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Montana AV, Mildon A, Daniel AI, Pitino MA, Baxter JAB, Beggs MR, Unger SL, O'Connor DL, Walton K. Is Maternal Body Weight or Composition Associated with Onset of Lactogenesis II, Human Milk Production, or Infant Consumption of Mother's Own Milk? A Systematic Review and Meta-Analysis. Adv Nutr 2024; 15:100228. [PMID: 38609047 DOI: 10.1016/j.advnut.2024.100228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 04/05/2024] [Accepted: 04/09/2024] [Indexed: 04/14/2024] Open
Abstract
Maternal adiposity impacts lactation performance, but the pathways are unclear. We conducted a systematic review to understand whether maternal adiposity (body mass index [BMI] or percentage fat mass) is associated with onset of lactogenesis II (copious milk; hours), human milk production (expressed volume/24 h), and infant consumption of mother's own milk (volume/24 h). We used random-effects standard meta-analyses to compare the relative risk (RR) of delayed lactogenesis II (>72 h) between mothers classified as underweight (BMI <18.5 kg/m2), healthy weight (BMI, 18.5-24.9 kg/m2), and overweight/obese (BMI ≥25 kg/m2) and random-effects meta-regressions to examine associations with hours to lactogenesis II and infant milk consumption. The certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation approach. We included 122 articles. Mothers with underweight (RR: 0.64; 95% CI: 0.49, 0.83; I2 = 39.48%; 8 articles/data points) or healthy weight status (RR: 0.67; 95% CI: 0.57, 0.79; I2 = 70.91%; 15 articles/data points) were less likely to experience delayed lactogenesis II than mothers with overweight/obesity. We found no association between maternal BMI and time to onset of lactogenesis II (β: 1.45 h; 95% CI: -3.19, 6.09 h; P = 0.52, I2 = 0.00%; 8 articles, 17 data points). Due to limited data, we narratively reviewed articles examining BMI or percentage fat mass and milk production (n = 6); half reported an inverse association and half no association. We found no association between maternal BMI (β: 6.23 mL; 95% CI: -11.26, 23.72 mL; P = 0.48, I2 = 47.23%; 58 articles, 75 data points) or percentage fat mass (β: 7.82 mL; 95% CI: -1.66, 17.29 mL; P = 0.10, I2 = 28.55%; 30 articles, 41 data points) and infant milk consumption. The certainty of evidence for all outcomes was very low. In conclusion, mothers with overweight/obesity may be at risk of delayed lactogenesis II. The available data do not support an association with infant milk consumption, but the included studies do not adequately represent mothers with obesity. This study was registered in PROSPERO as 285344.
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Affiliation(s)
- Amanda V Montana
- Translational Medicine, The Hospital for Sick Children, Toronto ON, Canada; Department of Nutritional Sciences, University of Toronto, Toronto ON, Canada
| | - Alison Mildon
- Department of Nutritional Sciences, University of Toronto, Toronto ON, Canada
| | | | - Michael A Pitino
- Translational Medicine, The Hospital for Sick Children, Toronto ON, Canada; Department of Nutritional Sciences, University of Toronto, Toronto ON, Canada
| | - Jo-Anna B Baxter
- Department of Nutritional Sciences, University of Toronto, Toronto ON, Canada
| | - Megan R Beggs
- Translational Medicine, The Hospital for Sick Children, Toronto ON, Canada; Department of Nutritional Sciences, University of Toronto, Toronto ON, Canada
| | - Sharon L Unger
- Department of Nutritional Sciences, University of Toronto, Toronto ON, Canada; Paediatrics, Mount Sinai Hospital, Toronto ON, Canada; Division of Neonatology, The Hospital for Sick Children, Toronto ON, Canada
| | - Deborah L O'Connor
- Translational Medicine, The Hospital for Sick Children, Toronto ON, Canada; Department of Nutritional Sciences, University of Toronto, Toronto ON, Canada; Paediatrics, Mount Sinai Hospital, Toronto ON, Canada
| | - Kathryn Walton
- Translational Medicine, The Hospital for Sick Children, Toronto ON, Canada; Department of Family Relations & Applied Nutrition, University of Guelph, Guelph, ON, Canada.
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Brockway MM, Daniel AI, Reyes SM, Granger M, McDermid JM, Chan D, Refvik R, Sidhu KK, Musse S, Patel PP, Monnin C, Lotoski L, Geddes D, Jehan F, Kolsteren P, Allen LH, Hampel D, Eriksen KG, Rodriguez N, Azad MB. Human Milk Macronutrients and Child Growth and Body Composition in the First Two Years: A Systematic Review. Adv Nutr 2024; 15:100149. [PMID: 37981047 PMCID: PMC10831902 DOI: 10.1016/j.advnut.2023.100149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 10/16/2023] [Accepted: 11/14/2023] [Indexed: 11/21/2023] Open
Abstract
Among exclusively breastfed infants, human milk (HM) provides complete nutrition in the first mo of life and remains an important energy source as long as breastfeeding continues. Consisting of digestible carbohydrates, proteins, and amino acids, as well as fats and fatty acids, macronutrients in human milk have been well studied; however, many aspects related to their relationship to growth in early life are still not well understood. We systematically searched Medline, EMBASE, the Cochrane Library, Scopus, and Web of Science to synthesize evidence published between 1980 and 2022 on HM components and anthropometry through 2 y of age among term-born healthy infants. From 9992 abstracts screened, 57 articles reporting observations from 5979 dyads were included and categorized based on their reporting of HM macronutrients and infant growth. There was substantial heterogeneity in anthropometric outcome measurement, milk collection timelines, and HM sampling strategies; thus, meta-analysis was not possible. In general, digestible carbohydrates were positively associated with infant weight outcomes. Protein was positively associated with infant length, but no associations were reported for infant weight. Finally, HM fat was not consistently associated with any infant growth metrics, though various associations were reported in single studies. Fatty acid intakes were generally positively associated with head circumference, except for docosahexaenoic acid. Our synthesis of the literature was limited by differences in milk collection strategies, heterogeneity in anthropometric outcomes and analytical methodologies, and by insufficient reporting of results. Moving forward, HM researchers should accurately record and account for breastfeeding exclusivity, use consistent sampling protocols that account for the temporal variation in HM macronutrients, and use reliable, sensitive, and accurate techniques for HM macronutrient analysis.
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Affiliation(s)
- Meredith Merilee Brockway
- Manitoba Interdisciplinary Lactation Centre (MILC), Children's Hospital Research Institute of Manitoba, University of Manitoba, Canada; Department of Pediatrics and Child Health, University of Manitoba, Canada; Faculty of Nursing, University of Calgary, Canada
| | - Allison I Daniel
- Centre for Global Child Health, Hospital for Sick Children, Canada; Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Canada
| | - Sarah M Reyes
- Manitoba Interdisciplinary Lactation Centre (MILC), Children's Hospital Research Institute of Manitoba, University of Manitoba, Canada
| | - Matthew Granger
- Department of Food and Human Nutritional Sciences, University of Manitoba, Canada
| | | | - Deborah Chan
- Department of Pediatrics and Child Health, University of Manitoba, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Canada
| | - Rebecca Refvik
- Department of Food and Human Nutritional Sciences, University of Manitoba, Canada
| | - Karanbir K Sidhu
- Department of Food and Human Nutritional Sciences, University of Manitoba, Canada
| | - Suad Musse
- Department of Food and Human Nutritional Sciences, University of Manitoba, Canada
| | - Pooja P Patel
- Department of Public Health and Community Medicine, Tufts University School of Medicine, USA
| | - Caroline Monnin
- Neil John Maclean Health Sciences Library, University of Manitoba, Canada
| | - Larisa Lotoski
- Department of Pediatrics and Child Health, University of Manitoba, Canada
| | - Donna Geddes
- School of Molecular Sciences, The University of Western Australia, Australia
| | - Fyezah Jehan
- Department of Pediatrics, Aga Khan University, Pakistan
| | - Patrick Kolsteren
- Department of Food Safety and Food Quality, Ghent University, Belgium
| | - Lindsay H Allen
- Western Human Nutrition Research Center, Agriculture Research Service, United States Department of Agriculture, USA; Department of Nutrition, University of California, Davis, USA
| | - Daniela Hampel
- Western Human Nutrition Research Center, Agriculture Research Service, United States Department of Agriculture, USA; Department of Nutrition, University of California, Davis, USA
| | - Kamilla G Eriksen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark
| | - Natalie Rodriguez
- Manitoba Interdisciplinary Lactation Centre (MILC), Children's Hospital Research Institute of Manitoba, University of Manitoba, Canada; Department of Pediatrics and Child Health, University of Manitoba, Canada
| | - Meghan B Azad
- Manitoba Interdisciplinary Lactation Centre (MILC), Children's Hospital Research Institute of Manitoba, University of Manitoba, Canada; Department of Pediatrics and Child Health, University of Manitoba, Canada.
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3
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Brockway MM, Daniel AI, Reyes SM, Gauglitz JM, Granger M, McDermid JM, Chan D, Refvik R, Sidhu KK, Musse S, Patel PP, Monnin C, Lotoski L, Geddes DT, Jehan F, Kolsteren P, Bode L, Eriksen KG, Allen LH, Hampel D, Rodriguez N, Azad MB. Human Milk Bioactive Components and Child Growth and Body Composition in the First 2 Years: A Systematic Review. Adv Nutr 2024; 15:100127. [PMID: 37802214 PMCID: PMC10831900 DOI: 10.1016/j.advnut.2023.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 09/11/2023] [Accepted: 09/26/2023] [Indexed: 10/08/2023] Open
Abstract
Human milk (HM) contains macronutrients, micronutrients, and a multitude of other bioactive factors, which can have a long-term impact on infant growth and development. We systematically searched MEDLINE, EMBASE, Cochrane Library, Scopus, and Web of Science to synthesize evidence published between 1980 and 2022 on HM components and anthropometry through 2 y of age among term-born infants. From 9992 abstracts screened, 141 articles were included and categorized based on their reporting of HM micronutrients, macronutrients, or bioactive components. Bioactives including hormones, HM oligosaccharides (HMOs), and immunomodulatory components are reported here, based on 75 articles from 69 unique studies reporting observations from 9980 dyads. Research designs, milk collection strategies, sampling times, geographic and socioeconomic settings, reporting practices, and outcomes varied considerably. Meta-analyses were not possible because data collection times and reporting were inconsistent among the studies included. Few measured infant HM intake, adjusted for confounders, precisely captured breastfeeding exclusivity, or adequately described HM collection protocols. Only 5 studies (6%) had high overall quality scores. Hormones were the most extensively examined bioactive with 46 articles (n = 6773 dyads), compared with 13 (n = 2640 dyads) for HMOs and 12 (n = 1422 dyads) for immunomodulatory components. Two studies conducted untargeted metabolomics. Leptin and adiponectin demonstrated inverse associations with infant growth, although several studies found no associations. No consistent associations were found between individual HMOs and infant growth outcomes. Among immunomodulatory components in HM, IL-6 demonstrated inverse relationships with infant growth. Current research on HM bioactives is largely inconclusive and is insufficient to address the complex composition of HM. Future research should ideally capture HM intake, use biologically relevant anthropometrics, and integrate components across categories, embracing a systems biology approach to better understand how HM components work independently and synergistically to influence infant growth.
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Affiliation(s)
- Meredith Merilee Brockway
- Manitoba Interdisciplinary Lactation Centre (MILC), Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB, Canada; Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada; Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Allison I Daniel
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada; Centre for Global Child Health, Hospital for Sick Children, Toronto, ON, Canada
| | - Sarah M Reyes
- Manitoba Interdisciplinary Lactation Centre (MILC), Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB, Canada; Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada
| | | | - Matthew Granger
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada
| | | | - Deborah Chan
- Manitoba Interdisciplinary Lactation Centre (MILC), Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB, Canada; Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, QC, Canada
| | - Rebecca Refvik
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Karanbir K Sidhu
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Suad Musse
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Pooja P Patel
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, Unites States
| | - Caroline Monnin
- Neil John Maclean Health Sciences Library, University of Manitoba, Winnipeg, MB, Canada
| | - Larisa Lotoski
- Manitoba Interdisciplinary Lactation Centre (MILC), Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB, Canada; Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada
| | - Donna T Geddes
- School of Molecular Sciences, The University of Western Australia, Perth, WA, Australia
| | - Fyezah Jehan
- Department of Pediatrics & Child Health, Aga Khan University, Karachi, Pakistan
| | - Patrick Kolsteren
- Department of Food Safety and Food Quality, Ghent University, Ghent, Belgium
| | - Lars Bode
- Department of Pediatrics, Mother-Milk-Infant Center of Research Excellence (MOMI CORE), University of California, San Diego (UC San Diego), San Diego, CA, United States
| | - Kamilla G Eriksen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Lindsay H Allen
- Department of Nutrition, University of California, Davis, CA, United States; Western Human Nutrition Research Center, Agriculture Research Service, United States Department of Agriculture, Washington, DC, Unites States
| | - Daniela Hampel
- Department of Nutrition, University of California, Davis, CA, United States; Western Human Nutrition Research Center, Agriculture Research Service, United States Department of Agriculture, Washington, DC, Unites States
| | - Natalie Rodriguez
- Manitoba Interdisciplinary Lactation Centre (MILC), Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB, Canada; Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada
| | - Meghan B Azad
- Manitoba Interdisciplinary Lactation Centre (MILC), Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB, Canada; Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada; Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada.
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Suwaydi MA, Lai CT, Rea A, Gridneva Z, Perrella SL, Wlodek ME, Geddes DT. Circadian Variation in Human Milk Hormones and Macronutrients. Nutrients 2023; 15:3729. [PMID: 37686759 PMCID: PMC10490050 DOI: 10.3390/nu15173729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 08/16/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023] Open
Abstract
There is an inadequate understanding of the daily variations in hormones and macronutrients in human milk (HM), and sample collection protocols vary considerably from study to study. To investigate changes in these milk components across 24 h, 22 lactating women collected small milk samples before and after each breastfeed or expression from each breast. Test weighing was used to determine the volume of HM consumed in each feed. The concentrations of leptin, adiponectin, insulin, fat, and glucose were measured, and the intakes were calculated. A linear mixed model was fitted to assess within-feed and circadian variation in HM feed volume and concentration, and intakes of several components. The average infant intake of HM was 879 g/24 h. Significantly higher pre-feed concentrations were found for adiponectin and glucose and lower post-feed concentrations were found for insulin and fat. Significant circadian rhythms were displayed for leptin, adiponectin, insulin, glucose (both concentration and intake), fat concentration, and milk volume. These findings demonstrate the necessity for setting up standardised and rigorous sampling procedures that consider both within-feed and circadian variations in HM components to gain a more precise understanding of the impacts of these components on infant health, growth and development.
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Affiliation(s)
- Majed A. Suwaydi
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia (C.T.L.); (Z.G.); (S.L.P.); (M.E.W.)
- School of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia
| | - Ching Tat Lai
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia (C.T.L.); (Z.G.); (S.L.P.); (M.E.W.)
| | - Alethea Rea
- Mathematics and Statistics, Harry Butler Institute, Murdoch University, Murdoch, WA 6150, Australia;
| | - Zoya Gridneva
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia (C.T.L.); (Z.G.); (S.L.P.); (M.E.W.)
| | - Sharon L. Perrella
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia (C.T.L.); (Z.G.); (S.L.P.); (M.E.W.)
| | - Mary E. Wlodek
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia (C.T.L.); (Z.G.); (S.L.P.); (M.E.W.)
- Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Donna T. Geddes
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia (C.T.L.); (Z.G.); (S.L.P.); (M.E.W.)
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Circle(s) of Life: The Circadian Clock from Birth to Death. BIOLOGY 2023; 12:biology12030383. [PMID: 36979075 PMCID: PMC10045474 DOI: 10.3390/biology12030383] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 02/24/2023] [Accepted: 02/27/2023] [Indexed: 03/03/2023]
Abstract
Most lifeforms on earth use endogenous, so-called circadian clocks to adapt to 24-h cycles in environmental demands driven by the planet’s rotation around its axis. Interactions with the environment change over the course of a lifetime, and so does regulation of the circadian clock system. In this review, we summarize how circadian clocks develop in humans and experimental rodents during embryonic development, how they mature after birth and what changes occur during puberty, adolescence and with increasing age. Special emphasis is laid on the circadian regulation of reproductive systems as major organizers of life segments and life span. We discuss differences in sexes and outline potential areas for future research. Finally, potential options for medical applications of lifespan chronobiology are discussed.
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Wong SD, Wright KP, Spencer RL, Vetter C, Hicks LM, Jenni OG, LeBourgeois MK. Development of the circadian system in early life: maternal and environmental factors. J Physiol Anthropol 2022; 41:22. [PMID: 35578354 PMCID: PMC9109407 DOI: 10.1186/s40101-022-00294-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 05/01/2022] [Indexed: 12/25/2022] Open
Abstract
In humans, an adaptable internal biological system generates circadian rhythms that maintain synchronicity of behavior and physiology with the changing demands of the 24-h environment. Development of the circadian system begins in utero and continues throughout the first few years of life. Maturation of the clock can be measured through sleep/wake patterns and hormone secretion. Circadian rhythms, by definition, can persist in the absence of environmental input; however, their ability to adjust to external time cues is vital for adaptation and entrainment to the environment. The significance of these external factors that influence the emergence of a stable circadian clock in the first years of life remain poorly understood. Infants raised in our post-modern world face adverse external circadian signals, such as artificial light and mistimed hormonal cues via breast milk, which may increase interference with the physiological mechanisms that promote circadian synchronization. This review describes the very early developmental stages of the clock and common circadian misalignment scenarios that make the developing circadian system more susceptible to conflicting time cues and temporal disorder between the maternal, fetal, infant, and peripheral clocks.
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Caba-Flores MD, Ramos-Ligonio A, Camacho-Morales A, Martínez-Valenzuela C, Viveros-Contreras R, Caba M. Breast Milk and the Importance of Chrononutrition. Front Nutr 2022; 9:867507. [PMID: 35634367 PMCID: PMC9133889 DOI: 10.3389/fnut.2022.867507] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 04/11/2022] [Indexed: 12/12/2022] Open
Abstract
During pregnancy the human fetus receives timed cues from the circadian rhythms of temperature, metabolites, and hormones from the mother. This influence is interrupted after parturition, the infant does not secrete melatonin and their circadian rhythms are still immature. However, evolution provided the solution to this problem. The newborn can continue receiving the mother's timed cues through breastmilk. Colostrum, transitional, and mature human milk are extraordinary complex biofluids that besides nutrients, contain an array of other non-nutritive components. Upon birth the first milk, colostrum, is rich in bioactive, immunological factors, and in complex oligosaccharides which help the proper establishment of the microbiome in the gut, which is crucial for the infants' health. Hormones, such as glucocorticoids and melatonin, transfer from the mother's plasma to milk, and then the infant is exposed to circadian cues from their mother. Also, milk components of fat, proteins, amino acids, and endogenous cannabinoids, among others, have a markedly different concentration between day and night. In the present review, we give an overview of nutritive and non-nutritive components and their daily rhythms in human milk and explore their physiological importance for the infant. Finally, we highlight some interventions with a circadian approach that emphasize the importance of circadian rhythms in the newborn for their survival, proper growth, and development. It is estimated that ~600,000 deaths/year are due to suboptimal breastfeeding. It is advisable to increase the rate of exclusive breastfeeding, during the day and night, as was established by the evolution of our species.
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Affiliation(s)
| | - Angel Ramos-Ligonio
- LADISER Inmunología y Biología Molecular, Facultad de Ciencias Químicas, Universidad Veracruzana, Orizaba, Mexico
| | - Alberto Camacho-Morales
- Unidad de Neurometabolismo, Centro de Investigación y Desarrollo en Ciencias de la Salud, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Mexico
| | | | | | - Mario Caba
- Centro de Investigaciones Biomédicas, Universidad Veracruzana, Xalapa, Mexico
- *Correspondence: Mario Caba
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Nagel EM, Kummer L, Jacobs DR, Foster L, Duncan K, Johnson K, Harnack L, Haapala J, Kharoud H, Gallagher T, Kharbanda EO, Pierce S, Fields DA, Demerath EW. Human Milk Glucose, Leptin, and Insulin Predict Cessation of Full Breastfeeding and Initiation of Formula Use. Breastfeed Med 2021; 16:978-986. [PMID: 34348043 PMCID: PMC8713450 DOI: 10.1089/bfm.2021.0131] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective: We aimed to investigate prospective associations between milk bioactives related to metabolic health (glucose, insulin, leptin, C reactive protein [CRP], and interleukin 6 [IL-6]) and incident formula initiation at 3 and 6 months postpartum. Design: This study included 363 mother-infant dyads who were fully breastfed at 1 month and participated in the prospective Mothers and Infants Linked for Healthy Growth study from pregnancy to 6 months postpartum. Associations between milk glucose, leptin, insulin, CRP, and IL-6 at 1 and 3 months and incident formula feeding (FF) at 3 and 6 months, respectively, were tested using multiple logistic regression, adjusting for numerous potential confounders such as maternal age and prepregnancy body mass index. Results: At 3 months postpartum, 1-month glucose (odds ratio [OR] 0.45 [95% confidence interval (CI): 0.27-0.75], p ≤ 0.01) and smaller decreases in glucose from 1 to 3 months (OR 0.51 [95% CI: 0.28-0.92], p = 0.03) were associated with lower odds of FF, whereas 1-month leptin (OR 2.30 [95% CI: 1.30-4.07], p < 0.01) and larger increase in insulin (OR 1.86 [95% CI: 1.23-2.81], p < 0.01) and leptin (OR 2.17 [95% CI: 1.29-3.68], p < 0.01) from 1 to 3 months were associated with increased odds of FF. At 6 months, insulin increases (OR 2.08 [95% CI: 1.03-4.17], p = 0.04) were associated with higher odds of FF. Conclusions: In a cohort of women with established lactation, 1-month milk glucose, insulin, and leptin predicted initiation of FF at 3 months. Early milk composition may provide a window into mammary gland function, allowing identification of women at risk of not meeting their breastfeeding goals.
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Affiliation(s)
- Emily M Nagel
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USA
| | - Leslie Kummer
- The Mayo Clinic, Division of Community Pediatric and Adolescent Medicine, Minneapolis, Minnesota, USA
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USA
| | - Laurie Foster
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USA
| | - Katy Duncan
- Department of Pediatrics, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma, USA
| | - Kelsey Johnson
- Department of Genetics, Cell Biology, and Development, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USA
| | - Lisa Harnack
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USA
| | - Jacob Haapala
- HealthPartners Institute, Bloomington, Minnesota, USA
| | - Harmeet Kharoud
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USA
| | - Tiffany Gallagher
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USA
| | | | - Stephanie Pierce
- Maternal-Fetal Medicine, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma, USA
| | - David A Fields
- Department of Pediatrics, University of Oklahoma College of Medicine, Oklahoma City, Oklahoma, USA
| | - Ellen W Demerath
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USA
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Moyo GT, Thomas-Jackson SC, Childress A, Dawson J, Thompson LD, Oldewage-Theron W. Chrononutrition and Breast Milk: A Review of the Circadian Variation of Hormones Present in Human Milk. CLINICAL LACTATION 2021. [DOI: 10.1891/clinlact-d-20-00035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
IntroductionBreast milk contains a wide range of hormones, nutrients, and bioactive compounds. Chrononutrition looks at the interaction between food, both meal timing and meal composition, and circadian rhythms.MethodThis review is a continuation on series on chrononutrition and breast milk. All human studies published in English were included regardless of location or year of publication.ResultsThis review identifies the hormonal circadian variation researched in breast milk to date for melatonin, cortisol, cortisone, leptin, and insulin.ConclusionThe circadian variation observed in some hormones reinforces the superiority of breast milk over formula milk. Melatonin has been the most studied, but more research for all the hormones is needed due to various gaps in the literature and varying levels of study quality. There is insufficient evidence to make recommendations specifically targeting the lactating mother, but we identify and recommend several ideas for future research.
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Suwaydi MA, Gridneva Z, Perrella SL, Wlodek ME, Lai CT, Geddes DT. Human Milk Metabolic Hormones: Analytical Methods and Current Understanding. Int J Mol Sci 2021; 22:ijms22168708. [PMID: 34445437 PMCID: PMC8395916 DOI: 10.3390/ijms22168708] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/30/2021] [Accepted: 08/09/2021] [Indexed: 02/07/2023] Open
Abstract
Human milk (HM) contains a wide array of peptide hormones including leptin and adiponectin, which are involved in the regulation of infant growth and development. These essential hormones might play an important role in the regulation of metabolic reprogramming of the new-born infant. However, HM hormone studies are sparse and heterogeneous in regard to the study design, sample collection, preparation and analysis methods. This review discussed the limitations of HM hormone analysis highlighting the gaps in pre-analytical and analytical stages. The methods used to quantify HM metabolic hormones (leptin, adiponectin, ghrelin, insulin, obestatin, resistin and apelin) can be classified as immunoassay, immunosensor and chromatography. Immunoassay methods (ELISA and RIA) have been predominantly used in the measurement of these HM hormones. The relative validity parameters of HM hormones analysis are often overlooked in publications, despite the complexity and differences of HM matrix when compared to that of plasma and urine. Therefore, appropriate reports of validation parameters of methodology and instrumentation are crucial for accurate measurements and therefore better understanding of the HM metabolic hormones and their influences on infant outcomes.
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Affiliation(s)
- Majed A. Suwaydi
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (M.A.S.); (S.L.P.); (M.E.W.); (C.T.L.); (D.T.G.)
- Department of Medical Laboratory Technology, College of Applied Medical Sciences, Jazan University, Jazan 54142, Saudi Arabia
| | - Zoya Gridneva
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (M.A.S.); (S.L.P.); (M.E.W.); (C.T.L.); (D.T.G.)
- Correspondence: ; Tel.: +61-8-6488-4467
| | - Sharon L. Perrella
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (M.A.S.); (S.L.P.); (M.E.W.); (C.T.L.); (D.T.G.)
| | - Mary E. Wlodek
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (M.A.S.); (S.L.P.); (M.E.W.); (C.T.L.); (D.T.G.)
- Population Health, Murdoch Children’s Research Institute (MCRI), Parkville, VIC 3052, Australia
| | - Ching Tat Lai
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (M.A.S.); (S.L.P.); (M.E.W.); (C.T.L.); (D.T.G.)
| | - Donna T. Geddes
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (M.A.S.); (S.L.P.); (M.E.W.); (C.T.L.); (D.T.G.)
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11
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Evaluation of Appetite-Regulating Hormones ın Young Children with Autism Spectrum Disorder. J Autism Dev Disord 2021; 51:632-643. [PMID: 32583136 DOI: 10.1007/s10803-020-04579-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This study aimed to investigate the role of leptin, ghrelin, neuropeptide Y, and nesfatin-1 in young children with autism spectrum disorder (ASD). A total of 44 children with ASD and 44 healthy controls aged 18-60 months were included. Plasma levels of hormones were measured using commercial enzyme-linked immunosorbent assay kits. Plasma leptin and ghrelin levels were significantly higher in the ASD group than in the control group. However, no significant difference for plasma neuropeptide Y and nesfatin-1 levels was detected between the groups. No relation was found between the severity of ASD symptoms, severity of eating problems, and plasma levels of hormones. Leptin and ghrelin may play a potential role in the pathogenesis of ASD.
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12
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Daniel AI, Shama S, Ismail S, Bourdon C, Kiss A, Mwangome M, Bandsma RHJ, O'Connor DL. Maternal BMI is positively associated with human milk fat: a systematic review and meta-regression analysis. Am J Clin Nutr 2021; 113:1009-1022. [PMID: 33675341 PMCID: PMC8023843 DOI: 10.1093/ajcn/nqaa410] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 12/08/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Lack of robust estimates of human-milk nutrient composition and influential maternal factors, such as body composition, are barriers to informing nutrition policies and programs. OBJECTIVE The objective was to understand the relation between maternal BMI and human-milk energy, fat, and/or total protein. METHODS Four electronic databases (MEDLINE, Embase, CINAHL, and Web of Science) were searched. Outcomes assessed were human-milk energy (kcal/L), fat (g/L), and total protein (g/L) from mothers 1 to 6 mo postpartum. Studies with data on maternal BMI or weight and height that quantified human-milk energy, fat, or protein between 1 and 6 mo postpartum were eligible. Random-effects meta-regression weighted by the inverse of the study-level SE was completed for each of the 3 outcomes. The certainty of evidence for each outcome was assessed using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach. RESULTS A total of 11,373 titles and abstracts were identified, and after full-text screening, 69 articles of 66 studies were included. Meta-regression results showed a positive association between maternal BMI and human-milk fat (β: 0.56 g/L; 95% CI: 0.034, 1.1; P = 0.04; I2 = 93.7%, n = 63 datapoints). There was no significant association between maternal BMI and human-milk energy (β: 3.9 kcal/L; 95% CI: -1.6, 9.5; P = 0.16, I2 = 93.3%, n = 40 datapoints) or total protein (β: 0.13 g/L; 95% CI: -0.16, 0.41; P = 0.37, I2 = 99.1%, n = 40 datapoints). The certainty of evidence for human-milk energy was low and the certainty of evidence for fat and total protein was very low. CONCLUSIONS Meta-regression analysis of available literature suggested an association between maternal BMI and human-milk fat between 1 and 6 mo postpartum. Future studies are needed to confirm the relation between maternal BMI; variation in human-milk energy, fat, and protein content; and the implications for child growth and development. This review is registered with International Prospective Register of Systematic Reviews (PROSPERO 2018 CRD42018098808) at https://www.crd.york.ac.uk/prospero/.
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Affiliation(s)
- Allison I Daniel
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
- Translational Medicine Program, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sara Shama
- Translational Medicine Program, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Samantha Ismail
- Translational Medicine Program, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Celine Bourdon
- Translational Medicine Program, Hospital for Sick Children, Toronto, Ontario, Canada
- The Childhood Acute Illness & Nutrition Network (CHAIN), Nairobi, Kenya
| | - Alex Kiss
- Department of Research Design and Biostatistics, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Martha Mwangome
- The Childhood Acute Illness & Nutrition Network (CHAIN), Nairobi, Kenya
- Kenya Medical Research Institute (KEMRI)/Wellcome Trust Research Program, Kilifi, Kenya
| | - Robert H J Bandsma
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
- Translational Medicine Program, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- The Childhood Acute Illness & Nutrition Network (CHAIN), Nairobi, Kenya
- Department of Biomedical Sciences, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Deborah L O'Connor
- Translational Medicine Program, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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13
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Quinn EA. Centering human milk composition as normal human biological variation. Am J Hum Biol 2021; 33:e23564. [DOI: 10.1002/ajhb.23564] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 11/25/2020] [Accepted: 12/23/2020] [Indexed: 02/06/2023] Open
Affiliation(s)
- Elizabeth A. Quinn
- Department of Anthropology Washington University in St. Louis Saint Louis Missouri USA
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Oliveira MNSD, Rodrigues AM, Faria AMCD, Pereira SCL, Maioli TU. Effects of Holder Pasteurization on Immune Composition of Human Milk. Breastfeed Med 2020; 15:803-808. [PMID: 33185462 DOI: 10.1089/bfm.2020.0124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Human milk (HM) is the ideal food for newborn (NB) nutrition, it provides all macro and micronutrients for human growth and development and also contains bioactive compounds, which influence the development of the neonatal digestive and immune systems. The holder pasteurization process is essential to prevent NB infection from donated milk. Therefore, the aim of this study was to check whether or not holder pasteurization could impact the concentration of immune components in HM and the capacity to induce epithelial cell growth. Materials and Methods: The study was performed on raw and holder pasteurized (62.5°C/30 minutes) paired milk samples after submission to the freezing process in both phases. For cytokine and adipokine measurements, ELISA was performed on 40 individual samples of HM from single donors. For analyzes of epithelial cell growth, HuTu-80 cells were cultivated in Minimum Essential Eagle medium with 15% of raw or pasteurized milk, eight pairs of milk were used. Results: The results showed that no alteration was observed in the concentration of cytokine after milk holder pasteurization, and leptin concentration was reduced in holder pasteurized milk. The heat treatment also did not impact the capacity of breast milk to promote intestinal epithelial cell growth. Conclusions: The results showed that donated breast milk pasteurization has a small impact on the HM bioactive concentration compounds. This technique is important to avoid NB infection.
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Affiliation(s)
- Mariana Naves Silva de Oliveira
- Departamento de Nutrição, Programa de Pós-Graduação em Nutrição e Saúde, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ana Maria Rodrigues
- Departamento de Nutrição, Programa de Pós-Graduação em Nutrição e Saúde, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Simone Cardoso Lisboa Pereira
- Departamento de Nutrição, Programa de Pós-Graduação em Nutrição e Saúde, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Tatiani Uceli Maioli
- Departamento de Nutrição, Programa de Pós-Graduação em Nutrição e Saúde, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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15
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Circadian Variation in Human Milk Composition, a Systematic Review. Nutrients 2020; 12:nu12082328. [PMID: 32759654 PMCID: PMC7468880 DOI: 10.3390/nu12082328] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/21/2020] [Accepted: 07/30/2020] [Indexed: 02/08/2023] Open
Abstract
Background: Breastfeeding is considered the most optimal mode of feeding for neonates and mothers. Human milk changes over the course of lactation in order to perfectly suit the infant’s nutritional and immunological needs. Its composition also varies throughout the day. Circadian fluctuations in some bioactive components are suggested to transfer chronobiological information from mother to child to assist the development of the biological clock. This review aims to give a complete overview of studies examining human milk components found to exhibit circadian variation in their concentration. Methods: We included studies assessing the concentration of a specific human milk component more than once in 24 h. Study characteristics, including gestational age, lactational stage, sampling strategy, analytical method, and outcome were extracted. Methodological quality was graded using a modified Newcastle-Ottawa Scale (NOS). Results: A total of 83 reports assessing the circadian variation in the concentration of 71 human milk components were included. Heterogeneity among studies was high. The methodological quality varied widely. Significant circadian variation is found in tryptophan, fats, triacylglycerol, cholesterol, iron, melatonin, cortisol, and cortisone. This may play a role in the child’s growth and development in terms of the biological clock.
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16
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Leghi GE, Middleton PF, Netting MJ, Wlodek ME, Geddes DT, Muhlhausler BS. A Systematic Review of Collection and Analysis of Human Milk for Macronutrient Composition. J Nutr 2020; 150:1652-1670. [PMID: 32240307 DOI: 10.1093/jn/nxaa059] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 01/02/2020] [Accepted: 02/24/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND As human milk (HM) composition varies by time and across even a single feed, methods of sample collection can significantly affect the results of compositional analyses and complicate comparisons between studies. OBJECTIVE The aim was to compare the results obtained for HM macronutrient composition between studies utilizing different sampling methodologies. The results will be used as a basis to identify the most reliable HM sampling approach. METHODS EMBASE, MEDLINE/PubMed, Cochrane Library, Scopus, Web of Science, and ProQuest databases were searched for relevant articles. Observational and interventional studies were included, and at least 2 authors screened studies and undertook data extraction. Quality assessment was conducted using the Newcastle-Ottawa scale and previously published pragmatic score. RESULTS A total of 5301 publications were identified from our search, of which 101 studies were included (n = 5049 breastfeeding women). Methods used for HM collection were divided into 3 categories: collection of milk from all feeds over 24 h (32 studies, n = 1309 participants), collection at one time point (62 studies, n = 3432 participants), and "other methods" (7 studies, n = 308 participants). Fat and protein concentrations varied between collection methods within lactation stage, but there were no obvious differences in lactose concentrations. There was substantial variability between studies in other factors potentially impacting HM composition, including stage of lactation, gestational age, and analytical method, which complicated direct comparison of methods. CONCLUSIONS This review describes the first systematic evaluation of sampling methodologies used in studies reporting HM composition and highlights the wide range of collection methods applied in the field. This information provides an important basis for developing recommendations for best practices for HM collection for compositional analysis, which will ultimately allow combination of information from different studies and thus strengthen the body of evidence relating to contemporary HM composition. This trial was registered at PROSPERO as CRD42017072563, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42017072563.
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Affiliation(s)
- Gabriela E Leghi
- School of Agriculture, Food and Wine, The University of Adelaide, Adelaide, Australia.,Women and Kids Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia
| | - Philippa F Middleton
- Women and Kids Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia
| | - Merryn J Netting
- Women and Kids Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia.,Discipline of Pediatrics, The University of Adelaide, Adelaide, Australia
| | - Mary E Wlodek
- Department of Physiology, The University of Melbourne, Melbourne, Australia
| | - Donna T Geddes
- School of Molecular Sciences, The University of Western Australia, Perth, Australia
| | - Beverly S Muhlhausler
- School of Agriculture, Food and Wine, The University of Adelaide, Adelaide, Australia.,Commonwealth Scientific and Industrial Research Organization (CSIRO), Adelaide, Australia
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17
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Leghi GE, Netting MJ, Middleton PF, Wlodek ME, Geddes DT, Muhlhausler BS. The impact of maternal obesity on human milk macronutrient composition: A systematic review and meta-analysis. Nutrients 2020; 12:nu12040934. [PMID: 32230952 PMCID: PMC7231188 DOI: 10.3390/nu12040934] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 03/25/2020] [Indexed: 12/11/2022] Open
Abstract
Maternal obesity has been associated with changes in the macronutrient concentration of human milk (HM), which have the potential to promote weight gain and increase the long-term risk of obesity in the infant. This article aimed to provide a synthesis of studies evaluating the effects of maternal overweight and obesity on the concentrations of macronutrients in HM. EMBASE, MEDLINE/PubMed, Cochrane Library, Scopus, Web of Science, and ProQuest databases were searched for relevant articles. Two authors conducted screening, data extraction, and quality assessment independently. A total of 31 studies (5078 lactating women) were included in the qualitative synthesis and nine studies (872 lactating women) in the quantitative synthesis. Overall, maternal body mass index (BMI) and adiposity measurements were associated with higher HM fat and lactose concentrations at different stages of lactation, whereas protein concentration in HM did not appear to differ between overweight and/or obese and normal weight women. However, given the considerable variability in the results between studies and low quality of many of the included studies, further research is needed to establish the impact of maternal overweight and obesity on HM composition. This is particularly relevant considering potential implications of higher HM fat concentration on both growth and fat deposition during the first few months of infancy and long-term risk of obesity.
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Affiliation(s)
- Gabriela E. Leghi
- School of Agriculture, Food and Wine, The University of Adelaide, Adelaide, SA 5064, Australia;
| | - Merryn J. Netting
- Women and Kids Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA 5000, Australia; (M.J.N.); (P.F.M.)
- Discipline of Paediatrics, The University of Adelaide, Adelaide, SA 5000, Australia
| | - Philippa F. Middleton
- Women and Kids Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA 5000, Australia; (M.J.N.); (P.F.M.)
| | - Mary E. Wlodek
- Department of Physiology, The University of Melbourne, Melbourne, VIC 3010, Australia;
| | - Donna T. Geddes
- School of Molecular Sciences, The University of Western Australia, Perth, WA 6009, Australia;
| | - Beverly S. Muhlhausler
- School of Agriculture, Food and Wine, The University of Adelaide, Adelaide, SA 5064, Australia;
- Commonwealth Scientific and Industrial Research Organisation (CSIRO), Adelaide, SA 5000, Australia
- Correspondence: ; Tel.: +61-8-8305-0697
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18
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Leghi GE, Netting M, Muhlhausler BS. The short-term impact of dietary fat and sugar intake on breast milk composition: A clinical trial protocol. Nutr Health 2020; 26:65-72. [PMID: 31948337 DOI: 10.1177/0260106019895367] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Breast milk is uniquely designed for the infant and contains the key nutrients and bioactive factors required to support optimal infant health and development. While previous studies have reported that maternal obesity can influence milk composition, whether this relationship is driven by maternal or dietary factors remains unclear. AIM The aim of this study is to assess the impact of test meals varying in fat and sugar content on post-prandial concentrations of macronutrients and metabolic hormones in the breast milk. METHODS This open label crossover study will include 25 lactating women. On the three days of the intervention, women will be randomized to receive a breakfast meal with a fat and sugar content consistent with the Australian Guide to Healthy Eating (9 g fat, 25 g of sugar) or a breakfast meal containing higher levels of fat (28 g fat, 18 g of sugar) or sugar (5 g fat, 56 g of sugar). All breakfast meals will be similar in composition (cereal, milk, yogurt, toast and spread) and matched for total energy content. This study will measure breast milk concentrations of metabolic hormones (leptin, insulin, adiponectin, ghrelin and glucagon-like peptide-1) and macronutrients in the following 12 hours. RESULTS AND CONCLUSION The results of this study will provide novel direct evidence of the impact of variations in dietary fat and sugar content to alter the macronutrient and/or metabolic hormone concentrations in breast milk. Data on the effect of maternal diet on milk composition is critical given the established importance of nutritional exposures in early infancy for an individual's life-long health outcomes.
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Affiliation(s)
- Gabriela E Leghi
- Department of Food and Wine Sciences, The University of Adelaide, Australia.,Healthy Mothers, Babies and Children Theme, South Australian Health and Medical Research Institute (SAHMRI), Australia
| | - Merryn Netting
- Healthy Mothers, Babies and Children Theme, South Australian Health and Medical Research Institute (SAHMRI), Australia.,Discipline of Paediatrics, School of Medicine, The University of Adelaide, Australia
| | - Beverly S Muhlhausler
- Department of Food and Wine Sciences, The University of Adelaide, Australia.,CSIRO, Australia
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Sebastiani G, Andreu-Fernández V, Herranz Barbero A, Aldecoa-Bilbao V, Miracle X, Meler Barrabes E, Balada Ibañez A, Astals-Vizcaino M, Ferrero-Martínez S, Gómez-Roig MD, García-Algar O. Eating Disorders During Gestation: Implications for Mother's Health, Fetal Outcomes, and Epigenetic Changes. Front Pediatr 2020; 8:587. [PMID: 33042925 PMCID: PMC7527592 DOI: 10.3389/fped.2020.00587] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 08/10/2020] [Indexed: 12/15/2022] Open
Abstract
Introduction: Eating disorders (EDs) have increased globally in women of childbearing age, related to the concern for body shape promoted in industrialized countries. Pregnancy may exacerbate a previous ED or conversely may be a chance for improving eating patterns due to the mother's concern for the unborn baby. EDs may impact pregnancy evolution and increase the risk of adverse outcomes such as miscarriage, preterm delivery, poor fetal growth, or malformations, but the knowledge on this topic is limited. Methods: We performed a systematic review of studies on humans in order to clarify the mechanisms underpinning the adverse pregnancy outcomes in patients with EDs. Results: Although unfavorable fetal development could be multifactorial, maternal malnutrition, altered hormonal pathways, low pre-pregnancy body mass index, and poor gestational weight gain, combined with maternal psychopathology and stress, may impair the evolution of pregnancy. Environmental factors such as malnutrition or substance of abuse may also induce epigenetic changes in the fetal epigenome, which mark lifelong health concerns in offspring. Conclusions: The precocious detection of dysfunctional eating behaviors in the pre-pregnancy period and an early multidisciplinary approach comprised of nutritional support, psychotherapeutic techniques, and the use of psychotropics if necessary, would prevent lifelong morbidity for both mother and fetus. Further prospective studies with large sample sizes are needed in order to design a structured intervention during every stage of pregnancy and in the postpartum period.
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Affiliation(s)
- Giorgia Sebastiani
- Neonatal Unit, Hospital Clinic-Maternitat, Institut Clinic de Ginecologia, Obstetricia i Neonatologia (ICGON), Barcelona Center for Maternal Fetal and Neonatal Medicine (BCNatal), Barcelona, Spain
| | - Vicente Andreu-Fernández
- Grup de Recerca Infancia i Entorn (GRIE), Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Valencian International University (VIU), Valencia, Spain
| | - Ana Herranz Barbero
- Neonatal Unit, Hospital Clinic-Maternitat, Institut Clinic de Ginecologia, Obstetricia i Neonatologia (ICGON), Barcelona Center for Maternal Fetal and Neonatal Medicine (BCNatal), Barcelona, Spain
| | - Victoria Aldecoa-Bilbao
- Neonatal Unit, Hospital Clinic-Maternitat, Institut Clinic de Ginecologia, Obstetricia i Neonatologia (ICGON), Barcelona Center for Maternal Fetal and Neonatal Medicine (BCNatal), Barcelona, Spain
| | - Xavier Miracle
- Neonatal Unit, Hospital Clinic-Maternitat, Institut Clinic de Ginecologia, Obstetricia i Neonatologia (ICGON), Barcelona Center for Maternal Fetal and Neonatal Medicine (BCNatal), Barcelona, Spain
| | - Eva Meler Barrabes
- Fetal i+D Fetal Medicine Research Center, BCNatal-Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Arantxa Balada Ibañez
- Neonatal Unit, Hospital Clinic-Maternitat, Institut Clinic de Ginecologia, Obstetricia i Neonatologia (ICGON), Barcelona Center for Maternal Fetal and Neonatal Medicine (BCNatal), Barcelona, Spain
| | - Marta Astals-Vizcaino
- Neonatal Unit, Hospital Clinic-Maternitat, Institut Clinic de Ginecologia, Obstetricia i Neonatologia (ICGON), Barcelona Center for Maternal Fetal and Neonatal Medicine (BCNatal), Barcelona, Spain
| | - Silvia Ferrero-Martínez
- Hospital Sant Joan de Déu, Barcelona Center for Maternal Fetal and Neonatal Medicine (BCNatal), Barcelona, Spain
| | - María Dolores Gómez-Roig
- Hospital Sant Joan de Déu, Barcelona Center for Maternal Fetal and Neonatal Medicine (BCNatal), Barcelona, Spain
| | - Oscar García-Algar
- Neonatal Unit, Hospital Clinic-Maternitat, Institut Clinic de Ginecologia, Obstetricia i Neonatologia (ICGON), Barcelona Center for Maternal Fetal and Neonatal Medicine (BCNatal), Barcelona, Spain.,Grup de Recerca Infancia i Entorn (GRIE), Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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20
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Human milk as "chrononutrition": implications for child health and development. Pediatr Res 2019; 85:936-942. [PMID: 30858473 DOI: 10.1038/s41390-019-0368-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 02/25/2019] [Accepted: 03/01/2019] [Indexed: 12/12/2022]
Abstract
Human biology follows recurring daily rhythms that are governed by circadian cues in the environment. Here we show that human milk is a powerful form of "chrononutrition," formulated to communicate time-of-day information to infants. However, 85% of breastfed infants in the US consume some milk that does not come directly from the breast but is pumped and stored in advance of feeding. Expressed milk is not necessarily circadian-matched (e.g., an infant might drink breastmilk pumped in the evening on the following morning). Ingesting mistimed milk may disrupt infants' developing circadian rhythms, potentially contributing to sleep problems and decreased physiological attunement with their mothers and environments. Dysregulated circadian biology may compromise infant health and development. Despite wide-ranging public health implications, the timing of milk delivery has received little empirical study, and no major pediatric or public health organization has issued recommendations regarding the circadian-matching of milk. However, potential adverse developmental and health consequences could be ameliorated by simple, low-cost interventions to label and circadian-match stored milk. The current paper reviews evidence for human milk as chrononutrition and makes recommendations for future research, practice, and policy.
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Gridneva Z, Kugananthan S, Rea A, Lai CT, Ward LC, Murray K, Hartmann PE, Geddes DT. Human Milk Adiponectin and Leptin and Infant Body Composition over the First 12 Months of Lactation. Nutrients 2018; 10:nu10081125. [PMID: 30127292 PMCID: PMC6115716 DOI: 10.3390/nu10081125] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 08/17/2018] [Accepted: 08/17/2018] [Indexed: 12/26/2022] Open
Abstract
Human milk (HM) adipokines may influence infant feeding patterns, appetite regulation, and body composition (BC). The associations between concentrations/calculated daily intakes (CDI) of HM adipokines in the first 12 months postpartum and maternal/term infant BC, and infant breastfeeding parameters were investigated. BC of breastfeeding dyads (n = 20) was measured at 2, 5, 9, and/or 12 months postpartum with ultrasound skinfolds (infants) and bioimpedance spectroscopy (infants/mothers). 24-h milk intake and feeding frequency were measured along with whole milk adiponectin and skim and whole milk leptin (SML and WML) and CDI were calculated. Statistical analysis used linear regression/mixed effects models; results were adjusted for multiple comparisons. Adipokine concentrations did not associate with infant BC. Higher CDI of adiponectin were associated with lower infant fat-free mass (FFM; p = 0.005) and FFM index (FFMI; p = 0.009) and higher fat mass (FM; p < 0.001), FM index (FMI; p < 0.001), and %FM (p < 0.001). Higher CDI of SML were associated with higher infant FM (p < 0.001), FMI (p < 0.001), and %FM (p = 0.002). At 12 months, higher CDI of WML were associated with larger increases in infant adiposity (2–12 month: FM, p = 0.0006; %FM, p = 0.0004); higher CDI of SML were associated with a larger decrease in FFMI (5–12 months: p = 0.0004). Intakes of HM adipokines differentially influence development of infant BC in the first year of life, which is a critical window of infant programming and may potentially influence risk of later disease via modulation of BC.
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Affiliation(s)
- Zoya Gridneva
- School of Molecular Sciences, M310, The University of Western Australia, Crawley, Perth, WA 6009, Australia.
| | - Sambavi Kugananthan
- School of Molecular Sciences, M310, The University of Western Australia, Crawley, Perth, WA 6009, Australia.
- School of Human Sciences, The University of Western Australia, Crawley, Perth, WA 6009, Australia.
| | - Alethea Rea
- Centre for Applied Statistics, The University of Western Australia, Crawley, Perth, WA 6009, Australia.
| | - Ching Tat Lai
- School of Molecular Sciences, M310, The University of Western Australia, Crawley, Perth, WA 6009, Australia.
| | - Leigh C Ward
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, Brisbane, QLD 4072, Australia.
| | - Kevin Murray
- School of Population and Global Health, The University of Western Australia, Crawley, Perth, WA 6009, Australia.
| | - Peter E Hartmann
- School of Molecular Sciences, M310, The University of Western Australia, Crawley, Perth, WA 6009, Australia.
| | - Donna T Geddes
- School of Molecular Sciences, M310, The University of Western Australia, Crawley, Perth, WA 6009, Australia.
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Nunes M, da Silva CH, Bosa VL, Bernardi JR, Werlang ICR, Goldani MZ. Could a remarkable decrease in leptin and insulin levels from colostrum to mature milk contribute to early growth catch-up of SGA infants? BMC Pregnancy Childbirth 2017; 17:410. [PMID: 29212463 PMCID: PMC5719575 DOI: 10.1186/s12884-017-1593-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 11/23/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Breast milk is known to contain many bioactive hormones and peptides, which can influence infant growth and development. In this context, the purpose of this study was to evaluate the influence of different clinical pregnancy conditions on hormone concentrations in colostrum and mature breast milk. METHODS An observational study was performed with mother-newborn pairs divided into five groups according to maternal clinical background: diabetes (12), hypertension (5), smoking (19), intrauterine growth restriction of unknown causes with small-for-gestational-age newborns at delivery (12), and controls (21). Socioeconomic data, anthropometric measurements and breast milk samples were collected between the first 24 and 48 h and 30 days postpartum. Leptin, adiponectin, and insulin levels in breast milk were measured by immunoassays. RESULTS A significant decrease in leptin (p = 0.050) and insulin (p = 0.012) levels from colostrum to mature breast milk in mothers of small-for-gestational-age infants was observed. Maternal body mass index was correlated with both leptin and insulin, but not with adiponectin. Insulin levels were negatively correlated to infant weight gain from birth to one month (p = 0.050). In addition, catch-up growth was verified for small-for-gestational-age infants throughout the first month of life. CONCLUSIONS This study suggests that a remarkable decrease in leptin and insulin levels in mature milk of mothers of small-for-gestational-age newborns may be involved in the rapid weight gain of these newborns. The physiological and external mechanisms by which these significant decreases and rapid weight gains occur in this group remain to be elucidated.
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Affiliation(s)
- Marina Nunes
- Laboratório de Pediatria Translacional / Núcleo de Estudos em Saúde da Criança e do Adolescente (NESCA) - Hospital de Clínicas de Porto Alegre, Porto Alegre/RS, Brazil.,Programa de Pós-Graduação em Saúde da Criança e do Adolescente - Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre/RS, Brazil
| | - Clécio Homrich da Silva
- Laboratório de Pediatria Translacional / Núcleo de Estudos em Saúde da Criança e do Adolescente (NESCA) - Hospital de Clínicas de Porto Alegre, Porto Alegre/RS, Brazil.,Programa de Pós-Graduação em Saúde da Criança e do Adolescente - Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre/RS, Brazil.,Departamento de Pediatria - Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre/RS, Brazil
| | - Vera Lucia Bosa
- Laboratório de Pediatria Translacional / Núcleo de Estudos em Saúde da Criança e do Adolescente (NESCA) - Hospital de Clínicas de Porto Alegre, Porto Alegre/RS, Brazil.,Departamento de Pediatria - Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre/RS, Brazil
| | - Juliana Rombaldi Bernardi
- Laboratório de Pediatria Translacional / Núcleo de Estudos em Saúde da Criança e do Adolescente (NESCA) - Hospital de Clínicas de Porto Alegre, Porto Alegre/RS, Brazil.,Programa de Pós-Graduação em Saúde da Criança e do Adolescente - Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre/RS, Brazil
| | - Isabel Cristina Ribas Werlang
- Laboratório de Pediatria Translacional / Núcleo de Estudos em Saúde da Criança e do Adolescente (NESCA) - Hospital de Clínicas de Porto Alegre, Porto Alegre/RS, Brazil.,Programa de Pós-Graduação em Saúde da Criança e do Adolescente - Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre/RS, Brazil
| | - Marcelo Zubaran Goldani
- Laboratório de Pediatria Translacional / Núcleo de Estudos em Saúde da Criança e do Adolescente (NESCA) - Hospital de Clínicas de Porto Alegre, Porto Alegre/RS, Brazil. .,Programa de Pós-Graduação em Saúde da Criança e do Adolescente - Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre/RS, Brazil. .,Departamento de Pediatria - Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre/RS, Brazil.
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The relationship of human milk leptin and macronutrients with gastric emptying in term breastfed infants. Pediatr Res 2017; 82:72-78. [PMID: 28355195 DOI: 10.1038/pr.2017.79] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 03/11/2017] [Indexed: 01/08/2023]
Abstract
BackgroundInfants breastfed on demand exhibit a variety of feeding patterns and self-regulate their nutrient intake, but factors influencing their gastric emptying (GE) are poorly understood. Despite research into appetite regulation properties of leptin, there is limited information about relationships between human milk leptin and infant GE.MethodsGastric volumes were calculated from ultrasound scans of infants' stomachs (n=20) taken before and after breastfeeding, and then every 12.5 min (median; range: 3-45 min) until the next feed. Skim milk leptin and macronutrient concentrations were measured and doses were calculated.ResultsThe leptin concentration was (mean±SD) 0.51±0.16 ng/ml; the leptin dose was 45.5±20.5 ng per feed. No relationships between both concentration and dose of leptin and time between the feeds (P=0.57; P=1, respectively) or residual stomach volumes before the subsequent feed (P=0.20; P=0.050) were found. Post-feed stomach volumes (GE rate) were not associated with leptin concentration (P=0.77) or dose (P=0.85).ConclusionGE in term breastfed infants was not associated with either skim milk leptin concentration or dose. Further investigation with inclusion of whole-milk leptin and other hormones that affect gastrointestinal activity is warranted.
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Pundir S, Wall CR, Mitchell CJ, Thorstensen EB, Lai CT, Geddes DT, Cameron-Smith D. Variation of Human Milk Glucocorticoids over 24 hour Period. J Mammary Gland Biol Neoplasia 2017; 22:85-92. [PMID: 28144768 DOI: 10.1007/s10911-017-9375-x] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 01/20/2017] [Indexed: 01/09/2023] Open
Abstract
Human milk (HM) contains a complex array of hormones, including members of the glucocorticoid family. The predominant glucocorticoids, cortisol and cortisone may influence the growth and behaviour of the breastfed infant. However, little is understood of the factors regulating the levels of these hormones within HM. The aim of the study was to examine HM cortisol and cortisone concentration, measured in samples collected at each feed during a 24 hour period. Twenty three exclusively breastfeeding mothers collected milk, prior to and after each breastfeeding session over 24 hour period at 3.2(1.60) months. HM cortisol and cortisone levels were measured using high pressure liquid chromatography mass spectroscopy. Cortisone was the predominant glucocorticoid (3.40 ng/ml), and cortisol was detected in all samples (1.62 ng/ml). A positive correlation was found between cortisone and cortisol (r = 0.61, y = 1.93 ± 0.24, p < 0.0001). Cortisol and cortisone concentrations were significantly higher in feeds in the morning (2.97 ng/ml and 4.88 ng/ml), compared to afternoon (1.20 ng/ml and 3.54 ng/ml), evening (0.69 ng/ml and 2.13 ng/ml) and night (1.59 and 3.27 ng/ml). No difference was found between glucocorticoids level of the milk expressed for collection either before or immediately after the breastfeed, or between milk collected from the left or right breast. This study shows that HM glucocorticoid concentrations exhibit a 24 hour pattern, with highest peak levels in the early morning, reflecting the circadian pattern as previously reported in plasma. Thus, HM glucocorticoid concentrations are likely to reflect those in the maternal circulation.
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Affiliation(s)
- Shikha Pundir
- Liggins Institute, The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Clare R Wall
- Faculty of Medical and Health Science, The University of Auckland, Auckland, New Zealand
| | - Cameron J Mitchell
- Liggins Institute, The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Eric B Thorstensen
- Liggins Institute, The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Ching T Lai
- School of Molecular Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Donna T Geddes
- School of Molecular Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - David Cameron-Smith
- Liggins Institute, The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
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Gridneva Z, Kugananthan S, Hepworth AR, Tie WJ, Lai CT, Ward LC, Hartmann PE, Geddes DT. Effect of Human Milk Appetite Hormones, Macronutrients, and Infant Characteristics on Gastric Emptying and Breastfeeding Patterns of Term Fully Breastfed Infants. Nutrients 2016; 9:nu9010015. [PMID: 28036041 PMCID: PMC5295059 DOI: 10.3390/nu9010015] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 12/16/2016] [Accepted: 12/22/2016] [Indexed: 12/17/2022] Open
Abstract
Human milk (HM) components influence infant feeding patterns and nutrient intake, yet it is unclear how they influence gastric emptying (GE), a key component of appetite regulation. This study analyzed GE of a single breastfeed, HM appetite hormones/macronutrients and demographics/anthropometrics/body composition of term fully breastfed infants (n = 41, 2 and/or 5 mo). Stomach volumes (SV) were calculated from pre-/post-feed ultrasound scans, then repeatedly until the next feed. Feed volume (FV) was measured by the test-weigh method. HM samples were analyzed for adiponectin, leptin, fat, lactose, total carbohydrate, lysozyme, and total/whey/casein protein. Linear regression/mixed effect models were used to determine associations between GE/feed variables and HM components/infant anthropometrics/adiposity. Higher FVs were associated with faster (−0.07 [−0.10, −0.03], p < 0.001) GE rate, higher post-feed SVs (0.82 [0.53, 1.12], p < 0.001), and longer GE times (0.24 [0.03, 0.46], p = 0.033). Higher whey protein concentration was associated with higher post-feed SVs (4.99 [0.84, 9.13], p = 0.023). Longer GE time was associated with higher adiponectin concentration (2.29 [0.92, 3.66], p = 0.002) and dose (0.02 [0.01, 0.03], p = 0.005), and lower casein:whey ratio (−65.89 [−107.13, −2.66], p = 0.003). FV and HM composition influence GE and breastfeeding patterns in term breastfed infants.
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Affiliation(s)
- Zoya Gridneva
- School of Chemistry and Biochemistry, The University of Western Australia, Crawley, Perth, Western Australia 6009, Australia.
| | - Sambavi Kugananthan
- School of Chemistry and Biochemistry, The University of Western Australia, Crawley, Perth, Western Australia 6009, Australia.
- School of Anatomy, Physiology and Human Biology, The University of Western Australia, Crawley, Perth, Western Australia 6009, Australia.
| | - Anna R Hepworth
- School of Chemistry and Biochemistry, The University of Western Australia, Crawley, Perth, Western Australia 6009, Australia.
| | - Wan J Tie
- School of Chemistry and Biochemistry, The University of Western Australia, Crawley, Perth, Western Australia 6009, Australia.
| | - Ching T Lai
- School of Chemistry and Biochemistry, The University of Western Australia, Crawley, Perth, Western Australia 6009, Australia.
| | - Leigh C Ward
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, Brisbane, Queensland 4072, Australia.
| | - Peter E Hartmann
- School of Chemistry and Biochemistry, The University of Western Australia, Crawley, Perth, Western Australia 6009, Australia.
| | - Donna T Geddes
- School of Chemistry and Biochemistry, The University of Western Australia, Crawley, Perth, Western Australia 6009, Australia.
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Leptin Levels Are Higher in Whole Compared to Skim Human Milk, Supporting a Cellular Contribution. Nutrients 2016; 8:nu8110711. [PMID: 27834797 PMCID: PMC5133097 DOI: 10.3390/nu8110711] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 10/26/2016] [Accepted: 11/02/2016] [Indexed: 12/22/2022] Open
Abstract
Human milk (HM) contains a plethora of metabolic hormones, including leptin, which is thought to participate in the regulation of the appetite of the developing infant. Leptin in HM is derived from a combination of de novo mammary synthesis and transfer from the maternal serum. Moreover, leptin is partially lipophilic and is also present in HM cells. However, leptin has predominately been measured in skim HM, which contains neither fat nor cells. We optimised an enzyme-linked immunosorbent assay for leptin measurement in both whole and skim HM and compared leptin levels between both HM preparations collected from 61 lactating mothers. Whole HM leptin ranged from 0.2 to 1.47 ng/mL, whilst skim HM leptin ranged from 0.19 to 0.9 ng/mL. Whole HM contained, on average, 0.24 ± 0.01 ng/mL more leptin than skim HM (p < 0.0001, n = 287). No association was found between whole HM leptin and fat content (p = 0.17, n = 287), supporting a cellular contribution to HM leptin. No difference was found between pre- and post-feed samples (whole HM: p = 0.29, skim HM: p = 0.89). These findings highlight the importance of optimising HM leptin measurement and assaying it in whole HM to accurately examine the amount of leptin received by the infant during breastfeeding.
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Quinn EA, Childs G. Ecological pressures and milk metabolic hormones of ethnic Tibetans living at different altitudes. Ann Hum Biol 2016; 44:34-45. [DOI: 10.3109/03014460.2016.1153144] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Elizabeth A. Quinn
- Department of Anthropology, Washington University in St. Louis, St. Louis, MO, USA
| | - Geoff Childs
- Department of Anthropology, Washington University in St. Louis, St. Louis, MO, USA
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Lemas DJ, Young BE, Baker PR, Tomczik AC, Soderborg TK, Hernandez TL, de la Houssaye BA, Robertson CE, Rudolph MC, Ir D, Patinkin ZW, Krebs NF, Santorico SA, Weir T, Barbour LA, Frank DN, Friedman JE. Alterations in human milk leptin and insulin are associated with early changes in the infant intestinal microbiome. Am J Clin Nutr 2016; 103:1291-300. [PMID: 27140533 PMCID: PMC4841936 DOI: 10.3945/ajcn.115.126375] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 03/08/2016] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Increased maternal body mass index (BMI) is a robust risk factor for later pediatric obesity. Accumulating evidence suggests that human milk (HM) may attenuate the transfer of obesity from mother to offspring, potentially through its effects on early development of the infant microbiome. OBJECTIVES Our objective was to identify early differences in intestinal microbiota in a cohort of breastfeeding infants born to obese compared with normal-weight (NW) mothers. We also investigated relations between HM hormones (leptin and insulin) and both the taxonomic and functional potentials of the infant microbiome. DESIGN Clinical data and infant stool and fasting HM samples were collected from 18 NW [prepregnancy BMI (in kg/m(2)) <24.0] and 12 obese (prepregnancy BMI >30.0) mothers and their exclusively breastfed infants at 2 wk postpartum. Infant body composition at 2 wk was determined by air-displacement plethysmography. Infant gastrointestinal microbes were estimated by using 16S amplicon and whole-genome sequencing. HM insulin and leptin were determined by ELISA; short-chain fatty acids (SCFAs) were measured in stool samples by using gas chromatography. Power was set at 80%. RESULTS Infants born to obese mothers were exposed to 2-fold higher HM insulin and leptin concentrations (P < 0.01) and showed a significant reduction in the early pioneering bacteria Gammaproteobacteria (P = 0.03) and exhibited a trend for elevated total SCFA content (P < 0.06). Independent of maternal prepregnancy BMI, HM insulin was positively associated with both microbial taxonomic diversity (P = 0.03) and Gammaproteobacteria (e.g., Enterobacteriaceae; P = 0.04) and was negatively associated with Lactobacillales (e.g., Streptococcaceae; P = 0.05). Metagenomic analysis showed that HM leptin and insulin were associated with decreased bacterial proteases, which are implicated in intestinal permeability, and reduced concentrations of pyruvate kinase, a biomarker of pediatric gastrointestinal inflammation. CONCLUSION Our results indicate that, although maternal obesity may adversely affect the early infant intestinal microbiome, HM insulin and leptin are independently associated with beneficial microbial metabolic pathways predicted to increase intestinal barrier function and reduce intestinal inflammation. This trial was registered at clinicaltrials.gov as NCT01693406.
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Affiliation(s)
| | | | - Peter R Baker
- Clinical Genetics and Metabolism, Department of Pediatrics
| | | | | | - Teri L Hernandez
- Divisions of Endocrinology, Metabolism, and Diabetes and College of Nursing
| | | | | | | | - Diana Ir
- Infectious Diseases, Department of Medicine
| | | | | | - Stephanie A Santorico
- Human Medical Genetics and Genomics Program; and Department of Mathematical and Statistical Sciences, University of Colorado Denver, Denver, CO; and
| | - Tiffany Weir
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Linda A Barbour
- Divisions of Endocrinology, Metabolism, and Diabetes and Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, CO
| | | | - Jacob E Friedman
- Sections of Neonatology, Divisions of Endocrinology, Metabolism, and Diabetes and
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