Maternal Obesity, Breast Milk Composition, and Infant Growth

母亲肥胖、母乳成分和婴儿生长

基本信息

批准号：
9271204
负责人：
ELLEN W. DEMERATH
金额：
$ 54万
依托单位：
UNIVERSITY OF MINNESOTA
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-07-10 至 2019-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9271204
关键词：
Academy Adipose tissue Affect Age-Months Air American Animal Model Anti-inflammatory Biochemistry Birth Body Composition Body fat Breast Feeding C-Peptide Cardiovascular Diseases Cell physiology Child Complex Conceptions Data Desire for food Diabetes prevention Diet Dose Dual-Energy X-Ray Absorptiometry Education Educational Materials Exclusive Breastfeeding Exhibits Fatty Acids Fatty acid glycerol esters Feeding Methods Glucose Goals Growth Health Hormonal Hormones Human Human Milk Immunologic Markers Individual Infant Insulin Insulin Resistance Insulin-Like Growth Factor Binding Protein 3 Insulin-Like Growth Factor I Interleukin-1 Interleukin-10 Interleukin-6 Intervention Lactation Length Leptin Life Liquid substance Mediating Metabolic Methods Milk Mothers National Children&apos s Study Neonatal Nurse Midwives Nutritional status Obesity Outcome Overweight Pancreas Pathway interactions Pediatrics Perinatal Play Plethysmography Postpartum Period Pregnancy Pregnant Women Professional Organizations Recruitment Activity Research Risk Sampling Science Serum Specialist TNF gene Techniques Testing Thinness Time Translations Umbilical Cord Blood United States Variant Vertical Disease Transmission Weight Weight Gain Woman adipokines adiponectin college cytokine developmental plasticity feeding gestational weight gain immune activation infant outcome inflammatory marker insulin secretion inter-individual variation intergenerational maternal obesity maternal weight metabolomics mother nutrition novel nutrition obesity in children obesity prevention obesity risk offspring polypeptide C postpartum weight prenatal prepregnancy obesity protective effect public health relevance response secondary analysis therapy design transmission process

项目摘要

DESCRIPTION (provided by applicant): Today the majority of pregnant women in the United States are either overweight or obese at conception with their offspring having greater adiposity at birth, a 2-fold greater risk of later obesity, and neonatal insulin resistance. Breastfeeding ha many clear benefits that may include protection against obesity and its sequelae, and exclusive breast milk feeding is recommended as the ideal infant feeding strategy for the first six months. It was long thought that breast milk composition was fairly uniform among women, having been optimized through evolutionary time to provide adequate sole nutrition for the growing infant regardless of the environmental circumstances. However, recent evidence shows that breast milk is a highly complex fluid with significant inter-individual variation in hormonal and cytokine concentrations. Pervasive maternal obesity is an evolutionarily novel condition for the human species but little effort has yet been made to systematically examine how this novel condition is associated with breast milk adipose-tissue derived hormone and cytokine (adipocytokine) variation, or whether that variation relates to infant metabolic status. Our objective is to comprehensively assess the "lactational programming" hypothesis, that is, whether or not recently documented variation in breast-milk composition is related to both maternal adiposity and to infant metabolic status. The central hypothesis is that a graded, dose-response relationship between maternal adiposity and adipocytokine concentrations in breast milk exists and that milk adipocytokine concentrations are associated with altered body composition in their exclusively breast-fed offspring. Guided by compelling preliminary data, and with consideration of potential confounders, this hypothesis will be tested by pursuing three Specific Aims: 1) Identify windows of exposure during the perinatal period (pre-pregnancy, pregnancy, post-partum) when elevated maternal weight and weight gain are associated with milk adipocytokine concentrations; 2) Test novel relationships between breast-milk adipocytokine concentrations and infant body composition and insulin secretion; and 3) Further characterize the relationship of maternal adiposity to milk variation and infant outcomes, to augment Aims 1 and 2 using state-of-the-science maternal and infant body composition methods, comprehensive breast-milk sampling techniques, and metabolomic analysis. The proposed research is significant because it tackles an understudied, but potentially important pathway explaining the vicious cycle of maternal-child obesity transmission prevalent today. The results of the study will be used to design interventions to reduce maternal weight during pregnancy and lactation and to augment lactation education materials to focus on the needs of obese breast-feeding women. The ultimate goal is to support women and infants during this crucial period of developmental plasticity, for the prevention of obesity, diabetes and cardiovascular disease.

描述（由申请人提供）：如今，美国大多数孕妇在受孕时都超重或肥胖，她们的后代出生时肥胖程度更高，以后肥胖和新生儿胰岛素抵抗的风险增加 2 倍。母乳喂养有许多明显的好处，可能包括预防肥胖及其后遗症，并且建议将纯母乳喂养作为前六个月的理想婴儿喂养策略。长期以来，人们一直认为，女性的母乳成分相当均匀，经过进化时间的优化，无论环境条件如何，都能为成长中的婴儿提供充足的单一营养。然而，最近的证据表明，母乳是一种高度复杂的液体，激素和细胞因子存在显着的个体差异。浓度。普遍的产妇肥胖对于人类来说是一种进化上的新病症，但目前还没有做出什么努力来系统地研究这种新病症如何与母乳脂肪组织衍生的激素和细胞因子（脂肪细胞因子）变异相关，或者这种变异是否与婴儿有关代谢状态。我们的目标是全面评估“哺乳期编程”假说，即最近记录的母乳成分变化是否与母亲肥胖和婴儿代谢状态有关。中心假设是，母体肥胖与母乳中脂肪细胞因子浓度之间存在分级的剂量反应关系，并且乳汁脂肪细胞因子浓度与其纯母乳喂养的后代的身体成分改变相关。在令人信服的初步数据的指导下，并考虑到潜在的混杂因素，该假设将通过追求三个具体目标进行检验：1）确定围产期（怀孕前、怀孕期间、产后）当母亲体重增加和体重增加与乳汁脂肪细胞因子浓度相关； 2) 测试母乳脂肪细胞因子浓度与婴儿身体成分和胰岛素分泌之间的新关系； 3) 进一步描述母亲肥胖与乳汁变异和婴儿结局的关系，利用最先进的母亲和婴儿身体成分方法、综合母乳采样技术和代谢组学分析来增强目标 1 和 2。这项拟议的研究意义重大，因为它解决了一个尚未充分研究但可能很重要的途径，可以解释当今普遍存在的母婴肥胖传播的恶性循环。该研究的结果将用于设计干预措施，以减轻怀孕和哺乳期间母亲的体重，并增加哺乳教育材料，以关注肥胖母乳喂养妇女的需求。最终目标是在发育可塑性的关键时期为妇女和婴儿提供支持，预防肥胖、糖尿病和心血管疾病。