Department of Pediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; and.
Pediatrics. 2019 May;143(5). doi: 10.1542/peds.2018-3075. Epub 2019 Apr 9.
Breast milk has higher cholesterol than formula. Infants who are breastfed have different cholesterol synthesis and metabolism in infancy than infants who are formula fed. Little is known as to whether breastfeeding is associated with subsequent lipid profile, independent of adiposity. We assessed the association of breastfeeding in early infancy with lipid profile and adiposity at ∼17.5 years in a setting where exclusive breastfeeding is not associated with higher socioeconomic position.
We used multivariable linear regression with multiple imputation and inverse probability weighting to examine the associations of contemporaneously reported feeding in the first 3 months of life (exclusive breastfeeding [7.5%], mixed feeding [40%], or always formula feeding [52%]) with lipids and adiposity at ∼17.5 years in 3261 participants in the Hong Kong Chinese birth cohort Children of 1997, adjusting for sex, birth weight, gestational weeks, parity, pregnancy characteristics, parents' highest education, mother's place of birth, and age at follow-up.
Exclusive breastfeeding, but not mixed feeding at 0 to 3 months, compared with formula feeding was associated with lower total cholesterol and low-density lipoprotein cholesterol but not with high-density lipoprotein cholesterol at ∼17.5 years. BMI and fat percentage measured by bioimpedance did not differ by type of infant feeding.
Exclusive breastfeeding in early infancy may promote a healthier lipid profile in late adolescence through mechanisms unrelated to adiposity, implicating its potential long-term benefits for cardiovascular health.
母乳中的胆固醇含量高于配方奶。母乳喂养的婴儿在婴儿期的胆固醇合成和代谢方式与配方奶喂养的婴儿不同。关于母乳喂养是否与随后的脂质谱有关,而与肥胖无关,目前知之甚少。我们评估了在一个不存在母乳喂养与较高社会经济地位相关的环境中,婴儿期早期母乳喂养与 17.5 岁左右的脂质谱和肥胖的关系。
我们使用多元线性回归和多重插补及逆概率加权法,分析了 3261 名 1997 年香港中国出生队列儿童在生命的头 3 个月(纯母乳喂养[7.5%]、混合喂养[40%]或始终配方奶喂养[52%])的同期喂养方式与 17.5 岁左右时血脂和肥胖的关系,调整了性别、出生体重、孕龄、产次、妊娠特征、父母最高学历、母亲出生地和随访年龄。
与配方奶喂养相比,纯母乳喂养(而非混合喂养)与 17.5 岁时的总胆固醇和低密度脂蛋白胆固醇较低相关,但与高密度脂蛋白胆固醇无关。通过生物阻抗法测量的 BMI 和脂肪百分比在不同的婴儿喂养方式之间没有差异。
婴儿期早期的纯母乳喂养可能通过与肥胖无关的机制促进青春期后期的更健康的脂质谱,这暗示了其对心血管健康的潜在长期益处。