Infant-feeding patterns and cardiovascular risk factors in young adulthood: Data from five cohorts in low- and middle-income countries

Caroline H D Fall, Judith B. Borja, Clive Osmond, Linda Richter, Santosh K. Bhargava, Reynaldo Martorell, Aryeh D. Stein, Fernando C. Barros, Cesar G. Victora

Research output: Contribution to journalArticlepeer-review

100 Scopus citations


Background: Infant-feeding patterns may influence lifelong health. This study tested the hypothesis that longer duration of breastfeeding and later introduction of complementary foods in infancy are associated with reduced adult cardiovascular risk. Methods: Data were pooled from 10 912 subjects in the age range of 15-41 years from five prospective birth-cohort studies in low-/middle-income countries (Brazil, Guatemala, India, Philippines and South Africa). Associations were examined between infant feeding (duration of breastfeeding and age at introduction of complementary foods) and adult blood pressure (BP), plasma glucose concentration and adiposity (skinfolds, waist circumference, percentage body fat and overweight/obesity). Analyses were adjusted for maternal socio-economic status, education, age, smoking, race and urban/rural residence and infant birth weight. Results: There were no differences in outcomes between adults who were ever breastfed compared with those who were never breastfed. Duration of breastfeeding was not associated with adult diabetes prevalence or adiposity. There were U-shaped associations between duration of breastfeeding and systolic BP and hypertension; however, these were weak and inconsistent among the cohorts. Later introduction of complementary foods was associated with lower adult adiposity. Body mass index changed by -0.19 kg/m2 [95% confidence interval (CI) -0.37 to -0.01] and waist circumference by -0.45 cm (95% CI -0.88 to -0.02) per 3-month increase in age at introduction of complementary foods. Conclusions: There was no evidence that longer duration of breastfeeding is protective against adult hypertension, diabetes or overweight/adiposity in these low-/middle-income populations. Further research is required to determine whether 'exclusive' breastfeeding may be protective. Delaying complementary foods until 6 months, as recommended by the World Health Organization, may reduce the risk of adult overweight/adiposity, but the effect is likely to be small.

Original languageEnglish (US)
Article numberdyq155
Pages (from-to)47-62
Number of pages16
JournalInternational Journal of Epidemiology
Issue number1
StatePublished - Feb 2011
Externally publishedYes


  • Blood pressure
  • Body composition
  • Breastfeeding
  • Complementary feeding
  • Diabetes
  • Infant feeding

ASJC Scopus subject areas

  • Epidemiology


Dive into the research topics of 'Infant-feeding patterns and cardiovascular risk factors in young adulthood: Data from five cohorts in low- and middle-income countries'. Together they form a unique fingerprint.

Cite this