Deakin University
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Does initial breastfeeding lead to lower blood cholesterol in adult life? A quantitative review of the evidence

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journal contribution
posted on 2008-08-01, 00:00 authored by C G Owen, P H Whincup, S J Kaye, R M Martin, G D Smith, D G Cook, E Bergstrom, S Black, M E J Wadsworth, C H Fall, J L Freudenheim, J Nie, Rachel HuxleyRachel Huxley, S Kolacek, C P Leeson, M S Pearce, O T Raitakari, I Lisinen, J S Viikari, A C Ravelli, A R Rudnicka, D P Strachan, S M Williams
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.
Design: 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.



American Journal of Clinical Nutrition






305 - 314


Oxford University Press


New York, N.Y.





Publication classification

C1.1 Refereed article in a scholarly journal

Copyright notice

2008, American Society for Nutrition