A nutritional supplement taken during preconception and pregnancy influences human milk macronutrients in women with overweight/obesity and gestational diabetes mellitus

Frontiers in Nutrition

Nutrition

Shiao-Yng Chan¹  Wei Wei Pang²  Soo Min Han³  Mark H. Vickers³  Wayne S. Cutfield⁴  José G. B. Derraik⁵  Keith M. Godfrey⁶  Fang Huang⁷  Sagar K. Thakkar⁸  Surabhi Devaraj⁸  Sarah El-Heis⁹  Cathryn Conlon⁹  Philip Titcombe⁹  Marysia Depczynski⁹  Aristea Binia⁹  Benjamin B. Albert⁹  Ray Wong⁹  Yap Seng Chong⁹  Paula Costello⁹  Vanessa Cox⁹  Rachael Taylor⁹  Hsin Fang Chang⁹  Gernalia Satianegara⁹  Shu E. Soh⁹  Christine Creagh⁹  Timothy Kenealy⁹  Irma Silva-Zolezzi⁹  Justin M. O’Sullivan⁹  Mrunalini Jagtap⁹  Shelia J. Barton⁹  Heidi Nield⁹  Vicky Tay⁹  Mary F. Chong⁹  Cyrus Cooper⁹  Zhang Han⁹  Clare Wall⁹  Mary Cavanagh⁹  Elizabeth Tham⁹  Gladys Woon⁹  Judith Hammond⁹  Nicholas C. Harvey⁹ 

[1] Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore;Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore;Global Centre for Asian Women’s Health, Dean’s Office, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore;Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore;Liggins Institute, The University of Auckland, Auckland, New Zealand;Liggins Institute, The University of Auckland, Auckland, New Zealand;A Better Start—National Science Challenge, The University of Auckland, Auckland, New Zealand;Liggins Institute, The University of Auckland, Auckland, New Zealand;Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand;MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, United Kingdom;NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, United Kingdom;Nestlé Research, Société des Produits Nestlé S.A., Beijing, China;Nestlé Research, Société des Produits Nestlé S.A., Singapore, Singapore;null;

关键词: human milk;    macronutrients;    gestational diabetes mellitus;    maternal BMI;    maternal nutrition;   

DOI  :  10.3389/fnut.2023.1282376

 received in 2023-08-24, accepted in 2023-09-26,  发布年份 2023

来源: Frontiers

【 摘 要 】

RationalMaternal overweight/obesity and gestational diabetes mellitus (GDM) are associated with an increased risk of their offspring developing overweight/obesity or type 2 diabetes later in life. However, the impacts of maternal overweight/obesity and dysglycemia on human milk (HM) macronutrient composition are not well understood.ObjectiveThrough a double-blind randomised controlled trial, we investigated the effects of maternal supplementation from preconception throughout pregnancy until birth on HM macronutrient concentrations, in association with maternal and infant factors including maternal pre-pregnancy body mass index (BMI) and GDM status. In addition, we aimed to characterise longitudinal changes in HM macronutrients.MethodsThe control supplement contained calcium, iodine, iron, β-carotene, and folic acid. The intervention supplement additionally contained zinc, vitamins B2, B6, B12, and D3, probiotics, and myo-inositol. HM samples were collected across seven time points from 1 week to 12 months from Singapore and/or New Zealand. HM macronutrient concentrations were measured using a MIRIS Human Milk Analyser. Potential differences in HM macronutrient concentrations were assessed using linear mixed models with a repeated measures design.ResultsOverall, HM macronutrient concentrations were similar between control and intervention groups. Among the control group, overweight/obesity and GDM were associated with higher HM fat and energy concentrations over the first 3 months. Such associations were not observed among the intervention group. Of note, mothers with GDM in the intervention group had lower HM fat by 10% (p = 0.049) and energy by 6% (p = 0.029) than mothers with GDM in the control group. Longitudinal changes in HM macronutrient concentrations over 12 months of lactation in New Zealand showed that HM fat and energy decreased in the first 6 months then increased until 12 months. HM lactose gradually decreased from 1 week to 12 months while crude protein decreased from 1 week to 6 months then remained relatively constant until 12 months of lactation.ConclusionMaternal overweight/obesity or GDM were associated with increased HM fat and energy levels. We speculate the intervention taken during preconception and pregnancy altered the impact of maternal BMI or GDM status on HM macronutrient composition. Further studies are required to identify the mechanisms underlying altered HM macronutrient concentration in the intervention group and to determine any long-term effects on offspring health.Clinical trial registrationClinicalTrials.gov, NCT02509988, Universal Trial Number U1111-1171-8056. Registered on 16 July 2015. This is an academic-led study by the EpiGen Global Research Consortium.

【 授权许可】

Unknown   
Copyright © 2023 Han, Derraik, Vickers, Devaraj, Huang, Pang, Godfrey, Chan, Thakkar, Cutfield and NiPPeR Study Group.