Breastfeeding and Cardiometabolic Profile in Childhood

Although the observed association between breastfeeding and cardiometabolic profile in childhood and adolescence in previous studies has biological plausibility, the precise mechanism and magnitude remain far from being fully understood.1 Early nutrition and epigenetic programming,2 anti-inflammatory properties,3 and cardiorespiratory fitness4 are among numerous hypotheses that are currently being actively investigated. In this issue of Circulation, Martin et al5 report on this subject. Their intervention study began in 1996 to 1997 in 31 Belarussian maternity hospitals and affiliated outpatient clinics with an enrollment of 17046 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 nonexclusive and exclusive) was assessed in the intervention and nonintervention groups.6 The planned 11.5-year follow-up of ≈80% of study participants who had fasted for the follow-up assessment and did not have diabetes mellitus allowed the authors to test whether an intervention to improve breastfeeding duration and exclusivity also influenced cardiometabolic risk factors in childhood. No significant differences between the intervention and control groups were found in levels of blood pressure, fasting insulin, adiponectin, glucose, apolipoprotein A1, or metabolic syndrome.