Maternal obesity and the human milk metabolome: associations with infant body composition and postnatal weight gain

• Published in: The American journal of clinical nutrition Vol. 110; no. 1; pp. 111 - 120
• Main Authors: Isganaitis, Elvira, Venditti, Sarah, Matthews, Tucker J, Lerin, Carles, Demerath, Ellen W, Fields, David A
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2019; Oxford University Press; American Society for Clinical Nutrition, Inc
• Subjects: Adenine; Adipose tissue; Adiposity; Baby foods; Body Composition; Body mass; body mass index; Body weight; Body weight gain; Breast Feeding; Breast milk; childhood obesity; Children; Chromatography; Complications; diabetes; Diabetes mellitus; Dual energy X-ray absorptiometry; Female; Gas chromatography; gas chromatography-mass spectrometry; Gestational Age; human milk; human milk oligosaccharides; Humans; Infant; Infant, Newborn; Infants; Liquid chromatography; Male; Mass spectrometry; Mass spectroscopy; maternal obesity; Metabolites; metabolome; Metabolome - physiology; metabolomics; Milk; milk composition; Milk, Human - chemistry; mothers; neonates; Nucleotides; Obesity; Obesity, Maternal - complications; Obesity, Maternal - metabolism; Oligosaccharides; Organic chemistry; Original Research Communications; Overweight; Pediatric Obesity; Postpartum; Pregnancy; Pregnancy complications; Pregnancy Complications - metabolism; pregnant women; Prospective Studies; Public health; Risk analysis; Risk Factors; Weight Gain; X-ray absorption spectroscopy; EE; human milk oligosaccharides; maternal obesity; breast milk; human milk; HMO; ov-ob; infant; DXA; body composition; WFA; metabolomics; FDR; KEGG; 1,5-AG; GPE
• ISSN: 0002-9165; 1938-3207; 1938-3207
• DOI: 10.1093/ajcn/nqy334

Maternal obesity is a risk factor for childhood obesity; this is a major public health concern given that ∼40% of pregnant women are either overweight or obese. Whether differences in milk composition in lean compared with obese women contribute to childhood obesity is unclear. We aimed to analyze relationships between maternal obesity and human milk metabolites, infant body composition, and postnatal weight gain. This was a prospective study in which mothers intending to breastfeed exclusively, and their newborn infants, were enrolled at delivery (n = 35 mother–infant pairs). We excluded mothers with diabetes, other medical conditions, or pregnancy complications. Participants were grouped by maternal prepregnancy BMI <25 (lean) or ≥25 kg/m2 (overweight/obese). We analyzed infant body composition by dual-energy X-ray absorptiometry and used untargeted liquid chromatography–gas chromatography–mass spectrometry to measure the milk content of 275 metabolites at 1 and 6 mo postpartum. At 1 mo postpartum, 10 metabolites differed between overweight/obese and lean groups with nominal P < 0.05, but none was altered with a false discovery rate <0.25. Many differentially abundant metabolites belonged to the same chemical class; e.g., 4/10 metabolites were nucleotide derivatives, and 3/10 were human milk oligosaccharides. Milk adenine correlated positively with both continuously distributed maternal BMI and with infant adiposity and fat accrual. Analysis of milk composition at 6 mo postpartum revealed 20 differentially abundant metabolites (P < 0.05) in overweight/obese compared with lean women, including 6 metabolites with a false discovery rate of <0.25. At both 1 and 6 mo, human milk abundance of 1,5-anhydroglucitol, which has not previously been described in milk, was positively associated with maternal BMI. Maternal obesity is associated with changes in the human milk metabolome. While only a subset of metabolites correlated with both maternal and infant weight, these point to potential milk-dependent mechanisms for mother–child transmission of obesity. This trial was registered at www.clinicaltrials.gov as NCT02535637.