Background Breastfeeding is associated with healthier weight and nutrient status in early life. However, the impact of breastfeeding on carotenoid status beyond infancy, and the influence of adiposity, is unknown. Objective The aim of the study was to retrospectively investigate the relationship between breastfeeding and carotenoid status, and the mediating effect of weight status and adiposity on this relationship among school-aged children. Methods This was a secondary analysis of baseline data collected from a randomized-controlled clinical trial. (ClinicalTrials.gov Identifier: NCT03521349). 7–12-year-old (n = 81) children were recruited from East-Central Illinois. Dual-energy x-ray absorptiometry (DXA) was used to assess visceral adipose tissue (VAT) and whole-body adiposity (%Fat). Weight was obtained to calculated body mass index percentile (BMI %ile). Skin carotenoids were assessed via reflection spectroscopy. Macular carotenoids were assessed as macular pigment optical density (MPOD). Dietary, birth, and breastfeeding information was self-reported by parents. Results Skin carotenoids were inversely related to %Fat (P < 0.01), VAT (P < 0.01) and BMI %ile (P < 0.01). VAT and BMI %ile significantly mediated this relationship between exclusive breastfeeding duration and skin carotenoids, following adjustment for dietary carotenoids, energy intake, and mother education. Conclusions Weight status and adipose tissue distribution mediate the positive correlation between exclusive breastfeeding duration and skin carotenoids among children aged 7–12 years. The results indicate the need to support breastfeeding and healthy physical growth in childhood for optimal carotenoid status.

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Excess adiposity or obesity has been inversely related to cognitive function and macular xanthophyll status. However, whether the neuroprotective effects of macular xanthophylls on cognitive function are independent of excess adiposity is unclear. We investigated the relationship between macular xanthophylls and intellectual ability among adults (N = 114) between 25 and 45 years with overweight and obesity (≥25 kg/m2). Dual energy X-ray absorptiometry and heterochromatic flicker photometry were used to assess whole body adiposity (%Fat) and macular pigment optical density (MPOD), respectively. Dietary xanthophylls (lutein and zeaxanthin) were assessed using 7-day diet records. The Kaufman Brief Intelligence Test-2 (KBIT-2) was used to assess general intelligence (IQ) as well as fluid and crystallized intelligence. Bivariate correlations revealed that MPOD was inversely related to %Fat and positively associated with IQ and fluid intelligence. Although %Fat was inversely correlated to IQ and fluid intelligence, this relationship did not persist following adjustment for sex and MPOD. Further, MPOD was an independent predictor of IQ and fluid intelligence. However, no significant relationships were observed between MPOD and crystalized intelligence. These results suggest that macular xanthophylls are selectively related to fluid intelligence, regardless of degree of adiposity among adults with overweight and obesity.

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