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Moholdt T, Stanford KI. Exercised breastmilk: a kick-start to prevent childhood obesity? Trends Endocrinol Metab 2024; 35:23-30. [PMID: 37735048 PMCID: PMC11005327 DOI: 10.1016/j.tem.2023.08.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 09/23/2023]
Abstract
Exercise has systemic health benefits through effects on multiple tissues, with intertissue communication. Recent studies indicate that exercise may improve breastmilk composition and thereby reduce the intergenerational transmission of obesity. Even if breastmilk is considered optimal infant nutrition, there is evidence for variations in its composition between mothers who are normal weight, those with obesity, and those who are physically active. Nutrition early in life is important for later-life susceptibility to obesity and other metabolic diseases, and maternal exercise may provide protection against the development of metabolic disease. Here we summarize recent research on the influence of maternal obesity on breastmilk composition and discuss the potential role of exercise-induced adaptations to breastmilk as a kick-start to prevent childhood obesity.
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Affiliation(s)
- Trine Moholdt
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Department of Gynaecology and Obstetrics, St. Olav's Hospital, Trondheim, Norway.
| | - Kristin I Stanford
- Dorothy M. Davis Heart and Lung Research Institute, Department of Physiology and Cell Biology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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Juncker HG, van Doesburg M, de Groot CJ, Pajkrt D, Korosi A, van Gils MJ, van Goudoever JB, van Keulen BJ. Physical activity in lactating women influences SARS-CoV-2-specific antibodies in human milk. Heliyon 2023; 9:e19218. [PMID: 37654447 PMCID: PMC10466918 DOI: 10.1016/j.heliyon.2023.e19218] [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: 09/23/2022] [Revised: 06/27/2023] [Accepted: 08/16/2023] [Indexed: 09/02/2023] Open
Abstract
Background Moderate exercise results in a significant increase in serum and salivary immunoglobulins. Maternal physical activity might therefore also be a factor influencing antibody levels in human milk. This study aims to determine the influence of physical activity on SARS-CoV-2-specific Immunoglobulin A (IgA) in human milk and Immunoglobulin G (IgG) in serum. Methods In this prospective cross-sectional cohort study, all lactating women in the Netherlands were eligible to participate. SARS-CoV-2-specific IgA in human milk and IgG in serum were determined using an enzyme-linked immunosorbent assay (ELISA). Data on performed physical activity was collected using the Short Questionnaire to Assess Health enhancing physical activity (SQUASH), which includes intensity and duration of the performed activity. Findings In total, 356 out of 2312 lactating women tested positive for SARS-CoV-2-specific antibodies in serum. Of them, 323 filled in the questionnaire and were included in the analysis. An association between the activity score and SARS-CoV-2-specific antibodies in human milk (B = 1·035, 95·0% CI = 1·019 to 1·052, p = 0·042) and serum (B = 1·019, 95·0% CI = 1·009 to 1·029, p = 0·048) was demonstrated. No association was found between the duration of physical activity and SARS-CoV-2-specific antibodies in human milk or serum. Interpretation Our findings suggest that physical activity is beneficial for the levels of SARS-CoV-2-specific antibodies in human milk and serum, with the intensity of the physical activity being the most important contributor to this relationship. A higher level of antibodies in human milk might provide better immunological protection for infants against COVID-19.
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Affiliation(s)
- Hannah G. Juncker
- Amsterdam UMC, Vrije Universiteit, University of Amsterdam, Emma Children's Hospital, Amsterdam Reproduction & Development Research Institute, Department of Pediatrics, Amsterdam, the Netherlands
- Swammerdam Institute for Life Sciences - Center for Neuroscience, University of Amsterdam, Amsterdam, the Netherlands
| | - Maritt van Doesburg
- Amsterdam UMC, Vrije Universiteit, University of Amsterdam, Emma Children's Hospital, Amsterdam Reproduction & Development Research Institute, Department of Pediatrics, Amsterdam, the Netherlands
| | - Christianne J.M. de Groot
- Amsterdam UMC, Vrije Universiteit, Amsterdam Reproduction & Development Research Institute, Department of Obstetrics and Gynaecology, Amsterdam, the Netherlands
| | - Dasja Pajkrt
- Amsterdam UMC, Vrije Universiteit, University of Amsterdam, Emma Children's Hospital, Amsterdam Reproduction & Development Research Institute, Department of Pediatrics, Amsterdam, the Netherlands
| | - Aniko Korosi
- Swammerdam Institute for Life Sciences - Center for Neuroscience, University of Amsterdam, Amsterdam, the Netherlands
| | - Marit J. van Gils
- Amsterdam UMC, University of Amsterdam, Amsterdam Infection and Immunity Institute, Department of Medical Microbiology and Infection Prevention, Amsterdam, the Netherlands
| | - Johannes B. van Goudoever
- Amsterdam UMC, Vrije Universiteit, University of Amsterdam, Emma Children's Hospital, Amsterdam Reproduction & Development Research Institute, Department of Pediatrics, Amsterdam, the Netherlands
| | - Britt J. van Keulen
- Amsterdam UMC, Vrije Universiteit, University of Amsterdam, Emma Children's Hospital, Amsterdam Reproduction & Development Research Institute, Department of Pediatrics, Amsterdam, the Netherlands
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McRoy JA, Akers LH, Edwards ES, Walsh JR, Akers JD. The Effects of Exercise on Breastmilk Composition and Supply. CLINICAL LACTATION 2022. [DOI: 10.1891/cl.2021-0012] [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
ObjectiveThe objective of this brief literature review was to identify and summarize the research on exercise’s effects on breastmilk composition and supply and report the implications of these findings.MethodAn online database search was conducted; sixteen articles met the inclusion criteria and were included within the review.ResultsBreastfeeding mothers were observed to have higher total milk volume, IgA, and lactic acid concentrations after maximal exercising. Exercising does not seem to affect lipid or major micronutrient content in breastmilk. These changes in supply and composition do not seem to affect lactation performance or infant acceptance.ConclusionDue to the limited evidence available, further research needs to be conducted to draw stronger conclusions on how exercise affects breastmilk composition and supply. Research is also warranted to clarify exercise/physical activity guidelines for women who are breastfeeding.
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Kiełbasa A, Gadzała-Kopciuch R, Buszewski B. Cytokines-Biogenesis and Their Role in Human Breast Milk and Determination. Int J Mol Sci 2021; 22:6238. [PMID: 34207900 PMCID: PMC8229712 DOI: 10.3390/ijms22126238] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/01/2021] [Accepted: 06/04/2021] [Indexed: 12/13/2022] Open
Abstract
Cytokines play a huge role in many biological processes. Their production, release and interactions are subject to a very complex mechanism. Cytokines are produced by all types of cells, they function very differently and they are characterized by synergism in action, antagonism, and aggregation activity, opposing action of one cytokine, overlapping activity, induction of another cytokine, inhibition of cytokine synthesis at the mRNA level as well as autoregulation-stimulation or inhibition of own production. The predominance of pro-inflammatory cytokines leads to a systemic inflammatory response, and anti-inflammatory-to an anti-inflammatory response. They regulate the organism's immune response and protect it against sudden disturbances in homeostasis. The synthesis and activity of cytokines are influenced by the central nervous system through the endocrine system (pituitary gland, adrenal glands).
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Affiliation(s)
- Anna Kiełbasa
- Department of Environmental Chemistry and Bioanalysis, Faculty of Chemistry, Nicolaus Copernicus University in Toruń, ul. Gagarina 7, 87-100 Toruń, Poland; (A.K.); (B.B.)
| | - Renata Gadzała-Kopciuch
- Department of Environmental Chemistry and Bioanalysis, Faculty of Chemistry, Nicolaus Copernicus University in Toruń, ul. Gagarina 7, 87-100 Toruń, Poland; (A.K.); (B.B.)
- Interdisciplinary Centre of Modern Technologies, Group for Separation and Bioanalytical Methods (Bio-Sep) Nicolaus Copernicus University in Toruń, ul. Wileńska 4, 87-100 Toruń, Poland
| | - Bogusław Buszewski
- Department of Environmental Chemistry and Bioanalysis, Faculty of Chemistry, Nicolaus Copernicus University in Toruń, ul. Gagarina 7, 87-100 Toruń, Poland; (A.K.); (B.B.)
- Interdisciplinary Centre of Modern Technologies, Group for Separation and Bioanalytical Methods (Bio-Sep) Nicolaus Copernicus University in Toruń, ul. Wileńska 4, 87-100 Toruń, Poland
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Moirasgenti M, Doulougeri K, Panagopoulou E, Theodoridis T. Psychological stress reduces the immunological benefits of breast milk. Stress Health 2019; 35:681-685. [PMID: 31691465 DOI: 10.1002/smi.2903] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 09/10/2019] [Accepted: 09/20/2019] [Indexed: 11/08/2022]
Abstract
Our study aimed to assess the impact of maternal psychological stress on the immunological components of breast milk. Eighty-nine women participated in the study. We assessed general stress, postpartum-specific stress, negative affectivity, salivary cortisol of mother, and secretory immunoglobulin A (sIgA) levels of breast milk 4-6 weeks after delivery. Controlling for the effects of women's age, weight, number, and duration of feedings, postpartum-specific stress was related to reduced sIgA concentration (R2 = .206, beta = -.275, p = .020). This study suggests that the established link between psychological stress and immunity may also extend to the immunity of the newborn by reducing the immunological benefits of breast milk. It also suggests that breastfeeding might be a potential mechanism of the relationship between maternal stress and the health of the offspring. Findings highlight the need for interventions addressing women during the postpartum period, in order to ensure the mother's well-being and the infant's optimal development.
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Affiliation(s)
- Maria Moirasgenti
- Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Karolina Doulougeri
- Department of Education and Social Policy, University of Macedonia, Thessaloniki, Greece
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Zielinska MA, Hamulka J. Protective Effect of Breastfeeding on the Adverse Health Effects Induced by Air Pollution: Current Evidence and Possible Mechanisms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4181. [PMID: 31671856 PMCID: PMC6862650 DOI: 10.3390/ijerph16214181] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 10/22/2019] [Accepted: 10/25/2019] [Indexed: 02/08/2023]
Abstract
Air pollution is a major social, economic, and health problem around the world. Children are particularly susceptible to the negative effects of air pollution due to their immaturity and excessive growth and development. The aims of this narrative review were to: (1) summarize evidence about the protective effects of breastfeeding on the adverse health effects of air pollution exposure, (2) define and describe the potential mechanisms underlying the protective effects of breastfeeding, and (3) examine the potential effects of air pollution on breastmilk composition and lactation. A literature search was conducted using electronic databases. Existing evidence suggests that breastfeeding has a protective effect on adverse outcomes of indoor and outdoor air pollution exposure in respiratory (infections, lung function, asthma symptoms) and immune (allergic, nervous and cardiovascular) systems, as well as under-five mortality in both developing and developed countries. However, some studies reported no protective effect of breastfeeding or even negative effects of breastfeeding for under-five mortality. Several possible mechanisms of the breastfeeding protective effect were proposed, including the beneficial influence of breastfeeding on immune, respiratory, and nervous systems, which are related to the immunomodulatory, anti-inflammatory, anti-oxidant, and neuroprotective properties of breastmilk. Breastmilk components responsible for its protective effect against air pollutants exposure may be long chain polyunsaturated fatty acids (LC PUFA), antioxidant vitamins, carotenoids, flavonoids, immunoglobins, and cytokines, some of which have concentrations that are diet-dependent. However, maternal exposure to air pollution is related to increased breastmilk concentrations of pollutants (e.g., Polycyclic aromatic hydrocarbons (PAHs) or heavy metals in particulate matter (PM)). Nonetheless, environmental studies have confirmed that breastmilk's protective effects outweigh its potential health risk to the infant. Mothers should be encouraged and supported to breastfeed their infants due to its unique health benefits, as well as its limited ecological footprint, which is associated with decreased waste production and the emission of pollutants.
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Affiliation(s)
- Monika A Zielinska
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences-SGGW, 159C Nowoursynowska Street, 02-776 Warsaw, Poland.
| | - Jadwiga Hamulka
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences-SGGW, 159C Nowoursynowska Street, 02-776 Warsaw, Poland.
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Vass RA, Kemeny A, Dergez T, Ertl T, Reglodi D, Jungling A, Tamas A. Distribution of bioactive factors in human milk samples. Int Breastfeed J 2019; 14:9. [PMID: 30792750 PMCID: PMC6371541 DOI: 10.1186/s13006-019-0203-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 01/29/2019] [Indexed: 01/01/2023] Open
Abstract
Background Breast milk provides nutrition for infants and also contains a variety of bioactive factors that influence the development of the newborn. Human milk is a complex biological fluid that can be separated into different layers (water phase and lipid phase with its component water and lipid fractions). It can affect the developing human body along the whole length of the gastrointestinal tract, and through the circulation, its factors may reach every organ. Methods In the present study, we analyzed milk samples collected monthly for 6 months from 16 mothers from the 4th week postpartum between 2014 and 2016 in Baranya County, Hungary. The 96 samples provided us information about the fluctuation of certain bioactive factors during the first 6 months of lactation. We investigated with Luminex technology the concentrations of several cytokines (CD40, Flt-3L), chemokines (MCP-1, RANTES, GRO, MIP-1ß, MDC, eotaxin, fractalkine), and epidermal growth factor (EGF). Paired t-tests and one-way ANOVA followed by Bonferroni post-hoc tests were used to compare the data. Results We detected the presence of each bioactive factor in every layer of the milk samples during the first 6 months of breastfeeding in widespread concentration ranges. In the case of GRO, MIP-1ß, MDC, Flt-3L, fractalkine, and eotaxin, the concentrations were constant during the first 6 months of lactation. The water phase of human milk contained higher factor concentrations compared to both fractions of the lipid phase for most factors (except eotaxin and MIP-1ß). The concentrations of CD40, EGF, MCP-1, and RANTES in the first 3 months were significantly different compared to the values detected between 4th and 6th months. In the water phase, the level of MCP-1 was significantly decreased, while all of the other factors increased during the 4th through 6th months. We found significantly higher EGF, GRO, and RANTES levels in the water fraction compared to the lipid fraction of the lipid phase. Conclusions The novel findings of this investigation were the presence of Flt-3L and MDC in all layers of breast milk, and nearly all bioactive factors in the lipid phase. Due to their widespread physiological effects these factors may have an essential role in organogenesis.
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Affiliation(s)
- Reka A Vass
- 1Department of Anatomy, MTA-PTE PACAP Research Group, Centre for Neuroscience, Medical School, University of Pécs, Pécs, Hungary
| | - Agnes Kemeny
- 2Department of Pharmacology and Pharmacotherapy; Medical School, University of Pécs, Pécs, Hungary.,3Department of Medical Biology and Central Electron Microscope Laboratory, Medical School, University of Pécs, Pécs, Hungary
| | - Timea Dergez
- 4Institute of Bioanalysis, Medical School, University of Pécs, Pécs, Hungary
| | - Tibor Ertl
- 5Department of Obstetrics and Gynaecology, Medical School, University of Pécs, Pécs, Hungary
| | - Dora Reglodi
- 1Department of Anatomy, MTA-PTE PACAP Research Group, Centre for Neuroscience, Medical School, University of Pécs, Pécs, Hungary
| | - Adel Jungling
- 1Department of Anatomy, MTA-PTE PACAP Research Group, Centre for Neuroscience, Medical School, University of Pécs, Pécs, Hungary
| | - Andrea Tamas
- 1Department of Anatomy, MTA-PTE PACAP Research Group, Centre for Neuroscience, Medical School, University of Pécs, Pécs, Hungary
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Dawod B, Marshall JS. Cytokines and Soluble Receptors in Breast Milk as Enhancers of Oral Tolerance Development. Front Immunol 2019; 10:16. [PMID: 30723472 PMCID: PMC6349727 DOI: 10.3389/fimmu.2019.00016] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 01/04/2019] [Indexed: 12/13/2022] Open
Abstract
The postpartum period is an important window during which environmental factors can shape the life-long health of the infant. This time period often coincides with substantial milk consumption either in the form of breast milk or from cow's milk sources, such as infant formulas. Although breast milk is the most beneficial source of nutrients for infants during the first 6 months after birth, its role in regulating food allergy development, through regulation of oral tolerance, is still controversial. Breast milk contains several factors that can impact mucosal immune function, including immune cells, antibodies, microbiota, oligosaccharides, cytokines, and soluble receptors. However, there is considerable variation in the assessed levels of cytokines and soluble receptors between studies and across the lactation period. Most of these cytokines and soluble receptors are absent, or only found in limited quantities, in commercial baby formulas. Differences in content of these pluripotent factors, which impact on both the mother and the neonate, could contribute to the controversy surrounding the role of breast milk regulating oral tolerance. This review highlights current knowledge about the importance of cytokines and soluble receptors in breast milk on the development of oral tolerance and tolerance-relateddisorders. Understanding the mechanisms by which such milk components might promote oral tolerance could aid in the development of improved strategies for allergy prevention.
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Affiliation(s)
- Bassel Dawod
- Department of Pathology, Dalhousie University, Halifax, NS, Canada
| | - Jean S Marshall
- Department of Pathology, Dalhousie University, Halifax, NS, Canada.,Department of Microbiology and Immunology, Dalhousie University, Halifax, NS, Canada
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Aparicio VA, Ocón O, Diaz-Castro J, Acosta-Manzano P, Coll-Risco I, Borges-Cósic M, Romero-Gallardo L, Moreno-Fernández J, Ochoa-Herrera JJ. Influence of a Concurrent Exercise Training Program During Pregnancy on Colostrum and Mature Human Milk Inflammatory Markers: Findings From the GESTAFIT Project. J Hum Lact 2018; 34:789-798. [PMID: 29601268 DOI: 10.1177/0890334418759261] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Although exercise reduces systemic inflammation, information regarding its influence on human milk is scarce or inexistent. Research Aim: The aim of this study was to investigate the influence of an exercise intervention during pregnancy on colostrum and mature human milk inflammatory markers. METHODS The authors conducted a pseudorandomized controlled trial. The exercise group followed a concurrent aerobic and strength training, three 60-minutes sessions per week, from the 17th gestational week until delivery. For the specific aims of this study, only women able to produce enough milk were included for data analyses, resulting in 24 exercise and 23 control women. Colostrum and mature human milk proinflammatory and anti-inflammatory cytokines (fractalkine, interleukin [IL]-1β, IL-6, IL-8, IL-10, interferon [IFN]-γ, and tumor necrosis factor [TNF]-α) were measured using Luminex xMAP technology. RESULTS The mothers who followed the exercise program had 36% lower IL-8 and 27% lower TNF-α concentrations in their colostrum than those in the control group ( p < .05 and p < .01, respectively). The colostrum from mothers who followed the exercise program also presented borderline significant 22% lower IL-6 ( p < .100). The mature milk from mothers who followed the exercise program had 30% greater fractalkine ( p = .05) and borderline significant 20% higher IL-10 ( p = .100). The exercise intervention did not affect IFN-γ concentrations. CONCLUSIONS This concurrent exercise program promoted a less proinflammatory profile in human milk, especially in colostrum. Moreover, it might increase mature human milk fractalkine, which could induce a greater neurodevelopment and neuroprotection in the newborn. This trial was registered at ClinicalTrials.gov (NCT02582567) on October 20, 2015.
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Affiliation(s)
- Virginia A Aparicio
- 1 Department of Physiology, Faculty of Pharmacy, Institute of Nutrition and Food Technology, University of Granada, Granada, Spain
| | - Olga Ocón
- 2 Department and UGC of Gynaecology and Obstetrics, Virgen de las Nieves University Hospital, Granada, Spain
| | - Javier Diaz-Castro
- 1 Department of Physiology, Faculty of Pharmacy, Institute of Nutrition and Food Technology, University of Granada, Granada, Spain
| | - Pedro Acosta-Manzano
- 3 Department of Physical Education and Sport, University of Granada, Granada, Spain
| | - Irene Coll-Risco
- 1 Department of Physiology, Faculty of Pharmacy, Institute of Nutrition and Food Technology, University of Granada, Granada, Spain
| | - Milkana Borges-Cósic
- 3 Department of Physical Education and Sport, University of Granada, Granada, Spain
| | | | - Jorge Moreno-Fernández
- 1 Department of Physiology, Faculty of Pharmacy, Institute of Nutrition and Food Technology, University of Granada, Granada, Spain
| | - Julio J Ochoa-Herrera
- 1 Department of Physiology, Faculty of Pharmacy, Institute of Nutrition and Food Technology, University of Granada, Granada, Spain
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Young BE, Levek C, Reynolds RM, Rudolph MC, MacLean P, Hernandez TL, Friedman JE, Krebs NF. Bioactive components in human milk are differentially associated with rates of lean and fat mass deposition in infants of mothers with normal vs. elevated BMI. Pediatr Obes 2018; 13:598-606. [PMID: 30092608 PMCID: PMC6390491 DOI: 10.1111/ijpo.12394] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 03/20/2018] [Accepted: 04/06/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To model breastfed infant growth and body composition patterns over the first 4 months with multiple bioactive components of human milk (HM) and clinical factors (including maternal BMI status), which are related to growth. METHODS Longitudinal observation of infant growth and body composition from 0 to 4 months among 41 predominantly breastfed infants (25 mothers of Normal-weight and 16 mothers with overweight/obesity). Fasted morning HM samples were collected at 5 time-points. Macronutrients, leptin, adiponectin, ghrelin, insulin, cytokines and n-6:n-3 esterified fatty acid ratio were measured. Infant weight-for-length Z-score (WLZ) trajectory, fat-free mass (FFM) gain, fat mass gain and %fat gain were modelled controlling for clinical covariates. RESULTS HM insulin negatively associated with WLZ trajectory among infants of NW mothers (P = 0.028), but not associated with WLZ trajectory among infants of OW/Ob mothers. HM glucose (P < 0.001) was associated with slower rates of infant FFM gain. Infants of mothers with OW/Ob exhibited slower rates of FFM gain. HM protein, adiponectin and insulin concentrations, and n-6:n-3 ratio were all significant predictors in the model of infant fat mass gain (P < 0.03). Any amount of formula supplementation was associated with faster fat gain (P = 0.002). The model of %fat gain was similar to that of fat mass gain, excepting HM adiponectin was not a significant covariate, and a trend for maternal OW/Ob to correlate with faster %fat gain (P = 0.056). CONCLUSIONS Bioactive components in HM may contribute to regulation of partitioning of body composition, and these contributions may differ between mothers of normal-weight vs. with OW/Ob.
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Affiliation(s)
- B. E. Young
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - C. Levek
- Department of Pediatrics and Colorado Children’s Hospital Research Institute Biostatistics Core, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - R. M. Reynolds
- Department of Pediatrics, Section of Neonatology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - M. C. Rudolph
- Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - P. MacLean
- Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - T. L. Hernandez
- Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA,College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - J. E. Friedman
- Department of Pediatrics, Section of Neonatology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA,Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - N. F. Krebs
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Rajani PS, Seppo AE, Järvinen KM. Immunologically Active Components in Human Milk and Development of Atopic Disease, With Emphasis on Food Allergy, in the Pediatric Population. Front Pediatr 2018; 6:218. [PMID: 30131949 PMCID: PMC6090044 DOI: 10.3389/fped.2018.00218] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 07/16/2018] [Indexed: 12/17/2022] Open
Abstract
Breast-feeding is currently recommended to prevent the development of allergic diseases; however, data are conflicting and mechanisms are unclear. The immunomodulatory composition of human milk is poorly characterized and varies between mothers. We and others have shown that high levels of human milk IgA and certain cytokines and human milk oligosaccharides are associated with protection against food allergy in the infant, but it is unclear whether they are responsible for or simply biomarkers of the vertical transfer of protection. Because human milk has pre- and probiotic properties, the anti-allergy protection afforded by human milk may be due to its control on the developing gut microbiome. In mice, murine milk IgA supports gut homeostasis and shapes the microbiota, which in turn diversifies the intestinal IgA repertoire that reciprocally promotes the diversity of gut microbiome; these mechanisms are poorly understood in humans. In addition, several human milk bioactives are immunostimulatory, which may in part provide protection against allergic diseases. The regulation of immunologically active components in human milk is incompletely understood, although accumulating evidence suggests that IgA and cytokines in human milk reflect maternal exposures. This review summarizes the current literature on human milk components that have been associated with protection against food allergy and related allergic disorders in early childhood and discusses the work relating to regulation of these levels in human milk and possible mechanisms of action.
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Affiliation(s)
| | | | - Kirsi M. Järvinen
- Division of Pediatric Allergy and Immunology and Center for Food Allergy, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
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Young BE, Patinkin ZW, Pyle L, de la Houssaye B, Davidson BS, Geraghty S, Morrow AL, Krebs N. Markers of Oxidative Stress in Human Milk do not Differ by Maternal BMI But are Related to Infant Growth Trajectories. Matern Child Health J 2018; 21:1367-1376. [PMID: 28138825 DOI: 10.1007/s10995-016-2243-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Objective Obesity in adults is associated with inflammation and oxidative stress. Whether or not this phenotype is reflected in human milk (HM) composition, or may impact infant growth remains unknown. We investigated whether HM from overweight/obese (OW/Ob) mothers exhibited higher concentrations of inflammatory cytokines and markers of oxidative stress. We also correlated these bioactive components with infant growth patterns. Methods This was an observational cohort of 56 breastfeeding mothers and their infants [33 normal weight (NW) and 23 OW/Ob]. Infants were followed until 6 months of age and HM collected at 2-weeks and 4-months. Results Markers of oxidative stress, 8-hydroxy-deoxyguanosine (8OHdG) and 4-hydroxynonenol (HNE), decreased in HM over time (p < 0.001) and did not differ between NW and OW/Ob women. Concentrations of inflammatory cytokines, IL-6, IL-8, and TNF-α, were all inter-correlated (p < 0.001) but did not differ between NW and OW/Ob women. HM fat, protein, lactose, and total calories did not differ between NW and OW/Ob women. Infant growth patterns did not differ by group. In a model of infant weight-for-length-Z score trajectory, there was a significant interaction between both lactose and 8OHdG with maternal group: HM lactose and 8OHdG concentrations were both positively associated with increases in WLZ trajectory only among infants breastfed by OW/Ob mothers. Conclusions for Practice HM composition was relatively stable between NW and OW/Ob women. In exclusively breastfed infants, HM concentrations of lactose and 8OHdG, a marker of oxidative stress, may contribute to regulation of infant weight gain, especially among infants of OW/Ob women.
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Affiliation(s)
- Bridget E Young
- Department of Pediatrics Section of Nutrition, University of Colorado School of Medicine, 12700 E 19th Ave, Aurora, CO, 80045, USA.
| | - Zachary W Patinkin
- Department of Pediatrics Section of Nutrition, University of Colorado School of Medicine, 12700 E 19th Ave, Aurora, CO, 80045, USA
| | - Laura Pyle
- Department of Pediatrics Section of Nutrition, University of Colorado School of Medicine, 12700 E 19th Ave, Aurora, CO, 80045, USA.,Department of Biostatistics and Informatics, University of Colorado School of Public Health, 12477 E 19Th Avenue, Box A036, Aurora, CO, 80045, USA
| | - Becky de la Houssaye
- Department of Pediatrics Section of Neonatology, University of Colorado School of Medicine, 12801 East 17th Ave, Box 8106, Aurora, CO, 80045, USA
| | - Barbara S Davidson
- Department of Pediatrics, Center for Interdisciplinary Research in Human Milk and Lactation, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA
| | - Sheela Geraghty
- Center for Breastfeeding Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA
| | - Ardythe L Morrow
- Department of Pediatrics, Center for Interdisciplinary Research in Human Milk and Lactation, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA
| | - Nancy Krebs
- Department of Pediatrics Section of Nutrition, University of Colorado School of Medicine, 12700 E 19th Ave, Aurora, CO, 80045, USA
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13
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Bø K, Artal R, Barakat R, Brown WJ, Davies GAL, Dooley M, Evenson KR, Haakstad LAH, Kayser B, Kinnunen TI, Larsén K, Mottola MF, Nygaard I, van Poppel M, Stuge B, Khan KM. Exercise and pregnancy in recreational and elite athletes: 2016/17 evidence summary from the IOC Expert Group Meeting, Lausanne. Part 3-exercise in the postpartum period. Br J Sports Med 2017. [PMID: 28642221 DOI: 10.1136/bjsports-2017-097964] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Kari Bø
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Raul Artal
- Department of Obstetrics, Gynecology and Women's Health, Saint Louis University, St Louis, Missouri, USA
| | - Ruben Barakat
- Facultad de Ciencias de la Actividad Física y del Deporte - INEF, Universidad Politécnica de Madrid, Madrid, Spain
| | - Wendy J Brown
- Centre for Research on Exercise Physical Activity and Health, School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Australia
| | - Gregory A L Davies
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Queen's University, Kingston, Canada
| | - Michael Dooley
- Department of Sport Gynaecology, Poundbury Clinic, Dorchester, UK.,Poundbury Clinic, King Edward VII Hospital, London, UK
| | - Kelly R Evenson
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Lene A H Haakstad
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Bengt Kayser
- Faculty of Biology and Medicine, Institute of Sport Science, University of Lausanne, Lausanne, Switzerland
| | - Tarja I Kinnunen
- School of Health Sciences, University of Tampere, Tampere, Finland
| | - Karin Larsén
- The Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Michelle F Mottola
- R Samuel McLaughlin Foundation-Exercise and Pregnancy Lab, The University of Western Ontario, London, Canada
| | - Ingrid Nygaard
- Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah, USA
| | | | - Britt Stuge
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
| | - Karim M Khan
- Department of Family Practice and School of Kinesiology, Centre for Hip Health and Mobility, University of British Columbia, Vancouver, Canada
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14
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Young BE, Patinkin Z, Palmer C, de la Houssaye B, Barbour LA, Hernandez T, Friedman JE, Krebs NF. Human milk insulin is related to maternal plasma insulin and BMI: but other components of human milk do not differ by BMI. Eur J Clin Nutr 2017; 71:1094-1100. [PMID: 28513622 PMCID: PMC5587359 DOI: 10.1038/ejcn.2017.75] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 02/28/2017] [Accepted: 03/07/2017] [Indexed: 01/10/2023]
Abstract
Background The impact of maternal BMI and insulin sensitivity on bioactive components of human milk (HM) is not well understood. As the prevalence of obesity and diabetes rises, it is increasingly critical that we understand how maternal BMI and hormones associated with metabolic disease relate to concentrations of bioactive components in HM. Methods This longitudinal cohort design followed 48 breastfeeding mothers through the first four months of lactation, collecting fasting morning HM samples at 2-weeks and 1, 2, 3, and 4-months, and fasting maternal blood at 2-weeks and 4-months. Insulin, glucose, adipokines leptin and adiponectin, appetite regulating hormone ghrelin, marker of oxidative stress 8OHdG, and inflammatory cytokines (IL-6, IL-8, and TNF-a) were measured in HM and maternal plasma. Results 26 normal weight (NW) (BMI=21.4±2.0 kg/m2), and 22 overweight/obese (OW/Ob) (BMI=30.4±4.2 kg/m2) were followed. Of all HM analytes measured, only insulin and leptin were different between groups - consistently higher in the OW/Ob group (leptin: p<0.001; insulin: p<0.03). HM insulin was 98% higher than maternal plasma insulin at 2-weeks and 32% higher at 4-months (p<0.001). Maternal fasting plasma insulin and HOMA-IR were positively related to HM insulin at 2-weeks (p<0.001, R2≥0.38, n=31), and 4-months (p≤0.005, R2≥0.20, n=38). Conclusions The concentrations of insulin in HM are higher than in maternal plasma and are related to maternal BMI and insulin sensitivity. With the exception of leptin, there were minimal other differences observed in HM composition across a wide range in maternal BMI.
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Affiliation(s)
- B E Young
- Department of Pediatrics, Section of Nutrition, School of Medicine, University of Colorado, Aurora, CO, USA
| | - Z Patinkin
- Department of Pediatrics, Section of Nutrition, School of Medicine, University of Colorado, Aurora, CO, USA
| | - C Palmer
- Department of Pediatrics, Section of Nutrition, School of Medicine, University of Colorado, Aurora, CO, USA
| | - B de la Houssaye
- Department of Pediatrics, Section of Neonatology, School of Medicine, University of Colorado, Aurora, CO, USA
| | - L A Barbour
- Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, School of Medicine, University of Colorado, Aurora, CO, USA.,Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, School of Medicine, University of Colorado, Aurora, CO, USA
| | - T Hernandez
- Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, School of Medicine, University of Colorado, Aurora, CO, USA.,Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, School of Medicine, University of Colorado, Aurora, CO, USA.,College of Nursing, University of Colorado, Aurora, CO, USA
| | - J E Friedman
- Department of Pediatrics, Section of Neonatology, School of Medicine, University of Colorado, Aurora, CO, USA.,Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, School of Medicine, University of Colorado, Aurora, CO, USA
| | - N F Krebs
- Department of Pediatrics, Section of Nutrition, School of Medicine, University of Colorado, Aurora, CO, USA
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15
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Wang HL, Visovsky C, Ji M, Groer M. Stress-related biobehavioral responses, symptoms, and physical activity among female veterans in the community: An exploratory study. NURSE EDUCATION TODAY 2016; 47:2-9. [PMID: 27372810 DOI: 10.1016/j.nedt.2016.06.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 05/29/2016] [Accepted: 06/05/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Female veterans experience multiple stresses during their lifetime. Some of them seek care in the civilian community. Common physical and psychological symptoms among female veterans include pain, fatigue, sleep quality, and depression. Physical activity has the potential to improve their well-being. OBJECTIVES This study was guided by the concept of allostasis. The purpose of the study was to determine the associations among stress-related biobehavioral responses and symptoms as well as to determine if physical activity moderated these associations among female veterans. DESIGN/SETTINGS/PARTICIPANTS/METHODS A cross-sectional and exploratory design was implemented among 82 female veterans (46±10.57years old) at a community event. Self-reported questionnaires and blood and hair samples were collected. Descriptive statistics and multivariate analyses were applied in this secondary data analysis. FINDINGS Female veterans experienced moderate perceived stress and greater body mass index, C-reactive protein, and hair cortisol levels at the same time as they reported moderate levels of pain and fatigue, poor sleep quality, and considerable depressive symptoms. The findings showed that greater body mass index was significantly associated with more severe pain and poor sleep quality. Physical activity negatively moderated the relationship between perceived stress and pain. CONCLUSION Female veterans need services to manage body weight and help them engage in physical activity. Nurse educators are responsible for instructing nurses to properly identify female veterans in the civilian community facility and to provide care in a respectful manner.
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Affiliation(s)
- Hsiao-Lan Wang
- University of South Florida College of Nursing, 12901 Bruce B. Downs Blvd., MDC22, Tampa, FL 33612, United States.
| | - Constance Visovsky
- University of South Florida College of Nursing, 12901 Bruce B. Downs Blvd., MDC22, Tampa, FL 33612, United States
| | - Ming Ji
- University of South Florida College of Nursing, 12901 Bruce B. Downs Blvd., MDC22, Tampa, FL 33612, United States
| | - Maureen Groer
- University of South Florida College of Nursing, 12901 Bruce B. Downs Blvd., MDC22, Tampa, FL 33612, United States
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16
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Munblit D, Treneva M, Peroni DG, Colicino S, Chow L, Dissanayeke S, Abrol P, Sheth S, Pampura A, Boner AL, Geddes DT, Boyle RJ, Warner JO. Colostrum and Mature Human Milk of Women from London, Moscow, and Verona: Determinants of Immune Composition. Nutrients 2016; 8:nu8110695. [PMID: 27827874 PMCID: PMC5133082 DOI: 10.3390/nu8110695] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 10/21/2016] [Accepted: 10/28/2016] [Indexed: 11/23/2022] Open
Abstract
Cytokines and growth factors in colostrum and mature milk may play an important role in infant immune maturation, and may vary significantly between populations. We aimed to examine associations between environmental and maternal factors, and human milk (HM) cytokine and growth factor levels. We recruited 398 pregnant/lactating women in the United Kingdom, Russia, and Italy. Participants underwent skin prick testing, questionnaire interview, and colostrum and mature milk sampling. HM cytokine and growth factor levels were quantified by electro-chemiluminescence. We found significant geographical variation in growth factor levels, but no evidence of variation between sites in cytokine detectability. There was an inverse correlation between time of milk sampling and growth factor levels in colostrum for Hepatocyte Growth Factor (HGF) and TGFβ1 and TGFβ3, but not TGFβ2, and levels were significantly higher in colostrum than mature milk for all growth factors. The kinetics of decline were different for each growth factor. Cytokines were present at much lower levels than growth factors, and the decline over time was less consistent. HM growth factors and cytokine levels vary between populations for unknown reasons. Levels of HM mediators decline at different rates postpartum, and these findings suggest specific biological roles for HM growth factors and cytokines in early postnatal development.
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Affiliation(s)
- Daniel Munblit
- Department of Paediatrics, Imperial College London, London W2 1NY, UK.
- International Inflammation (in-FLAME) Network of the World Universities Network, Sydney 2006, NSW, Australia.
- Faculty of Pediatrics, I. M. Sechenov First Moscow State Medical University, Moscow 119991, Russia.
| | - Marina Treneva
- International Inflammation (in-FLAME) Network of the World Universities Network, Sydney 2006, NSW, Australia.
- Allergy Department, Veltischev Clinical Pediatric Research Institute of Pirogov Russian National Research Medical University, Moscow 125412, Russia.
| | - Diego G Peroni
- International Inflammation (in-FLAME) Network of the World Universities Network, Sydney 2006, NSW, Australia.
- Department of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, 56126 Pisa, Italy.
| | - Silvia Colicino
- National Heart and Lung Institute, Imperial College London, London SW3 6NP, UK.
| | - LiYan Chow
- Department of Paediatrics, Imperial College London, London W2 1NY, UK.
| | - Shobana Dissanayeke
- Royal Holloway University of London School of Biological Sciences, Biomedical Sciences, London TW20 0EX, UK.
| | - Priya Abrol
- Department of Paediatrics, Imperial College London, London W2 1NY, UK.
| | - Shreya Sheth
- Department of Paediatrics, Imperial College London, London W2 1NY, UK.
| | - Alexander Pampura
- International Inflammation (in-FLAME) Network of the World Universities Network, Sydney 2006, NSW, Australia.
- Allergy Department, Veltischev Clinical Pediatric Research Institute of Pirogov Russian National Research Medical University, Moscow 125412, Russia.
| | - Attilio L Boner
- Department of Life and Reproduction Sciences, Section of Paediatrics, University of Verona, 37124 Verona, Italy.
| | - Donna T Geddes
- International Inflammation (in-FLAME) Network of the World Universities Network, Sydney 2006, NSW, Australia.
- School of Chemistry and Biochemistry, The University of Western Australia, Perth 6009, WA, Australia.
| | - Robert J Boyle
- Department of Paediatrics, Imperial College London, London W2 1NY, UK.
- International Inflammation (in-FLAME) Network of the World Universities Network, Sydney 2006, NSW, Australia.
| | - John O Warner
- Department of Paediatrics, Imperial College London, London W2 1NY, UK.
- International Inflammation (in-FLAME) Network of the World Universities Network, Sydney 2006, NSW, Australia.
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17
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Thibeau S, D'Apolito K, Minnick AF, Dietrich MS, Kane B, Cooley S, Groer M. Relationships of Maternal Stress with Milk Immune Components in African American Mothers of Healthy Term Infants. Breastfeed Med 2016; 11:6-14. [PMID: 26701800 PMCID: PMC4742984 DOI: 10.1089/bfm.2015.0117] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND In the United States, African American infants experience the highest mortality, and their mothers report the lowest breastfeeding rates. Science reports decreased infant mortality among breastfed infants and suggests that milk immune component (MIC) levels are associated with maternal stressors. Little is known about these relationships among African Americans; therefore the aim was to explore the relationships of African American mothers' stressors and MICs 1-14 days postdelivery. MATERIALS AND METHODS Mothers meeting eligibility requirements were approached for consent 48-72 hours postdelivery of a healthy term infant and given instructions to collect milk (Days 3, 9, and 14) and saliva (Day 9), as well as complete three Perceived Stress Scale questionnaires (Days 3, 9, and 14) and a survey of pregnancy stressors experiences. Pearson correlations and linear regressions were performed to assess the relationships of maternal stressors with MICs. RESULTS There was at least one statistically significant correlation of a maternal stressor with nine of the 10 MICs (effect sizes ranging from r = 0.22 to 0.38) on Days 3 and 9. Of all MICs, epidermal growth factor had the most associations with maternal stress indicators. No mediational relationship of cortisol with MICs was observed. CONCLUSIONS Many of the MIC changes observed could potentially impact the health of term and preterm infants. Further research is warranted.
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Affiliation(s)
- Shelley Thibeau
- 1 Center for Nursing Research , Ochsner Health System, New Orleans, Louisiana
| | - Karen D'Apolito
- 2 Vanderbilt University School of Nursing , Nashville, Tennessee
| | - Ann F Minnick
- 2 Vanderbilt University School of Nursing , Nashville, Tennessee
| | - Mary S Dietrich
- 2 Vanderbilt University School of Nursing , Nashville, Tennessee.,3 Department of Biostatistics, Vanderbilt University School of Medicine , Nashville, Tennessee
| | - Bradley Kane
- 4 Bio-behavioral Lab, University of South Florida College of Nursing , Tampa, Florida
| | - Shaun Cooley
- 4 Bio-behavioral Lab, University of South Florida College of Nursing , Tampa, Florida
| | - Maureen Groer
- 4 Bio-behavioral Lab, University of South Florida College of Nursing , Tampa, Florida
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18
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Munblit D, Boyle RJ, Warner JO. Factors affecting breast milk composition and potential consequences for development of the allergic phenotype. Clin Exp Allergy 2015; 45:583-601. [PMID: 25077553 DOI: 10.1111/cea.12381] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
There is conflicting evidence on the protective role of breastfeeding in relation to allergic sensitization and disease. The factors in breast milk which influence these processes are still unclear and under investigation. We know that colostrum and breast milk contain a variety of molecules which can influence immune responses in the gut-associated lymphoid tissue of a neonate. This review summarizes the evidence that variations in colostrum and breast milk composition can influence allergic outcomes in the infant, and the evidence that maternal and environmental factors can modify milk composition. Taken together, the data presented support the possibility that maternal dietary interventions may be an effective way to promote infant health through modification of breast milk composition.
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Affiliation(s)
- D Munblit
- Department of Paediatrics, Imperial College London, London, UK; International Inflammation (in-FLAME) Network, of the World Universities Network (WUN)
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19
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Abstract
Immunoglobulin A (IgA) is a predominant immunoglobulin present in human breast milk and is known to play an important role in infant gut immunity maturation. Breast milk composition varies between populations, but the environmental and maternal factors responsible for these variations are still unclear. We examined the relationship between different exposures and levels of IgA in colostrum. The objective of this study was to examine whether exposures analysed influence levels of IgA in colostrum. The present study used 294 colostrum samples from the MecMilk International cohort, collected from women residing in London, Moscow and Verona. Samples were analysed in automated Abbott Architect Analyser. We found an inverse correlation between time postpartum and colostrum total IgA level (r=-0.49, P<0.001). Adjusting for maternal parity, smoking, fresh fruit and fish consumption and allergen sensitization, multiple regression model showed that IgA levels were influenced by colostrum collection time (P<0.0001) and country of collection (P<0.01). Mode of delivery influence did not appear to be significant in univariate comparisons, once adjusted for the above maternal characteristics it showed a significant influence on total IgA (P=0.01). We conclude that the concentration of IgA in colostrum drops rapidly after birth and future studies should always consider this factor in analysis. IgA concentration varied significantly between countries, with the highest level detected in Moscow and lowest in Verona. Mode of delivery effect should be confirmed on larger cohorts. Further work is needed to determine ways to correct for IgA decline over time in colostrum, and to find the cause of variations in IgA levels between the countries.
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20
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Kawano A, Emori Y. The relationship between maternal postpartum psychological state and breast milk secretory immunoglobulin A level. J Am Psychiatr Nurses Assoc 2015; 21:23-30. [PMID: 25589451 DOI: 10.1177/1078390314566882] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Maternal psychological state may influence the passive transfer of immune factors (e.g., immunoglobulin) via the mother's breast milk. OBJECTIVE The aim of this study was to determine whether a correlation exists between mothers' postpartum psychological state and their breast milk secretory immunoglobulin A (SIgA) levels. STUDY DESIGN Eighty-one mothers who delivered at an urban general hospital were included in our analysis. Two weeks after delivery, we measured their breast milk SIgA levels and simultaneously documented their psychological state using the Profile of Mood States (POMS), General Health Questionnaire (GHQ), and State-Trait Anxiety Inventory (STAI) scales. RESULTS Breast milk SIgA levels were negatively correlated with negative POMS states (tension-anxiety, depression-dejection, anger-hostility, fatigue, and confusion). A negative correlation was also observed between SIgA levels and GHQ mental health (r = -.625, P = .000), and a similar negative correlation was observed with STAI trait and state anxieties. However, no correlation existed between breast milk SIgA levels and the positive POMS state (vigor). CONCLUSIONS These results indicate that the maternal psychological state may affect the immune properties of breast milk.
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Affiliation(s)
- Atsuko Kawano
- Atsuko Kawano, RN, NMW, PhD, Yoko Emori, RN, NMW, PhD, University of Tsukuba, Ibaraki, Japan
| | - Yoko Emori
- Atsuko Kawano, RN, NMW, PhD, Yoko Emori, RN, NMW, PhD, University of Tsukuba, Ibaraki, Japan
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21
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Baumgartel KL, Conley YP. The utility of breastmilk for genetic or genomic studies: a systematic review. Breastfeed Med 2013; 8:249-56. [PMID: 23259645 PMCID: PMC3663450 DOI: 10.1089/bfm.2012.0054] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study synthesized scientific literature that applies genetic or genomic approaches to breastmilk. A literature search of PubMed was conducted in March 2012 using the key words "breast milk," "lactation," "genetic," "gene expression," and "epigenetic." Additional articles were identified/selected for evaluation with MeSH term searches, and a review of article reference lists was obtained from the search. The initial 657 abstracts retrieved from the literature search were reviewed, and 16 studies were selected for evaluation. Studies that examined the transmission of viruses/bacteria into breastmilk and/or measured concentration of specific proteins without examination of genetic material from milk were excluded. Data related to subjects, tissue, purpose, setting, gene/protein, approach (candidate versus genome-wide), platform, statistical analysis, and results were extracted. Gene expression and epigenetic/epigenomic study designs have been successfully implemented using breastmilk. A major weakness of both gene expression studies and epigenetic studies that examine breastmilk is the omission of maternal information known to influence milk composition. This review article is the first to synthesize evidence related to the application of breastmilk to evaluate RNA and epigenetic modifications. Additional research is needed that applies epigenetic analyses to human breastmilk samples. Findings from this review can be used for future research designs that use breastmilk for genetic analyses.
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22
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Marcuzzi A, Vecchi Brumatti L, Caruso L, Copertino M, Davanzo R, Radillo O, Comar M, Monasta L. Presence of IL-9 in paired samples of human colostrum and transitional milk. J Hum Lact 2013; 29:26-31. [PMID: 23277461 DOI: 10.1177/0890334412466958] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Human colostrum and breast milk are known to contain high levels of cytokines, cytokine receptors, and chemokines. OBJECTIVE To investigate the presence and compare levels of soluble cytokines in paired samples of human colostrum and milk. METHODS Levels of 27 cytokines were measured in 9 paired samples of human colostrum (day 2 after delivery) and breast milk (day 4 or 5 after delivery) by using multiplex technology. RESULTS The majority of cytokines and chemokines investigated have been previously described in colostrum and/or breast milk. For the first time, we describe the presence of IL-9 in both human colostrum and milk. Of the 27 cytokines investigated, only IL-5 was absent in both colostrum and milk, whereas IL-1β, IL-2, IL-4, IL-15, IL-17, and MIP-1α were present in colostrum, but not in breast milk. In general, colostrum contained higher concentrations of cytokines with respect to human milk. CONCLUSION Our data confirm and expand previous studies showing that human colostrum and breast milk are rich in cytokines and chemokines, including IL-9, which might contribute to the development of the immune system of the newborn.
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Affiliation(s)
- Annalisa Marcuzzi
- Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy.
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23
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Young BE, Johnson SL, Krebs NF. Biological determinants linking infant weight gain and child obesity: current knowledge and future directions. Adv Nutr 2012; 3:675-86. [PMID: 22983846 PMCID: PMC3648749 DOI: 10.3945/an.112.002238] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Childhood obesity rates have reached epidemic proportions. Excessive weight gain in infancy is associated with persistence of elevated weight status and later obesity. In this review, we make the case that weight gain in the first 6 mo is especially predictive of later obesity risk due to the metabolic programming that can occur early postpartum. The current state of knowledge regarding the biological determinants of excess infant weight gain is reviewed, with particular focus on infant feeding choice. Potential mechanisms by which different feeding approaches may program the metabolic profile of the infant, causing the link between early weight gain and later obesity are proposed. These mechanisms are likely highly complex and involve synergistic interactions between endocrine effects and factors that alter the inflammatory and oxidative stress status of the infant. Gaps in current knowledge are highlighted. These include a lack of data describing 1) what type of infant body fat distribution may impart risk and 2) how maternal metabolic dysfunction (obesity and/or diabetes) may affect milk composition and exert downstream effects on infant metabolism. Improved understanding and management of these early postnatal determinants of childhood obesity may have great impact on reducing its prevalence.
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Lange CAK, Stavrakas P, Luhmann UFO, de Silva DJ, Ali RR, Gregor ZJ, Bainbridge JWB. Intraocular oxygen distribution in advanced proliferative diabetic retinopathy. Am J Ophthalmol 2011; 152:406-412.e3. [PMID: 21723532 DOI: 10.1016/j.ajo.2011.02.014] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2010] [Revised: 02/18/2011] [Accepted: 02/20/2011] [Indexed: 12/17/2022]
Abstract
PURPOSE To determine the preretinal distribution of oxygen in advanced proliferative diabetic retinopathy, and to investigate the relationship between intraocular oxygen tensions and vitreous cytokine concentrations. DESIGN Comparative cross-sectional study. METHODS Oxygen levels were measured at sites in the vitreous and at the inner retinal surface using an optical oxygen sensor in 14 control subjects and in 14 subjects with advanced proliferative diabetic retinopathy who had developed tractional retinal detachments despite previous panretinal photocoagulation. The vitreous and plasma concentrations of 42 cytokines were measured using multiplex cytokine arrays and their correlation with intraocular oxygen tension was investigated. RESULTS The mean oxygen tension in the mid-vitreous in diabetic retinopathy was 46% lower than that in control subjects (P = .017). However, the mean preretinal oxygen tension at the posterior pole in diabetic retinopathy was 37% higher than in controls (P = .039). We measured significant alterations in the vitreous concentrations of 9 cytokines-eotaxin, Flt-3 ligand, growth-related oncogene (GRO), interleukin (IL)-6, IL-8, IL-9, IFN-inducible protein-10 (IP-10), macrophage-derived cytokine (MDC), and vascular endothelial growth factor (VEGF)-in advanced proliferative diabetic retinopathy, and found that oxygen tension at the posterior pole was directly correlated with vitreous VEGF concentration. CONCLUSION We identified significant intraocular oxygen gradients in proliferative diabetic retinopathy. Our findings are consistent with the hypothesis that VEGF induces the development of neovascular complexes in the posterior retina that are richly perfused but nonetheless fail to redress hypoxia in the mid-vitreous. Upregulation of vitreous VEGF may be a consequence of retinal hypoxia at unidentified sites or of chronic inflammatory processes in advanced proliferative diabetic retinopathy.
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Affiliation(s)
- Clemens A K Lange
- University College London, Institute of Ophthalmology and Moorfields Eye Hospital, National Institute for Health Research and Biomedical Research Centre, London, United Kingdom; University Eye Hospital Freiburg, Albert-Ludwigs-University, Freiburg, Germany; Vitreoretinal Service, Moorfields Eye Hospital, London, United Kingdom
| | | | - Ulrich F O Luhmann
- University College London, Institute of Ophthalmology and Moorfields Eye Hospital, National Institute for Health Research and Biomedical Research Centre, London, United Kingdom
| | | | - Robin R Ali
- University College London, Institute of Ophthalmology and Moorfields Eye Hospital, National Institute for Health Research and Biomedical Research Centre, London, United Kingdom
| | - Zdenek J Gregor
- Vitreoretinal Service, Moorfields Eye Hospital, London, United Kingdom
| | - James W B Bainbridge
- University College London, Institute of Ophthalmology and Moorfields Eye Hospital, National Institute for Health Research and Biomedical Research Centre, London, United Kingdom; Vitreoretinal Service, Moorfields Eye Hospital, London, United Kingdom.
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Agarwal S, Karmaus W, Davis S, Gangur V. Immune markers in breast milk and fetal and maternal body fluids: a systematic review of perinatal concentrations. J Hum Lact 2011; 27:171-86. [PMID: 21678611 DOI: 10.1177/0890334410395761] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Breastfeeding represents the continued exposure of the infant to the maternal immune environment.Uterine, perinatal, and postnatal exposure to immune factors may contribute to an infant’s risk of developing immune-mediated disorders, including allergies. A PubMed search was conducted to review studies in humans and analyze concentrations of immune markers (TGF-beta, IFN-gamma, eotaxin, CCL5, CXCL10, TNF-alpha, MCP-1, IL-1beta, IL-4, IL-5, IL-6,IL-8, IL-10, IL-12, IL-13, sCD14, sIgA, IgG4, IgM) found in maternal serum, amniotic fluid, cord serum, colostrum, transition and mature milk. Concentrations of immune markers showed large variations across samples and studies. Reports documented conflicting results. Small sample sizes, differences in population characteristics, inconsistent sample collection times, and various sample collection and measurement methods may have led to wide variations in the concentrations of immune markers. Studies analyzing the associations between immune markers in maternal fluids and infant allergies remain inconclusive because of gaps in knowledge and a lack of standardized methods.
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Thibeau S, D’Apolito K. Review of the Relationships Between Maternal Characteristics and Preterm Breastmilk Immune Components. Biol Res Nurs 2011; 14:207-16. [DOI: 10.1177/1099800411400064] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The immune properties of breastmilk are the most effective preventative means of reducing infant mortality through both passive and active immunity. Breastmilk for term infants has been linked to decreased incidence of respiratory and ear infections and gastrointestinal distress. This protection is even more important for the preterm infant. Prematurity is one of the leading causes of infant death in the United States. Hospitalized infant outcomes associated with consumption of breastmilk are shorter length of stay and decreased incidence of nosocomial infections and necrotizing enterocolitis (NEC). The presence of nosocomial infections and necrotizing enterocolitis increases risk of preterm mortality and morbidity as well as healthcare expenditures. However, breastmilk immunological components such as secretory immunoglobulin A, lactoferrin (LFT), and cytokines provide a framework of immunity that, in conjunction with nutritional support, significantly improves neonatal health. The relationship between maternal characteristics and breastmilk immune properties is central to further the understanding of the impact of breastmilk on preterm infant morbidity and mortality. The purpose of this article is to review the numerous immune components in breastmilk, the moderators of the immune components, and the relevance of these components to preterm/infant health. Exploration of the complexity of breastmilk immune components may direct future development of interventions to improve and sustain the immunological benefits of preterm breastmilk.
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Affiliation(s)
| | - Karen D’Apolito
- Neonatology Program, Vanderbilt University School of Nursing
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Walter J, Ghosh MK, Kuhn L, Semrau K, Sinkala M, Kankasa C, Thea DM, Aldrovandi GM. High concentrations of interleukin 15 in breast milk are associated with protection against postnatal HIV transmission. J Infect Dis 2009; 200:1498-502. [PMID: 19835475 DOI: 10.1086/644603] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Given the central role that interleukin 15 (IL-15) plays in human immunodeficiency virus (HIV) immunity, we hypothesized that IL-15 in breast milk may protect against postnatal HIV transmission. In a nested case-control study, we compared breast milk IL-15 levels in 22 HIV-infected women who transmitted HIV to their infants to those in 72 nontransmitters. Samples were collected in the first month of life, prior to HIV infection. IL-15 concentrations were associated with a decreased risk of HIV transmission in unadjusted analysis and after adjusting for milk viral load, CD4 cell count, and other cytokines in breast milk. IL-15-mediated immunity may protect against HIV transmission during breast-feeding.
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Affiliation(s)
- Jan Walter
- Children's Hospital Los Angeles, University of Southern California, 4546 Sunset Boulevard, Los Angeles, CA 90027, USA
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