TY - JOUR
T1 - Fatty Acid Transfer from Blood to Milk Is Disrupted in Mothers with Low Milk Production, Obesity, and Inflammation
AU - Walker, Rachel E.
AU - Harvatine, Kevin J.
AU - Ross, A. Catharine
AU - Wagner, Erin A.
AU - Riddle, Sarah W.
AU - Gernand, Alison D.
AU - Nommsen-Rivers, Laurie A.
N1 - Funding Information:
Supported by NIH grants NIH 5 K12 HD051953 (to LAN-R) and NIH 5UL1TR001425-03 (to LAN-R); USDA National Institute of Food and Agriculture grant 2020-67034-31767 (to REW); and the Dorothy Foehr Huck Endowment (to ACR).
Funding Information:
We acknowledge the excellent technical assistance of both Elizabeth Soucy in the Gernand laboratory and Rebecca Bomberger in the Harvatine laboratory as well as the assistance of the Penn State Biomarker Core Lab for hsCRP measurements. The authors’ responsibilities were as follows—REW, ADG, and LAN-R: designed the research; REW, EAW, SWR, and LAN-R: conducted the research; KJH, ACR, ADG, and LAN-R: provided essential materials and mentorship to the corresponding author; REW and ADG: analyzed the data; REW and LAN-R: wrote the paper; REW: had primary responsibility for the final content; and all authors: read and approved the final manuscript. Data described in the article, code book, and analytic code will be made available upon request pending approval of a data sharing agreement. Supported by NIH grants NIH 5 K12 HD051953 (to LAN-R) and NIH 5UL1TR001425-03 (to LAN-R); USDA National Institute of Food and Agriculture grant 2020-67034-31767 (to REW); and the Dorothy Foehr Huck Endowment (to ACR). Author disclosures: The authors report no conflicts of interest. Supplemental Figures 1 and 2 and Supplemental Tables 1 and 2 are available from the “Supplementary data” link in the online posting of the article and from the same link in the online table of contents at https://academic.oup.com/jn/. ADG and LAN-R contributed equally to this work as co–senior authors.
Publisher Copyright:
© 2022 American Society for Nutrition.
PY - 2022/12
Y1 - 2022/12
N2 - Background: Obesity is associated with chronic inflammation and is a risk factor for insufficient milk production. Inflammation-mediated suppression of LPL could inhibit mammary uptake of long-chain fatty acids (LCFAs; >16 carbons). Objectives: In an ancillary case–control analysis, we investigated whether women with low milk production despite regular breast emptying have elevated inflammation and disrupted transfer of LCFAs from plasma into milk. Methods: Data and specimens from a low milk supply study and an exclusively breastfeeding control group were analyzed, with milk production measured by 24-h test-weighing at 2–10 wk postpartum. Low milk supply groups were defined as very low (VL; <300 mL/d; n = 23) or moderate (MOD; ≥300 mL/d; n = 20) milk production, and compared with controls (≥699 mL/d; n = 18). Serum and milk fatty acids (weight% of total) were measured by GC, serum and milk TNF-α by ELISA, and serum high-sensitivity C-reactive protein (hsCRP) by clinical analyzer. Group differences were assessed by linear regression models, chi-square exact tests, and Kruskal–Wallis nonparametric tests. Results: VL cases, as compared with MOD cases and controls, had higher prevalence of elevated serum hsCRP (>5 mg/L; 57%, 15%, and 22%, respectively; P = 0.004), detectable milk TNF-α (67%, 32%, and 33%, respectively; P = 0.04), and obesity (78%, 40%, and 22%, respectively; P = 0.003). VL cases had lower mean ± SD LCFAs in milk (60% ± 3%) than MOD cases (65% ± 4%) and controls (66% ± 5%) (P < 0.001). Milk and serum LCFAs were strongly correlated in controls (r = 0.82, P < 0.001), but not in the MOD (r = 0.25, P = 0.30) or VL (r = 0.20, P = 0.41) groups (Pint < 0.001). Conclusions: Mothers with very low milk production have significantly higher obesity and inflammatory biomarkers, lower LCFAs in milk, and disrupted association between plasma and milk LCFAs. These data support the hypothesis that inflammation disrupts normal mammary gland fatty acid uptake. Further research should address impacts of inflammation and obesity on mammary fatty acid uptake for milk production.
AB - Background: Obesity is associated with chronic inflammation and is a risk factor for insufficient milk production. Inflammation-mediated suppression of LPL could inhibit mammary uptake of long-chain fatty acids (LCFAs; >16 carbons). Objectives: In an ancillary case–control analysis, we investigated whether women with low milk production despite regular breast emptying have elevated inflammation and disrupted transfer of LCFAs from plasma into milk. Methods: Data and specimens from a low milk supply study and an exclusively breastfeeding control group were analyzed, with milk production measured by 24-h test-weighing at 2–10 wk postpartum. Low milk supply groups were defined as very low (VL; <300 mL/d; n = 23) or moderate (MOD; ≥300 mL/d; n = 20) milk production, and compared with controls (≥699 mL/d; n = 18). Serum and milk fatty acids (weight% of total) were measured by GC, serum and milk TNF-α by ELISA, and serum high-sensitivity C-reactive protein (hsCRP) by clinical analyzer. Group differences were assessed by linear regression models, chi-square exact tests, and Kruskal–Wallis nonparametric tests. Results: VL cases, as compared with MOD cases and controls, had higher prevalence of elevated serum hsCRP (>5 mg/L; 57%, 15%, and 22%, respectively; P = 0.004), detectable milk TNF-α (67%, 32%, and 33%, respectively; P = 0.04), and obesity (78%, 40%, and 22%, respectively; P = 0.003). VL cases had lower mean ± SD LCFAs in milk (60% ± 3%) than MOD cases (65% ± 4%) and controls (66% ± 5%) (P < 0.001). Milk and serum LCFAs were strongly correlated in controls (r = 0.82, P < 0.001), but not in the MOD (r = 0.25, P = 0.30) or VL (r = 0.20, P = 0.41) groups (Pint < 0.001). Conclusions: Mothers with very low milk production have significantly higher obesity and inflammatory biomarkers, lower LCFAs in milk, and disrupted association between plasma and milk LCFAs. These data support the hypothesis that inflammation disrupts normal mammary gland fatty acid uptake. Further research should address impacts of inflammation and obesity on mammary fatty acid uptake for milk production.
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U2 - 10.1093/jn/nxac220
DO - 10.1093/jn/nxac220
M3 - Article
C2 - 36208911
AN - SCOPUS:85140800413
SN - 0022-3166
VL - 152
SP - 2716
EP - 2726
JO - Journal of Nutrition
JF - Journal of Nutrition
IS - 12
ER -