Nutritional Difference in Infants: Contrasting Carbohydrate and Lipid Profiles between Normal and Obese States
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Background: For supporting the infant’s growth and development, Human Milk (HM) is the most suitable nutritional source, especially during 6 months. Growth study showed different growth between breastfed infants and formula-fed infants, in which they are thinner compared to formula-fed infants, but some breastfed infants are overnutrition (overweight and obese).
Objective: to investigate the macronutrient content of HM in exclusive breast-feeding infants aged under 12 months old.
Methods: The study’s design was a case-control, conducted on 20 lactating mothers (residents and employee) in the pediatric departemen at Regional General Hospital Dr. Soetomo Surabaya in March–April 2018. HM of the infant with overnutrition was included in the Overnutrition (ON) group, and HM of the infant with normal nutrition was included in the Normal (N) group. To obtain the HM samples, the researchers recruited lactating mothers who participated in this study voluntarily. The lactating mothers must breastfeed their infants predominantly, and their infant’s age must be less than 12 months old. The macronutrients content in HM were measured using a Human Milk Analyzer (HMA) (MIRIS®, Uppsala, Sweden). Statistical analysis conducted was test of normality (Shapiro Wilk) and test of homogeneity followed by Mann Whitney U test and Fisher exact test with the level of significance <0.05.
Results: We got 20 samples of HM from 20 lactating mothers, in which ten infants were determined as overnutrition (2 were categorized as overweight and 8 were obese) and grouped in ON, while 10 infants were normal and were grouped in the N group. It was found that the ON group had higher lipid content than the N group (4.33[2.0-6.8] vs. 2.40 [1.2-3.9] g, p=0.019). Protein content was almost similar in both groups (p=0.853), The ON group had lower carbohydrate content than (2.42 [1.5-3.7] g) than the N group (3.42 [2.1-4] g), p=0.004. The ON group had higher energy content (53.85 [31.20-76.20] kcal/ml) than the N group (39.90 [26.40-51.90] kcal/ml, p=0.065).
Conclusion: The incidence of overnutrition during infancy is likely affected by high lipids content in HM than other macronutrients. The carbohydrate content was significantly low in overnutrition infants.
Abdelhamid, E.R. et al. (2020) ‘Breast milk macronutrients in relation to infants’ anthropometric measures’, Open Access Macedonian Journal of Medical Sciences, 8(June), pp. 845–850. doi:10.3889/oamjms.2020.4980.
Adhikari, S. et al. (2021) ‘Maternal Dietary Intake, Nutritional Status, and Macronutrient Composition of Human Breast Milk: Systematic Review’, British Journal of Nutrition [Preprint], doi:10.1017/S0007114521002786.
Affordable Learning Solution (2019) Introduction to Nutrition, Introduction to Nutrition. Edited by Affordable Learning Solution et al. California: LibreTexts. doi: 10.5005/jp/books/13041_3.
Albracht-Schulte, K. et al. (2018) ‘Omega-3 fatty acids in obesity and metabolic syndrome: a mechanistic update’, Journal of Nutritional Biochemistry, 58(2017), pp. 1–16. doi: 10.1016/j.jnutbio.2018.02.012.
Appleton, J. et al. (2018) ‘Infant formula feeding practices associated with rapid weight gain: A systematic review’, Maternal and Child Nutrition, 14(3), pp. 1–14. doi: 10.1111/mcn.12602.
Arisaka, O. et al. (2020) ‘Childhood obesity: Rapid weight gain in early childhood and subsequent cardiometabolic risk’, Clinical Pediatric Endocrinology, 29(4), pp. 135–142. doi: 10.1297/cpe.29.135.
Aumeistere, L. et al. (2017) ‘Lactose content of breast milk among lactating women in Latvia’, FOODBALT, (June), pp. 169–173. doi: 10.22616/foodbalt.2017.023.
Aumeistere, L. et al. (2019) ‘Impact of maternal diet on human milk composition among lactating women in Latvia’, Medicina (Lithuania), 55(5), pp. 1–12. doi: 10.3390/medicina55050173.
Basir, S.M.A. et al. (2019) ‘Maternal diet and its association with human milk energy and macronutrient composition among exclusively breastfeeding Malaysian Malay mothers’, Malaysian Journal of Nutrition, 25(2), pp. 309–320. doi: 10.31246/mjn-2019-0020.
Berger, P.K. et al. (2020) ‘Carbohydrate composition in breast milk and its effect on infant health’, Current Opinion in Clinical Nutrition and Metabolic Care, 23(4), pp. 277–281. doi: 10.1097/MCO.0000000000000658.
Bzikowska-Jura, A. et al. (2018) ‘Maternal nutrition and body composition during breastfeeding: Association with human milk composition’, Nutrients, 10(10). doi:10.3390/nu10101379.
Chamorro, R. et al. (2022) ‘Reduced n-3 and n-6 PUFA (DHA and AA) Concentrations in Breast Milk and Erythrocytes Phospholipids during Pregnancy and Lactation in Women with Obesity’, International Journal of Environmental Research and Public Health, 19(4). doi: 10.3390/ijerph19041930.
Chen, Y. et al. (2017) Effect of high-fat diet on secreted milk transcriptome in midlactation mice, Physiological Genomics. doi: 10.1152/physiolgenomics.00080.2017.
Cianciosi, D., Simal-Gándara, J. and Forbes-Hernández, T.Y. (2019) ‘The importance of berries in the human diet’, Mediterranean Journal of Nutrition and Metabolism, 12(4), pp. 335–340. doi: 10.3233/MNM-190366.
Czosnykowska-łukacka, M., Królak-Olejnik, B. and Orczyk-Pawiłowicz, M. (2018) ‘Breast milk macronutrient components in prolonged lactation’, Nutrients, 10(12), pp. 1–15. doi: 10.3390/nu10121893.
D’Angelo, S., Motti, M.L. and Meccariello, R. (2020) ‘ω-3 and ω-6 Polyunsaturated Fatty Acids, Obesity and Cancer’, Nutrients, 12(9), pp. 2751–2773. doi: 10.20471/LO.2020.48.02-03.16.
Duale, A., Singh, P. and Al Khodor, S. (2022) ‘Breast Milk: A Meal Worth Having’, Frontiers in Nutrition, 8(January), pp. 1–18. doi: 10.3389/fnut.2021.800927.
EFSA (2017) Dietary Reference Values for nutrients: Summary report. doi: 10.2903/sp.efsa.2017.e15121.
Eriksen, K.G. et al. (2018) ‘Human milk composition and infant growth’, Current Opinion in Clinical Nutrition and Metabolic Care, 21(3), pp. 200–206. doi: 10.1097/MCO.0000000000000466.
Fenton, T.R. and Elmrayed, S. (2021) ‘The Importance of Reporting Energy Values of Human Milk as Metabolizable Energy’, Frontiers in Nutrition, 8(July), pp. 7–9. doi: 10.3389/fnut.2021.655026.
de Fluiter, K.S. et al. (2021) ‘Appetite-regulating hormone trajectories and relationships with fat mass development in term-born infants during the first 6 months of life’, European Journal of Nutrition, 60(7), pp. 3717–3725. doi: 10.1007/s00394-021-02533-z.
Galante, L. et al. (2020) ‘Growth Factor Concentrations in Human Milk Are Associated with Infant Weight and BMI From Birth to 5 Years’, Frontiers in Nutrition, 7(July). doi: 10.3389/fnut.2020.00110.
Gedefaw, G. et al. (2020) ‘Effect of cesarean section on initiation of breast feeding: Findings from 2016 Ethiopian Demographic and Health Survey’, PLoS ONE, 15(12 December), pp. 1–13. doi:10.1371/journal.pone.0244229.
George, A.D. et al. (2021) ‘The fatty acid species and quantity consumed by the breastfed infant are important for growth and development’, Nutrients, 13(11), pp. 1–11. doi:10.3390/nu13114183.
Gila-Díaz, A. et al. (2020) ‘Influence of maternal age and gestational age on breast milk antioxidants during the first month of lactation’, Nutrients, 12(9), pp. 1–14. doi:10.3390/nu12092569.
Goran, M.I. et al. (2017) ‘Fructose in breast milk is positively associated with infant body composition at 6 months of age’, Nutrients, 9(2), pp. 1–11. doi: 10.3390/nu9020146.
Gridneva, Z. et al. (2019) ‘Carbohydrates in human milk and body composition of term infants during the first 12 months of lactation’, Nutrients, 11(7), pp. 1–24. doi: 10.3390/nu11071472.
Guesnet, P. et al. (2019) ‘Impact of maternal dietary lipids on human health’, Cahiers de Nutrition et de Dietetique, 54(2), pp. 100–107. doi: 10.1016/j.cnd.2018.12.001.
Huang, Z. and Hu, Y.M. (2020) ‘Dietary patterns and their association with breast milk macronutrient composition among lactating women’, International Breastfeeding Journal, 15(1), pp. 1–10. doi:10.1186/s13006-020-00293-w.
Jardí, C. et al. (2019) ‘Consumption of free sugars and excess weight in infants. A longitudinal study’, Anales de Pediatría (English Edition), 90(3), pp. 165–172. doi: 10.1016/j.anpede.2018.03.011.
Kalyanasundaram, S., Narayanan, V.K. and Krishnamurthy, K. (2021) ‘The role of lactose in milk and an overview of intolerance to lactose’, Journal of Public Health Nutrition, 4(1), pp. 300–301.
De la Garza Puentes, A. et al. (2019) ‘The effect of maternal obesity on breast milk fatty acids and its association with infant growth and cognition-the PREOBE follow-up’, Nutrients, 11(2154), pp. 1–18. doi: 10.1016/s0261-5614(19)32921-8.
Laving, A.R., Hussain, S.R.A. and Atieno, D.O. (2018) ‘Overnutrition: Does complementary feeding play a role?’, Annals of Nutrition and Metabolism, 73(suppl 1), pp. 15–18. doi: 10.1159/000490088.
Léké, A. et al. (2019) ‘Macronutrient composition in human milk from mothers of preterm and term neonates is highly variable during the lactation period’, Clinical Nutrition Experimental, 26, pp. 59–72. doi: 10.1016/j.yclnex.2019.03.004.
Lestari, O.A. and Purwayantie, S. (2018) The calories and glycaemic index of bubur pedas, traditional food of West Kalimantan, Indonesia, International Conference on Tropical Agrifood, Feed, and Fuel.
Lima, N.P. et al. (2019) ‘Association of breastfeeding, maternal anthropometry and body composition in women at 30 years of age’, Cadernos de Saude Publica, 35(2), pp. 1–11. doi: 10.1590/0102-311x00122018.
Linderborg, K.M. et al. (2020) ‘Interactions between cortisol and lipids in human milk’, International Breastfeeding Journal, 15(1), pp. 1–11. doi:10.1186/s13006-020-00307-7.
Lindholm, A. et al. (2020) ‘Nutrition- and feeding practice-related risk factors for rapid weight gain during the first year of life: a population-based birth cohort study’, BMC Pediatrics, 20(1), pp. 1–14. doi: 10.1186/s12887-020-02391-4.
Lubis, G. and Amelin, F. (2019) ‘Association of Lactation Period and Maternal Body Mass Index with Breast Milk Macronutrient Content of West Sumatera Breastfeeding Mothers’, pp. 4–9. doi: 10.4108/eai.13-11-2018.2283637.
Maślak, A.D. et al. (2020) ‘Causes of overweight and obesity in children and adolescents’, Journal of Education, Health and Sport, 10(5), pp. 11–18. doi:10.12775/jehs.2020.10.05.001.
Murty, D.S. et al. (2019) ‘Macronutrient content in preterm and full-term human milk in the first three weeks after delivery’, Paediatrica Indonesiana, 59(3), pp. 130–138. doi: 10.14238/pi.
Palou, M., Picó, C. and Palou, A. (2018) ‘Leptin as a breast milk component for the prevention of obesity’, Nutrition reviews, 76(12), pp. 875–892. doi: 10.1093/nutrit/nuy046.
Rito, A.I. et al. (2019) ‘Association between characteristics at birth, breastfeeding and obesity in 22 countries: The WHO European childhood obesity surveillance initiative - COSI 2015/2017’, Obesity Facts, 12(2), pp. 226–243. doi:10.1159/000500425.
Sakayori, N. et al. (2020) ‘Maternal dietary imbalance between omega-6 and omega-3 fatty acids triggers the offspring’s overeating in mice’, Communications Biology, 3(1), pp. 1–13. doi: 10.1038/s42003-020-01209-4.
Siddik, M.A.B. and Shin, A.C. (2019) ‘Recent progress on branched-chain amino acids in obesity, diabetes, and beyond’, Endocrinology and Metabolism, 34(3), pp. 234–246. doi: 10.3803/EnM.2019.34.3.234.
Singh, A.K. et al. (2017) ‘Comparison of Growth Pattern in Neonates on Breast Feed Versus Formula Feed’, Med Phoenix, 2(1), pp. 18–23. doi: 10.3126/medphoenix.v2i1.18381.
Singhal, A. (2017) ‘Long-Term Adverse Effects of Early Growth Acceleration or Catch-Up Growth’, Annals of Nutrition and Metabolism, 70(3), pp. 236–240. doi: 10.1159/000464302.
Siziba, L.P. et al. (2019) ‘Changes in human milk fatty acid composition during lactation: The ulm SPATZ health study’, Nutrients, 11(12). doi: 10.3390/nu11122842.
Soori, M., Mohammadi, Y., Goodarzi, M.T., et al. (2020) ‘Association between breast milk adipokines with growth in breast feeding infants, a systematic review and meta-analysis’, Turkish Journal of Biochemistry, 45(6), pp. 659–669. doi: 10.1515/tjb-2020-0178.
Soori, M., Mohammadi, Y., Taghi Goodarzi, M., et al. (2020) ‘Relationship Between Breast Milk Ghrelin and Infants’ Serum Ghrelin and Growth in Breastfeeding Infants: A Systematic Review and Meta-Analysis’, Journal of Pediatrics Review, 8(3), pp. 153–162. doi: 10.32598/jpr.8.3.868.1.
Stan, S. V. et al. (2021) ‘Estimated Energy Requirements of Infants and Young Children up to 24 Months of Age’, Current Developments in Nutrition, 5(11), pp. 1–9. doi: 10.1093/cdn/nzab122.
Tang, M. (2018) ‘Protein intake during the first two years of life and its association with growth and risk of overweight’, International Journal of Environmental Research and Public Health, 15(8). doi: 10.3390/ijerph15081742.
Torres-Castillo, N. et al. (2018) ‘High Dietary ω-6:ω-3 PUFA Ratio Is Positively Associated with Excessive Adiposity and Waist Circumference’, Obesity Facts, 11(4), pp. 344–353. doi: 10.1159/000492116.
Uwaezuoke, S.N., Eneh, C.I. and Ndu, I.K. (2017) ‘Relationship Between Exclusive Breastfeeding and Lower Risk of Childhood Obesity: A Narrative Review of Published Evidence’, Clinical Medicine Insights: Pediatrics, 11, p. 117955651769019. Doi: 10.1177/1179556517690196.
Vergilio Visentainer, J. et al. (2018) ‘Lipids and Fatty Acids in Human Milk: Benefits and Analysis’, in Biochemistry and Health Benefits of Fatty Acids. Intech, pp. 1–21. doi: 10.5772/intechopen.80429.
Ward, E. et al. (2021) ‘Acute changes to breast milk composition following consumption of high-fat and high-sugar meals’, Maternal and Child Nutrition, 17(3), pp. 1–9. doi: 10.1111/mcn.13168.
Wells, J.C. et al. (2021) ‘The “drive to eat” hypothesis: energy expenditure and fat-free mass but not adiposity are associated with milk intake and energy intake in 12-week infants’, American Journal of Clinical Nutrition, 114(2), pp. 505–514. doi: 10.1093/ajcn/nqab067.
Wu, W. et al. (2021) ‘Chinese Breast Milk Fat Composition and Its Associated Dietary Factors: A Pilot Study on Lactating Mothers in Beijing’, Frontiers in Nutrition, 8(May), pp. 1–12. doi: 10.3389/fnut.2021.606950.
Yu, J. et al. (2021) ‘Insufficient sleep during infancy is correlated with excessive weight gain in childhood: a longitudinal twin cohort study’, Journal of clinical sleep medicine: JCSM : official publication of the American Academy of Sleep Medicine, 17(11), pp. 2147–2154. doi: 10.5664/jcsm.9350.
Zheng, M. et al. (2021) ‘Protein Intake During Infancy and Subsequent Body Mass Index in Early Childhood: Results from the Melbourne InFANT Program’, Journal of the Academy of Nutrition and Dietetics, 121(9), pp. 1775–1784. doi: 10.1016/j.jand.2021.02.022.
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