The short-term impact of dietary fat and sugar intake on breast milk composition: A clinical trial protocol

Effect of Different Dietary Patterns on Macronutrient Composition in Human Breast Milk: A Systematic Review and Meta-Analysis

The aim of this meta-analysis was to systematically review the relationships between lactation diet and the composition of mature breast milk through screening multiple databases and gray literatures, with priority given to quantitative articles published in Chinese and English. We identified 27 cross-sectional studies that included 4355 lactating women. According to these data, dietary patterns were categorized into four patterns based on the fat and protein energy supplying ratio, including rational-fat and rational-protein dietary (RR), high-fat and high-protein dietary (HH), rational-fat and high-protein dietary (RH), and high-fat and rational-protein dietary (HR). The results showed the fat content in mature milk was increased with increments of fat intake, while both the protein and lactose contents in mature milk did not increase with their intakes for lactating mothers. Among these four dietary patterns, the energy ratio of macronutrients in human milk at the RR was the closest to the estimated energy ratio for infants aged 0-6 M. In conclusion, our study represents that the rational dietary pattern should be advocated, and the irrational dietary patterns, especially high-fat and high-protein dietary patterns, should be avoided during lactation stage.

Acute changes to breast milk composition following consumption of high-fat and high-sugar meals

Breast milk composition is influenced by habitual diet, yet little is known about the short-term effects of changes in maternal diet on breast milk macronutrient concentrations. Our aim was to determine the acute effect of increased consumption of sugar/fat on breast milk protein, lactose and lipids. Exclusively breastfeeding women (n = 9) were provided with a control, higher fat (+28 g fat) and higher sugar (+66 g sugar) diet over three separate days at least 1 week apart. Hourly breast milk samples were collected concurrently for the analysis of triglycerides, cholesterol, protein, and lactose concentrations. Breast milk triglycerides increased significantly following both the higher fat and sugar diet with a greater response to the higher sugar compared to control diet (mean differences of 3.05 g/dL ± 0.39 and 13.8 g/dL ± 0.39 in higher fat and sugar diets, respectively [P < 0.001]). Breast milk cholesterol concentrations increased most in response to the higher sugar diet (0.07 g/dL ± 0.005) compared to the control (0.04 g/dL) and the higher fat diet (0.05 g/dL) P < 0.005. Breast milk triglyceride and lactose concentrations increased (P < 0.001, P = 0.006), whereas protein decreased (p = 0.05) in response to the higher fat diet compared to the control. Independent of diet, there were significant variations in breast milk composition over the day; triglycerides and cholesterol concentrations were higher at end of day (P < 0.001), whereas protein and lactose concentrations peaked at Hour 10 (of 12) (P < 0.001). In conclusion, controlled short-term feeding to increase daily sugar/fat consumption altered breast milk triglycerides, cholesterol, protein and lactose. The variations observed in breast milk protein and lactose across the 12 h period is suggestive of a circadian rhythm.

An infant presenting with extreme hypertriglyceridemia diagnosed as glycogen storage disease type Ia

Background Marked hypertriglyceridemia in infancy is extremely rare. Patients with severe hypertriglyceridemia in early life may be unmasked by a primary or secondary cause. Case presentation A female infant was born in a good condition with normal Apgar scores. No special clinical symptoms and signs had been found within the first two months of life. Poor oral intake and failure to thrive were two main clinical manifestations when she was referred to our hospital at the age of 3.5 months. The milky serum was the only one characteristic presentation. Laboratory testing showed extremely high level of triglycerides, cholesterol and lactate. Many other laboratory indexes cannot be detected because of severe hyperlipemic samples. Multi-gene panel testing for 249 genes about genetic and metabolic liver disease were performed. Gene analysis revealed a G6PC gene deficiency. The patient was a homozygote for c.248G > A, p.R83H and her parents were both the heterozygotes. The infant had been diagnosed as glycogen storage disease type Ia. Conclusions We report an infant presenting with extreme hypertriglyceridemia diagnosed as glycogen storage disease type Ia by genetic testing. The gene panel can be used to confirm the diagnosis and delineate the exact type of glycogen storage disease, which could ultimately really help to reduce unnecessary tests and invasive examinations. Serum lipid should be close monitoring in order to prevent the complications and improve the prognosis.