prospective follow-up. We tested the hypothesis that breastmilk feeding benefits the lipoprotein profile in adolescents born preterm, in whom randomisation to different diets at birth is feasible.
  
  
  METHODS
  926 infants born preterm were randomly assigned in two parallel trials to receive (trial 1) donated banked breastmilk or preterm formula, or (trial 2) standard term formula or preterm formula, as sole diet or as supplements to mother's milk in both trials. We followed up 216 participants at age 13-16 years and measured ratio of low-density to high-density lipoprotein cholesterol (LDL to HDL), ratio of apolipoprotein B to apolipoprotein A-1 (apoB to apoA-1), and concentration of C-reactive protein (CRP; a measure of the inflammatory process associated with atherosclerosis).
  
  
  RESULTS
  Adolescents who had been randomised to banked breastmilk had a lower CRP concentration (p=0.006) and LDL to HDL ratio (mean difference 0.34 [14% lower], 95% CI -0.67 to -0.01; p=0.04) than those given preterm formula. A greater proportion of human milk intake in infancy was associated with lower ratios of LDL to HDL (p=0.03) and apoB to apoA-1 (p=0.004)--independent of gestation and potential confounding factors--and with lower CRP concentration (p=0.03). CRP concentration correlated with the two lipoprotein ratios (p<0.0001 and p=0.003, respectively).
  
  
  CONCLUSIONS
  Our data provide experimental evidence for the long-term benefits of breastmilk feeding on the risk of atherosclerosis.
authors.affiliation: MRC Childhood Nutrition Research Centre, Institute of Child Health, London, UK. a.singhal@ich.ucl.ac.uk
authors.forename: Atul
authors.initials: A
authors.lastname: Singhal
authors.forename: Tim J
authors.initials: TJ
authors.lastname: Cole
authors.forename: Mary
authors.initials: M
authors.lastname: Fewtrell
authors.forename: Alan
authors.initials: A
authors.lastname: Lucas
mesh_terms: D000293:Adolescent; D016632:Apolipoprotein A-I / Q000097:blood; D001055:Apolipoproteins B / Q000097:blood; D001942:Breast Feeding; D002097:C-Reactive Protein / Q000032:analysis; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D041943:Infant Formula; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007234:Infant, Premature; D008074:Lipoproteins / Q000097:blood*; D008297:Male
chemical_list: D016632:Apolipoprotein A-I; D001055:Apolipoproteins B; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D008074:Lipoproteins; D002097:C-Reactive Protein