Adherence to Mediterranean Diet of Breastfeeding Mothers and Fatty Acids Composition of Their Human Milk: Results From the Italian MEDIDIET Study

Abstract

Background and AimsThe content of fatty acids (FA) in human milk may be influenced by maternal nutrition. We evaluated the role of a Mediterranean diet in influencing the content of FA in human milk among 282 breastfeeding mothers participating in the MEDIDIET study.Materials and MethodsMediterranean Diet Score (MDS), a composite index, was used to evaluate adherence to the Mediterranean diet. It includes 9 components (i.e., vegetables, fruit, cereals, legumes, monounsaturated to saturated FA ratio – MUFA/SFA, fish, dairy products, meat, and alcohol) and therefore potentially ranges from 0 (no adherence) to 9 (complete adherence) points. None of the mothers obtained the highest score due to the low alcohol consumption in the study population. Mothers were categorized in approximate tertiles of adherence: 0–3 (34.4%), 4 (26.2%), and 5–8 points (39.4%). The mean content of FA across categories of MDS was compared using ANOVA and test for trend.ResultsA high adherence of breastfeeding mothers to the Mediterranean diet was associated with lower content of SFA in human milk (42.58 ± 4.36 for MDS = 0–3, 42.58 ± 4.89 for MDS = 4, and 40.92 ± 5.22% of fats for MDS = 5–8 points; p ANOVA and p for trend = 0.02). Conversely, a high adherence was associated with higher content of MUFA in human milk (43.27 ± 4.27 for MDS = 0–3, 43.27 ± 4.47 for MDS = 4, and 45.24 ± 5.22% of fats for MDS = 5–8 points; p ANOVA and p for trend < 0.01), ω-3 FA (1.07 ± 0.25 for MDS = 0–3, 1.22 ± 0.49 for MDS = 4, and 1.31 ± 0.51% of fats for MDS = 5–8 points; p ANOVA and p for trend < 0.01), and the major types of ω-3 FA (i.e., α-linolenic acid – ALA, eicosapentaenoic acid – EPA, docosahexaenoic acid – DHA, docosapentaenoic acid – DPA). These associations were mainly driven by the adherence to the vegetables, MUFA/SFA, fish, and dairy products components of the Mediterranean diet.ConclusionA high adherence to the Mediterranean diet was associated with human milk showing a lower content of SFA and higher content of MUFA and ω-3 FA, including DHA. The Mediterranean diet may contribute in human milk production with higher content of specific FA which is directly involved in infant’s neural and visual development, as reported by previous studies.

Associations between Maternal Diet, Human Milk Macronutrients, and Breast-Fed Infant Growth during the First Month of Life in the SMILE Iwamizawa in Japan

“…Although mechanisms are not clear that link maternal fish consumption and energy and fat content in human milk, these associations might be manifested here as a result of increased variance of fish consumption among the Japanese population. It should be noted that several studies on the association between maternal diet and human milk components have already been reported [ 39 , 40 ]. They focused on the association between the Italian Mediterranean diet and lipid components such as n-3 fatty acids in human milk.…”

Relationships of pregnancy and postpartum diet quality with offspring birth weight and weight status through 12 months

“…Several components of maternal intake (e.g., macronutrients, micronutrients, lipids, trace elements) influence breastmilk composition [41,42], which have been related to differences in infant growth [40,43]. In contrast, very few studies have examined relationships of overall maternal diet quality with breastmilk composition [44]. Although the total estimated association of breastfeeding (partial or exclusive breastfeeding for at least 6 months vs. less than 6 months) with WFLz (difference of À0.…”

“…Several components of maternal intake (e.g., macronutrients, micronutrients, lipids, trace elements) influence breastmilk composition [41, 42], which have been related to differences in infant growth [40, 43]. In contrast, very few studies have examined relationships of overall maternal diet quality with breastmilk composition [44]. Although the total estimated association of breastfeeding (partial or exclusive breastfeeding for at least 6 months vs. less than 6 months) with WFLz (difference of −0.3, 95% CI:−0.5 to −0.04) and BMIz (difference of −0.3, 95% CI: −0.05 to −0.03) was negative, the positive association of maternal postpartum diet quality with infant growth only in those receiving breastmilk for at least 6 months suggests that interventions targeting improved postpartum diet quality, especially via decreasing intake of moderation components, in mothers breastfeeding for at least 6 months may promote optimal infant growth trajectories.…”

Fats in Human Milk: 2022 Updates on Chemical Composition

“…99 In HM from Mediterranean regions, where consumption of olive oil is high, the concentrations of oleic acid and its congeners may exceed 40%, and the total content of monounsaturated FAs may exceed 45% of total FA in HM. 100,101 These esterified FAs in TAGs interact extensively with the polyunsaturated FAs (PUFAs). 102 We have described the interactions in the following sections:…”