Effect of weight change and breastfeeding (EVA study) on risk factors for cardiovascular disease

Supervisors:
Professor Hilde K. Brekke, clinical nutritionist, UiO
Researcher, MD. Beate Fossum Løland, OUS

Background
Women who have given birth to children have an increased risk of developing cardiovascular disease and type 2 diabetes. Breastfeeding has a number of positive health effects for both mother and child. For mothers, breastfeeding seems to prevent cardiovascular disease and diabetes, among other things. One hypothesis is that breastfeeding can reduce the risk by resetting the woman's metabolism to its pre-pregnancy status. To date, this hypothesis has not been tested experimentally.
One in three Norwegian women is overweight or obese when they become pregnant, which constitutes a risk factor for cardiovascular disease. Studies also show that many women put on more weight than recommended during pregnancy, and have difficulty reaching their pre-pregnancy weight after giving birth. This gives an increased risk of developing overweight or obesity later in life. Previous studies carried out by our research group have shown that a 12-week weight reduction program is safe and effective for breastfeeding women who are overweight. The program's goal is a weight loss of 0.5 kg per week and has also shown a positive effect on blood lipids and fasting insulin.
During a pregnancy, the levels of cholesterol and triglycerides gradually increase, at the same time as the degree of insulin resistance increases. A certain resetting of the metabolic changes occurs in the period after parturition. Breastfeeding can probably speed up and reinforce this process. It is unclear whether the effect of breastfeeding is mediated via weight reduction. In an attempt to separate the effects of breastfeeding and weight reduction, the participants are randomized to one of four groups, where they either receive breastfeeding guidance, participation in a weight program, both interventions or neither of the two treatments.

Goal
In the PhD project, we want to investigate whether breastfeeding leads to changes in risk markers for cardiovascular disease and diabetes beyond the effect of weight loss in women with BMI 25-35 before pregnancy.

Cooperation
The Department of Nutritional Sciences, UiO and the National Center for Women's Health Research are carrying out the project in collaboration with the National Expertise Service for Breastfeeding.
Other partners are Cornell University, USA, Gothenburg University, Sweden, Örebro County Council, Sweden, and the Institute of Public Health.

Links:
The project: Effect of weight change and lactation (the EVA-study) (med.uio.no)
Published results (www.sciencedirect.com)