Does initial breastfeeding lead to lower blood cholesterol in adult life? A quantitative review of the evidence.
BACKGROUND
Earlier studies have suggested that infant feeding may program long-term changes in cholesterol metabolism.


OBJECTIVE
We aimed to examine whether breastfeeding is associated with lower blood cholesterol concentrations in adulthood.


METHODS
The study consisted of a systematic review of published observational studies relating initial infant feeding status to blood cholesterol concentrations in adulthood (ie, aged >16 y). Data were available from 17 studies (17 498 subjects; 12 890 breastfed, 4608 formula-fed). Mean differences in total cholesterol concentrations (breastfed minus formula-fed) were pooled by using fixed-effect models. Effects of adjustment (for age at outcome, socioeconomic position, body mass index, and smoking status) and exclusion (of nonexclusive breast feeders) were examined.


RESULTS
Mean total blood cholesterol was lower (P = 0.037) among those ever breastfed than among those fed formula milk (mean difference: -0.04 mmol/L; 95% CI: -0.08, 0.00 mmol/L). The difference in cholesterol between infant feeding groups was larger (P = 0.005) and more consistent in 7 studies that analyzed "exclusive" feeding patterns (-0.15 mmol/L; -0.23, -0.06 mmol/L) than in 10 studies that analyzed nonexclusive feeding patterns (-0.01 mmol/L; -0.06, 0.03 mmol/L). Adjustment for potential confounders including socioeconomic position, body mass index, and smoking status in adult life had minimal effect on these estimates.


CONCLUSIONS
Initial breastfeeding (particularly when exclusive) may be associated with lower blood cholesterol concentrations in later life. Moves to reduce the cholesterol content of formula feeds below those of breast milk should be treated with caution.
Owen
Christopher G
CG
Division of Community Health Sciences, St George's, University of London, London, United Kingdom. cowen@sgul.ac.uk
Whincup
Peter H
PH
Kaye
Samantha J
SJ
Martin
Richard M
RM
Davey Smith
George
G
Cook
Derek G
DG
Bergstrom
Erik
E
Black
Stephanie
S
Wadsworth
Michael E J
ME
Fall
Caroline H
CH
Freudenheim
Jo L
JL
Nie
Jing
J
Huxley
Rachel R
RR
Kolacek
Sanja
S
Leeson
C Paul
CP
Pearce
Mark S
MS
Raitakari
Olli T
OT
Lisinen
Irina
I
Viikari
Jorma S
JS
Ravelli
Anita C
AC
Rudnicka
Alicja R
AR
Strachan
David P
DP
Williams
Sheila M
SM
D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D001942:Breast Feeding; D002784:Cholesterol / Q000097:blood / Q000378:metabolism*; D015986:Confounding Factors, Epidemiologic; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000453:epidemiology; D007223:Infant; D007225:Infant Food; D041943:Infant Formula; D007227:Infant Nutritional Physiological Phenomena / Q000502:physiology*; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008895:Milk, Human; D016017:Odds Ratio; D012307:Risk Factors; D012907:Smoking; D012959:Socioeconomic Factors
D002784:Cholesterol