The childhood obesity epidemic poses a persistent challenge, as maternal obesity and excessive infant weight gain are significant predictors of childhood and adult obesity. Recognizing that breast milk is a primary source of nutrition during the first years of life and that its composition is influenced by maternal factors, researchers conducted an investigation to explore the relationship between maternal body mass index (BMI), serum lipids and insulin levels, and the fat and calorie content of breast milk.
The team, led by Professor Michael Ross, along with Dr Mina Desai from the University of California, Dr Manasa Kavasery, Dr MacKenzie Cervantes and Dr Guang Han from UCLA Medical Center, Professor Bernardo Horta from the Federal University of Pelotas, Dr Kelly Coca from the Federal University of São Paulo and Dr Suleyma Costa from the University of Campinas, investigated these associations. Their findings were published in the journal Children.
The study included exclusively breastfeeding women at 7 to 8 weeks postpartum. They were categorized by BMI into normal and overweight/obese (O/W) groups. Researchers collected continuous breast milk samples from foremilk to hindmilk and analyzed the samples along with maternal blood to assess serum lipids and insulin levels.
Key findings revealed that overweight or obese women had significantly higher fat and calorie content in their breast milk compared with women with a normal BMI. Foremilk and hindmilk samples from overweight and obese women contained significantly more fat and calories. Among all participants, maternal serum triglycerides, insulin, and HOMA-IR were significantly correlated with foremilk triglyceride concentration, indicating that insulin action and maternal serum triglycerides contribute to breast milk fat content.
Dr Ross said: “Our research indicates that the higher milk fat content in overweight and obese women has caloric implications for infant growth and childhood obesity. This suggests the possibility of modulating milk fat content by reducing maternal serum lipids or insulin.”
The research highlighted that higher energy intake during infancy is associated with greater weight gain and increased risk of obesity in later years. The composition of breast milk did not differ significantly in protein, carbohydrate and solid content between the two groups. However, fat and calorie content increased significantly from the first to the last milk sample in both groups, with a several-fold increase in fat concentration and an almost two-fold increase in calorie content, being more pronounced in obese/overweight women.
The research also examined the lipid profile of breast milk and maternal plasma. Obese women/obese women had higher levels of free fatty acids, diacylglycerols, ceramides and phospholipids in their milk compared to women with a normal BMI. Maternal plasma lipid levels showed no significant differences between the groups, except for total free fatty acids, which were lower in obese women/obese women.
Dr Ross noted: “Our findings emphasize the importance of maternal health and its direct impact on breast milk composition. By addressing maternal obesity and metabolic health, we can improve the nutritional quality of breast milk and mitigate the risk of childhood obesity.”
Research suggests that dietary interventions or pharmacological approaches to reduce maternal serum lipids or insulin could potentially modulate breast milk composition, thereby influencing infant growth and reducing the risk of obesity. Further research is needed to explore these interventions and their efficacy in improving breast milk quality.
In conclusion, Dr. Ross and his team provide valuable insights into the impact of maternal BMI and metabolic health on breast milk composition. Their findings underscore the need for targeted strategies to address maternal obesity and optimize infant nutrition, with the ultimate goal of curbing rising rates of childhood obesity.
Journal reference
Ross, M.G., Kavasery, M.P., Cervantes, M.K., Han, G., Horta, B., Coca, K.P., Costa, S.O., & Desai, M. (2024). High-fat, high-calorie breast milk in overweight or obese women and its association with maternal serum insulin concentration and triglyceride levels. Children, 11(141). DOI: https://doi.org/10.3390/children11020141
About the Author
Dr. Ross He received his BS from MIT, his PhD and MPH from Harvard, and completed his residency in obstetrics and gynecology at Brigham and Women's Hospital and his fellowship in maternal-fetal medicine at Harbor-UCLA. He is board certified in obstetrics and gynecology and maternal-fetal medicine. He was Chairman of the Department of Obstetrics and Gynecology at Harbor-ULCA from 1996 to 2011. He has received continuous funding from the NIH for 40 years and support from the March of Dimes, the United Cerebral Palsy Foundation, and the National Science Foundation. He is currently Distinguished Professor of Obstetrics and Gynecology and Public Health at UCLA and Co-Director of the Women's and Children's Health Institute at the Lundquist Institute. He is President of Los Angeles Perinatal Associates, a private maternal-fetal medicine practice in Southern California.
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