Sims Clark R, Saben Jessica L, Martinez Audrey, Sobik Sarah R, Crimmins Meghan R, Bulmanski Jessica E, Turner Donald, Furst Annalee, Jansen Lisa T, Bode Lars, Andres Aline
Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States.
Arkansas Children's Nutrition Center, Little Rock, AR, United States.
Front Nutr. 2024 Mar 13;11:1303822. doi: 10.3389/fnut.2024.1303822. eCollection 2024.
Maternal obesity is associated with increased concentrations of human milk (HM) obesogenic hormones, pro-inflammatory cytokines, and oligosaccharides (HMOs) that have been associated with infant growth and adiposity. The objective of this pilot study was to determine if adherence to a Mediterranean meal plan during lactation modulates macronutrients and bioactive molecules in human milk from mothers with obesity.
Sixteen healthy, exclusively breastfeeding women with obesity (body mass index ≥30 kg/m) enrolled between 4 and 5 months postpartum. The women followed a 4-week Mediterranean meal plan which was provided at no cost. Maternal and infant anthropometrics, HM composition, and infant intakes were measured at enrollment and at weeks 2 and 4 of the intervention. Thirteen mother-infant dyads completed the study. Additionally, participants from an adjacent, observational cohort who had obesity and who collected milk at 5 and 6 months postpartum were compared to this cohort.
Participants' healthy eating index scores improved (+27 units, < 0.001), fat mass index decreased (-4.7%, < 0.001), and daily energy and fat intake were lower (-423.5 kcal/day, p < 0.001 and-32.7 g/day, < 0.001, respectively) following the intervention. While HM macronutrient concentrations did not change, HM leptin, total human milk oligosaccharides (HMOs), HMO-bound fucose, Lacto-N-fucopentaose (LNFP)-II, LNFP-III, and difucosyllacto-N-tetrose (DFLNT) concentrations were lower following the intervention. Infant intakes of leptin, tumor necrosis factor (TNF)-α, total HMOs, HMO-bound fucose, LNFP-III and DFLNT were lower following the intervention. Specific components of the maternal diet (protein and fat) and specific measures of maternal diet quality (protein, dairy, greens and beans, fruit and vegetables) were associated with infant intakes and growth.
Adherence to a Mediterranean meal plan increases dietary quality while reducing total fat and caloric intake. In effect, body composition in women with obesity improved, HM composition and infants' intakes were modulated. These findings provide, for the first time, evidence-based data that enhancing maternal dietary quality during lactation may promote both maternal and child health. Longer intervention studies examining the impact of maternal diet quality on HM composition, infant growth, and infant development are warranted.
母亲肥胖与母乳中致肥胖激素、促炎细胞因子和低聚糖（HMOs）浓度升高有关，这些物质与婴儿生长和肥胖相关。这项初步研究的目的是确定哺乳期坚持地中海饮食计划是否会调节肥胖母亲母乳中的常量营养素和生物活性分子。
16名健康的、纯母乳喂养的肥胖女性（体重指数≥30kg/m²）在产后4至5个月入组。这些女性遵循了一项免费提供的为期4周的地中海饮食计划。在入组时以及干预的第2周和第4周测量母婴人体测量学指标、母乳成分和婴儿摄入量。13对母婴完成了研究。此外，将来自相邻观察队列、患有肥胖症且在产后5个月和6个月收集母乳的参与者与该队列进行了比较。
干预后，参与者的健康饮食指数得分提高（+27分，P<0.001），脂肪质量指数下降（-4.7%，P<0.001），每日能量和脂肪摄入量降低（分别为-423.5千卡/天，P<0.001和-32.7克/天，P<0.001）。虽然母乳常量营养素浓度没有变化，但干预后母乳中的瘦素、总母乳低聚糖（HMOs）、HMO结合岩藻糖、乳糖-N-岩藻五糖（LNFP）-II、LNFP-III和二岩藻糖基乳糖-N-四糖（DFLNT）浓度降低。干预后婴儿的瘦素、肿瘤坏死因子（TNF）-α、总HMOs、HMO结合岩藻糖、LNFP-III和DFLNT摄入量降低。母亲饮食的特定成分（蛋白质和脂肪）以及母亲饮食质量的特定指标（蛋白质、乳制品、绿色蔬菜和豆类、水果和蔬菜）与婴儿摄入量和生长相关。
坚持地中海饮食计划可提高饮食质量，同时降低总脂肪和热量摄入。实际上，肥胖女性的身体成分得到改善，母乳成分和婴儿摄入量得到调节。这些发现首次提供了基于证据的数据，表明哺乳期提高母亲饮食质量可能促进母婴健康。有必要进行更长时间的干预研究，以检验母亲饮食质量对母乳成分、婴儿生长和婴儿发育的影响。
