Does having been breastfed in infancy influence lipid profile in later life?: a review of the literature.

High plasma concentrations of cholesterol are a principal risk factor for atherogenesis and thus a major cause of cardiovascular disease. Animal and epidemiological evidence suggest that exposures acting in early life may play a role in cardiovascular disease risk, and infant nutrition is one early-life factor that has generated much interest amongst lifecourse researchers in recent years. A systematic review of epidemiological studies found that mean total cholesterol levels in adults were 0.18 mmol/L (95% CI = 0.06 to 0.30) lower amongst those who had been breastfed compared with those who received formula milk. Experimental evidence from the follow-up into adolescence of nutritional manipulation trials in preterm infants provides support for the hypothesis that breast milk may programme a beneficial lipid profile in later life. However, data in term infants are largely observational and so residual confounding can never be excluded, and there is little consistent evidence that any effect of breastfeeding on lipids translates into a reduced risk of cardiovascular disease in later life. The mechanistic basis for a programming effect of breastfeeding on adult cholesterol levels remains to be established in humans.