Birthweight, weight in infancy and risk of coronary heart disease in adult life

From 1911 the birthweight, weight at one year, and type of feeding in infancy were recorded routinely for all babies born in Hertfordshire. These records have been used to trace men and women born in the county during 1911-1930. An initial study showed that men who were lighter at birth and one year had higher death rates from coronary heart disease (CHD). This thesis describes further work in Hertfordshire.Men who were exclusively bottle-fed from birth or breast-fed but not weaned at one year had higher death rates from CHD than men who were breast-fed and weaned within a year. Women of lower birthweight had higher mortality from cardiovascular disease and CHD, though the trend for CHD was not statistically significant. There were no associations in women between mortality and weight at one year or feeding in infancy.In both sexes, lower birthweight was associated with a more adverse risk factor profile, including shorter adult height, and higher waist/hip ratio, systolic blood pressure, and 120-minute glucose concentrations. In women, lower birthweight was also associated with increased insulin resistance and lower serum HDL-cholesterol and apolipoprotein A1 concentrations. In men, there were similar relationships with weight at one year, and lower weight at one was also associated with increased insulin resistance and higher concentrations of apolipoprotein B, fibrinogen and factor VII. In women, low weight at one year was not associated with increased risk factors. Men who were bottle-fed from birth, or breast-fed but not weaned at one year, had higher serum LDL-cholesterol and apolipoprotein B concentrations than men who were breast-fed and weaned at one. These associations with birthweight, weight at one year and infant feeding were independent of adult body size, social class and smoking.