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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: 7] [Impact Index Per Article: 7.0] [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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Ramírez-Silva I, Ariza AC, Barragán-Vázquez S, Mendoza Jiménez M, Ortiz-Panozo E, Batis C, Burguete-García A, Ávila-Jimenez L, Zambrano E, Rivera JA. Longitudinal patterns of breastfeeding and its association with adiposity and subjective indicators of satiety/appetite in the first 2 years of life. Appetite 2023; 190:107030. [PMID: 37678585 DOI: 10.1016/j.appet.2023.107030] [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: 05/04/2023] [Revised: 08/18/2023] [Accepted: 09/04/2023] [Indexed: 09/09/2023]
Abstract
Evidence about the association between breastfeeding and its duration with growth, appetite and satiety indicators, and adiposity in low and middle-income countries facing nutritional transition is scarce. The aim of this study was to evaluate the association between longitudinal patterns of breastfeeding (exclusive [EBF] and continued [CBF]) with adiposity and growth, and the mediating role of appetite and satiety indicators in these associations in Mexican children during the first 2 years of life. Information from 378 mother-child pairs from the MAS-Lactancia birth cohort was analysed. Information was collected at birth and at months 1, 3, 6, 9, 12, 18 and 24 of life. Duration of EBF and CBF was computed. Linear mixed models were used to assess the association of EBF and CBF with growth and adiposity. Path analysis was used for mediation analysis. Compared with the reference group (EBF duration <1 month), males with >3 to ≤6 months of EBF had less abdominal circumference (β = -0.66, p = 0.05), Z-score weight-for-length (β = -0.17, p = 0.19) and length-for-age (β = -0.49, p < 0.01). Participants without CBF beyond 6 months had higher BMI Z-score (β = 0.19, p < 0.01), abdominal circumference (β = 0.62, p < 0.01) and skinfold sum (β = 0.80, p = 0.09), and o difference in length-for-age. For EBF, mediation was confirmed for satiety responsiveness on the association with BMI Z-Score, for food fussiness for the association with abdominal circumference and length-for-age Z-score, and enjoyment of food on the association with length-for-age Z-score. For CBF, mediation was confirmed for food fussiness in the association with length-for-age. This study suggests that a longer exposure to EBF and CBF is associated with lower adiposity in children under 2 years of age, and that this association could be partially mediated by appetite and satiety indicators.
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Affiliation(s)
- Ivonne Ramírez-Silva
- Center for Nutrition and Health Research, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico. Av. Universidad 655, Col. Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, C.P. 62100, Cuernavaca, Morelos, Mexico
| | - Ana Carolina Ariza
- Center for Nutrition and Health Research, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico. Av. Universidad 655, Col. Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, C.P. 62100, Cuernavaca, Morelos, Mexico
| | - Sofía Barragán-Vázquez
- Center for Nutrition and Health Research, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico. Av. Universidad 655, Col. Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, C.P. 62100, Cuernavaca, Morelos, Mexico
| | - Melanie Mendoza Jiménez
- Center for Nutrition and Health Research, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico. Av. Universidad 655, Col. Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, C.P. 62100, Cuernavaca, Morelos, Mexico
| | - Eduardo Ortiz-Panozo
- Center for Population Health Research, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico. Av. Universidad 655, Col. Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, C.P. 62100, Cuernavaca, Morelos, Mexico
| | - Carolina Batis
- Center for Nutrition and Health Research, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico. Av. Universidad 655, Col. Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, C.P. 62100, Cuernavaca, Morelos, Mexico
| | - Ana Burguete-García
- Center for Research in Infectious Diseases, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico. Av. Universidad 655, Col. Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, C.P. 62100, Cuernavaca, Morelos, Mexico
| | - Laura Ávila-Jimenez
- Coordinación Auxiliar Médica de Investigación en Salud, Delegación Estatal Morelos, Instituto Mexicano Del Seguro Social, Mexico
| | - Elena Zambrano
- Department of the Biology of Reproduction, Salvador Zubiran National Institute of Medical Sciences and Nutrition, Mexico City, Mexico
| | - Juan A Rivera
- Center for Population Health Research, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico. Av. Universidad 655, Col. Santa María Ahuacatitlán, Cerrada Los Pinos y Caminera, C.P. 62100, Cuernavaca, Morelos, Mexico.
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Baaleman DF, Wegh CAM, de Leeuw TJM, van Etten-Jamaludin FS, Vaughan EE, Schoterman MHC, Belzer C, Smidt H, Tabbers MM, Benninga MA, Koppen IJN. What are Normal Defecation Patterns in Healthy Children up to Four Years of Age? A Systematic Review and Meta-Analysis. J Pediatr 2023; 261:113559. [PMID: 37331467 DOI: 10.1016/j.jpeds.2023.113559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 06/08/2023] [Accepted: 06/12/2023] [Indexed: 06/20/2023]
Abstract
OBJECTIVE To summarize available data on defecation frequency and stool consistency of healthy children up to age 4 in order to estimate normal references values. STUDY DESIGN Systematic review including cross-sectional, observational, and interventional studies published in English, that reported on defecation frequency and/or stool consistency in healthy children 0-4 years old. RESULTS Seventy-five studies were included with 16 393 children and 40 033 measurements of defecation frequency and/or stool consistency. Based on visual inspection of defecation frequency data, a differentiation was made between two age categories: young infants (0-14 weeks old) and young children (15 weeks-4 years old). Young infants had a mean defecation frequency of 21.8 per week (95 % CI, 3.9-35.2) compared with 10.9 (CI, 5.7-16.7) in young children (P < .001). Among young infants, human milk-fed (HMF) infants had the highest mean defecation frequency per week (23.2 [CI, 8.8-38.1]), followed by formula-fed (FF) infants (13.7 [CI 5.4-23.9]), and mixed-fed (MF) infants (20.7 [CI, 7.0-30.2]). Hard stools were infrequently reported in young infants (1.5%) compared with young children (10.5%), and a reduction in the frequency of soft/watery stools was observed with higher age (27.0% in young infants compared with 6.2% in young children). HMF young infants had softer stools compared with FF young infants. CONCLUSIONS Young infants (0-14 weeks old) have softer and more frequent stools compared with young children (15 weeks-4 years old).
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Affiliation(s)
- Desiree F Baaleman
- Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
| | - Carrie A M Wegh
- Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands; Laboratory of Microbiology, Wageningen University & Research, Wageningen, The Netherlands
| | - Tessa J M de Leeuw
- Laboratory of Microbiology, Wageningen University & Research, Wageningen, The Netherlands
| | | | | | | | - Clara Belzer
- Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Hauke Smidt
- Laboratory of Microbiology, Wageningen University & Research, Wageningen, The Netherlands
| | - Merit M Tabbers
- Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Marc A Benninga
- Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Ilan J N Koppen
- Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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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: 3] [Impact Index Per Article: 3.0] [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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Cheshmeh S, Nachvak SM, Hojati N, Elahi N, Heidarzadeh‐Esfahani N, Saber A. The effects of breastfeeding and formula feeding on the metabolic factors and the expression level of obesity and diabetes-predisposing genes in healthy infants. Physiol Rep 2022; 10:e15469. [PMID: 36200185 PMCID: PMC9535349 DOI: 10.14814/phy2.15469] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 08/23/2022] [Accepted: 09/01/2022] [Indexed: 11/24/2022] Open
Abstract
Diabetes mellitus (DM) and obesity are common illnesses characterized by glucose metabolism issues and excessive weight gain. Breastfeeding is the best way to feed a newborn up to 6 months old and it has been shown to reduce the risk of diabetes and obesity later in life due to its nutritional properties. The purpose of this study was to investigate the effects of breastfeeding, formula feeding, and formula-plus breastfeeding (mix-feeding) on the anthropometric indices, metabolic variables, and the expression level of obesity and diabetes-predisposing genes of healthy infants. A total of 150 healthy infants were enrolled in this cross-sectional study. All infants (aged 24 months) were divided into three groups based on the type of feeding, breastfeeding, formula feeding, and mix-feeding. The anthropometric indices, glycemic indexes, lipid profile, and the expression levels of acetyl-coenzyme A carboxylase beta (ACACB), brain-derived neurotrophic factor (BDNF), liver X receptor α (LXR-α), peroxisome proliferator-activated receptor γ (PPAR-γ), and phosphatase and tensin homolog (PTEN) genes were measured in all infants using reverse transcription-polymerase chain reaction (RT-PCR) method. The anthropometric indices including weight, height, head circumference, insulin, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were lower in the breastfeeding infants in comparison to other groups. As well, the expression level of the ACACB gene was significantly downregulated in breastfeeding infants, while the PPAR-γ gene was significantly upregulated, but the expression levels of LXR- α, PTEN and BDNF did not change significantly across groups. Breastfeeding compared to formula feeding had positive effects on anthropometric indices, metabolic variables, and diabetes-predisposing genes.
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Affiliation(s)
- Sahar Cheshmeh
- Department of Nutritional Sciences, School of Nutritional Sciences and Food TechnologyKermanshah University of Medical SciencesKermanshahIran
- Student Research Committee, School of Nutritional Sciences and Food TechnologyKermanshah University of Medical SciencesKermanshahIran
| | - Seyed Mostafa Nachvak
- Department of Nutritional Sciences, School of Nutritional Sciences and Food TechnologyKermanshah University of Medical SciencesKermanshahIran
| | - Niloofar Hojati
- Department of Nutritional Sciences, School of Nutritional Sciences and Food TechnologyKermanshah University of Medical SciencesKermanshahIran
- Student Research Committee, School of Nutritional Sciences and Food TechnologyKermanshah University of Medical SciencesKermanshahIran
| | - Negin Elahi
- Department of Nutritional Sciences, School of Nutritional Sciences and Food TechnologyKermanshah University of Medical SciencesKermanshahIran
- Student Research Committee, School of Nutritional Sciences and Food TechnologyKermanshah University of Medical SciencesKermanshahIran
| | - Neda Heidarzadeh‐Esfahani
- Department of Nutritional Sciences, School of Nutritional Sciences and Food TechnologyKermanshah University of Medical SciencesKermanshahIran
- Student Research Committee, School of Nutritional Sciences and Food TechnologyKermanshah University of Medical SciencesKermanshahIran
| | - Amir Saber
- Department of Nutritional Sciences, School of Nutritional Sciences and Food TechnologyKermanshah University of Medical SciencesKermanshahIran
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Suwaydi MA, Zhou X, Perrella SL, Wlodek ME, Lai CT, Gridneva Z, Geddes DT. The Impact of Gestational Diabetes Mellitus on Human Milk Metabolic Hormones: A Systematic Review. Nutrients 2022; 14:nu14173620. [PMID: 36079876 PMCID: PMC9460195 DOI: 10.3390/nu14173620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 08/29/2022] [Accepted: 08/29/2022] [Indexed: 02/07/2023] Open
Abstract
Gestational diabetes mellitus (GDM) is a common pregnancy complication with short- and long-term health consequences for the infant and mother. Breastfeeding is the recommended mode of feeding as it offers an opportunity to reduce the risk of GDM consequences, likely partially mediated through changes in human milk (HM) composition. This review systematically reviewed 12 identified studies that investigated the impact of GDM on concentrations of HM metabolic hormones. Meta-analysis was not possible due to significant heterogeneity in study designs and hormone measurement techniques. The risk of bias was assessed using the National Institute for Clinical Excellence (NICE) tool. The methodological qualities were medium in half of the studies, while 25% (3/12) of studies carried a high risk of bias. Significant relationships were reported between GDM and concentrations of HM ghrelin (3/3 studies), insulin (2/4), and adiponectin (2/6), which may play an integral role in infant growth and development. In conclusion, preliminary evidence suggests that GDM may alter HM metabolic hormone concentrations; however, these relationships may be limited to the early lactation stage.
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Affiliation(s)
- Majed A. Suwaydi
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia or
- Department of Medical Laboratory Technology, College of Applied Medical Sciences, Jazan University, Jazan 54142, Saudi Arabia
| | - Xiaojie Zhou
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia or
| | - Sharon L. Perrella
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia or
| | - Mary E. Wlodek
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia or
- Population Health, Murdoch Children’s Research Institute (MCRI), Parkville, VI 3052, Australia
| | - Ching Tat Lai
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia or
| | - Zoya Gridneva
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia or
- Correspondence: ; Tel.: +61-8-6488-4467
| | - Donna T. Geddes
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia or
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Rostom H, Meng X, Price H, Fry A, Elajnaf T, Humphrey R, Guha N, James T, Kennedy SH, Hannan FM. Protocol for an observational study investigating hormones triggering the onset of sustained lactation: the INSIGHT study. BMJ Open 2022; 12:e062478. [PMID: 36041762 PMCID: PMC9438014 DOI: 10.1136/bmjopen-2022-062478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Lactation is a hormonally controlled process that promotes infant growth and neurodevelopment and reduces the long-term maternal risk of diabetes, cardiovascular disease and breast cancer. Hormones, such as prolactin and progesterone, mediate mammary development during pregnancy and are critical for initiating copious milk secretion within 24-72 hours post partum. However, the hormone concentrations mediating lactation onset are ill defined. METHODS AND ANALYSIS The primary objective of the investigating hormones triggering the onset of sustained lactation study is to establish reference intervals for the circulating hormone concentrations initiating postpartum milk secretion. The study will also assess how maternal factors such as parity, pregnancy comorbidities and complications during labour and delivery, which are known to delay lactation, may affect hormone concentrations. This single-centre observational study will recruit up to 1068 pregnant women over a 3-year period. A baseline blood sample will be obtained at 36 weeks' gestation. Participants will be monitored during postpartum days 1-4. Lactation onset will be reported using a validated breast fullness scale. Blood samples will be collected before and after a breastfeed on up to two occasions per day during postpartum days 1-4. Colostrum, milk and spot urine samples will be obtained on a single occasion. Serum hormone reference intervals will be calculated as mean±1.96 SD, with 90% CIs determined for the upper and lower reference limits. Differences in hormone values between healthy breastfeeding women and those at risk of delayed onset of lactation will be assessed by repeated measures two-way analysis of variance or a mixed linear model. Correlations between serum hormone concentrations and milk composition and volume will provide insights into the endocrine regulation of milk synthesis. ETHICS AND DISSEMINATION Approval for this study had been granted by the East of England-Cambridgeshire and Hertfordshire Research Ethics Committee (REC No. 20/EE/0172), by the Health Research Authority (HRA), and by the Oxford University Hospitals National Health Service Foundation Trust. The findings will be published in high-ranking journals and presented at national and international conferences. TRIAL REGISTRATION NUMBER ISRCTN12667795.
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Affiliation(s)
- Hussam Rostom
- Larsson-Rosenquist Foundation Oxford Centre for the Endocrinology of Human Lactation, Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK
| | - Xin Meng
- Larsson-Rosenquist Foundation Oxford Centre for the Endocrinology of Human Lactation, Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK
| | - Helen Price
- Larsson-Rosenquist Foundation Oxford Centre for the Endocrinology of Human Lactation, Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK
| | - Alexandria Fry
- Larsson-Rosenquist Foundation Oxford Centre for the Endocrinology of Human Lactation, Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK
| | - Taha Elajnaf
- Larsson-Rosenquist Foundation Oxford Centre for the Endocrinology of Human Lactation, Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK
| | - Robert Humphrey
- Clinical Biochemistry, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Nishan Guha
- Clinical Biochemistry, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Tim James
- Clinical Biochemistry, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Stephen H Kennedy
- Larsson-Rosenquist Foundation Oxford Centre for the Endocrinology of Human Lactation, Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK
| | - Fadil M Hannan
- Larsson-Rosenquist Foundation Oxford Centre for the Endocrinology of Human Lactation, Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK
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Sinkiewicz-Darol E, Adamczyk I, Łubiech K, Pilarska G, Twarużek M. Leptin in Human Milk-One of the Key Regulators of Nutritional Programming. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27113581. [PMID: 35684517 PMCID: PMC9182392 DOI: 10.3390/molecules27113581] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 05/30/2022] [Accepted: 05/31/2022] [Indexed: 11/16/2022]
Abstract
Breast milk is the optimal food for infants and toddlers, providing basic nutrients. It is also a source of many biologically active substances. Among them are hormones responsible for metabolic balance. One of the hormones taken in with breast milk by a breastfed baby is leptin. This hormone is involved in the regulation of appetite, informing the brain about the body’s energy resources. Having the correct mechanisms related to the action of leptin is a factor reducing the risk of obesity. The natural presence of leptin in the composition of breast milk suggests that it has a specific role in shaping the health of a breastfed child. Obesity as a disease of civilization affects more and more people, including children. The development of this disease is multifaceted and determined by many factors, including genetic and environmental factors such as eating habits and low physical activity. Behind obesity, there are complex mechanisms in which many elements of the human body are involved. Understanding the effects of breastfeeding as a natural source of leptin can help prevent childhood obesity and development of this disease in future life.
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Affiliation(s)
- Elena Sinkiewicz-Darol
- Department of Physiology and Toxicology, Faculty of Biological Sciences, Kazimierz Wielki University, Chodkiewicza 30 St., 85-064 Bydgoszcz, Poland; (I.A.); (G.P.); (M.T.)
- Human Milk Bank, Ludwik Rydygier Provincial Polyclinical Hospital, St. Josef 53-59, 87-100 Torun, Poland
- Correspondence: (E.S.-D.); (K.Ł.)
| | - Iwona Adamczyk
- Department of Physiology and Toxicology, Faculty of Biological Sciences, Kazimierz Wielki University, Chodkiewicza 30 St., 85-064 Bydgoszcz, Poland; (I.A.); (G.P.); (M.T.)
- Human Milk Bank, Ludwik Rydygier Provincial Polyclinical Hospital, St. Josef 53-59, 87-100 Torun, Poland
| | - Katarzyna Łubiech
- Department of Physiology and Toxicology, Faculty of Biological Sciences, Kazimierz Wielki University, Chodkiewicza 30 St., 85-064 Bydgoszcz, Poland; (I.A.); (G.P.); (M.T.)
- Correspondence: (E.S.-D.); (K.Ł.)
| | - Gabriela Pilarska
- Department of Physiology and Toxicology, Faculty of Biological Sciences, Kazimierz Wielki University, Chodkiewicza 30 St., 85-064 Bydgoszcz, Poland; (I.A.); (G.P.); (M.T.)
| | - Magdalena Twarużek
- Department of Physiology and Toxicology, Faculty of Biological Sciences, Kazimierz Wielki University, Chodkiewicza 30 St., 85-064 Bydgoszcz, Poland; (I.A.); (G.P.); (M.T.)
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9
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Gridneva Z, Rea A, Lai CT, Tie WJ, Kugananthan S, Warden AH, Perrella SL, Murray K, Geddes DT. Human Milk Macronutrients and Bioactive Molecules and Development of Regional Fat Depots in Western Australian Infants during the First 12 Months of Lactation. Life (Basel) 2022; 12:life12040493. [PMID: 35454985 PMCID: PMC9029383 DOI: 10.3390/life12040493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/22/2022] [Accepted: 03/26/2022] [Indexed: 12/19/2022] Open
Abstract
We investigated associations between intakes of human milk (HM) components (macronutrients and biologically active molecules) and regional fat depots development in healthy term infants (n = 20) across the first year of lactation. Infant limb (mid-arm and mid-thigh) lean and fat areas were assessed by ultrasound imaging at 2, 5, 9 and 12 months of age. Concentrations of HM total protein, whey protein, casein, adiponectin, leptin, lysozyme, lactoferrin, secretory IGA, total carbohydrates, lactose, HM oligosaccharides (total HMO, calculated) and infant 24-h milk intake were measured, and infant calculated daily intakes (CDI) of HM components were determined. This pilot study shows higher 24-h milk intake was associated with a larger mid-arm fat area (p = 0.024), higher breastfeeding frequency was associated with larger mid-arm (p = 0.008) and mid-thigh (p < 0.001) fat areas. Lysozyme (p = 0.001) and HMO CDI (p = 0.004) were time-dependently associated with the mid-arm fat area. Intakes of HM components and breastfeeding parameters may modulate infant limb fat depots development during the first year of age and potentially promote favorable developmental programming of infant body composition; however, further studies are needed to confirm these findings.
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Affiliation(s)
- Zoya Gridneva
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (C.T.L.); (W.J.T.); (S.K.); (A.H.W.); (S.L.P.); (D.T.G.)
- Correspondence: ; Tel.: +61-8-6488-4467
| | - Alethea Rea
- Mathematics and Statistics, Murdoch University, Murdoch, WA 6150, Australia;
| | - Ching Tat Lai
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (C.T.L.); (W.J.T.); (S.K.); (A.H.W.); (S.L.P.); (D.T.G.)
| | - Wan Jun Tie
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (C.T.L.); (W.J.T.); (S.K.); (A.H.W.); (S.L.P.); (D.T.G.)
| | - Sambavi Kugananthan
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (C.T.L.); (W.J.T.); (S.K.); (A.H.W.); (S.L.P.); (D.T.G.)
| | - Ashleigh H. Warden
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (C.T.L.); (W.J.T.); (S.K.); (A.H.W.); (S.L.P.); (D.T.G.)
| | - Sharon L. Perrella
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (C.T.L.); (W.J.T.); (S.K.); (A.H.W.); (S.L.P.); (D.T.G.)
| | - Kevin Murray
- School of Population and Global Health, The University of Western Australia, Crawley, WA 6009, Australia;
| | - Donna T. Geddes
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (C.T.L.); (W.J.T.); (S.K.); (A.H.W.); (S.L.P.); (D.T.G.)
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Wollmer E, Ungell AL, Nicolas JM, Klein S. Review of paediatric gastrointestinal physiology relevant to the absorption of orally administered medicines. Adv Drug Deliv Rev 2022; 181:114084. [PMID: 34929252 DOI: 10.1016/j.addr.2021.114084] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 11/13/2021] [Accepted: 12/13/2021] [Indexed: 12/11/2022]
Abstract
Despite much progress in regulations to improve paediatric drug development, there remains a significant need to develop better medications for children. For the design of oral dosage forms, a detailed understanding of the specific gastrointestinal (GI) conditions in children of different age categories and how they differ from GI conditions in adults is essential. Several review articles have been published addressing the ontogeny of GI characteristics, including luminal conditions in the GI tract of children. However, the data reported in most of these reviews are of limited quality because (1) information was cited from very old publications and sometimes low quality sources, (2) data gaps in the original data were filled with textbook knowledge, (3) data obtained on healthy and sick children were mixed, (4) average data obtained on groups of patients were mixed with data obtained on individual patients, and (5) results obtained using investigative techniques that may have altered the outcome of the respective studies were considered. Consequently, many of these reviews draw conclusions that may be incorrect. The aim of the present review was to provide a comprehensive and updated overview of the available original data on the ontogeny of GI luminal conditions relevant to oral drug absorption in the paediatric population. To this end, the PubMed and Web of Science metadatabases were searched for appropriate studies that examined age-related conditions in the oral cavity, esophagus, stomach, small intestine, and colon. Maturation was observed for several GI parameters, and corresponding data sets were identified for each paediatric age group. However, it also became clear that the ontogeny of several GI traits in the paediatric population is not yet known. The review article provides a robust and valuable data set for the development of paediatric in vitro and in silico biopharmaceutical tools to support the development of age-appropriate dosage forms. In addition, it provides important information on existing data gaps and should provide impetus for further systematic and well-designed in vivo studies on GI physiology in children of specific age groups in order to close existing knowledge gaps and to sustainably improve oral drug therapy in children.
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Jiang H, Gallier S, Feng L, Han J, Liu W. Development of the digestive system in early infancy and nutritional management of digestive problems in breastfed and formula-fed infants. Food Funct 2022; 13:1062-1077. [DOI: 10.1039/d1fo03223b] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Food digestion and absorption in infants are closely related to early growth and long-term health. Human milk and infant formula are the main food sources for 0-6 month-old infants. Due...
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12
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Pre-operative fasting in children: A guideline from the European Society of Anaesthesiology and Intensive Care. Eur J Anaesthesiol 2022; 39:4-25. [PMID: 34857683 DOI: 10.1097/eja.0000000000001599] [Citation(s) in RCA: 80] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Current paediatric anaesthetic fasting guidelines have recommended conservative fasting regimes for many years and have not altered much in the last decades. Recent publications have employed more liberal fasting regimes with no evidence of increased aspiration or regurgitation rates. In this first solely paediatric European Society of Anaesthesiology and Intensive Care (ESAIC) pre-operative fasting guideline, we aim to present aggregated and evidence-based summary recommendations to assist clinicians, healthcare providers, patients and parents. We identified six main topics for the literature search: studies comparing liberal with conservative regimens; impact of food composition; impact of comorbidity; the use of gastric ultrasound as a clinical tool; validation of gastric ultrasound for gastric content and gastric emptying studies; and early postoperative feeding. The literature search was performed by a professional librarian in collaboration with the ESAIC task force. Recommendations for reducing clear fluid fasting to 1 h, reducing breast milk fasting to 3 h, and allowing early postoperative feeding were the main results, with GRADE 1C or 1B evidence. The available evidence suggests that gastric ultrasound may be useful for clinical decision-making, and that allowing a 'light breakfast' may be well tolerated if the intake is well controlled. More research is needed in these areas as well as evaluation of how specific patient or treatment-related factors influence gastric emptying.
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de Almeida CC, Baião DDS, Leandro KC, Paschoalin VMF, da Costa MP, Conte-Junior CA. Protein Quality in Infant Formulas Marketed in Brazil: Assessments on Biodigestibility, Essential Amino Acid Content and Proteins of Biological Importance. Nutrients 2021; 13:nu13113933. [PMID: 34836188 PMCID: PMC8622549 DOI: 10.3390/nu13113933] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 10/28/2021] [Accepted: 10/30/2021] [Indexed: 11/16/2022] Open
Abstract
Infant formulas, designed to provide similar nutritional composition and performance to human milk, are recommended when breastfeeding is not enough to provide for the nutritional needs of children under 12 months of age. In this context, the present study aimed to assess the protein quality and essential amino acid content of both starting (phase 1) and follow-up (phase 2) formulas from different manufacturers. The chemical amino acid score and protein digestibility corrected by the amino acid score were calculated. The determined protein contents in most formulas were above the maximum limit recommended by FAO and WHO guidelines and at odds with the protein contents declared in the label. All infant formulas contained lactoferrin (0.06 to 0.44 g·100 g−1) and α-lactalbumin (0.02 to 1.34 g·100 g−1) below recommended concentrations, whereas ĸ-casein (8.28 to 12.91 g·100 g−1), α-casein (0.70 to 2.28 g·100 g−1) and β-lactoglobulin (1.32 to 4.19 g·100 g−1) were detected above recommended concentrations. Essential amino acid quantification indicated that threonine, leucine and phenylalanine were the most abundant amino acids found in the investigated infant formulas. In conclusion, infant formulas are still unconforming to nutritional breast milk quality and must be improved in order to follow current global health authority guidelines.
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Affiliation(s)
- Cristine Couto de Almeida
- Graduate Program in Sanitary Surveillance (PPGVS), National Institute of Health Quality Control (INCQS), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-900, Brazil; (C.C.d.A.); (K.C.L.)
- Center for Food Analysis (NAL), Technological Development Support Laboratory (LADETEC), Federal University of Rio de Janeiro (UFRJ), Cidade Universitária, Rio de Janeiro 21941-598, Brazil
- Graduate Program in Veterinary Hygiene (PPGHV), Faculty of Veterinary Medicine, Fluminense Federal University (UFF), Vital Brazil Filho, Niterói 24230-340, Brazil;
| | - Diego dos Santos Baião
- Laboratory of Advanced Analysis in Biochemistry and Molecular Biology (LAABBM), Department of Biochemistry, Federal University of Rio de Janeiro (UFRJ), Cidade Universitária, Rio de Janeiro 21941-909, Brazil; (D.d.S.B.); (V.M.F.P.)
| | - Katia Christina Leandro
- Graduate Program in Sanitary Surveillance (PPGVS), National Institute of Health Quality Control (INCQS), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-900, Brazil; (C.C.d.A.); (K.C.L.)
| | - Vania Margaret Flosi Paschoalin
- Laboratory of Advanced Analysis in Biochemistry and Molecular Biology (LAABBM), Department of Biochemistry, Federal University of Rio de Janeiro (UFRJ), Cidade Universitária, Rio de Janeiro 21941-909, Brazil; (D.d.S.B.); (V.M.F.P.)
- Graduate Studies in Food Science (PPGCAL), Institute of Chemistry (IQ), Federal University of Rio de Janeiro (UFRJ), Cidade Universitária, Rio de Janeiro 21941-909, Brazil
- Graduate Studies in Chemistry (PGQu), Institute of Chemistry (IQ), Federal University of Rio de Janeiro (UFRJ), Cidade Universitária, Rio de Janeiro 21941-909, Brazil
| | - Marion Pereira da Costa
- Graduate Program in Veterinary Hygiene (PPGHV), Faculty of Veterinary Medicine, Fluminense Federal University (UFF), Vital Brazil Filho, Niterói 24230-340, Brazil;
- Laboratory of Inspection and Technology of Milk and Derivatives (LaITLácteos), School of Veterinary Medicine and Animal Science, Federal University of Bahia (UFBA), Salvador 40170-110, Brazil
| | - Carlos Adam Conte-Junior
- Graduate Program in Sanitary Surveillance (PPGVS), National Institute of Health Quality Control (INCQS), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-900, Brazil; (C.C.d.A.); (K.C.L.)
- Center for Food Analysis (NAL), Technological Development Support Laboratory (LADETEC), Federal University of Rio de Janeiro (UFRJ), Cidade Universitária, Rio de Janeiro 21941-598, Brazil
- Graduate Program in Veterinary Hygiene (PPGHV), Faculty of Veterinary Medicine, Fluminense Federal University (UFF), Vital Brazil Filho, Niterói 24230-340, Brazil;
- Laboratory of Advanced Analysis in Biochemistry and Molecular Biology (LAABBM), Department of Biochemistry, Federal University of Rio de Janeiro (UFRJ), Cidade Universitária, Rio de Janeiro 21941-909, Brazil; (D.d.S.B.); (V.M.F.P.)
- Graduate Studies in Food Science (PPGCAL), Institute of Chemistry (IQ), Federal University of Rio de Janeiro (UFRJ), Cidade Universitária, Rio de Janeiro 21941-909, Brazil
- Graduate Studies in Chemistry (PGQu), Institute of Chemistry (IQ), Federal University of Rio de Janeiro (UFRJ), Cidade Universitária, Rio de Janeiro 21941-909, Brazil
- Correspondence: ; Tel.: +21-98728-6704 or +21-3938-7825
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Alsharairi NA. The Role of Short-Chain Fatty Acids in Mediating Very Low-Calorie Ketogenic Diet-Infant Gut Microbiota Relationships and Its Therapeutic Potential in Obesity. Nutrients 2021; 13:3702. [PMID: 34835958 PMCID: PMC8624546 DOI: 10.3390/nu13113702] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 12/13/2022] Open
Abstract
As the very low-calorie ketogenic diet (VLCKD) gains increased interest as a therapeutic approach for many diseases, little is known about its therapeutic use in childhood obesity. Indeed, the role of VLCKD during pregnancy and lactation in influencing short chain fatty acid (SCFA)-producing bacteria and the potential mechanisms involved in the protective effects on obesity are still unclear. Infants are characterized by a diverse gut microbiota composition with higher abundance of SCFA-producing bacteria. Maternal VLCKD during pregnancy and lactation stimulates the growth of diverse species of SCFA-producing bacteria, which may induce epigenetic changes in infant obese gene expression and modulate adipose tissue inflammation in obesity. Therefore, this review aims to determine the mechanistic role of SCFAs in mediating VLCKD-infant gut microbiota relationships and its protective effects on obesity.
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Affiliation(s)
- Naser A Alsharairi
- Heart, Mind & Body Research Group, Griffith University, Gold Coast, QLD 4222, Australia
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15
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Wang H, Esemu-Ezewu P, Pan J, Ivanovska J, Gauda EB, Belik J. Adiponectin and the regulation of gastric content volume in the newborn rat. World J Gastroenterol 2021; 27:5566-5574. [PMID: 34588752 PMCID: PMC8433619 DOI: 10.3748/wjg.v27.i33.5566] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/15/2021] [Accepted: 08/12/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Oral intake is dependent on the gastric ability to accommodate the food bolus. Comparatively, neonates have a smaller gastric capacity than adults and this may limit the volume of their milk intake. Yet, we previously reported that the newborn rat gastric milk volume is greatest after birth and, when normalized to body weight, decreases with postnatal age. Such age-dependent changes are not the result of intake differences, but greater gastric accommodation and reduced emptying rate.
AIM Hypothesizing that breastmilk-derived adiponectin is the factor regulating gastric accommodation in neonates, we comparatively evaluated its effects on the rat fundic muscle tone at different postnatal ages.
METHODS In freshly dispersed smooth muscle cells (SMC), we measured the adiponectin effect on the carbachol-induced length changes.
RESULTS Adiponectin significantly reduced the carbachol-stimulated SMC shortening independently of age. In the presence of the inhibitor iberiotoxin, the adiponectin effect on SMC shortening was suppressed, suggesting that it is mediated via large-conductance Ca2+ sensitive K+ channel activation. Lastly, we comparatively measured the newborn rat gastric milk curd adiponectin content in one- and two-week-old rats and found a 50% lower value in the latter.
CONCLUSION Adiponectin, a major component of breastmilk, downregulates fundic smooth muscle contraction potential, thus facilitating gastric volume accommodation. This rodent’s adaptive response maximizes breastmilk intake volume after birth.
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Affiliation(s)
- Huanhuan Wang
- Department of Paediatrics, The Hospital for Sick Children, Toronto M5G 1X8, Ontario, Canada
| | - Paul Esemu-Ezewu
- Department of Paediatrics, The Hospital for Sick Children, Toronto M5G 1X8, Ontario, Canada
| | - Jingyi Pan
- Department of Paediatrics, The Hospital for Sick Children, Toronto M5G 1X8, Ontario, Canada
| | - Julijana Ivanovska
- Department of Paediatrics, The Hospital for Sick Children, Toronto M5G 1X8, Ontario, Canada
| | - Estelle B Gauda
- Department of Paediatrics, The Hospital for Sick Children, Toronto M5G 1X8, Ontario, Canada
| | - Jaques Belik
- Department of Paediatrics and Physiology, The Hospital for Sick Children, Toronto M5G 1X8, Ontario, Canada
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Geddes DT, Gridneva Z, Perrella SL, Mitoulas LR, Kent JC, Stinson LF, Lai CT, Sakalidis V, Twigger AJ, Hartmann PE. 25 Years of Research in Human Lactation: From Discovery to Translation. Nutrients 2021; 13:3071. [PMID: 34578947 PMCID: PMC8465002 DOI: 10.3390/nu13093071] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 08/26/2021] [Accepted: 08/26/2021] [Indexed: 02/06/2023] Open
Abstract
Researchers have recently called for human lactation research to be conceptualized as a biological framework where maternal and infant factors impacting human milk, in terms of composition, volume and energy content are studied along with relationships to infant growth, development and health. This approach allows for the development of evidence-based interventions that are more likely to support breastfeeding and lactation in pursuit of global breastfeeding goals. Here we summarize the seminal findings of our research programme using a biological systems approach traversing breast anatomy, milk secretion, physiology of milk removal with respect to breastfeeding and expression, milk composition and infant intake, and infant gastric emptying, culminating in the exploration of relationships with infant growth, development of body composition, and health. This approach has allowed the translation of the findings with respect to education, and clinical practice. It also sets a foundation for improved study design for future investigations in human lactation.
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Affiliation(s)
- Donna Tracy Geddes
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | - Zoya Gridneva
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | - Sharon Lisa Perrella
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | - Leon Robert Mitoulas
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
- Medela, AG, Lättichstrasse 4b, 6340 Baar, Switzerland
| | - Jacqueline Coral Kent
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | - Lisa Faye Stinson
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | - Ching Tat Lai
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | - Vanessa Sakalidis
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | | | - Peter Edwin Hartmann
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
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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: 13] [Impact Index Per Article: 4.3] [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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Human Milk Oligosaccharide Profiles and Associations with Maternal Nutritional Factors: A Scoping Review. Nutrients 2021; 13:nu13030965. [PMID: 33802639 PMCID: PMC8002381 DOI: 10.3390/nu13030965] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/11/2021] [Accepted: 03/12/2021] [Indexed: 12/12/2022] Open
Abstract
Human milk oligosaccharides (HMOs) are complex unconjugated glycans associated with positive infant health outcomes. This study has examined current knowledge of the effect of maternal diet and nutritional status on the composition of HMOs in breast milk. Using the PRISMA-ScR guidelines, a comprehensive, systematic literature search was conducted using Scopus, Web of Science, Global Health (CABI), and MEDLINE. Titles and abstracts were screened independently by two reviewers against predefined inclusion and exclusion criteria. Fourteen studies met the inclusion criteria and reported on maternal dietary intake (n = 3), maternal body composition indices (n = 9), and dietary supplementation interventions (n = 2). In total, data from 1388 lactating mothers (4011 milk samples) were included. Design methodologies varied substantially across studies, particularly for milk sample collection, HMO analysis, dietary and body composition assessment. Overall, this review has identified potential associations between maternal dietary intake and nutritional status and the HMO composition of human milk, though an abundance and sufficiency of evidence is lacking. Standardised procedures for human milk sample collection and HMO analysis, along with robust and validated nutrition assessment techniques, should be employed to further investigate the impact of maternal nutritional factors on HMO composition.
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Perrella S, Gridneva Z, Lai CT, Stinson L, George A, Bilston-John S, Geddes D. Human milk composition promotes optimal infant growth, development and health. Semin Perinatol 2021; 45:151380. [PMID: 33431112 DOI: 10.1016/j.semperi.2020.151380] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Human milk is a living dynamic fluid that promotes optimal nutrition and development of the infant and impacts health across the lifespan. This review reports on the diverse range of nutrients, immune protection factors, hormones, microbes and metabolites in human milk and their impacts on infant nutrition and health. While many of these components are stable across lactation and similar between women, some vary over time, and in response to maternal and infant health status, maternal diet and geographic location. Human milk may be considered as personalized nutrition, with many components working synergistically to stimulate and support the infant's immature immune system, while enhancing appropriate development, growth and body composition.
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Affiliation(s)
- Sharon Perrella
- School of Molecular Science, The University of Western Australia, M310, 35 Stirling Highway, Crawley Western Australia 6009, Australia.
| | - Zoya Gridneva
- School of Molecular Science, The University of Western Australia, M310, 35 Stirling Highway, Crawley Western Australia 6009, Australia
| | - Ching Tat Lai
- School of Molecular Science, The University of Western Australia, M310, 35 Stirling Highway, Crawley Western Australia 6009, Australia
| | - Lisa Stinson
- School of Molecular Science, The University of Western Australia, M310, 35 Stirling Highway, Crawley Western Australia 6009, Australia
| | - Alexandra George
- School of Molecular Science, The University of Western Australia, M310, 35 Stirling Highway, Crawley Western Australia 6009, Australia
| | - Sabrina Bilston-John
- School of Molecular Science, The University of Western Australia, M310, 35 Stirling Highway, Crawley Western Australia 6009, Australia
| | - Donna Geddes
- School of Molecular Science, The University of Western Australia, M310, 35 Stirling Highway, Crawley Western Australia 6009, Australia
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George AD, Gay MCL, Wlodek ME, Geddes DT. The importance of infants' lipid intake in human milk research. Nutr Rev 2021; 79:1353-1361. [PMID: 33448303 DOI: 10.1093/nutrit/nuaa141] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Human milk lipids are among the many nutrients delivered to the infant, providing >50% of the infant's calorie intake. These lipids are highly complex and variable, and bioactive, contributing to infant growth, development, and health. The lipid concentration of milk samples is often measured in human cohorts; however, few studies measure infant intake of milk. Intake is important because it considers the variability of both lipid concentration and infants' consumed volume of milk. Measurement of infants' lipid intake in exclusively breastfeeding infants requires 3 main considerations: human milk sampling protocol (ie, the collection of representative samples); measurement of the infant milk intake, because volume varies widely between infants; and appropriate analytical laboratory methods. The purpose of this review was to provide an overview of existing methodology and demonstrate the importance of measuring infants' lipid intake to understand the impact that human milk lipids have on infant outcomes.
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Affiliation(s)
- Alexandra D George
- School of Molecular Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Melvin C L Gay
- School of Molecular Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Mary E Wlodek
- Department of Physiology, School of Biomedical Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Donna T Geddes
- School of Molecular Sciences, The University of Western Australia, Perth, Western Australia, Australia
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21
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Smith JP, Forrester RI. Association between breastfeeding and new mothers' sleep: a unique Australian time use study. Int Breastfeed J 2021; 16:7. [PMID: 33407681 PMCID: PMC7788894 DOI: 10.1186/s13006-020-00347-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 12/09/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Infant sleep is of great interest to new parents. There is ongoing debate about whether infants fed with breastmilk substitutes sleep longer than those exclusively or partially breastfed, but what does this mean for the mother? What expectations are realistic for mothers desiring to exclusively breastfeed as recommended by health authorities? There are both biological and social influences on infant and maternal sleep. More accurate information on average maternal sleep hours for diverse feeding practices may help guide realistic expectations and better outcomes for mothers, infants and families. METHODS Using a unique time use dataset purposefully designed to study the time use of new mothers, this study investigated whether the weekly duration of maternal sleep, sleep disturbance, unpaid housework, and free time activities differed by detailed feeding method. The study collected 24/7 time use data from 156 mothers of infants aged 3, 6 and/or 9 months between April 2005 and April 2006, recruited via mother's groups, infant health clinics, and childcare services throughout Australia. Sociodemographic and feeding status data were collected by questionnaire. Statistical analysis used linear mixed modelling and residual maximum likelihood analysis to compare effects of different infant feeding practices on maternal time use. RESULTS There were no significant differences in time spent asleep between lactating and non lactating mothers, though lactating mothers had more time awake at night. Lactating mothers spent more time (8.5 h weekly) in childcaring activity (p = 0.007), and in employment (2.7 vs. 1.2 h, p < 0.01), but there were no significant differences in free time. Those not breastfeeding spent more time in unpaid domestic work. Exclusive breastfeeding was associated with reduced maternal sleep hours (average 7.08 h daily). Again, free time did not differ significantly between feeding groups. Exclusively breastfeeding mothers experienced reduced sleep hours, but maintained comparable leisure time to other mothers by allocating their time differently. Domestic work hours differed, interacting in complex ways with infant age and feeding practice. CONCLUSIONS Optimal breastfeeding may require realistic maternal sleep expectations and equitable sharing of paid and unpaid work burdens with other household members in the months after the birth of an infant.
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Affiliation(s)
- Julie P. Smith
- Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, Australia
| | - Robert I. Forrester
- Statistical Consulting Unit, The Australian National University, Canberra, Australia
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Shen J, Mu C, Wang H, Huang Z, Yu K, Zoetendal EG, Zhu W. Stimulation of Gastric Transit Function Driven by Hydrolyzed Casein Increases Small Intestinal Carbohydrate Availability and Its Microbial Metabolism. Mol Nutr Food Res 2020; 64:e2000250. [PMID: 32945612 DOI: 10.1002/mnfr.202000250] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 08/07/2020] [Indexed: 11/07/2022]
Abstract
Gastrointestinal (GI) functions affect gut nutrient flow and microbial metabolism. Dietary peptides modulate GI functions and improve small intestinal health, but the mechanism remains elusive. This study aims to investigate whether dietary peptides affect small intestinal microbial metabolism, and the underlying mechanisms. An ileal-cannulated pig model is adopted to explore the relationship between gut nutrient flow and microbial metabolism after treatment with hydrolyzed casein (peptides) or intact casein (Control)-based diet. The results demonstrate that hydrolyzed casein enhances microbial carbohydrate metabolism with higher Streptococcus abundance and higher lactate level in the ileum. Meanwhile, hydrolyzed casein increases ileal flows of nutrients, especially carbohydrate, leading to a higher carbohydrate availability in ileal digesta. To unveil the mechanisms, it is found that the hydrolyzed casein enhances the ghrelin signal and improves development of interstitial cells of Cajal and muscular layer in gastric corpus, indicating the enhanced upper GI transit function. In addition, hydrolyzed casein improves small intestinal health, as indicated by higher villus heights and luminal lactate concentrations in the jejunum and ileum. In conclusion, hydrolyzed casein stimulates upper GI transit function, enhances gut nutrient flow, and increases small intestinal carbohydrate availability and its microbial metabolism, which favor the small intestinal health.
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Affiliation(s)
- Junhua Shen
- Laboratory of Gastrointestinal Microbiology, Jiangsu Key Laboratory of Gastrointestinal Nutrition and Animal Health, College of Animal Science and Technology, National Center for International Research on Animal Gut Nutrition, Nanjing Agricultural University, Nanjing, 210095, China
| | - Chunlong Mu
- Laboratory of Gastrointestinal Microbiology, Jiangsu Key Laboratory of Gastrointestinal Nutrition and Animal Health, College of Animal Science and Technology, National Center for International Research on Animal Gut Nutrition, Nanjing Agricultural University, Nanjing, 210095, China
| | - Huisong Wang
- Laboratory of Gastrointestinal Microbiology, Jiangsu Key Laboratory of Gastrointestinal Nutrition and Animal Health, College of Animal Science and Technology, National Center for International Research on Animal Gut Nutrition, Nanjing Agricultural University, Nanjing, 210095, China
| | - Zan Huang
- Laboratory of Gastrointestinal Microbiology, Jiangsu Key Laboratory of Gastrointestinal Nutrition and Animal Health, College of Animal Science and Technology, National Center for International Research on Animal Gut Nutrition, Nanjing Agricultural University, Nanjing, 210095, China
| | - Kaifan Yu
- Laboratory of Gastrointestinal Microbiology, Jiangsu Key Laboratory of Gastrointestinal Nutrition and Animal Health, College of Animal Science and Technology, National Center for International Research on Animal Gut Nutrition, Nanjing Agricultural University, Nanjing, 210095, China
| | - Erwin G Zoetendal
- Laboratory of Microbiology, Wageningen University, Wageningen, 6703 HB, The Netherlands
| | - Weiyun Zhu
- Laboratory of Gastrointestinal Microbiology, Jiangsu Key Laboratory of Gastrointestinal Nutrition and Animal Health, College of Animal Science and Technology, National Center for International Research on Animal Gut Nutrition, Nanjing Agricultural University, Nanjing, 210095, China
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23
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George AD, Gay MCL, Murray K, Muhlhausler BS, Wlodek ME, Geddes DT. Human Milk Sampling Protocols Affect Estimation of Infant Lipid Intake. J Nutr 2020; 150:2924-2930. [PMID: 32886106 PMCID: PMC7675139 DOI: 10.1093/jn/nxaa246] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/01/2020] [Accepted: 07/24/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Human milk (HM) lipid content is highly variable, and infants consume different volumes of milk. This makes precise sampling and calculation of the infant lipid intake problematic. OBJECTIVES In order to describe inaccuracies of estimates of lipid content introduced by various sampling protocols, we compared the true infant lipid intake with estimated intakes using different milk sampling protocols. METHODS Monthly milk samples (n = 1026) from months 1 to 6 of lactation were collected from 20 healthy, exclusively breastfeeding women. Infant lipid intake was measured by 24-hour test-weighing at month 3. Total lipid content was measured by creamatocrit. Concentrations and infant lipid intakes were calculated using 11 sampling protocols, using either the true milk intake or an average of 800 mL/d. These estimates were compared with the true infant lipid intake using repeated-measures ANOVA and linear mixed modeling with multiple comparisons. RESULTS The mean maternal age was 32.0 years (SD ± 3.10), and infants were born term (40.1 ± 1.1 weeks) with a mean birth weight of 3.87 kg (SD ± 0.39). The mean true infant lipid intake was 28.6 g/d (SD ± 9.8). The mean estimated lipid intake using 1 morning pre-feed sample underestimated intake by >8.0 g/d. Estimates of infant lipid intake using other sampling protocols and an assumed intake volume of 800 mL/d also resulted in a wide range of differences (0.8-18.1 g/d) from the true intake. Use of 6 daily pre- and post-feed milk samples had a mean difference of only 0.1 g/d (95% CI, -2.9 to 2.7) from the true intake. CONCLUSIONS A sampling protocol with 6 pre- and post-feed samples provides the most accurate estimate of lipid intake if it is not possible to perform 24-hour test weights. The potential inaccuracies of sampling protocols should be taken into consideration in the interpretation and translation of infant lipid intake results.
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Affiliation(s)
| | - Melvin C L Gay
- School of Molecular Sciences, The University of Western Australia, Perth, Australia
| | - Kevin Murray
- School of Population and Global Health, 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 Organisation, Adelaide, Australia
| | - Mary E Wlodek
- Department of Physiology, School of Biomedical Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Victoria, Australia
| | - Donna T Geddes
- School of Molecular Sciences, The University of Western Australia, Perth, Australia
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24
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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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25
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Shen J, Wang H, Pi Y, Gao K, Zhu W. Casein hydrolysate supplementation in low-crude protein diets increases feed intake and nitrogen retention without affecting nitrogen utilization of growing pigs. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2020; 100:1748-1756. [PMID: 31825531 DOI: 10.1002/jsfa.10196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 11/20/2019] [Accepted: 12/11/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND An extreme reduction of the crude protein (CP) level in diets, even balanced with amino acids (AAs), is detrimental for intestinal nitrogen (N) metabolism and the growth of pigs. This study investigated the effects of casein hydrolysate supplementation in low-CP diets on growth performance, N balance, and intestinal N supply for pigs. A total of 24 barrows were randomly assigned to one of three dietary treatments of 160 g kg-1 CP (control), 130 g kg-1 CP (LAA), and 130 g kg-1 CP plus casein hydrolysate (LCH) for 28 days. RESULTS The LCH group had a higher average daily feed intake (ADFI) and average daily gain (ADG) than the LAA group, and a higher ADG than the control (P < 0.05). Compared with the control, both the LAA and LCH decreased N intake, serum urea N, fecal N, and N excretion, and increased apparent N availability, with LCH having higher N intake and N retention than LAA group (P < 0.05). Compared with LAA, LCH increased ileal fluxes of CP and AA (P < 0.05), and with values similar to those of the control. However, ileal flows of CP and AA were similar between LCH and LAA, both of which were lower than those in the control (P < 0.05). CONCLUSION Using protein hydrolysate to replace some crystalline AAs in low-CP diets increased feed intake, N retention and ADG without affecting N utilization. These findings point to the important impact of protein hydrolysate supplementation on improving growth for pigs fed low-CP diets. © 2019 Society of Chemical Industry.
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Affiliation(s)
- Junhua Shen
- Laboratory of Gastrointestinal Microbiology, Jiangsu Key Laboratory of Gastrointestinal Nutrition and Animal Health, College of Animal Science and Technology, Nanjing Agricultural University, Nanjing, China
- National Center for International Research on Animal Gut Nutrition, Nanjing Agricultural University, Nanjing, China
| | - Huisong Wang
- Laboratory of Gastrointestinal Microbiology, Jiangsu Key Laboratory of Gastrointestinal Nutrition and Animal Health, College of Animal Science and Technology, Nanjing Agricultural University, Nanjing, China
- National Center for International Research on Animal Gut Nutrition, Nanjing Agricultural University, Nanjing, China
| | - Yu Pi
- Laboratory of Gastrointestinal Microbiology, Jiangsu Key Laboratory of Gastrointestinal Nutrition and Animal Health, College of Animal Science and Technology, Nanjing Agricultural University, Nanjing, China
- National Center for International Research on Animal Gut Nutrition, Nanjing Agricultural University, Nanjing, China
| | - Kan Gao
- Laboratory of Gastrointestinal Microbiology, Jiangsu Key Laboratory of Gastrointestinal Nutrition and Animal Health, College of Animal Science and Technology, Nanjing Agricultural University, Nanjing, China
- National Center for International Research on Animal Gut Nutrition, Nanjing Agricultural University, Nanjing, China
| | - Weiyun Zhu
- Laboratory of Gastrointestinal Microbiology, Jiangsu Key Laboratory of Gastrointestinal Nutrition and Animal Health, College of Animal Science and Technology, Nanjing Agricultural University, Nanjing, China
- National Center for International Research on Animal Gut Nutrition, Nanjing Agricultural University, Nanjing, China
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Carbohydrates in Human Milk and Body Composition of Term Infants during the First 12 Months of Lactation. Nutrients 2019; 11:nu11071472. [PMID: 31261649 PMCID: PMC6683013 DOI: 10.3390/nu11071472] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 06/25/2019] [Accepted: 06/26/2019] [Indexed: 02/01/2023] Open
Abstract
Human milk (HM) carbohydrates may affect infant appetite regulation, breastfeeding patterns, and body composition (BC). We investigated relationships between concentrations/calculated daily intakes (CDI) of HM carbohydrates in first year postpartum and maternal/term infant BC, as well as breastfeeding parameters. BC of dyads (n = 20) was determined at 2, 5, 9, and/or 12 months postpartum using ultrasound skinfolds (infants) and bioelectrical impedance spectroscopy (infants/mothers). Breastfeeding frequency, 24-h milk intake and total carbohydrates (TCH) and lactose were measured to calculate HM oligosaccharides (HMO) concentration and CDI of carbohydrates. Statistical analysis used linear regression/mixed effects models; results were adjusted for multiple comparisons. Higher TCH concentrations were associated with greater infant length, weight, fat-free mass (FFM), and FFM index (FFMI), and decreased fat mass (FM), FM index (FMI), %FM and FM/FFM ratio. Higher HMO concentrations were associated with greater infant FFM and FFMI, and decreased FMI, %FM, and FM/FFM ratio. Higher TCH CDI were associated with greater FM, FMI, %FM, and FM/FFM ratio, and decreased infant FFMI. Higher lactose CDI were associated with greater FM, FMI, %FM, and FM/FFM, ratio and decreased FFMI. Concentrations and intakes of HM carbohydrates differentially influence development of infant BC in the first 12 months postpartum, and may potentially influence risk of later obesity via modulation of BC.
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Human Milk Casein and Whey Protein and Infant Body Composition over the First 12 Months of Lactation. Nutrients 2018; 10:nu10091332. [PMID: 30235880 PMCID: PMC6164442 DOI: 10.3390/nu10091332] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 09/05/2018] [Accepted: 09/17/2018] [Indexed: 12/30/2022] Open
Abstract
Human milk (HM) influences infant feeding patterns and body composition (BC). This small proof-of concept longitudinal study investigated relationships between infant/maternal BC and HM casein, whey and total protein during the first 12 months of lactation. BC of breastfeeding dyads (n = 20) was measured at 2 (n = 15), 5 (n = 20), 9 (n = 19), and/or 12 (n = 18) months postpartum with ultrasound skinfolds (infants) and bioimpedance spectroscopy (infants/mothers). Proteins concentrations and 24-h milk intake were measured and calculated daily intakes (CDI) determined. Higher maternal weight, body mass index, fat-free mass, fat-free mass index, and fat mass index were associated with higher concentration of whey protein (p ≤ 0.034, n = 20). There were no associations between infant BC and concentrations of all proteins, and CDI of whey and total protein. Higher CDI of casein were associated with lower infant fat-free mass (p = 0.003, n = 18) and higher fat mass (p < 0.001), fat mass index (p = 0.001, n = 18), and % fat mass (p < 0.001, n = 18) measured with ultrasound skinfolds. These results show a differential effect of HM casein on development of infant BC during the first year of life, suggesting that there is a potential to improve outcome for the infant through interventions, such as continuation of breastfeeding during the first 12 months of life and beyond, which may facilitate favourable developmental programming that could reduce risk of non-communicable diseases later in life.
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28
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Gay MCL, Koleva PT, Slupsky CM, Toit ED, Eggesbo M, Johnson CC, Wegienka G, Shimojo N, Campbell DE, Prescott SL, Munblit D, Geddes DT, Kozyrskyj AL. Worldwide Variation in Human Milk Metabolome: Indicators of Breast Physiology and Maternal Lifestyle? Nutrients 2018; 10:nu10091151. [PMID: 30420587 PMCID: PMC6163258 DOI: 10.3390/nu10091151] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 08/16/2018] [Accepted: 08/20/2018] [Indexed: 01/12/2023] Open
Abstract
Human milk provides essential substrates for the optimal growth and development of a breastfed infant. Besides providing nutrients to the infant, human milk also contains metabolites which form an intricate system between maternal lifestyle, such as the mother's diet and the gut microbiome, and infant outcomes. This study investigates the variation of these human milk metabolites from five different countries. Human milk samples (n = 109) were collected one month postpartum from Australia, Japan, the USA, Norway, and South Africa and were analyzed by nuclear magnetic resonance. The partial least squares discriminant analysis (PLS-DA) showed separation between either maternal countries of origin or ethnicities. Variation between countries in concentration of metabolites, such as 2-oxoglutarate, creatine, and glutamine, in human milk, between countries, could provide insights into problems, such as mastitis and/or impaired functions of the mammary glands. Several important markers of milk production, such as lactose, betaine, creatine, glutamate, and glutamine, showed good correlation between each metabolite. This work highlights the importance of milk metabolites with respect to maternal lifestyle and the environment, and also provides the framework for future breastfeeding and microbiome studies in a global context.
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Affiliation(s)
- Melvin C L Gay
- School of Molecular Sciences, University of Western Australia, Perth, WA 6009, Australia.
| | - Petya T Koleva
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, AB T6G 1C9, Canada.
| | - Carolyn M Slupsky
- Departments of Nutrition/Food Science & Technology, University of California Davis, California, CA 95616-5270, USA.
| | - Elloise du Toit
- Division of Medical Microbiology, University of Cape Town, Cape Town, Rondebosch 7701, South Africa.
| | - Merete Eggesbo
- Department of Environmental Exposure and Epidemiology, Norwegian Institute of Public Health, Oslo N-0213, Norway.
| | - Christine C Johnson
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI 48208, USA.
| | - Ganesa Wegienka
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI 48208, USA.
| | - Naoki Shimojo
- Department of Pediatrics, Chiba University, Chiba 260-8677, Japan.
| | - Dianne E Campbell
- Department of Allergy and Immunology, Children's Hospital at Westmead, University of Sydney, Sydney, NSW 2145, Australia.
| | - Susan L Prescott
- School of Medicine, University of Western Australia, Nedlands, WA 6009, Australia.
- ORIGINS Project, Telethon Kids Institute, Perth Children's Hospital, Perth, WA 6009, Australia.
| | - Daniel Munblit
- Department of Paediatrics, Imperial College London, London W2 1NY, UK.
- Faculty of Pediatrics, Sechenov University, Moscow 119991, Russia.
| | - Donna T Geddes
- School of Molecular Sciences, University of Western Australia, Perth, WA 6009, Australia.
| | - Anita L Kozyrskyj
- Departments of Pediatrics/Obstetrics & Gynecology, School of Public Health, University of Alberta, Edmonton, Alberta AB T6G 1C9, Canada.
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Monks J, Orlicky DJ, Stefanski AL, Libby AE, Bales ES, Rudolph MC, Johnson GC, Sherk VD, Jackman MR, Williamson K, Carlson NE, MacLean PS, McManaman JL. Maternal obesity during lactation may protect offspring from high fat diet-induced metabolic dysfunction. Nutr Diabetes 2018; 8:18. [PMID: 29695710 PMCID: PMC5916951 DOI: 10.1038/s41387-018-0027-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 12/17/2017] [Accepted: 02/07/2018] [Indexed: 01/21/2023] Open
Abstract
Background/Objectives The current obesity epidemic has spurred exploration of the developmental origin of adult heath and disease. A mother’s dietary choices and health can affect both the early wellbeing and lifelong disease-risk of the offspring. Subjects/Methods To determine if changes in the mother’s diet and adiposity have long-term effects on the baby’s metabolism, independently from a prenatal insult, we utilized a mouse model of diet-induced-obesity and cross-fostering. All pups were born to lean dams fed a low fat diet but were fostered onto lean or obese dams fed a high fat diet. This study design allowed us to discern the effects of a poor diet from those of mother’s adiposity and metabolism. The weaned offspring were placed on a high fat diet to test their metabolic function. Results In this feeding challenge, all male (but not female) offspring developed metabolic dysfunction. We saw increased weight gain in the pups nursed on an obesity-resistant dam fed a high fat diet, and increased pathogenesis including liver steatosis and adipose tissue inflammation, when compared to pups nursed on either obesity-prone dams on a high fat diet or lean dams on a low fat diet. Conclusion Exposure to maternal over-nutrition, through the milk, is sufficient to shape offspring health outcomes in a sex- and organ-specific manner, and milk from a mother who is obesity-prone may partially protect the offspring from the insult of a poor diet.
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Affiliation(s)
- Jenifer Monks
- Division of Reproductive Sciences, Department of Obstetrics & Gynecology, School of Medicine, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, 80045, USA.
| | - David J Orlicky
- Pathology Department, School of Medicine, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Adrianne L Stefanski
- Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Andrew E Libby
- Division of Reproductive Sciences, Department of Obstetrics & Gynecology, School of Medicine, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Elise S Bales
- Division of Reproductive Sciences, Department of Obstetrics & Gynecology, School of Medicine, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Michael C Rudolph
- Division of Endocrinology, Metabolism, & Diabetes, Department of Medicine, School of Medicine, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Ginger C Johnson
- Division of Endocrinology, Metabolism, & Diabetes, Department of Medicine, School of Medicine, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Vanessa D Sherk
- Division of Endocrinology, Metabolism, & Diabetes, Department of Medicine, School of Medicine, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Matthew R Jackman
- Division of Endocrinology, Metabolism, & Diabetes, Department of Medicine, School of Medicine, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Kayla Williamson
- Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Nichole E Carlson
- Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Paul S MacLean
- Division of Endocrinology, Metabolism, & Diabetes, Department of Medicine, School of Medicine, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - James L McManaman
- Division of Reproductive Sciences, Department of Obstetrics & Gynecology, School of Medicine, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, 80045, USA
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30
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Gridneva Z, Rea A, Hepworth AR, Ward LC, Lai CT, Hartmann PE, Geddes DT. Relationships between Breastfeeding Patterns and Maternal and Infant Body Composition over the First 12 Months of Lactation. Nutrients 2018; 10:E45. [PMID: 29303992 PMCID: PMC5793273 DOI: 10.3390/nu10010045] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 12/22/2017] [Accepted: 01/02/2018] [Indexed: 12/12/2022] Open
Abstract
Breastfeeding has been implicated in the establishment of infant appetite regulation, feeding patterns and body composition (BC). A holistic approach is required to elucidate relationships between infant and maternal BC and contributing factors, such as breastfeeding parameters. Associations between maternal and breastfed term infant BC (n = 20) and feeding parameters during first 12 months of lactation were investigated. BC was measured at 2, 5, 9 and/or 12 months postpartum with ultrasound skinfolds (US; infants only) and bioimpedance spectroscopy (infants and mothers). 24-h milk intake (MI) and feeding frequency (FFQ) were measured. Higher FFQ was associated with larger 24-h MI (p ≤ 0.003). Higher 24-h MI was associated with larger infant fat mass (FM) (US: p ≤ 0.002), greater percentage FM (US: p ≤ 0.008), greater FM index (FMI) (US: p ≤ 0.001) and lower fat-free mass index (FFMI) (US: p = 0.015). Lower FFQ was associated with both larger FFM (US: p ≤ 0.001) and FFMI (US: p < 0.001). Greater maternal adiposity was associated with smaller infant FFM measured with US (BMI: p < 0.010; %FM: p = 0.004; FMI: p < 0.011). Maternal BC was not associated with FFQ or 24-h MI. These results reinforce that early life is a critical window for infant programming and that breastfeeding may 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.
| | - Alethea Rea
- Centre for Applied Statistics, The University of Western Australia, Crawley, Perth, WA 6009, Australia.
| | - Anna R Hepworth
- 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.
| | - Ching T Lai
- School of Molecular Sciences, M310, 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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31
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Abstract
The review describes the molecular characteristics of so far detected breast milk adipokines and ranks their breast milk level compared to the respective levels in maternal and infant blood. Moreover, analytical knowledge for measurements of breast milk adipokines will be delineated. Next, we summarized data about two main potential influencing factors on adipokine concentration in breast milk, maternal weight and pasteurization of milk. Finally, associations between adipokines in breast milk and weight gain in infants as well as the putative mechanisms for effects of breast milk adipokines on food intake and weight gain in later life will debated. Our findings suggest that a source of adipokines in human breast milk cannot be uniformly defined. In dependence on the ratio between serum and breast milk levels the major quantity of these proteins may be derived from peripheral tissues, from the breast tissue itself or from both. Thus, leptin and in part adiponectin levels in breast milk are dependent on a plenty of influencing factors with an important relevance of maternal anthropometric characteristics There is some evidence that leptin, adiponectin and ghrelin levels in breast milk may be associated with growth gain of infants and even with increased risk for being overweight during infancy or childhood. We hypothesize that a dysregulation in adipokine homeostasis in early life could promote obesity and metabolic disturbance in later life.
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Affiliation(s)
- Juergen Kratzsch
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Leipzig, Germany.
| | - Yoon Ju Bae
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Leipzig, Germany
| | - Wieland Kiess
- Hospital for Children and Adolescents, Center of Paediatric Research, University of Leipzig, Leipzig, Germany
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32
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Escuder-Vieco D, Espinosa-Martos I, Rodríguez JM, Fernández L, Pallás-Alonso CR. Effect of HTST and Holder Pasteurization on the Concentration of Immunoglobulins, Growth Factors, and Hormones in Donor Human Milk. Front Immunol 2018; 9:2222. [PMID: 30319659 PMCID: PMC6170621 DOI: 10.3389/fimmu.2018.02222] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 09/07/2018] [Indexed: 02/06/2023] Open
Abstract
Donor human milk (DHM) is submitted to Holder pasteurization (HoP) to ensure its microbiological safety in human milk banks but this treatment affects some of its bioactive compounds. The objective of this work was to compare the effects of HoP and high temperature short time (HTST) treatments on some bioactive compounds found in DHM. A total of 24 DHM batches were processed in a continuous HTST system (70, 72, and 75°C for 5-25 s) and by HoP (62.5°C for 30 min). The concentrations of immunoglobulins (Igs) A, G, and M, transforming growth factor-beta 2 (TGF-β2), adiponectine, ghrelin, and leptin were measured using a multiplex system, whereas the concentration of epidermal growth factor (EGF) was determined by ELISA. In relation to Igs, IgG showed the highest preservation rates (87-101%) after HTST treatments, followed by IgA (54-88%) and IgM (25-73%). Ig retention after any of the HTST treatments was higher than after HoP (p < 0.001). Treatment times required to reduce the concentration of IgM by 90% (D-value) were 130, 88, and 49 s at 70, 72, and 75°C, while the number of degrees Celsius required to change the D-value by one factor of 10 (z-value) was 11.79°C. None of the heat treatments had a significant effect on the concentrations of TGF-β2, EGF, adiponectin, and ghrelin. In contrast, leptin was detected only in 4 of the samples submitted to HoP, whereas it was present in all samples after the different HTST treatments, with retention rates ranging between 34 and 68%. Globally, the concentration of IgA, IgG, IgM, and leptin in DHM was significantly higher after HTST pasteurization performed in a continuous system designed to be used in human milk banks than after the HoP procedure that is routinely applied at present.
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Affiliation(s)
- Diana Escuder-Vieco
- Banco Regional de Leche Materna, Hospital Universitario 12 de Octubre, Instituto de Investigación i+12, Madrid, Spain
- *Correspondence: Diana Escuder-Vieco
| | | | - Juan M. Rodríguez
- Sección Departamental de Nutrición y Ciencia de los Alimentos (Veterinaria), Universidad Complutense de Madrid, Madrid, Spain
| | - Leónides Fernández
- Sección Departamental de Farmacia Galénica y Tecnología Alimentaria (Veterinaria), Universidad Complutense de Madrid, Madrid, Spain
| | - Carmen Rosa Pallás-Alonso
- Banco Regional de Leche Materna, Hospital Universitario 12 de Octubre, Instituto de Investigación i+12, Madrid, Spain
- Servicio de Neonatología, Hospital Universitario 12 de Octubre, Instituto de Investigación i+12, Universidad Complutense de Madrid, Madrid, Spain
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33
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Abstract
By performing an in-depth analysis of one high profile example, this article aims to help breastfeeding support professionals understand the methodological flaws that characterize recent studies claiming to show the efficacy of frenotomy for the diagnoses of posterior tongue-tie and upper lip-tie. The example study does not address definitional confusion or control for the effects of the passage of time. It does not consider the effects of caring attention, validation, and lactation consultant support. It also does not consider the extensive research over the past three decades that has established that reflux in the first 6 months of life is benign, even though increased reflux frequency may correlate with unsettled infant behavior. The study authors relied on the hypothesis that reflux is caused by excessive air swallowing in infants with poor latch due to posterior tongue-tie and upper lip-tie, which lacks credible physiological mechanisms or supporting evidence. The authors' claim that conducting a randomized controlled trial to investigate the efficacy of frenotomy would be unethical contradicts the basic principles of good science. This article argues that our breastfeeding women and their babies deserve the most rigorous scientific methods available, and acknowledgment of the biases inherent in less rigorous research, if we are to make appropriate decisions concerning intervention with frenotomy and to prevent unnecessary oral surgery.
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Affiliation(s)
- Pamela Douglas
- 1 The Possums Clinic, Brisbane, Queensland, Australia.,2 Maternity, Newborn and Families Research Collaborative, MHIQ, Griffith University, Brisbane, Australia.,3 Discipline of General Practice, The University of Queensland, Brisbane, Australia
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34
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Kugananthan S, Gridneva Z, Lai CT, Hepworth AR, Mark PJ, Kakulas F, Geddes DT. Associations between Maternal Body Composition and Appetite Hormones and Macronutrients in Human Milk. Nutrients 2017; 9:E252. [PMID: 28282925 PMCID: PMC5372915 DOI: 10.3390/nu9030252] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 02/18/2017] [Accepted: 03/07/2017] [Indexed: 12/18/2022] Open
Abstract
Human milk (HM) appetite hormones and macronutrients may mediate satiety in breastfed infants. This study investigated associations between maternal adiposity and concentrations of HM leptin, adiponectin, protein and lactose, and whether these concentrations and the relationship between body mass index and percentage fat mass (%FM) in a breastfeeding population change over the first year of lactation. Lactating women (n = 59) provided milk samples (n = 283) at the 2nd, 5th, 9th and/or 12th month of lactation. Concentrations of leptin, adiponectin, total protein and lactose were measured. Maternal %FM was measured using bioimpedance spectroscopy. Higher maternal %FM was associated with higher leptin concentrations in both whole (0.006 ± 0.002 ng/mL, p = 0.008) and skim HM (0.005 ± 0.002 ng/mL, p = 0.007), and protein (0.16 ± 0.07 g/L, p = 0.028) concentrations. Adiponectin and lactose concentrations were not associated with %FM (0.01 ± 0.06 ng/mL, p = 0.81; 0.08 ± 0.11 g/L, p = 0.48, respectively). Whole milk concentrations of adiponectin and leptin did not differ significantly over the first year of lactation. These findings suggest that the level of maternal adiposity during lactation may influence the early appetite programming of breastfed infants by modulating concentrations of HM components.
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Affiliation(s)
- Sambavi Kugananthan
- School of Human Sciences, The University of Western Australia, Crawley WA 6009, Australia.
- School of Molecular Sciences, The University of Western Australia, Crawley WA 6009, Australia.
| | - Zoya Gridneva
- School of Molecular Sciences, The University of Western Australia, Crawley WA 6009, Australia.
| | - Ching T Lai
- School of Molecular Sciences, The University of Western Australia, Crawley WA 6009, Australia.
| | - Anna R Hepworth
- School of Molecular Sciences, The University of Western Australia, Crawley WA 6009, Australia.
| | - Peter J Mark
- School of Human Sciences, The University of Western Australia, Crawley WA 6009, Australia.
| | - Foteini Kakulas
- School of Molecular Sciences, The University of Western Australia, Crawley WA 6009, Australia.
| | - Donna T Geddes
- School of Molecular Sciences, The University of Western Australia, Crawley WA 6009, Australia.
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