Ross Michael G, Coca Kelly P, Rocha Ana Carolina Lavio, Camargo Bárbara Tideman Sartório, de Castro Luciola Sant'Anna, Horta Bernardo L, Desai Mina
The Lundquist Institute at Harbor-UCLA, Torrance, CA 90502, USA.
Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California Los Angeles at Harbor-UCLA, Torrance, CA 90502, USA.
J Clin Med. 2024 Nov 18;13(22):6947. doi: 10.3390/jcm13226947.
Among US breastfeeding women, those with obesity have significantly increased breast milk fat and caloric content from foremilk to hindmilk, with a 4-fold increase in fat content from the first to last milk sample. In view of different dietary norms and nutritional standards, we sought to evaluate the relationship between maternal BMI with breast milk fat and calorie content in women from Brazil, a low-middle-income country. Women who delivered singleton-term neonates were recruited from the Ana Abrao Breastfeeding Center (AABC) and Human Milk Bank at the Federal University of Sao Paulo, Brazil. These women were then studied at 7-8 weeks postpartum. Women were grouped by BMI categories of nonobese (NonOB; BMI 18.5-29.9) and obese (OB; BMI ≥ 30). A breast pump was applied, and milk samples were obtained continuously in 10 mL aliquots from foremilk to hindmilk; samples were analyzed for macronutrients and lipids, and maternal blood was analyzed for serum lipids and glucose. As compared to NonOB women, those with OB had significantly higher milk fat in the mid (4.9 ± 0.3 vs. 3.9 ± 0.2) and last hindmilk (6.6 ± 0.4 vs. 5.5 ± 0.3) samples, though not in the first foremilk sample, as compared to NonOB women. In both NonOB and OB subjects, milk caloric and fat content increased 1.5 to 2-fold from foremilk to hindmilk, with the average milk caloric value being 11% greater in OB women. Protein content was significantly increased in all three milk samples (first, middle, and last) in women with OB. : Although the value of breastfeeding remains clear, these findings may have significant implications for infant nutrition and excessive infant weight gain in women with OB.
在美国的哺乳期女性中，肥胖女性母乳中脂肪和热量含量从前奶到后奶显著增加，从第一个奶样到最后一个奶样，脂肪含量增加了4倍。鉴于不同的饮食规范和营养标准，我们试图评估巴西（一个中低收入国家）女性的母体BMI与母乳脂肪和热量含量之间的关系。在巴西圣保罗联邦大学的安娜·阿夫劳母乳喂养中心（AABC）和母乳库招募了分娩单胎足月儿的女性。这些女性在产后7至8周接受研究。根据BMI类别将女性分为非肥胖组（NonOB；BMI 18.5 - 29.9）和肥胖组（OB；BMI≥30）。使用吸奶器，从前奶到后奶以10毫升的等分试样连续采集奶样；对样品进行常量营养素和脂质分析，并对母体血液进行血脂和血糖分析。与NonOB女性相比，OB女性在中间（4.9±0.3对3.9±0.2）和最后后奶（6.6±0.4对5.5±0.3）样品中的乳脂肪显著更高，尽管与NonOB女性相比，第一个前奶样品中并非如此。在NonOB和OB受试者中，母乳热量和脂肪含量从前奶到后奶均增加了1.5至2倍，OB女性的平均母乳热量值高11%。OB女性的所有三个奶样（第一个、中间和最后一个）中的蛋白质含量均显著增加。虽然母乳喂养的价值仍然明确，但这些发现可能对肥胖女性的婴儿营养和婴儿体重过度增加具有重要意义。
