Highlights
- •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.
Methods
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.
Results
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).
Conclusions
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
Graphical Abstract
Keywords
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Article info
Publication history
Published online: November 01, 2018
Accepted:
September 12,
2018
Received in revised form:
September 6,
2018
Received:
April 29,
2018
See Editorial, pages 13–14Identification
Copyright
© 2018 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
