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Am J Clin Nutr. 2019 Apr 4. pii: nqy334. doi: 10.1093/ajcn/nqy334. [Epub ahead of print]

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

Author information

1
Research Division, Joslin Diabetes Center, Boston, MA.
2
Department of Pediatrics, Harvard Medical School, Boston, MA.
3
Endocrinology Department, Institut de Recerca Sant Joan de Déu, Barcelona, Spain.
4
Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.
5
Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK.

Abstract

BACKGROUND:

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

OBJECTIVES:

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

METHODS:

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

RESULTS:

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

CONCLUSIONS:

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

KEYWORDS:

body composition; breast milk; human milk; human milk oligosaccharides; infant; maternal obesity; metabolomics

PMID:
30968129
DOI:
10.1093/ajcn/nqy334

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