Breast milk n-3 long-chain polyunsaturated fatty acids and blood pressure: an individual participant meta-analysis

Lenie Van Rossem,Rebecca K Vinding,Jonathan Y Bernard,Steffen Husby,Barbara Heude,Hans Bisgaard,Henriette B Kyhl,Lotte Lauritzen,Kim F Michaelsen,Signe Bruun,Alet H Wijga,Klaus Bønnelykke,Carel Thijs,Ken D Stark,Martine Armand,Henriette A Smit

doi:10.1007/s00394-020-02310-4

Abstract

PurposeIt is controversial whether a higher intake of n-3 long-chain polyunsaturated fatty acids (n-3 LC PUFA) through breastfeeding is associated or not to a lower blood pressure (BP) during childhood. We aimed to clarify this point by undertaking a meta-analysis involving the data from seven European birth cohorts.MethodsWe searched https://www.birthcohort.net for studies that had collected breast milk samples, and had at least one BP measurement in childhood. Principal investigators were contacted, and all agreed to share data. One additional study was identified by contacts with the principal investigators. For each cohort, we analyzed the association of breast milk n-3 LC PUFAs with systolic and diastolic BP with linear mixed effects models or linear regression, and pooled the estimates with a random effects model. We also investigated age-specific and sex-specific associations.ResultsA total of 2188 participants from 7 cohorts were included. Overall, no associations between breast milk n-3 LC PUFAs and BP were observed. In the pooled analysis, each 0.1 wt% increment in breast milk docosahexaenoic acid (DHA) was associated with a 1.19 (95% CI − 3.31, 0.94) mmHg lower systolic BP. Associations were similar for boys and girls and at different ages.ConclusionIn this individual participant meta-analysis, we found no evidence for an association between breast milk n-3 LC PUFAs and BP.

Highlights

Breastfeeding has established short term advantages for the infants such as fewer infections [1], but may benefit longer term health as well, especially on cardiovascular health
N-3 LC PUFAs are important for blood pressure (BP) control, among others via incorporation in endothelial cells in blood vessels, effects on balance between sympatic and parasympatic signaling from the brain, and eicosanoid regulation of BP [6,7,8]
We investigated the association between n-3 LC PUFAs in breast milk and long term BP

Summary

Introduction

Breastfeeding has established short term advantages for the infants such as fewer infections [1], but may benefit longer term health as well, especially on cardiovascular health. The beneficial effect of breastfeeding as compared to infant formula on BP is suggested to be due to differences in n-3 LC PUFA, especially DHA. There is a competition in the biosynthesis of DHA and arachidonic acid (AA), a n-6 LCPUFA, as the same enzymes are involved in the conversion steps from their respective precursors alpha-linolenic acid (n-3 PUFA) or linoleic acid (n-6 PUFA) [9]. This potential mechanism could be especially important in early life, where exposure may permanently change the function and structure of organs [10]. A simple comparison of breastfeeding with formula feeding can not fully elucidate the potential role of n-3 LC PUFAs, as the fatty acid composition of breast milk varies between mothers [12], due to maternal diet and metabolic status [13, 14] and maternal genes [15]

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