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Maternal obesity and the human milk metabolome: associations with infant body composition and postnatal weight gain.

Citation
Isganaitis, E., et al. “Maternal Obesity And The Human Milk Metabolome: Associations With Infant Body Composition And Postnatal Weight Gain.”. The American Journal Of Clinical Nutrition, pp. 111-120.
Center Boston Area Joslin Diabetes Center
Multicenter
Multicenter
Author Elvira Isganaitis, Sarah Venditti, Tucker J Matthews, Carles Lerin, Ellen W Demerath, David A Fields
Keywords body composition, breast milk, human milk, human milk oligosaccharides, infant, maternal obesity, metabolomics
Abstract

BACKGROUND: Maternal obesity is a risk factor for childhood obesity; this is a major public health concern given that ∼40% of pregnant women are either overweight or obese. Whether differences in milk composition in lean compared with obese women contribute to childhood obesity is unclear.

OBJECTIVES: We aimed to analyze relationships between maternal obesity and human milk metabolites, infant body composition, and postnatal weight gain.

METHODS: This was a prospective study in which mothers intending to breastfeed exclusively, and their newborn infants, were enrolled at delivery (n = 35 mother-infant pairs). We excluded mothers with diabetes, other medical conditions, or pregnancy complications. Participants were grouped by maternal prepregnancy BMI <25 (lean) or ≥25 kg/m2 (overweight/obese). We analyzed infant body composition by dual-energy X-ray absorptiometry and used untargeted liquid chromatography-gas chromatography-mass spectrometry to measure the milk content of 275 metabolites at 1 and 6 mo postpartum.

RESULTS: At 1 mo postpartum, 10 metabolites differed between overweight/obese and lean groups with nominal P < 0.05, but none was altered with a false discovery rate <0.25. Many differentially abundant metabolites belonged to the same chemical class; e.g., 4/10 metabolites were nucleotide derivatives, and 3/10 were human milk oligosaccharides. Milk adenine correlated positively with both continuously distributed maternal BMI and with infant adiposity and fat accrual. Analysis of milk composition at 6 mo postpartum revealed 20 differentially abundant metabolites (P < 0.05) in overweight/obese compared with lean women, including 6 metabolites with a false discovery rate of <0.25. At both 1 and 6 mo, human milk abundance of 1,5-anhydroglucitol, which has not previously been described in milk, was positively associated with maternal BMI.

CONCLUSIONS: Maternal obesity is associated with changes in the human milk metabolome. While only a subset of metabolites correlated with both maternal and infant weight, these point to potential milk-dependent mechanisms for mother-child transmission of obesity. This trial was registered at www.clinicaltrials.gov as NCT02535637.

Year of Publication
2019
Journal
The American journal of clinical nutrition
Volume
110
Issue
1
Number of Pages
111-120
Date Published
12/2019
ISSN Number
1938-3207
DOI
10.1093/ajcn/nqy334
Alternate Journal
Am. J. Clin. Nutr.
PMID
30968129
PMCID
PMC6599743
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