Longer lactation duration is associated with decreased prevalence of non-alcoholic fatty liver disease in women
Open accessAbstract
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.
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From the Coronary Artery Risk Development in Young Adults study, a longer duration of lactation improved postpartum glucose tolerance and other metabolic perturbations, including metabolic syndrome, nonalcoholic fatty liver disease, and the amount of visceral and pericardial fat.
“From the CARDIA study, a longer duration of lactation improved postpartum glucose tolerance and other metabolic perturbations, including metabolic syndrome [73], nonalcoholic fatty liver disease [74], and the amount of visceral and pericardial fat [75].”
From Gestational Diabetes Mellitus: Diagnostic Approaches and Maternal-Offspring Complications (2022) · cites this paper as [74]
The Results (Lactation duration and prevalent NAFLD at year-25; page unavailable) show that CARDIA women who lactated for more than six months had lower odds of NAFLD in midlife than women who lactated for 0–1 month. This supports the portion attributed to citation [74], but the observational association does not establish that lactation improved NAFLD, nor was NAFLD assessed in the postpartum period. (LLM, conf=0.87)
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NAD+ Repletion Enhances Mammary Lactogenesis and Improves Offspring Development in a Sow Model
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- Authors
- Ajmera, V. H., Terrault, N. A., VanWagner, L. B., Sarkar, M., Lewis, C. E., Carr, J. J., & Gunderson, E. P.
- Affiliations
- University of California San Diego (US)
- University of California, San Francisco (US)
- Northwestern University (US)
- University of Alabama at Birmingham (US)
- Vanderbilt University (US)
- Kaiser Permanente (US)
- Corresponding author
- Ajmera, Veeral H.
- ORCID
- Venue
- Journal of Hepatology
- Publisher
- Elsevier BV
- Published
- 2019-01
- Volume
- 70
- Issue
- 1
- Pages
- 126-132
- ISSN
- 0168-8278 (ISSN-L)
- PMC
- PMC6599460
- OpenAlex
- W2899029235
- Cited by
- 75
- References
- 32
- Citations by year
- 2026: 4 · 2025: 12 · 2024: 9 · 2023: 8 · 2022: 13 · 2021: 11 · 2020: 12 · 2019: 4 · 2018: 1 · 2017: 1
- FWCI
- 5.46
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institutes of Health (KL2TR001424)
- National Heart, Lung, and Blood Institute (K23HL136891, R01HL098445)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK090047, K01DK059944, R01DK106201, K23DK111944, P30DK026743, T32DK060414)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Epidemiology › Breastfeeding Practices and Influences
- Health Sciences › Medicine › Surgery › Organ Transplantation Techniques and Outcomes
- Keywords
- lactation length, breastfeeding, hepatic steatosis, liver attenuation, insulin sensitivity, modifiable risk factors, women's health, midlife, chronic liver disease, triglycerides, blood glucose, body mass index, racial and ethnic differences, socioeconomic status, postpartum period, postmenopausal women
- MeSH terms
- Adolescent, Adult, Blood Glucose, Breast Feeding, Female, Follow-Up Studies, Humans, Insulin, Lactation, Prognosis, Retrospective Studies, Risk Factors, Time Factors, Triglycerides, United States, Biomarkers, Prevalence, Disease Progression, Young Adult, Non-alcoholic Fatty Liver Disease
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