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哺乳期母亲能量摄入减少会降低母亲体重以及母乳中瘦素、胰岛素和脂联素的浓度,而不影响乳汁分泌量、乳汁常量营养素组成或婴儿生长。

Reduction in Maternal Energy Intake during Lactation Decreased Maternal Body Weight and Concentrations of Leptin, Insulin and Adiponectin in Human Milk without Affecting Milk Production, Milk Macronutrient Composition or Infant Growth.

作者信息

Leghi Gabriela E, Netting Merryn J, Lai Ching T, Narayanan Ardra, Dymock Michael, Rea Alethea, Wlodek Mary E, Geddes Donna T, Muhlhausler Beverly S

机构信息

School of Agriculture, Food and Wine, The University of Adelaide, Adelaide 5064, Australia.

Women and Kids Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide 5000, Australia.

出版信息

Nutrients. 2021 May 31;13(6):1892. doi: 10.3390/nu13061892.

Abstract

Maternal diet has the potential to affect human milk (HM) composition, but very few studies have directly assessed the effect of maternal diets on HM composition. The primary aim of this study was to assess the effect of improving dietary quality in lactating women over 2 weeks on the concentrations of macronutrients and metabolic hormones in HM. The secondary aims were to assess the impact of the dietary intervention on 24 h milk production, maternal body composition and infant growth. Fifteen women completed a 1-week baseline period followed by a 2-week dietary intervention phase targeted towards reducing fat and sugar intake. Maternal anthropometric and body composition and infant growth measurements were performed weekly. Total 24 h milk production was measured before and after the dietary intervention, and HM samples were collected daily. Maternal intakes of energy (-33%), carbohydrate (-22%), sugar (-29%), fat (-54%) and saturated fat (-63%) were significantly reduced during the dietary intervention. HM insulin, leptin and adiponectin concentrations were 10-25% lower at the end of the dietary intervention, but HM concentrations of macronutrients were unaffected. Maternal body weight (-1.8%) and fat mass (-6.3%) were significantly reduced at the end of the dietary intervention, but there were no effects on 24 h milk production or infant growth. These results suggest that reducing maternal energy, carbohydrate, fat and sugar intake over a 2-week period is associated with significant reductions in HM insulin, leptin and adiponectin concentrations. These changes may be secondary to decreases in maternal weight and fat mass. The limited studies to date that have investigated the association between metabolic hormone concentrations in HM and infant growth raise the possibility that the changes in HM composition observed in the current study could impact infant growth and adiposity, but further studies are required to confirm this hypothesis.

摘要

母亲的饮食有可能影响母乳的成分,但直接评估母亲饮食对母乳成分影响的研究非常少。本研究的主要目的是评估在两周内改善哺乳期妇女的饮食质量对母乳中常量营养素和代谢激素浓度的影响。次要目的是评估饮食干预对24小时产奶量、母亲身体成分和婴儿生长的影响。15名女性完成了为期1周的基线期,随后进入为期2周的饮食干预阶段,目标是减少脂肪和糖的摄入量。每周对母亲的人体测量指标、身体成分和婴儿生长情况进行测量。在饮食干预前后测量24小时总产奶量,并每天收集母乳样本。在饮食干预期间,母亲的能量摄入量(-33%)、碳水化合物摄入量(-22%)、糖摄入量(-29%)、脂肪摄入量(-54%)和饱和脂肪摄入量(-63%)显著降低。在饮食干预结束时,母乳中的胰岛素、瘦素和脂联素浓度降低了10%-25%,但母乳中常量营养素的浓度未受影响。在饮食干预结束时,母亲的体重(-1.8%)和脂肪量(-6.3%)显著降低,但对24小时产奶量或婴儿生长没有影响。这些结果表明,在两周内减少母亲的能量、碳水化合物、脂肪和糖摄入量与母乳中胰岛素、瘦素和脂联素浓度的显著降低有关。这些变化可能是母亲体重和脂肪量下降的继发结果。迄今为止,有限的研究调查了母乳中代谢激素浓度与婴儿生长之间的关联,这增加了本研究中观察到的母乳成分变化可能影响婴儿生长和肥胖的可能性,但需要进一步的研究来证实这一假设。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a596/8227075/408938b90081/nutrients-13-01892-g001.jpg

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