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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2005;25:1482.)
© 2005 American Heart Association, Inc.

Atherosclerosis and Lipoproteins

Breastfeeding and Atherosclerosis

Intima-Media Thickness and Plaques at 65-Year Follow-Up of the Boyd Orr Cohort

Richard M. Martin; Shah Ebrahim; Maura Griffin; George Davey Smith; Andrew N. Nicolaides; Niki Georgiou; Simone Watson; Stephen Frankel; Jeff M.P. Holly; David Gunnell

From the Department of Social Medicine (R.M.M., S.E., G.D.S., S.W., S.F., D.G.), University of Bristol, Bristol, UK; The Vascular Noninvasive Screening and Diagnostic Centre (M.G.), London, UK; Department of Neurovascular Sciences (A.N.N., N.G.), The Cyprus Institute of Neurology and Genetics, Nicosia; and Department of Surgery (J.M.P.H.), University of Bristol, Bristol Royal Infirmary, UK.

Correspondence to Dr Martin, University of Bristol, Canynge Hall, Whiteladies Rd, Bristol, Avon BS8 2PR UK. E-mail richard.martin{at}bristol.ac.uk

Objectives— The impact of breastfeeding in infancy on cardiovascular disease risk is uncertain. We related breastfeeding in infancy to atherosclerosis in adulthood.

Methods and Results— A historic cohort study based on a 65-year follow-up of the Carnegie (Boyd Orr) survey of diet and health in prewar Britain, 1937 to 1939. A total of 732 eligible cohort members living in or around Aberdeen, Bristol, Dundee, Wisbech, and London were invited for follow-up examinations in 2002, and 405 (55%) participated. In models controlling for age and sex, breastfeeding was inversely associated with common carotid intima-media thickness (IMT; difference –0.03 mm; 95% CI, –0.07 to 0.01), bifurcation IMT (difference –0.19 mm; 95% CI, –0.37 to –0.01), carotid plaque (odds ratio [OR], 0.52; 95% CI, 0.29 to 0.92), and femoral plaque (OR, 0.54; 95% CI, 0.26 to 1.12), compared with bottle-feeding. Controlling for socioeconomic variables in childhood and adulthood, smoking and alcohol made little difference to effect estimates. Controlling for factors potentially on the causal pathway (blood pressure, adiposity, cholesterol, insulin resistance, and C-reactive protein) made little difference to observed associations.

Conclusions— Breastfeeding may be associated with a reduced risk of atherosclerosis in later life. Measurement error and power considerations limit the extent to which conclusions about the mechanisms underlying this relationship can be made.

We investigated the association between breastfeeding in infancy and later atherosclerosis among 405 participants in a 65-year follow-up study. Breastfeeding was inversely associated with intima-media thickness and carotid and femoral plaque prevalence, even after controlling for socioeconomic and behavioral factors. Breastfeeding may lower atherosclerosis risk in later life.

Key Words: infant nutrition • breastfeeding • cardiovascular disease risk factors • intima-media thickness • atherosclerosis • historical cohort

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