Maternal Obesity, Breast Milk Composition, and Infant Growth

母亲肥胖、母乳成分和婴儿生长

• 批准号: 9271204
• 负责人: ELLEN W. DEMERATH
• 金额: $ 54万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-07-10 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9271204
• 关键词: Academy; Adipose tissue; Affect; Age-Months; Air; American; Animal Model; Anti-inflammatory; Biochemistry; Birth; Body Composition; Body fat; Breast Feeding; C-Peptide; Cardiovascular Diseases; Cell physiology; Child; Complex; Conceptions; Data; Desire for food; Diabetes prevention; Diet; Dose; Dual-Energy X-Ray Absorptiometry; Education; Educational Materials; Exclusive Breastfeeding; Exhibits; Fatty Acids; Fatty acid glycerol esters; Feeding Methods; Glucose; Goals; Growth; Health; Hormonal; Hormones; Human; Human Milk; Immunologic Markers; Individual; Infant; Insulin; Insulin Resistance; Insulin-Like Growth Factor Binding Protein 3; Insulin-Like Growth Factor I; Interleukin-1; Interleukin-10; Interleukin-6; Intervention; Lactation; Length; Leptin; Life; Liquid substance; Mediating; Metabolic; Methods; Milk; Mothers; National Children' s Study; Neonatal; Nurse Midwives; Nutritional status; Obesity; Outcome; Overweight; Pancreas; Pathway interactions; Pediatrics; Perinatal; Play; Plethysmography; Postpartum Period; Pregnancy; Pregnant Women; Professional Organizations; Recruitment Activity; Research; Risk; Sampling; Science; Serum; Specialist; TNF gene; Techniques; Testing; Thinness; Time; Translations; Umbilical Cord Blood; United States; Variant; Vertical Disease Transmission; Weight; Weight Gain; Woman; adipokines; adiponectin; college; cytokine; developmental plasticity; feeding; gestational weight gain; immune activation; infant outcome; inflammatory marker; insulin secretion; inter-individual variation; intergenerational; maternal obesity; maternal weight; metabolomics; mother nutrition; novel; nutrition; obesity in children; obesity prevention; obesity risk; offspring; polypeptide C; postpartum weight; prenatal; prepregnancy obesity; protective effect; public health relevance; response; secondary analysis; therapy design; transmission process

DESCRIPTION (provided by applicant): Today the majority of pregnant women in the United States are either overweight or obese at conception with their offspring having greater adiposity at birth, a 2-fold greater risk of later obesity, and neonatal insulin resistance. Breastfeeding ha many clear benefits that may include protection against obesity and its sequelae, and exclusive breast milk feeding is recommended as the ideal infant feeding strategy for the first six months. It was long thought that breast milk composition was fairly uniform among women, having been optimized through evolutionary time to provide adequate sole nutrition for the growing infant regardless of the environmental circumstances. However, recent evidence shows that breast milk is a highly complex fluid with significant inter-individual variation in hormonal and cytokine concentrations. Pervasive maternal obesity is an evolutionarily novel condition for the human species but little effort has yet been made to systematically examine how this novel condition is associated with breast milk adipose-tissue derived hormone and cytokine (adipocytokine) variation, or whether that variation relates to infant metabolic status. Our objective is to comprehensively assess the "lactational programming" hypothesis, that is, whether or not recently documented variation in breast-milk composition is related to both maternal adiposity and to infant metabolic status. The central hypothesis is that a graded, dose-response relationship between maternal adiposity and adipocytokine concentrations in breast milk exists and that milk adipocytokine concentrations are associated with altered body composition in their exclusively breast-fed offspring. Guided by compelling preliminary data, and with consideration of potential confounders, this hypothesis will be tested by pursuing three Specific Aims: 1) Identify windows of exposure during the perinatal period (pre-pregnancy, pregnancy, post-partum) when elevated maternal weight and weight gain are associated with milk adipocytokine concentrations; 2) Test novel relationships between breast-milk adipocytokine concentrations and infant body composition and insulin secretion; and 3) Further characterize the relationship of maternal adiposity to milk variation and infant outcomes, to augment Aims 1 and 2 using state-of-the-science maternal and infant body composition methods, comprehensive breast-milk sampling techniques, and metabolomic analysis. The proposed research is significant because it tackles an understudied, but potentially important pathway explaining the vicious cycle of maternal-child obesity transmission prevalent today. The results of the study will be used to design interventions to reduce maternal weight during pregnancy and lactation and to augment lactation education materials to focus on the needs of obese breast-feeding women. The ultimate goal is to support women and infants during this crucial period of developmental plasticity, for the prevention of obesity, diabetes and cardiovascular disease.

描述（由申请人提供）：今天，美国大多数孕妇在受孕时超重或肥胖，其后代在出生时肥胖程度更高，后来肥胖的风险增加2倍，新生儿胰岛素抵抗。母乳喂养有许多明显的好处，可能包括防止肥胖及其后遗症，并且推荐纯母乳喂养作为婴儿头六个月的理想喂养策略。长期以来，人们一直认为女性的母乳成分是相当一致的，在进化过程中，母乳的成分得到了优化，无论环境如何，都能为成长中的婴儿提供足够的唯一营养。然而，最近的证据表明，母乳是一种高度复杂的液体，在激素和细胞因子方面存在显著的个体差异