scholarly journals The Function and Alteration of Immunological Properties in Human Milk of Obese Mothers

Nutrients ◽  
2019 ◽  
Vol 11 (6) ◽  
pp. 1284 ◽  
Author(s):  
Ummu D. Erliana ◽  
Alyce D. Fly
Keyword(s):  
Human Milk ◽  
Maternal Obesity ◽  
Infant Nutrition ◽  
Nutrition Status ◽  
Immunological Properties ◽  
Reactive Protein ◽  
First Choice ◽  
Immunological Factors ◽  
The Impact

Maternal obesity is associated with metabolic changes in mothers and higher risk of obesity in the offspring. Obesity in breastfeeding mothers appears to influence human milk production as well as the quality of human milk. Maternal obesity is associated with alteration of immunological factors concentrations in the human milk, such as C-reactive protein (CRP), leptin, IL-6, insulin, TNF-Alpha, ghrelin, adiponectin, and obestatin. Human milk is considered a first choice for infant nutrition due to the complete profile of macro nutrients, micro nutrients, and immunological properties. It is essential to understand how maternal obesity influences immunological properties of human milk because alterations could impact the nutrition status and health of the infant. This review summarizes the literature regarding the impact of maternal obesity on the concentration of particular immunological properties in the human milk.

scholarly journals The Impact of Maternal Obesity on Human Milk Macronutrient Composition: A Systematic Review and Meta-Analysis

Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 934 ◽  
Author(s):  
Gabriela E. Leghi ◽  
Merryn J. Netting ◽  
Philippa F. Middleton ◽  
Mary E. Wlodek ◽  
Donna T. Geddes ◽  
...  
Keyword(s):  
Human Milk ◽  
Maternal Obesity ◽  
Overweight And Obesity ◽  
Cochrane Library ◽  
Maternal Body Mass Index ◽  
Qualitative Synthesis ◽  
Lactating Women ◽  
Maternal Overweight ◽  
The Impact

Maternal obesity has been associated with changes in the macronutrient concentration of human milk (HM), which have the potential to promote weight gain and increase the long-term risk of obesity in the infant. This article aimed to provide a synthesis of studies evaluating the effects of maternal overweight and obesity on the concentrations of macronutrients in HM. EMBASE, MEDLINE/PubMed, Cochrane Library, Scopus, Web of Science, and ProQuest databases were searched for relevant articles. Two authors conducted screening, data extraction, and quality assessment independently. A total of 31 studies (5078 lactating women) were included in the qualitative synthesis and nine studies (872 lactating women) in the quantitative synthesis. Overall, maternal body mass index (BMI) and adiposity measurements were associated with higher HM fat and lactose concentrations at different stages of lactation, whereas protein concentration in HM did not appear to differ between overweight and/or obese and normal weight women. However, given the considerable variability in the results between studies and low quality of many of the included studies, further research is needed to establish the impact of maternal overweight and obesity on HM composition. This is particularly relevant considering potential implications of higher HM fat concentration on both growth and fat deposition during the first few months of infancy and long-term risk of obesity.

scholarly journals The Impact of Maternal Obesity on Human Milk Macronutrient Composition: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 773-773
Author(s):  
Gabriela Leghi ◽  
Merryn J Netting ◽  
Philippa F Middleton ◽  
Mary E Wlodek ◽  
Donna T Geddes ◽  
...  
Keyword(s):  
Human Milk ◽  
Maternal Obesity ◽  
Meta Analysis ◽  
Overweight And Obesity ◽  
Qualitative Assessment ◽  
Cochrane Library ◽  
Qualitative Synthesis ◽  
Lactating Women ◽  
Maternal Overweight ◽  
The Impact

Abstract Objectives This article aimed to provide a synthesis of studies evaluating the effects of maternal overweight and obesity, including body mass index (BMI) and other measures of adiposity, on the concentrations of macronutrients (fat, protein and lactose) in human milk (HM). Methods EMBASE, MEDLINE/PubMed, Cochrane Library, Scopus, Web of Science and ProQuest databases were searched for relevant articles. Two authors conducted screening, data extraction and quality assessment independently. Meta-analyses of eligible studies were conducted using Review Manager software version 5.3. Results A total of 31 studies (5078 lactating women) were included in the qualitative synthesis and 9 studies (872 lactating women) in the quantitative synthesis. The meta-analysis indicated that maternal overweight and obesity were associated with higher concentrations of fat in mature HM (p = 0.01) and lactose in colostrum (p = 0.002). While the qualitative analyses broadly supported the findings of the meta-analysis, the qualitative assessment identified considerable variability in the results between studies and low quality of many of the included studies, making it difficult to draw robust conclusions. Conclusions Overall, maternal BMI and adiposity measurements were associated with differences in the concentrations of fat and lactose in HM, however the direction of change was dependent on the stage of lactation, whereas protein concentration in HM did not appear to differ between overweight and/or obese and normal weight women. This is particularly relevant considering potential implications of higher HM fat concentration on both growth and fat deposition during the first few months of infancy and long-term risk of obesity. Funding Sources GEL was supported by a FOODplus Early Life Nutrition Scholarship, The University of Adelaide. BSM received a Career Development Award from the National Health and Medical Research Council of Australia (NHMRC).

scholarly journals A Mediterranean Meal Plan Modulates Human Milk Composition in Women With Obesity

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 818-818
Author(s):  
Clark Sims ◽  
Audrey , Martinez ◽  
Aline Andres
Keyword(s):  
Human Milk ◽  
Dietary Intervention ◽  
Maternal Obesity ◽  
Post Partum ◽  
Milk Composition ◽  
Healthy Eating Index ◽  
Fat Intake ◽  
Post Intervention ◽  
Meal Plan ◽  
The Impact

Abstract Objectives Human milk (HM) is impacted by both maternal obesity and diet. HM from women with obesity has higher fat, leptin and insulin concentrations. Additionally, maternal dietary fat intake is associated with increased HM fat content. The objective of this study was to determine the impact of a Mediterranean meal plan on the composition of HM from women with obesity. Methods In this pilot study, thirteen women with obesity (body mass index (BMI) ≥ 30 kg/m2) enrolled at five months post-partum and followed a provided Mediterranean meal plan focused on reducing fat intake and increasing unsaturated fat and fiber intake for four weeks. Participants’ diet was assessed using Nutrition Data System for Research. HM was collected at baseline and after the 4-week intervention and the concentrations of metabolites, hormones and cytokines were assayed. Wilcoxon signed-rank tests and analysis of variance were used to assess changes in participant diet and HM composition. Summary statistics are presented as mean ± standard deviation. Results The participants’ Healthy Eating Index Score, a measure of diet quality, significantly improved (38.3 ± 5.13 vs. 78.2 ± 6.75, p < 0.001) and total fat intake was significantly lower (99.6 ± 23.3 g vs. 66.9 ± 12.0 g/day, p < 0.001) after the intervention. Human milk leptin (694 ± 464 pg/ml vs. 437 ± 324 pg/ml, p = 0.007) and tumor necrosis factor α (0.515 ± 0.267 pg/ml vs. 0.310 ± 0.127 pg/ml, p = 0.010) concentrations were lower post intervention, whereas HM macronutrient composition was unchanged. The concentrations of several individual human milk oligosaccharides (HMO) and total HMOs (7720 ± 797 nmol/ml vs. 6986 ± 940 nmol/ml, p = 0.049), as well as HM tyrosine concentration (18.2 ± 6.16 nmol/ml vs. 14.5 ± 4.69 nmol/ml, p = 0.005) were significantly lower post intervention. Conclusions The composition of HM from women with obesity can be modulated by short-term adherence to a Mediterranean meal pattern. These findings merit further studies that use longer interventions and examine the impact of any changes in HM composition on infant growth and development. Modifying HM composition via a dietary intervention may provide a novel strategy to promote child development and health. Funding Sources USDA ARS #6026-51,000-010-05S and #6026-51,000-012-06S, NIH/NIDDK R01DK107516, Arkansas Children's Research Institute/Arkansas Biosciences Institute GR037121.

scholarly journals The Effect of Pelvic Floor Muscles Exercise on Quality of Life in Women with Stress Urinary Incontinence and Its Relationship with Vaginal Deliveries: A Randomized Trial

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Magdalena Ptak ◽  
Sylwester Ciećwież ◽  
Agnieszka Brodowska ◽  
Andrzej Starczewski ◽  
Jolanta Nawrocka-Rutkowska ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Pelvic Floor ◽  
Sleep Problems ◽  
Pelvic Floor Muscles ◽  
Combined Training ◽  
Vaginal Deliveries ◽  
First Choice ◽  
The Impact

Introduction. Urinary incontinence (UI) is a health problem affecting the quality of women’s lives (QOL) at various life stages. Stress urinary incontinence (SUI) can be caused by previous vaginal deliveries and is especially likely to occur in the perimenopausal period. The most commonly recommended first-choice treatment methods involve exercises for the pelvic floor muscles (PFM). The aim of this study was to assess the impact of isolated PFM exercises and combined training of the PFM and the m.transversus abdominis (TrA) muscle on the QoL of patients with SUI with regard to the number of vaginal deliveries.Material and Methods. 137 women with SUI were qualified for analysis (mean age 53,1 ± 5,5). To assess the effectiveness of PFM training QOL questionnaire was used (ICIQ-LUTS qol). PFM training for groups A (PFM+TrA) and B (PFM) was intended for 12 weeks. Statistica v. 12.0 PL, StatSoft, USA, was used for statistical calculations.Results. The analysis demonstrated that conservative treatment based on the A training program (PFM + TrA) yielded statistically significantly better results than the B program (PFM), with the improvement observed in such QoL domains as the performance of household duties, physical activity and travelling, social limitations, emotions, sleep problems and fatigue, the frequency of changing panty liners, fluid intake control, and embarrassment.Conclusion. Both the combined training of the PFM and the synergistic (TrA) muscle and the isolated PFM exercises improve the QoL of women with SUI. Nonetheless, the combined PFM and TrA muscle physiotherapy is more effective. The exercises for the PFM and the synergistic muscle give better results in women who have given birth fewer than three times than isolated PFM exercises.

scholarly journals Infant Intakes of Human Milk Amino Acids Are Associated With Maternal Obesity and Infant Growth

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 810-810
Author(s):  
Jessica Saben ◽  
Clark Sims ◽  
Lindsay Pack ◽  
Renny Lan ◽  
Aline Andres
Keyword(s):  
Amino Acids ◽  
Human Milk ◽  
Early Life ◽  
Maternal Obesity ◽  
Child Growth ◽  
Infant Growth ◽  
Formula Milk ◽  
Mixed Effect ◽  
The Impact ◽  
Maternal Bmi

Abstract Objectives Branched chain amino acids (AA) (BCAAs: leucine (Leu), isoleucine (Ile), and valine) and aromatic AA (AAAs: phenylalanine (Phe) and tyrosine (Tyr)) have been hypothesized to take part in early-life metabolic programing. To date studies testing the effect of early-life AA consumption on metabolic programing have been focused on formula milk proteins, where increased consumption was associated with obesity risk. However, a knowledge gap exists regarding how variations in human milk (HM) free AA concentrations might impact child growth. Here, we aimed to characterize HM free AA concentrations and infant intakes of HM AAs from women with obesity (OB) compared to those with normal weight (NW). We hypothesized that infants born to women with OB would consume greater amounts of HM BCAAs and AAAs, which would be positively associated with their growth. Methods HM samples were collected at 0.5 months (0.5M; n = 151), 2 months (2M; n = 129), and 6 months (6M; n = 93) postpartum from NW (body mass index (BMI) = 18.5 – 24.9 kg/m2) and OB (BMI > 30 kg/m2) mothers. HM free AA were quantified at each timepoint via mass spectrometry. Infant HM intake, anthropometrics and body composition were assessed at each timepoint. Linear mixed effect models examined the relationships between maternal BMI and HM AA composition, HM AA intake, and infant growth over the first 6Ms postpartum. Models were adjusted for maternal race, breastfeeding exclusivity, infant sex and infant age. Results Concentrations of Ile, Leu, and AAAs were higher (p < 0.05) across all timepoints in HM from women with OB compared to those with NW. Infant intakes, normalized to kg body weight, of these AAs were only significantly higher at 2M. Maternal BMI was negatively associated (p < 0.05) with infant intakes of HM asparagine, cystine, and histidine and positively associated with Ile, Leu, and AAAs intakes across timepoints. Infant intakes of HM Ile (b = −0.083), Leu (b = −0.045), and proline (b = -0.024) were negative predictors of infant weight-for-age z-scores over the first 6M postpartum (p < 0.05). Conclusions Maternal obesity is associated with increased BCAA and AAA infant exposures over the first 6M of life. However, the impact of these AAs on infant growth are not consistent with observations made with infant formulas. Funding Sources USDA ARS Project # 6026-51,000-010-05S and 6026-51,000-012-06S.

scholarly journals The Impact of Dietary Fucosylated Oligosaccharides and Glycoproteins of Human Milk on Infant Well-Being

Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 1105 ◽  
Author(s):  
Magdalena Orczyk-Pawiłowicz ◽  
Jolanta Lis-Kuberka
Keyword(s):  
Human Milk ◽  
Infant Nutrition ◽  
Feeding Strategy ◽  
Well Being ◽  
Human Milk Oligosaccharides ◽  
Adhesive Properties ◽  
Milk Oligosaccharides ◽  
Wide Range ◽  
Carbohydrate Components ◽  
The Impact

Apart from optimal nutritional value, human milk is the feeding strategy to support the immature immunological system of developing newborns and infants. The most beneficial dietary carbohydrate components of breast milk are human milk oligosaccharides (HMOs) and glycoproteins (HMGs), involved in both specific and nonspecific immunity. Fucosylated oligosaccharides represent the largest fraction of human milk oligosaccharides, with the simplest and the most abundant being 2′-fucosyllactose (2′-FL). Fucosylated oligosaccharides, as well as glycans of glycoproteins, as beneficial dietary sugars, elicit anti-adhesive properties against fucose-dependent pathogens, and on the other hand are crucial for growth and metabolism of beneficial bacteria, and in this aspect participate in shaping a healthy microbiome. Well-documented secretor status related differences in the fucosylation profile of HMOs and HMGs may play a key but underestimated role in assessment of susceptibility to fucose-dependent pathogen infections, with a potential impact on applied clinical procedures. Nevertheless, due to genetic factors, about 20% of mothers do not provide their infants with beneficial dietary carbohydrates such as 2′-FL and other α1,2-fucosylated oligosaccharides and glycans of glycoproteins, despite breastfeeding them. The lack of such structures may have important implications for a wide range of aspects of infant well-being and healthcare. In light of the above, some artificial mixtures used in infant nutrition are supplemented with 2′-FL to more closely approximate the unique composition of maternal milk, including dietary-derived fucosylated oligosaccharides and glycoproteins.

scholarly journals The Impact of Maternal Breast Milk in Preventing Necrotizing Enterocolitis: A Narrative Review

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Siamak Afaghi ◽  
Fateme Sadat Rahimi ◽  
Farzad Esmaeili Tarki ◽  
Sahar Yazdani ◽  
Amirhossein Hosseini ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Growth Factor ◽  
Breast Milk ◽  
Human Milk ◽  
Necrotizing Enterocolitis ◽  
Transforming Growth Factor ◽  
Protective Role ◽  
Donor Human Milk ◽  
First Choice ◽  
The Impact

Context: Necrotizing enterocolitis (NEC), as a life-threatening gastrointestinal tract disease, is associated with high rates of morbidity and mortality. Extensive inflammation, progressive hemorrhagic necrosis, and overwhelming infection of the gut are reasons why NEC is known as a devastating disease in premature infants. Almost 45% of affected preterm infants die, and those who survive suffer from multiple complications. Human milk, the best food for newborns, plays a significant role in supporting the immune system. Both mother’s own milk (MOM) and donor human milk (DHM) are particularly important in the prevention and lessening of the severity of NEC. Evidence Acquisition: We searched PubMed, Elsevier, and Google Scholar databases for articles that investigated the correlation between NEC and human milk. Then all data were accessed about their relevancy to this current subject. Results: In summary, the purpose of this article is to firstly review the protective role of breast milk components against NEC, and secondly discussing the correlation between human milk and NEC in clinical studies. Human milk bio-components, including Lactoferrin, oligosaccharides, maternal soluble IgA, epidermal growth factor, transforming growth factor, prebiotic, probiotics, and antioxidants, have a protective effect against NEC. However, the importance of these components in donor human milk and the formula is underestimated. Conclusions: Human milk, as the first-choice of nutritional source, comprises a wide diversity of copious bio-components, which dwindle the risk and severity of NEC in many ways. The exact mechanisms are still unclear, the evidence strongly point out that human milk is superior to any other nutrition concerning protecting the gastrointestinal tract from NEC.

Abstract 3253: The Predictability of C-reactive Protein, Lipoprotein-Associated Phospholipase A2, and Depression on Later Health Outcomes in Patients Experiencing a First-Time Stroke

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
mary K brethour ◽  
Karen C Albright ◽  
David E Vance ◽  
Andrei V Alexandrov ◽  
Anne W Alexandrov
Keyword(s):  
Quality Of Life ◽  
Health Outcomes ◽  
Tissue Injury ◽  
Beck Depression Inventory Score ◽  
Significant Independent Predictor ◽  
Post Stroke ◽  
Reactive Protein ◽  
Post Stroke Depression ◽  
The Impact

Background: Strokes trigger an acute inflammatory response prompted by brain tissue injury at the infarct site and the surrounding ischemic penumbra. CRP and Lp-PLA2 have been significantly correlated in some studies with infarct size and post-stroke complications, and up to 60% of stroke survivors experience depression which may contribute to poor health outcomes. We sought to examine interaction effects between baseline CRP and Lp-PLA2 levels with depression in patients with a first-ever ischemic stroke. Methods: Baseline levels of CRP, Lp-PLA2 and depression were measured in 24 consecutive stroke patients presenting to the ED within 24 hours of symptoms onset. Depression levels, NIHSS, mRS, and quality of life (SF-36) were re-measured at 3 months post-stroke. Hierarchial multiple regression models were used to assess each outcome measure; Spearman correlations were used to reduce the number of predictor variables. Results: The median age of the participants was 62 (range 45 - 85); 62% were male, 25% African American, and 75% Caucasian. Stroke subtypes were 62% lacunar, 4% large vessel; and 33% cardioembolic; 45% were taking a statin prior to admission and mean baseline LDL was 108.6 + 33.8mg/dL (range 66-189). Of the 24 participants enrolled, 20 completed the study. At 3 months post-stroke, 92% were taking a statin; mean LDL was 89.71. The median admission NIHSS score was 3.1 (range 0-15), and 17% were treated with IV t-PA Baseline CRP values ranged from <0.1 to 34.9 with a median of 0.3. Baseline Lp-PLA 2 values ranged from 85 to 617 with a median of 194. The mean Beck Depression Inventory score on admission was 5.9 + 4.6. Neither the biological markers of CRP and Lp-PLA 2 nor the interaction between CRP and Lp-PLA2 and depression were significant independent predictors of health outcomes at 3 months post-stroke. Depression, however, was a significant independent predictor of functionality (p=.009) and quality of life (p=.02) at 3 months post-stroke. Discussion: The impact of depression on 3 month outcomes is significant. While these 2 biomarkers were unreliable at predicting health outcomes, providers should standardize their assessment of depression to ensure proper detection and treatment that may improve health outcomes post-stroke.

scholarly journals Human Milk Exosomal MicroRNA: Associations with Maternal Overweight/Obesity and Infant Body Composition at 1 Month of Life

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1091
Author(s):  
Kruti B. Shah ◽  
Steven D. Chernausek ◽  
Lori D. Garman ◽  
Nathan P. Pezant ◽  
Jasmine F. Plows ◽  
...  
Keyword(s):  
Body Composition ◽  
Human Milk ◽  
Fat Mass ◽  
Maternal Obesity ◽  
Normal Weight ◽  
The Body ◽  
Fat Free Mass ◽  
Negatively Associated ◽  
Maternal Overweight ◽  
The Impact

Among all the body fluids, breast milk is one of the richest sources of microRNAs (miRNAs). MiRNAs packaged within the milk exosomes are bioavailable to breastfeeding infants. The role of miRNAs in determining infant growth and the impact of maternal overweight/obesity on human milk (HM) miRNAs is poorly understood. The objectives of this study were to examine the impact of maternal overweight/obesity on select miRNAs (miR-148a, miR-30b, miR-29a, miR-29b, miR-let-7a and miR-32) involved in adipogenesis and glucose metabolism and to examine the relationship of these miRNAs with measures of infant body composition in the first 6 months of life. Milk samples were collected from a cohort of 60 mothers (30 normal-weight [NW] and 30 overweight [OW]/obese [OB]) at 1-month and a subset of 48 of these at 3 months of lactation. Relative abundance of miRNA was determined using real-time PCR. The associations between the miRNAs of interest and infant weight and body composition at one, three, and six months were examined after adjusting for infant gestational age, birth weight, and sex. The abundance of miR-148a and miR-30b was lower by 30% and 42%, respectively, in the OW/OB group than in the NW group at 1 month. miR-148a was negatively associated with infant weight, fat mass, and fat free mass, while miR-30b was positively associated with infant weight, percent body fat, and fat mass at 1 month. Maternal obesity is negatively associated with the content of select miRNAs in human milk. An association of specific miRNAs with infant body composition was observed during the first month of life, suggesting a potential role in the infant’s adaptation to enteral nutrition.

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