title: Long-term consequences of breastfeeding on cholesterol, obesity, systolic blood pressure and type 2 diabetes: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To systematically review the evidence on the associations between breastfeeding and overweight/obesity, blood pressure, total cholesterol and type 2 diabetes.
  
  
  METHODS
  Two independent literature searches were carried out using the MEDLINE, LILACS, SCIELO and Web of Science databases. Studies restricted to infants and those without an internal comparison group were excluded. Fixed- and random-effects models were used to pool the estimates.
  
  
  RESULTS
  Breastfed subjects were less likely to be considered obese/overweight [pooled odds ratio: 0.74 (95% confidence interval (CI): 0.70; 0.78)] (n = 113). Among the 11 high-quality studies, the association was smaller [pooled odds ratio: 0.87 (95%CI: 0.76; 0.99)]. Total cholesterol (n = 46) was independent of breastfeeding [pooled mean difference: -0.01 mmol/L (95%CI: -0.05; 0.02)]. Systolic blood pressure (n = 43) was lower among breastfed subjects [mean difference: -0.80 (95%CI: -1.17; -0.43)], but no association was observed among larger studies, and for diastolic blood pressure (n = 38) [mean difference: -0.24 (95%CI: -0.50; 0.02)]. For type 2 diabetes (n = 11), the odds ratio was lower among those subjects who had been breastfed [pooled odds ratio: 0.65 (95%CI: 0.49; 0.86)].
  
  
  CONCLUSIONS
  Breastfeeding decreased the odds of type 2 diabetes and based on high-quality studies, decreased by 13% the odds of overweight/obesity. No associations were found for total cholesterol or blood pressure.
authors.affiliation: Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Petolas, Brazil.
authors.forename: Bernardo L
authors.initials: BL
authors.lastname: Horta
authors.affiliation: Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Petolas, Brazil.
authors.forename: Christian
authors.initials: C
authors.lastname: Loret de Mola
authors.affiliation: Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Petolas, Brazil.
authors.forename: Cesar G
authors.initials: CG
authors.lastname: Victora
mesh_terms: D000293:Adolescent; D001794:Blood Pressure; D001942:Breast Feeding; D002648:Child; D000067576:Child Health; D002675:Child, Preschool; D002784:Cholesterol / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007223:Infant; D009765:Obesity / Q000453:epidemiology*; D012307:Risk Factors; D012923:Social Class; D013997:Time Factors; D055815:Young Adult
chemical_list: D002784:Cholesterol
keywords: Blood lipids; blood pressure; breastfeeding; meta-analysis; obesity; systematic review; type 2 diabetes