Lactational programming of glucose homeostasis: a window of opportunity

Abstract

The window of lactation is a critical period during which nutritional and environmental exposures impact lifelong metabolic disease risk. Significant organ and tissue development, organ expansion and maturation of cellular functions occur during the lactation period, making this a vulnerable time during which transient insults can have lasting effects. This review will cover current literature on factors influencing lactational programming such as milk composition, maternal health status and environmental endocrine disruptors. The underlying mechanisms that have the potential to contribute to lactational programming of glucose homeostasis will also be addressed, as well as potential interventions to reduce offspring metabolic disease risk.

Relationship of Maternal Weight Status Before, During, and After Pregnancy with Breast Milk Hormone Concentrations

“…There is, however, evidence that human milk exhibits substantial individual variation in the concentration of appetite‐regulating hormones, cytokine levels, fatty acid profiles, and other factors . As reviewed by Ellsworth et al , animal models have provided intriguing evidence that maternal obesity may alter milk leptin, insulin, and other bioactive elements, which in turn are associated with diabetes, obesity, and hepatic steatosis in the adulthood offspring . As animal models do not always translate well into human studies because of species differences in growth rate, mammary gland physiology, and critical windows of development , more human research is needed to test the “lactational programming” hypothesis; that is, the variation in levels of hormones, cytokines, and other bioactive compounds present in breast milk may have sustained effects on the offspring’s appetite and metabolic rate.…”

“…As reviewed by Ellsworth et al , animal models have provided intriguing evidence that maternal obesity may alter milk leptin, insulin, and other bioactive elements, which in turn are associated with diabetes, obesity, and hepatic steatosis in the adulthood offspring . As animal models do not always translate well into human studies because of species differences in growth rate, mammary gland physiology, and critical windows of development , more human research is needed to test the “lactational programming” hypothesis; that is, the variation in levels of hormones, cytokines, and other bioactive compounds present in breast milk may have sustained effects on the offspring’s appetite and metabolic rate. Although 25% of women in the United States have BMI in the obese range prior to pregnancy , increasing the risk of obesity in the offspring by two‐ to threefold , the role of human milk composition in the transmission of obesity risk from mother to child has only recently been examined as a potential mechanism.…”

“…Furthermore, studies of milk hormone variation to date have not taken account of maternal metabolic status at different critical developmental windows. Growing evidence has suggested that fetal, infant, and childhood adiposity and obesity risk are modified by pregnancy glucose dysregulation, gestational weight gain (GWG), and postpartum weight loss (PPWL), independent of prepregnancy BMI , and also that metabolic status during these periods could be involved in mammary gland development and lactogenesis I and II . This is important because GWG, PPWL, and subclinical glucose dysregulation may be more easily modifiable aspects of maternal metabolic status than current or prepregnancy BMI.…”

Does early weaning shape future endocrine and metabolic disorders? Lessons from animal models

“…However, the early postnatal period, especially lactation, is sometimes more crucial in increasing the susceptibility to maladaptive metabolic programming. 14,15 Rodent models as a useful tool for studying developmental programming…”

Role of the maternal melatonin circadian rhythm absence in early catch-up growth in children

“…Формирование циркадианного ритма продукции эпифизарного мелатонина в норме продолжается ускоренными темпами в первые дни и недели жизни, а материнское влияние на этот процесс осуществляется через грудное вскармливание. Известно, что в грудном молоке содержится более 60 биологически актив ных факторов, причем концентрация соматотропного гормона, пролактина, ИФр-1, инсулина, лептина, релаксина, эпидермального фактора роста в грудном молоке выше, чем в периферической крови матери [61][62][63][64]. У здоровых матерей в грудном молоке, особенно в молозиве, выявлены высокие уровни триптофана и мелатонина, подверженные циркадным изменениям [65,66].…”