Maternal obesity and the human milk metabolome: associations with infant body composition and postnatal weight gain. Issue 1 (10th April 2019)

• Record Type: Journal Article
• Authors: Isganaitis, Elvira; Venditti, Sarah; Matthews, Tucker J; Lerin, Carles; Demerath, Ellen W; Fields, David A
• Is Part Of: American journal of clinical nutrition. Volume 110:Issue 1(2019)
• Page Start: 111
• Page End: 120
• Publication Date: 2019-04-10
• Subjects: human milk -- breast milk -- maternal obesity -- metabolomics -- body composition -- human milk oligosaccharides -- infant; Diet therapy -- Periodicals; Nutrition -- Periodicals; Dietetics -- Periodicals; 613.205
• DOI: 10.1093/ajcn/nqy334
• Languages: English
• ISSNs: 0002-9165

Abstract

ABSTRACT: Background: Maternal obesity is a risk factor for childhood obesity; this is a major public health concern given that ∼40% of pregnant women are either overweight or obese. Whether differences in milk composition in lean compared with obese women contribute to childhood obesity is unclear. Objectives: We aimed to analyze relationships between maternal obesity and human milk metabolites, infant body composition, and postnatal weight gain. Methods: This was a prospective study in which mothers intending to breastfeed exclusively, and their newborn infants, were enrolled at delivery ( n = 35 mother–infant pairs). We excluded mothers with diabetes, other medical conditions, or pregnancy complications. Participants were grouped by maternal prepregnancy BMI <25 (lean) or ≥25 kg/m 2 (overweight/obese). We analyzed infant body composition by dual-energy X-ray absorptiometry and used untargeted liquid chromatography–gas chromatography–mass spectrometry to measure the milk content of 275 metabolites at 1 and 6 mo postpartum. Results: At 1 mo postpartum, 10 metabolites differed between overweight/obese and lean groups with nominal P < 0.05, but none was altered with a false discovery rate <0.25. Many differentially abundant metabolites belonged to the same chemical class; e.g., 4/10 metabolites were nucleotide derivatives, and 3/10 were human milk oligosaccharides. Milk adenine correlated positively with both continuously distributed maternal BMI and with infant adiposity and fat accrual. Analysis of milk composition at 6 mo postpartum revealed 20 differentially abundant metabolites ( P < 0.05) in overweight/obese compared with lean women, including 6 metabolites with a false discovery rate of <0.25. At both 1 and 6 mo, human milk abundance of 1, 5-anhydroglucitol, which has not previously been described in milk, was positively associated with maternal BMI. Conclusions: Maternal obesity is associated with changes in the human milk metabolome. While only a subset of metabolites correlated with both maternal and infant weight, these point to potential milk-dependent mechanisms for mother–child transmission of obesity. This trial was registered at www.clinicaltrials.gov as NCT02535637.