Nutrition During Pregnancy and Lactation Exploring New Evidence: Proceedings of a Workshop (2020) / Chapter Skim
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6 New Developments and Emerging Topics
6 New Developments and Emerging Topics
Pages 71-86
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From page 71... ...
The microbiome has also come to the forefront, with evidence to suggest that maternal diet may play a key role in its formation. The interplay between maternal metabolism and dietary composition has also been explored, with evidence to suggest it has an influence on bioactive compounds in breast milk, which in turn can influence infant growth and development.
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From page 72... ...
Her presentation covered current recommendations and resources for monitoring intake, changes in the landscape of products, regulations and labeling, caffeine metabolism, and adverse effects. Caffeine Intake Recommendations and Monitoring Caffeine is the most widely consumed psychostimulant worldwide.
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From page 73... ...
Thorlton highlighted some key resources that can be used to monitor caffeine consumption patterns. Related to safety, the Center for Food Safety and Applied Nutrition Adverse Event Reporting System tracks adverse event reports related to foods, cosmetics, or dietary supplements.
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From page 74... ...
To c better understand caffeine metabolism, FDA has recently released guidance on the inclusion of pregnant women in clinical trials. Regulations and Labeling of Caffeinated Products The dietary supplement market has expanded substantially over the past 30 years.
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From page 75... ...
(2017) , for instance, found that pregnant women who did not smoke, had caffeine intake above 300 mg/d, and had the genetic olymorphism for rapid caffeine metabolism were at increased risk of havp ing an infant with decreased birth size.
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From page 76... ...
She suggested that focus should be given to how tolerance to commensal microbes is acquired, and how and when immune differentiation between these commensal microbes and pathogenic microbes occurs. Equally important are investigations into understanding the process of how and when colonization resistance to pathogenic microbes occurs, and understanding the role of commensal microbes in occupying these niches and thereby limiting the capacity of pathogenic microbes in competing for nutrients and substrates in body niches, Aagaard said.
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From page 77... ...
Aagaard reported that maternal high-fat diet and ever consuming infant formula were stronger drivers of differences in the amount of Bacteroides species in the infant gut than Cesarean delivery. Evidence from Nonhuman Primate Models Using the Japanese macaque as a nonhuman primate model, Aagaard's group assessed the influence of the maternal diet on the infant's icrobiome m and explored whether the effects persisted in the long term (Ma et al., 2014; Pace et al., 2018; Prince et al., 2019)
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From page 78... ...
harbored by milk microbiota. These studies collectively reveal a successive mechanism by which the maternal diet during lactation alters milk HMO composition, which in turn shapes the functional milk microbiome prior to infant ingestion.
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From page 79... ...
," she said. FRUCTOSE AND OLIGOSACCHARIDES IN HUMAN BREAST MILK AND THEIR EFFECTS ON INFANT BODY COMPOSITION AND COGNITIVE OUTCOMES Michael Goran, professor of pediatrics at Children's Hospital Los Angeles, which is affiliated with the Keck School of Medicine of the University of Southern California, explained his interest in understanding the effects of breast milk sugar content stemmed from an exploration of modifiable determinants of obesity in children.
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From page 80... ...
Studies have explored differences in HMO concentrations between and within lactating women. Analyses of data from the Canadian CHILD Cohort found that women who secreted 2′-fucosyllactose in their breast milk had different HMO profiles than those who did not secrete it (Azad et al., 2018)
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From page 81... ...
In a small pilot study of 27 lactating women, detectable levels of fructose were found in breast milk, although the concentrations were variable. Fructose content of breast milk was positively associated with measures of infant body composition, including body weight, lean mass, fat mass, and bone mineral content (Goran et al., 2017)
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From page 82... ...
is the only one that appeared to have an inverse relationship with infant weight change in the first 6 months. The Mothers Milk Study is also investigating different mechanisms and gut bacteria products that may affect metabolism, brain development, energy regulation, and infant feeding behaviors.
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From page 83... ...
Aagaard admitted that, in the nonhuman primate data, it is difficult to differentiate between effects of diet during gestation versus lactation owing to the inability to cross-foster in the Japanese macaque. Aagaard questioned the clinical relevance and practical reality of trying to implement specific dietary changes during lactation, noting that longitudinal studies that have investigated this
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From page 84... ...
Breast Milk and Infant Formula Becky Banks, a midwife in private practice, asked the speakers if any of the breast milk findings they presented differ by whether the milk was consumed directly from the breast or was expressed. Goran stated that the Canadian Healthy Infant Longitudinal Development (CHILD)
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From page 85... ...
Fructose Referring to Goran's comment about GLUT-5 transporters, Banks wanted to know when an infant starts absorbing and metabolizing fructose. Goran stated that the available evidence comes from animal studies, which suggest GLUT-5 is not active until fructose is introduced in the diet.
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