Background: Death from cardiovascular disease (CVD) is the leading cause of death globally and in particular in the Eastern Mediterranean region (EMR). The relationship between early feeding practices and CVD remains to be fully established.

Aim: To examine the relationship between early infant feeding practices as risk factors of death from CVD with a focus on high blood pressure (HBP) in the 22 countries of the EMR.

Methods: First: global and regional data were compiled for deaths from CVD, HBP, nutritional deficiencies. Second: data from the EMR countries were compiled for adult obesity, high cholesterol (HC) and blood sugar (HBS) and pollution. Countries from the EMR were divided into high and low risk by HBP and biochemical data.  Third: deaths from wasting, stunting, non-exclusive and discontinued breastfeeding and nutritional deficiencies including anemia, vitamin A deficiency, low bone mineral density and Zinc deficiency, were compared in both groups. Fourth: a small scale in-depth study (SSIDS) was conducted for 32 breastfed and 28 non-breastfed mother-child pairs under-five years of age. HBP and high density lipoproteins (HDL) and low density lipoproteins (LDL) and highly sensitive C-reactive protein (HsCRP) were measured.

Findings: Nine EMR countries were identified as high risk for CVD with HBP, obesity, HC and HBS and pollution. Deaths from nutritional deficiencies and feeding practices were higher in this group. In the SSIDS, HsCPR was significantly lower in mothers and children who were breastfed and HDL significantly higher in children introduced foods after 6 months of age.

Conclusions: Optimal infant feeding practices contribute directly and indirectly to reducing deaths from CVD.