Breast milk fatty acid profile in relation to infant growth and body composition: results from the INFAT study

Abstract

Background: There is some evidence that the n-6/n-3 long-chain polyunsaturated fatty acids (LCPUFAs) ratio in early nutrition, and thus in breast milk, could influence infant body composition. Methods:In an open-label randomized controlled trial (RCT), 208 healthy pregnant women were allocated to a dietary intervention (supplementation with 1,200 mg n-3 LCPUFAs per day and instructions to reduce arachidonic acid (AA) intake) from the 15th wk of gestation until 4 mo of lactation or to follow their habitual diet. Breast milk LCPUFAs at 6 wk and 4 mo postpartum were related to infant body composition assessed by skinfold thickness (SFT) measurements and ultrasonography during the first year of life. results: Dietary intervention significantly reduced breast milk n-6/n-3 LCPUFAs ratio. In the whole sample, early breast milk docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), and n-3 LCPUFAs at 6 wk postpartum were positively related to the sum of four SFT measurements at age 1. Breast milk AA and n-6 LCPUFAs at 6 wk postpartum were negatively associated with weight, BMI, and lean body mass (LBM) up to 4 mo postpartum. conclusion: Breast milk n-3 LCPUFAs appear to stimulate fat mass growth over the first year of life, whereas AA seems to be involved in the regulation of overall growth, especially in the early postpartum period. t he amount of n-3 long-chain polyunsaturated fatty acids (LCPUFAs) in human breast milk is subject to maternal nutrition and further modified by maternal adipose tissue stores (1), gestational age and stage of lactation (2,3), and the individual's genetic constitution (variants in the FADS1/2 gene cluster) (4,5). There is an ongoing debate about whether the amount of n-3 LCPUFAs, and particularly the proportions of docosahexaenoic acid (DHA,, provided to the developing infant during the breastfeeding period may result in functional differences of health outcomes in the offspring.As recently reviewed, there is insufficient evidence from randomized controlled trials (RCTs) to support or refute the practice of giving n-3 LCPUFA supplementation ("fish oil") to breastfeeding mothers to improve infant growth, children's neurodevelopment, visual acuity, or allergy risk (6).An upcoming question in the context of fetal programming of later disease susceptibility is whether the balance between the n-6 and n-3 LCPUFAs in early nutrition, and thus in breast milk, could play a role in childhood obesity (7). Although prenatal and/or postnatal n-3 LCPUFA supplementation has been shown to reduce obesity in rodents (8,9), although not consistently proven (10,11), evidence in humans is limited and restricted to a few post hoc studies using in large part inadequate methods to assess infant fat mass (12).The INFAT (The Impact of Nutritional Fatty acids during pregnancy and lactation for early human Adipose Tissue development) study addresses the question as to whether lowering the n-6/n-3 long-chain fatty acid (FA) ratio in the diet of pregnant and breastfeeding women may reduce adipose tissue growth early ...

Accretion of Fat-Free Mass Rather Than Fat Mass in Infancy Is Positively Associated with Linear Growth in Childhood

“…Another study by Savastano et al (39) showed that subcutaneous body fat helps in insulating the body. Postnatal FM gain could be stimulated by breast-milk adiponectin and n-3 long-chain PUFAs, as supported by other studies (32,40). This FM gain could mediate the association of breast-milk FA and adiponectin concentrations with linear growth.…”

Effect of fish oil supplementation in pregnancy on bone, lean, and fat mass at six years: randomised clinical trial

“…Potential explanations for the discrepancy between our findings and previous studies include differences in the dose and type of n-3 LCPUFA supplied, the timing of the supplementation, the trial design, and the accuracy of measurements. The dose of n-3 LCPUFA in our trial was 2.4 g per day, which is higher than in most previous studies, in which 900 mg or 1.5 g was administered,792526 and the high number of participants increased the statistical power to detect effects on growth and body composition compared with previous studies 27. One other trial supplemented with a dose similar to ours from week 30 of pregnancy and completed follow-up for 243 participants at age 19 years, finding no effect on waist circumference or BMI, which could be caused by low numbers 28.…”

Postnatal weight gain induced by overfeeding pups and maternal high-fat diet during the lactation period modulates glucose metabolism and the production of pancreatic and gastrointestinal peptides

“…The changes in fatty-acid composition in milk might have directly influenced the concentration of these compounds in pup serum. A Recent human study suggests that breast milk fatty-acid profile related to infant growth and body composition [31]. Both maternal high-fat diet and overfeeding during the postnatal period resulted in a significant increase of bodyweight in offspring, about 20% greater than pups in the Control group.…”