Associations of Maternal Weight Status Before, During, and After Pregnancy with Inflammatory Markers in Breast Milk
Kara M Whitaker, Regina C Marino, Jacob L Haapala, Laurie Foster, Katy D Smith, April M Teague, David R Jacobs, Patricia L Fontaine, Patricia M McGovern, Tonya C Schoenfuss, Lisa Harnack, David A Fields, Ellen W Demerath, Kara M Whitaker, Regina C Marino, Jacob L Haapala, Laurie Foster, Katy D Smith, April M Teague, David R Jacobs, Patricia L Fontaine, Patricia M McGovern, Tonya C Schoenfuss, Lisa Harnack, David A Fields, Ellen W Demerath
Abstract
Objective: The goal of this study was to examine the associations of maternal weight status before, during, and after pregnancy with breast milk C-reactive protein (CRP) and interleukin 6 (IL-6), two bioactive markers of inflammation, measured at 1 and 3 months post partum.
Methods: Participants were 134 exclusively breastfeeding mother-infant dyads taking part in the Mothers and Infants Linked for Health (MILK) study, who provided breast milk samples. Pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) were assessed by chart abstraction; postpartum weight loss was measured at the 1- and 3-month study visits. Linear regression was used to examine the associations of maternal weight status with repeated measures of breast milk CRP and IL-6 at 1 and 3 months, after adjustment for potential confounders.
Results: Pre-pregnancy BMI and excessive GWG, but not total GWG or postpartum weight loss, were independently associated with breast milk CRP after adjustment (β = 0.49, P < 0.001 and β = 0.51, P = 0.011, respectively). No associations were observed for IL-6.
Conclusions: High pre-pregnancy BMI and excessive GWG are associated with elevated levels of breast milk CRP. The consequences of infants receiving varying concentrations of breast milk inflammatory markers are unknown; however, it is speculated that there are implications for the intergenerational transmission of disease risk.
Conflict of interest statement
Disclosures:
No other conflicts of interest were reported.
© 2017 The Obesity Society.
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References
- American Academy of Pediatrics. Policy Statement: Breastfeeding and the Use of Human Milk. Pediatrics. 2012;129:e827–e841.
- Fields DA, Demerath EW. Relationship of insulin, glucose, leptin, IL-6 and TNF-alpha in human breast milk with infant growth and body composition. Pediatr Obes. 2012;7(4):304–312.
- Fields DA, George B, Williams M, et al. Associations between human breast milk hormones and adipocytokines and infant growth and body composition in the first 6 months of life. Pediatr Obes. 2017
- Quinn EA, Largado F, Borja JB, Kuzawa CW. Maternal characteristics associated with milk leptin content in a sample of Filipino women and associations with infant weight for age. J Hum Lact. 2015;31(2):273–281.
- Martin LJ, Woo JG, Geraghty SR, et al. Adiponectin is present in human milk and is associated with maternal factors. Am J Clin Nutr. 2006;83(5):1106–1111.
- Andreas NJ, Hyde MJ, Herbert BR, et al. Impact of maternal BMI and sampling strategy on the concentration of leptin, insulin, ghrelin and resistin in breast milk across a single feed: a longitudinal cohort study. BMJ Open. 2016;6(7):e010778.
- Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. JAMA. 2012;307(5):491–497.
- Institute of Medicine and National Research Council. Weight gain during pregnancy: reexamining the guidelines. Washington DC: 2009.
- Das UN. Is obesity an inflammatory condition? Nutrition. 2001;17(11–12):953–966.
- Fantuzzi G. Adipose tissue, adipokines, and inflammation. The Journal of allergy and clinical immunology. 2005;115(5):911–919.
- Yudkin JS, Stehouwer CD, Emeis JJ, Coppack SW. C-reactive protein in healthy subjects: associations with obesity, insulin resistance, and endothelial dysfunction: a potential role for cytokines originating from adipose tissue? Arterioscler Thromb Vasc Biol. 1999;19(4):972–978.
- Hribal ML, Fiorentino TV, Sesti G. Role of C reactive protein (CRP) in leptin resistance. Current pharmaceutical design. 2014;20(4):609–615.
- Gabay C. Interleukin-6 and chronic inflammation. Arthritis Res Ther. 2006;8(Suppl 2):S3.
- Brooks GC, Blaha MJ, Blumenthal RS. Relation of C-reactive protein to abdominal adiposity. Am J Cardiol. 2010;106(1):56–61.
- Wang X, Bao W, Liu J, et al. Inflammatory markers and risk of type 2 diabetes: a systematic review and meta-analysis. Diabetes Care. 2013;36(1):166–175.
- Fields DA, Schneider CR, Pavela G. A narrative review of the associations between six bioactive components in breast milk and infant adiposity. Obesity. 2016;24(6):1213–1221.
- Chowanadisai W, Lonnerdal B. Alpha(1)-antitrypsin and antichymotrypsin in human milk: origin, concentrations, and stability. Am J Clin Nutr. 2002;76(4):828–833.
- Lonnerdal B. Bioactive proteins in human milk: mechanisms of action. J Pediatr. 2010;156(2 Suppl):S26–30.
- Maffei HV, Nobrega FJ. Gastric pH and microflora of normal and diarrhoeic infants. Gut. 1975;16(9):719–726.
- Davidson LA, Lonnerdal B. Fecal alpha 1-antitrypsin in breast-fed infants is derived from human milk and is not indicative of enteric protein loss. Acta Paediatr Scand. 1990;79(2):137–141.
- Savino F, Fissore MF, Liguori SA, Oggero R. Can hormones contained in mothers’ milk account for the beneficial effect of breast-feeding on obesity in children? Clin Endocrinol. 2009;71(6):757–765.
- Savino F, Liguori SA, Fissore MF, Oggero R. Breast milk hormones and their protective effect on obesity. Int J Pediatr Endocrinol. 2009;2009:327505.
- Fujimori M, Franca EL, Morais TC, Fiorin V, de Abreu LC, Honorio-Franca AC. Cytokine and adipokine are biofactors can act in blood and colostrum of obese mothers. Biofactors. 2017;43(2):243–250.
- Young BE, Patinkin Z, Palmer C, et al. Human milk insulin is related to maternal plasma insulin and BMI: but other components of human milk do not differ by BMI. Eur J Clin Nutr. 2017
- Young BE, Johnson SL, Krebs NF. Biological determinants linking infant weight gain and child obesity: current knowledge and future directions. Adv Nutr. 2012;3(5):675–686.
- Powe CE, Knott CD, Conklin-Brittain N. Infant sex predicts breast milk energy content. Am J Hum Biol. 2010;22(1):50–54.
- Thakkar SK, Giuffrida F, Cristina CH, et al. Dynamics of human milk nutrient composition of women from Singapore with a special focus on lipids. Am J Hum Biol. 2013;25(6):770–779.
- Fetherston CM, Wells JI, Hartmann PE. Severity of mastitis symptoms as a predictor of C-reactive protein in milk and blood during lactation. Breastfeed Med. 2006;1(3):127–135.
- Wallace JM, Ferguson SJ, Loane P, Kell M, Millar S, Gillmore WS. Cytokines in human breast milk. Br J Biomed Sci. 1997;54(2):85–87.
- Andreas NJ, Hyde MJ, Gale C, et al. Effect of maternal body mass index on hormones in breast milk: a systematic review. PLoS One. 2014;9(12):e115043.
- Cottam DR, Mattar SG, Barinas-Mitchell E, et al. The chronic inflammatory hypothesis for the morbidity associated with morbid obesity: implications and effects of weight loss. Obes Surg. 2004;14(5):589–600.
- Mehta R, Petrova A. Very preterm gestation and breastmilk cytokine content during the first month of lactation. Breastfeed Med. 2011;6(1):21–24.
- Jiang R, Jacobs DR, Jr, Mayer-Davis E, et al. Nut and seed consumption and inflammatory markers in the multi-ethnic study of atherosclerosis. Am J Epidemiol. 2006;163(3):222–231.
- Pedersen SH, Wilkinson AL, Andreasen A, et al. Longitudinal analysis of mature breastmilk and serum immune composition among mixed HIV-status mothers and their infants. Clin Nutr. 2016;35(4):871–879.
- Vasiu I, Dabrowski R, Martinez-Subiela S, et al. Milk C-reactive protein in canine mastitis. Vet Immunol Immunopathol. 2017;186:41–44.
- Truchet S, Chat S, Ollivier-Bousquet M. Milk secretion: The role of SNARE proteins. J Mammary Gland Biol Neoplasia. 2014;19(1):119–130.
- Hawkes JS, Bryan DL, Gibson RA. Cytokine production by human milk cells and peripheral blood mononuclear cells from the same mothers. J Clin Immunol. 2002;22(6):338–344.
- Jakaitis BM, Denning PW. Human breast milk and the gastrointestinal innate immune system. Clin Perinatol. 2014;41(2):423–435.
- Tawia S. Development of oral tolerance to allergens via breastmilk. Breastfeed Rev. 2015;23(3):35–39.
- Tan SS, Ng PM, Ho B, Ding JL. The antimicrobial properties of C-reactive protein (CRP) J Endotoxin Res. 2005;11(4):249–256.
Source: PubMed