As evidenced by multiple studies over the years, women who breastfeed have a lower risk of developing cardiovascular disease and diabetes when compared to those who cannot or cannot breastfeed. However, the mechanisms by which this risk is reduced for breastfeeding women are still not fully understood.
Doc Appiah, Ph.D., assistant professor of public health at the University of Texas Tech Health Sciences Center and director of the university’s master’s program in public health, said the presence of excess fats, particularly visceral fat and pericardial fat could help explain this finding. Using this hypothesis, Appiah and a team of researchers recently completed a study titled “Association of Lactation Duration with Visceral and Peripheral Fat Volumes in Newborn Women: The Cardia Study”. Journal of Endocrinology and Metabolism The results were published in our February issue.
Appiah’s team included Cora E. Lewis, MD, and James M. Shikani (University of Alabama at Birmingham); David R. Jacobs Jr., Ph.D., and Myron Gross, Ph.D., (University of Minnesota); Jeff Carr, MD (Vanderbilt University Medical Center); And Charles B. Kisenberry Jr., Ph.D., Stephen Sydney, MD, and chief research scientist Erica B. Gunderson, Ph.D., (Kaiser Permanente Northern California). The National Institute of Diabetes and Digestive and Kidney Diseases provided funding to Gunderson, the lead author of the study, to create derivative variants related to pregnancy, and to analyze lactation and cardiovascular disease development in the Coronary Artery Risk Evolution in Young Men (CARDIA) study of women.
Visceral fat, often referred to as active fat, can increase your risk of serious health problems such as cardiovascular disease, heart attack, type 2 diabetes, stroke, breast, colon and rectal cancer, and Alzheimer’s disease. Although it can build up in the arteries, visceral fat is usually stored in the abdominal cavity near vital organs such as the stomach, liver, and intestine.
Pericardial fat, which is deposits of fatty tissue on the outside of the heart, may also affect some cardiovascular diseases.
“We know that these two types of organ-related fats contribute to diabetes in addition to cardiovascular disease, so we wanted to see how breastfeeding affects these types of fats,” said Appiah. “If breastfeeding affects these fats, then this means that it could provide a physiological mechanism through which we can understand how breastfeeding actually affects these two major diseases. This was the primary motivation for this study.”
Because these fats are related to insulin production and other cardiac metabolic factors, Appiah said the weight change could affect the relationship between breastfeeding and these fats. For example, visceral fat that accumulates around the abdomen also tends to be adipokines, which are the cytokines produced by adipose tissue. Adipokines also secrete hormones that affect insulin sensitivity in muscles. When the amount of visceral fat increases, so does competition for insulin binding sites, which increases the risk of developing insulin resistance or glucose intolerance.
Excess fat in the pericardium also increases weight on the heart and can affect its contraction or how it beats, which may also affect other cardiovascular diseases. Although several studies have looked at visceral fat, or abdominal fat, and its effect on heart health, Appiah said that little is known about pericardial fat.
“However, there is still enough science to show that the more fat you have in your pericardium, the more likely you are to develop cardiovascular disease,” said Appiah. “What this really means is that breastfeeding affects weight gain, so women who usually breastfeed will not gain more weight, which will also affect less fat accumulation in the abdomen or around the heart.”
Gunderson said previous studies in women in the 30-year-old CARDIA study showed that lactation duration was associated with a 50% lower relative risk of progression to type 2 diabetes in women, regardless of metabolic features, body size before pregnancy, and social factors. And lifestyle. Behaviors. Lactation may also prevent the future development of cardiovascular disease in women by reversing hypertriglyceridemia during pregnancy by removing excess fatty acids in breast milk production and by preventing the lowering of high-density lipoprotein cholesterol after childbirth.
“This reduction in fat in the pericardium was only partially mediated by subsequent weight gain, indicating the presence of robust systemic metabolic changes independent of overall obesity,” Gunderson said. “Thus, reduced lipid deposition in the heart and other organs may explain the preventive benefits of breastfeeding for the prevention of cardiovascular disease in women.”
To generate data for his research, Appiah also used his own CARDIA study. CARDIA, sponsored by the National Institutes of Health – National Heart, Lung, and Blood Institute, is a long-term study of cardiovascular disease involving more than 5,000 black (48%) and white (52%) women aged between 18 and 30 years old when the study began in 1985. 1986.
As one of the longest running studies of its kind, the CARDIA study has continued to observe these participants for more than 30 years and has helped researchers understand how factors seen in early adulthood may increase the risk of developing cardiovascular disease later in life.
“There aren’t many studies that have actually followed young women throughout their birth years and measured cardiovascular risk factors for all of them,” said Appiah. “It also includes cumulative measures of lactation, which made CARDIA more distinctive in addressing this research because it is not just one episode of breastfeeding that counts. We wanted to look at the entire reproductive age and CARDIA was the best study to do so.”
Gunderson, who is also a professor of health systems science at the Kaiser Permanente Bernard J. Tyson School of Medicine, said the CARDIA data enabled the research team to calculate biomarkers and metabolic risk factors before pregnancy that may affect future obesity and cardiovascular health.
“After taking into account lifestyle behaviors and other risk factors throughout life, low visceral and pericardial fat persisted among women with the longest breastfeeding period,” Gunderson said. “This indicates that breastfeeding may have effects that last many years through middle age.”
After the study’s initial enrollment in 1985-1986, women in the CARDIA study update their measurements and other history roughly every five years, giving the investigators a clearer picture of the woman’s full reproductive age. The results showed, as Appiah discovered in his research, that women who breastfed more during their childbearing years experienced less weight gain and tended to accumulate less fat around the abdomen or around the heart.
Appiah said these findings support some of the findings of the American College of Pediatrics (ACP), which recommends exclusively breastfeeding during the first six months of a child’s life, then combining breastfeeding with appropriate food for ages between six and 12 months. Food can be mixed. However, the ACP also recommends that you should breastfeed for two years or more if able to.
“We are now showing that increasing breastfeeding is actually beneficial to women’s health and can help prevent cardiovascular disease,” said Appiah. “This study provides further evidence for some of these recommendations that were previously made.”
Appiah said there are other lactation issues his team is looking into, including looking at how breastfeeding affects other cytokines and hormones.
“We know that these fats produce adipokines and other cytokines associated with plaque buildup in the arteries,” said Appiah. Therefore, we want to look at how these cytokines are affected by breastfeeding. We also want to look at how lactation affects left ventricular structure and function independently of pericardial fat. These are the next steps for this project. “