Associations between Maternal Body Composition and Appetite Hormones and Macronutrients in Human Milk
<p>Associations between whole human milk (HM) leptin and (<b>a</b>) maternal percentage fat mass; and (<b>b</b>) maternal BMI. Combined subset data points (measured in pre- and post-feed samples) are shown as cross-sectional (pale blue) and longitudinal (dark blue). Lines are fixed effects from univariate linear mixed effect models: pale blue dotted line—combined cohort (<a href="#nutrients-09-00252-t004" class="html-table">Table 4</a>); medium blue dashed line—combined cohort with outliers removed (<a href="#sec3dot3dot2-nutrients-09-00252" class="html-sec">Section 3.3.2</a>); solid dark blue line—longitudinal cohort (<a href="#app1-nutrients-09-00252" class="html-app">Table S1</a>).</p> "> Figure 2
<p>Associations between skim human milk (HM) leptin and (<b>a</b>) maternal percentage fat mass; and (<b>b</b>) maternal BMI. Combined subset data points are shown as cross-sectional (pale purple) and longitudinal (dark purple). Lines are fixed effects from univariate linear mixed effect models: pale purple dotted line—combined cohort (<a href="#nutrients-09-00252-t004" class="html-table">Table 4</a>); medium purple dashed line—combined cohort with outliers removed (<a href="#sec3dot3dot2-nutrients-09-00252" class="html-sec">Section 3.3.2</a>); solid dark purple line—longitudinal cohort (<a href="#app1-nutrients-09-00252" class="html-app">Table S1</a>).</p> "> Figure 3
<p>Associations between protein concentration and (<b>a</b>) maternal percentage fat mass; and (<b>b</b>) maternal BMI. Combined subset data points are shown as cross-sectional (pale orange) and longitudinal (dark orange). Lines are fixed effects from univariate linear mixed effect models: pale orange dotted line—combined cohort (<a href="#nutrients-09-00252-t005" class="html-table">Table 5</a>); solid dark red line—longitudinal cohort (<a href="#app1-nutrients-09-00252" class="html-app">Table S1</a>).</p> "> Figure 4
<p>Longitudinal changes in (<b>a</b>) maternal percentage fat mass and (<b>b</b>) maternal BMI from 2 to 12 months of lactation. Lines are colour-coordinated for the individual participants (e.g., dark orange in panel (<b>a</b>) is a same dark orange in panel (<b>b</b>)) for illustrative purposes only (<span class="html-italic">n</span> = 21).</p> ">
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Participants
2.2. Human Milk Sample Collection
2.3. Anthropometry and Body Composition
2.4. Leptin and Adiponectin Measurements
2.5. Protein and Lactose Measurements
2.6. Statistical Analyses
3. Results
3.1. Participants
3.2. Changes in Components’ Concentration with Feeding (Pre- and Post-Feed)
3.3. Associations in Combined Subset
3.3.1. Differences in Concentrations of Human Milk Components at Different Months of Lactation
3.3.2. Associations between Maternal Adiposity and HM Leptin
3.3.3. Associations between Maternal Adiposity and HM Adiponectin
3.3.4. Associations between Maternal Adiposity and HM Protein
3.3.5. Associations between Maternal Adiposity and HM Lactose
3.4. Associations in the Longitudinal Subset
3.4.1. Participants
3.4.2. Longitudinal Changes in Concentrations of Human Milk Components
3.4.3. Associations between Maternal Body Mass Index and Percentage Fat Mass
3.4.4. Associations between Maternal Adiposity and Human Milk Components in Longitudinal Subset
4. Discussion
5. Conclusions
Supplementary Materials
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Month of Lactation | 2 | 5 | 9 | 12 | Total |
---|---|---|---|---|---|
Participants * | |||||
Cross-sectional | - | - | - | - | 38 |
Longitudinal | - | - | - | - | 21 |
Total | - | - | - | - | 59 |
Sessions | |||||
Cross-sectional | 8 | 8 | 13 | 9 | 38 |
Longitudinal | 15 | 21 | 19 | 18 | 73 |
Total | 23 | 29 | 32 | 27 | 111 |
Samples (complete cases) | |||||
Cross-sectional | 19 | 21 | 33 | 27 | 100 |
Longitudinal | 41 | 55 | 47 | 40 | 183 |
Total | 60 | 76 | 80 | 67 | 283 |
Samples (available cases) ** | |||||
Whole milk adiponectin | 66 | 79 | 86 | 72 | 303 |
Whole milk leptin | 66 | 79 | 86 | 72 | 303 |
Skim milk leptin | 62 | 77 | 85 | 71 | 295 |
Total protein | 64 | 78 | 87 | 69 | 298 |
Lactose | 65 | 78 | 86 | 67 | 296 |
Month of Lactation | 2 | 5 | 9 | 12 | Total |
---|---|---|---|---|---|
(n = 23) | (n = 29) | (n = 32) | (n = 27) | (n = 111) | |
Maternal BMI a | 27.0 ± 7.3 | 23.5 ± 4.5 | 23.9 ± 5.2 | 24.4 ± 5.5 | 24.6 ± 5.7 |
(20.1–51.3) | (17.0–35.2) | (16.9–37.2) | (18.2–37.2) | (16.9–51.3) | |
Maternal fat mass (%) | 34.9 ± 6.4 | 32.5 ± 6.0 | 30.9 ± 7.9 | 31.3 ± 7.2 | 32.3 ± 7.0 |
(19.6–49.3) | (23.2–47.2) | (16.7–47.9) | (19.4–45.3) | (16.7–49.3) | |
Whole milk leptin (ng/mL) | 0.55 ± 0.29 | 0.50 ± 0.17 | 0.53 ± 0.15 | 0.54 ± 0.13 | 0.53 ± 0.19 |
(0.21–2.24) | (0.20–0.85) | (0.21–0.99) | (0.24–0.89) | (0.20–2.24) | |
Skim milk leptin (ng/mL) | 0.34 ± 0.21 | 0.27 ± 0.07 | 0.26 ± 0.09 | 0.26 ± 0.08 | 0.28 ± 0.12 |
(0.19–1.46) | (0.20–0.48) | (0.19–0.76) | (0.19–0.54) | (0.19–1.46) | |
Adiponectin (ng/mL) | 11.12 ± 4.39 | 9.30 ± 3.94 | 8.46 ± 2.26 | 11.07 ± 7.88 | 9.88 ± 5.05 |
(5.62–25.62) | (5.17–29.67) | (4.56–20.29) | (4.74–54.92) | (4.56–54.92) | |
Total protein (g/L) | 12.94 ± 6.15 | 11.7 ± 5.70 | 10.83 ± 4.63 | 12.83 ± 6.74 | 11.96 ± 5.82 |
(6.54–31.51) | (7.00–34.76) | (3.32–29.69) | (6.60–36.89) | (3.32–36.89) | |
Lactose (g/L) | 67.54 ± 9.05 | 68.07 ± 8.10 | 68.37 ± 8.83 | 69.70 ± 9.11 | 68.41 ± 8.75 |
(50.35–89.06) | (50.92–110.07) | (51.81–100.05) | (51.00–98.36) | (50.35–110.07) |
Predictor | Univariate a | Accounting for Month of Lactation (Linear) b | Accounting for Month of Lactation (Factor) b | |||
---|---|---|---|---|---|---|
PE ± SE | p | PE ± SE | p | PE ± SE | p | |
Adiponectin (ng/mL) | 0.45 ± 0.42 | 0.29 | 0.45 ± 0.42 | 0.30 | 0.45 ± 0.42 | 0.29 c |
Leptin (ng/mL) | ||||||
Whole milk | −0.008 ± 0.016 | 0.65 | −0.008 ± 0.017 | 0.65 | 0.007 ± 0.016 | 0.66 |
Skim milk | −0.002 ± 0.009 | 0.84 | −0.002 ± 0.009 | 0.86 c | −0.001 ± 0.009 | 0.87 c |
Protein (g/L) | −0.14 ± 0.32 | 0.68 | −0.14 ± 0.32 | 0.68 | −0.14 ± 0.32 | 0.68 |
Lactose (g/L) | −0.36 ± 0.91 | 0.69 | −0.38 ± 0.88 | 0.66 | −0.39 ± 0.88 | 0.66 |
Predictor | Adiponectin (ng/mL) | Whole Milk Leptin (ng/mL) | Skim Milk Leptin (ng/mL) | |||
---|---|---|---|---|---|---|
PE ± SE | p | PE ± SE | p | PE ± SE | p | |
Univariate models b | ||||||
BMI | 0.10 ± 0.07 | 0.17 | 0.01 ± 0.003 | <0.001 | 0.008 ± 0.002 | <0.001 a |
%FM | 0.01 ± 0.06 | 0.81 | 0.006 ± 0.002 | 0.008 | 0.005 ± 0.002 | 0.007 |
Month d | - | 0.042 | - | 0.52 | - | 0.024 |
Intercept | 10.58 ± 0.71 | - | 0.55 ± 0.03 | - | 0.34 ± 0.02 | - |
5 e | −1.39 ± 0.87 | 0.12 | −0.06 ± 0.05 | 0.18 | −0.07 ± 0.03 | 0.038 |
9 e | −2.27 ± 0.88 | 0.013 | −0.01 ± 0.05 | 0.75 | −0.08 ± 0.03 | 0.011 |
12 e | −0.26 ± 0.93 | 0.78 | −0.02 ± 0.05 | 0.72 | −0.10 ± 0.03 | 0.005 |
Adjusted model for %FM (month of lactation as linear main effect) c | ||||||
Intercept | 9.76 ± 0.61 | - | 0.52 ± 0.03 | - | 0.32 ± 0.02 | - |
%FM | 0.008 ± 0.06 | 0.90 | 0.006 ± 0.002 | 0.007 | 0.004 ± 0.002 | 0.021 |
Month d | −0.05 ± 0.09 | 0.57 | 0.003 ± 0.004 | 0.47 | −0.008 ± 0.003 | 0.012 |
Adjusted model for %FM (month of lactation as a factor) c | ||||||
Intercept | 10.59 ± 0.72 | - | 0.54 ± 0.03 | - | 0.34 ± 0.02 | - |
%FM | −0.01 ± 0.06 | 0.86 | 0.006 ± 0.002 | 0.009 | 0.004 ± 0.002 | 0.028 |
Month d | - | 0.044 | - | 0.51 | - | 0.063 |
5 e | −1.40 ± 0.88 | 0.12 | −0.04 ± 0.04 | 0.34 | −0.06 ± 0.03 | 0.070 |
9 e | −2.30 ± 0.90 | 0.014 | 0.01 ± 0.05 | 0.76 | −0.07 ± 0.03 | 0.031 |
12 e | −0.29 ± 0.95 | 0.77 | 0.007 ± 0.05 | 0.88 | −0.09 ± 0.03 | 0.011 |
Adjusted model for BMI (month of lactation as linear main effect) c | ||||||
Intercept | 9.76 ± 0.60 | - | 0.52 ± 0.03 | - | 0.33 ± 0.02 | - |
BMI | 0.09 ± 0.07 | 0.19 | 0.01 ± 0.003 | <0.001 | 0.008 ± 0.002 | <0.001 |
Month d | −0.04 ± 0.09 | 0.62 | 0.002 ± 0.004 | 0.59 | −0.008 ± 0.003 | 0.005 |
Adjusted model for BMI (month of lactation as a factor) c | ||||||
Intercept | 10.51 ± 0.71 | - | 0.54 ± 0.003 | - | 0.34 ± 0.02 | - |
BMI | 0.07 ± 0.07 | 0.33 | 0.01 ± 0.003 | <0.001 | 0.007 ± 0.002 | 0.001 |
Month d | - | 0.063 | - | 0.74 | - | 0.039 |
5 e | −1.23 ± 0.89 | 0.17 | −0.03 ± 0.04 | 0.50 | −0.05 ± 0.03 | 0.13 |
9 e | −2.13 ± 0.89 | 0.021 | 0.01 ± 0.04 | 0.78 | −0.07 ± 0.03 | 0.025 |
12 e | −0.16 ± 0.94 | 0.87 | 0.004 ± 0.05 | 0.92 | −0.09 ± 0.03 | 0.007 |
Predictor | Lactose (g/L) | Protein (g/L) | ||
---|---|---|---|---|
PE ± SE | p | PE ± SE | p | |
Univariate models b | ||||
BMI | 0.06 ± 0.14 | 0.66 | 0.14 ± 0.09 | 0.14 |
%FM | 0.08 ± 0.11 | 0.48 | 0.16 ± 0.07 | 0.028 a |
Month d | - | 0.65 | - | 0.37 |
Intercept | 67.32 ± 1.43 | - | 12.90 ± 1.11 | - |
5 e | 0.56 ± 1.89 | 0.77 | −1.39 ± 1.48 | 0.35 |
9 e | 1.31 ± 1.88 | 0.49 | −2.47 ± 1.47 | 0.10 |
12 e | 2.35 ± 1.97 | 0.24 | −0.63 ± 1.55 | 0.69 |
Adjusted model for %FM (month of lactation as linear main effect) c | ||||
Intercept | 68.89 ± 1.13 | - | 11.93 ± 0.87 | - |
%FM | 0.09 ± 0.11 | 0.43 | 0.16 ± 0.07 | 0.036 |
Month d | 0.08 ± 0.15 | 0.59 | −0.03 ± 0.14 | 0.84 |
Adjusted model for %FM (month of lactation as a factor) c | ||||
Intercept | 67.58 ± 1.44 | - | 12.54 ± 1.11 | - |
%FM | 0.06 ± 0.11 | 0.55 | 0.15 ± 0.07 | 0.054 |
Month d | - | 0.67 | - | 0.56 |
5 e | 0.60 ± 1.85 | 0.75 | −0.94 ± 1.47 | 0.53 |
9 e | 1.37 ± 1.87 | 0.50 | −1.78 ± 1.49 | 0.24 |
12 e | 2.27 ± 1.96 | 0.25 | −0.02 ± 1.56 | 0.99 |
Adjusted model for BMI (month of lactation as linear main effect) c | ||||
Intercept | 67.71 ± 2.92 | - | 12.10 ± 0.88 | - |
BMI | 0.06 ± 0.13 | 0.63 | 0.13 ± 0.09 | 0.16 |
Month d | 0.20 ± 0.17 | 0.26 | −0.07 ± 0.14 | 0.61 |
Adjusted model for BMI (month of lactation as a factor) c | ||||
Intercept | 67.55 ± 1.44 | - | 12.69 ± 1.12 | - |
BMI | 0.06 ± 0.13 | 0.66 | 0.12 ± 0.09 | 0.21 |
Month d | - | 0.69 | - | 0.48 |
5 e | 0.63 ± 1.88 | 0.74 | −1.01 ± 1.50 | 0.50 |
9 e | 1.29 ± 1.87 | 0.49 | −2.14 ± 1.49 | 0.16 |
12 e | 2.22 ± 1.95 | 0.26 | −0.36 ± 1.56 | 0.82 |
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Share and Cite
Kugananthan, S.; Gridneva, Z.; Lai, C.T.; Hepworth, A.R.; Mark, P.J.; Kakulas, F.; Geddes, D.T. Associations between Maternal Body Composition and Appetite Hormones and Macronutrients in Human Milk. Nutrients 2017, 9, 252. https://doi.org/10.3390/nu9030252
Kugananthan S, Gridneva Z, Lai CT, Hepworth AR, Mark PJ, Kakulas F, Geddes DT. Associations between Maternal Body Composition and Appetite Hormones and Macronutrients in Human Milk. Nutrients. 2017; 9(3):252. https://doi.org/10.3390/nu9030252
Chicago/Turabian StyleKugananthan, Sambavi, Zoya Gridneva, Ching T. Lai, Anna R. Hepworth, Peter J. Mark, Foteini Kakulas, and Donna T. Geddes. 2017. "Associations between Maternal Body Composition and Appetite Hormones and Macronutrients in Human Milk" Nutrients 9, no. 3: 252. https://doi.org/10.3390/nu9030252