Bioactive compounds in mothers milk affecting offspring outcomes: A narrative review

Abstract

Summary Background Compared to the exhaustive study of transgenerational programming of obesity and diabetes through exposures in the prenatal period, postnatal programming mechanisms are understudied, including the potential role of breast milk composition linking maternal metabolic status (body mass index and diabetes) and offspring growth, metabolic health and future disease risk. Methods This narrative review will principally focus on four emergent bioactive compounds [microRNA's (miRNA), lipokines/signalling lipids, small molecules/metabolites and fructose] that, until recently were not known to exist in breast milk. The objective of this narrative review is to integrate evidence across multiple fields of study that demonstrate the importance of these compositional elements of breast milk during lactation and the subsequent effect of breast milk components on the health of the infant. Results Current knowledge on the presence of miRNA's, lipokines/signalling lipids, small molecules/metabolites and fructose in breast milk and their associations with infant outcomes is compelling, but far from resolved. Two themes emerge: (1) maternal metabolic phenotypes are associated with these bioactives and (2) though existing in milk at low concentrations, they are also associated with offspring growth and body composition. Conclusion Breast milk research is gaining momentum though we must remain focused on understanding how non‐nutritive bioactive components are affected by the maternal phenotype, how they subsequently impact infant outcomes. Though early, there is evidence to suggest fructose is associated with fat mass in the 1st months of life whereas 12,13 diHOME (brown fat activator) and betaine are negatively associated with early adiposity and growth.

Gestational Diabetes Mellitus Is Associated with Differences in Human Milk Hormone and Cytokine Concentrations in a Fully Breastfeeding United States Cohort

“…However, the composition of human milk is not uniform among women, and the impact of maternal clinical factors on this variation is now being investigated [ 11 ]. It has been hypothesized that GDM may alter human milk in ways that could adversely program infant appetite, metabolic rate, and gut microbiome [ 12 ]. It is important to better understand GDM and other maternal factors as they relate to milk composition variation because of their potential to influence growth in children at high risk of future obesity, and because this information is necessary in order to design interventions that can optimize this critical first food.…”

Factors Influencing Cortisol Concentrations in Breastmilk and Its Associations with Breastmilk Composition and Infant Development in the First Six Months of Lactation

“…Breastmilk is the gold standard in infant nutrition and provides not only all necessary nutrients, but also a variety of bioactive compounds that support healthy infant growth and development [ 1 , 2 , 3 ]. Among many of the bioactive factors, breastmilk contains glucocorticoids (GCs): cortisol, cortisone (an inactive cortisol metabolite), and corticosterone [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 ].…”

“…According to the lactational programming hypothesis, they affect metabolic and neurobiological development, and, in consequence, offspring phenotype and behavior [ 13 , 14 , 15 , 16 ]. Studies investigated maternal psychological [ 10 , 15 , 17 , 18 , 19 , 20 , 21 , 22 ], socio-demographic [ 7 , 10 , 18 , 23 ], or anthropometric [ 3 , 10 , 24 ] determinants of breastmilk GCs levels provide inconclusive results. Similarly, results regarding the mode of delivery [ 5 , 10 ], preterm birth [ 6 , 10 , 17 ] or seasonal variations [ 10 , 23 ] were inconsistent.…”

Infant body composition: A comprehensive overview of assessment techniques, nutrition factors, and health outcomes

“…102 As these hormones are known to play a role in hunger, fat deposition, and adipose tissue, and preliminary evidence suggests a relationship between breast milk concentrations of these hormones and body composition, more research on this topic is warranted. 102 Other compounds in breast milk, including microRNAs, lipokines/signaling lipids, and small molecules/metabolites, have also been implicated in infant body composition, the evidence of which has been recently summarized in a review of the literature by Gregg et al 103…”