Research Article| Volume 70, ISSUE 1, P126-132, January 2019

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Longer lactation duration is associated with decreased prevalence of non-alcoholic fatty liver disease in women

Published:November 01, 2018DOI:


      • Lactation duration >6 months was protective against NAFLD in mid-life after adjustment for confounders.
      • The benefits of increased lactation duration on weight and waist circumference mediated <1/4 of this benefit.
      • Longer lactation duration may be an important lifestyle intervention to prevent the NAFLD during mid-life.

      Background & Aims

      Lactation lowers blood glucose and triglycerides, and increases insulin sensitivity. We hypothesized that a longer duration of lactation would be associated with lower prevalence of non-alcoholic fatty liver disease (NAFLD), which is the leading cause of chronic liver disease in the United States.


      Participants from the Coronary Artery Risk Development in Young Adults cohort study who delivered ≥ 1 child post-baseline (Y0: 1985–1986), and underwent CT quantification of hepatic steatosis 25 years following cohort entry (Y25: 2010–2011) were included (n = 844). The duration of lactation was summed for all post-baseline births, and NAFLD at Y25 was assessed by central review of CT images and defined by liver attenuation ≤ 40 Hounsfield Units after exclusion of other causes of hepatic steatosis. Unadjusted and multivariable logistic regression analyses were performed using an a priori set of confounding variables; age, race, education, and baseline body mass index.


      Of 844 women who delivered after baseline (48% black, 52% white, mean age 49 years at Y25 exam), 32% reported lactation duration of 0 to 1 month, 25% reported >1 to 6 months, 43% reported more than 6 months, while 54 (6%) had NAFLD. Longer lactation duration was inversely associated with NAFLD in unadjusted logistic regression. For women who reported >6 months lactation compared to those reporting 0–1 month, the odds ratio for NAFLD was 0.48 (95% CI 0.25–0.94; p = 0.03) and the association remained after adjustment for confounders (adjusted odds ratio 0.46; 95% CI 0.22–0.97; p = 0.04).


      A longer duration of lactation, particularly greater than 6 months, is associated with lower odds of NAFLD in mid-life and may represent a modifiable risk factor for NAFLD.

      Lay summary

      A longer duration of breastfeeding has been associated with multiple potential health benefits for the mother including reduction in heart disease, diabetes and certain cancers. In this study we found that breastfeeding for longer than 6 months was associated with a lower risk of non-alcoholic fatty liver disease in mid-life.

      Graphical abstract


      Linked Article

      • Breastfeeding and NAFLD from the maternal side of the mother-infant dyad
        Journal of HepatologyVol. 70Issue 1
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          Breastfeeding has health benefits for both partners in the mother-infant dyad. Human breast milk provides the infant with optimal nutrition, immune protection, and metabolic regulation. The advantages of breastfeeding for mothers are not as well studied as those for infants, but there is adequate evidence to state that women who breastfeed are likely to have improved health in the short-term, and are at lower risk of developing future diseases.1
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