Buffered or impaired: Maternal anemia, inflammation and breast milk macronutrients in northern Kenya.
C-reactive protein
infection
iron-deficiency anemia
non-iron deficiency anemia
transferrin receptor
Journal
American journal of physical anthropology
ISSN: 1096-8644
Titre abrégé: Am J Phys Anthropol
Pays: United States
ID NLM: 0400654
Informations de publication
Date de publication:
02 2019
02 2019
Historique:
received:
09
06
2018
revised:
25
09
2018
accepted:
25
10
2018
pubmed:
24
12
2018
medline:
21
12
2019
entrez:
22
12
2018
Statut:
ppublish
Résumé
Maternal anemia has adverse consequences for the mother-infant dyad. To evaluate whether and how milk nutrient content may change in ways that could "buffer" infants against the conditions underlying maternal anemia, this study assessed associations between milk macronutrients and maternal iron-deficiency anemia (IDA), non-iron-deficiency anemia (NIDA), and inflammation. A secondary analysis of cross-sectional data and milk from northern Kenya was conducted (n = 204). The combination of hemoglobin and transferrin receptor defined IDA/NIDA. Elevated serum C-reactive protein defined acute inflammation. The effects of IDA, NIDA, and inflammation on milk macronutrients were evaluated in regression models. IDA (β = 0.077, p = .022) and NIDA (β = 0.083, p = .100) predicted higher total protein (ln). IDA (β = -0.293, p = .002), NIDA (β = -0.313, p = .047), and inflammation (β = -0.269, p = .007) each predicted lower fat (ln); however, anemia accompanying inflammation predicted higher fat (β = 0.655, p = .007 for IDA and β = 0.468, p = .092 for NIDA). NIDA predicted higher lactose (β = 1.020, p = .003). Milk macronutrient content both increases and decreases in the presence of maternal anemia and inflammation, suggesting a more complicated and dynamic change than simple impairment of nutrient delivery during maternal stress. Maternal fat delivery to milk may be impaired under anemia. Mothers may buffer infant nutrition against adverse conditions or poor maternal health by elevating milk protein (mothers with IDA/NIDA), lactose (mothers with NIDA), or fat (mothers with anemia and inflammation). This study demonstrates the foundational importance of maternal micronutrient health and inflammation or infection for advancing the ecological understanding of human milk nutrient variation.
Sections du résumé
BACKGROUND
Maternal anemia has adverse consequences for the mother-infant dyad. To evaluate whether and how milk nutrient content may change in ways that could "buffer" infants against the conditions underlying maternal anemia, this study assessed associations between milk macronutrients and maternal iron-deficiency anemia (IDA), non-iron-deficiency anemia (NIDA), and inflammation.
METHODS
A secondary analysis of cross-sectional data and milk from northern Kenya was conducted (n = 204). The combination of hemoglobin and transferrin receptor defined IDA/NIDA. Elevated serum C-reactive protein defined acute inflammation. The effects of IDA, NIDA, and inflammation on milk macronutrients were evaluated in regression models.
RESULTS
IDA (β = 0.077, p = .022) and NIDA (β = 0.083, p = .100) predicted higher total protein (ln). IDA (β = -0.293, p = .002), NIDA (β = -0.313, p = .047), and inflammation (β = -0.269, p = .007) each predicted lower fat (ln); however, anemia accompanying inflammation predicted higher fat (β = 0.655, p = .007 for IDA and β = 0.468, p = .092 for NIDA). NIDA predicted higher lactose (β = 1.020, p = .003).
CONCLUSIONS
Milk macronutrient content both increases and decreases in the presence of maternal anemia and inflammation, suggesting a more complicated and dynamic change than simple impairment of nutrient delivery during maternal stress. Maternal fat delivery to milk may be impaired under anemia. Mothers may buffer infant nutrition against adverse conditions or poor maternal health by elevating milk protein (mothers with IDA/NIDA), lactose (mothers with NIDA), or fat (mothers with anemia and inflammation). This study demonstrates the foundational importance of maternal micronutrient health and inflammation or infection for advancing the ecological understanding of human milk nutrient variation.
Identifiants
pubmed: 30575959
doi: 10.1002/ajpa.23752
pmc: PMC6352968
mid: NIHMS998840
doi:
Substances chimiques
Receptors, Transferrin
0
C-Reactive Protein
9007-41-4
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
329-339Subventions
Organisme : Wenner-Gren Foundation
ID : 7460
Pays : International
Organisme : National Science Foundation
ID : BCS 1638167
Pays : International
Organisme : NICHD NIH HHS
ID : P2C HD042828
Pays : United States
Organisme : National Science Foundation
ID : BCS 0622358
Pays : International
Organisme : Wenner-Gren Foundation
ID : 9278
Pays : International
Informations de copyright
© 2018 Wiley Periodicals, Inc.
Références
Am J Clin Nutr. 1995 Sep;62(3):559-63
pubmed: 7661117
Pediatr Blood Cancer. 2012 Feb;58(2):233-8
pubmed: 21548016
J Nutr. 1986 Apr;116(4):499-513
pubmed: 3514820
Am J Phys Anthropol. 2004 Mar;123(3):277-91
pubmed: 14968423
Am J Phys Anthropol. 2016 Jan;159(Suppl 61):S172-95
pubmed: 26808104
Breastfeed Med. 2012 Aug;7:295-301
pubmed: 22047109
Eur J Clin Nutr. 1994 Nov;48 Suppl 3:S78-86; discussion S86-9
pubmed: 7843163
Circulation. 2001 Jul 31;104(5):E20-1
pubmed: 11479266
Physiol Rev. 1984 Jan;64(1):65-102
pubmed: 6420813
Pediatrics. 2005 Sep;116(3):e432-5
pubmed: 16140689
Am J Hum Biol. 2011 Sep-Oct;23(5):664-73
pubmed: 21695742
Anemia. 2014;2014:561567
pubmed: 25215230
Monogr Ser World Health Organ. 1968;57:3-329
pubmed: 4976616
Am J Hum Biol. 2010 Nov-Dec;22(6):768-74
pubmed: 20721981
Proc Natl Acad Sci U S A. 2018 Apr 24;115(17):E3914-E3921
pubmed: 29632170
Bull World Health Organ. 1995;73(4):443-8
pubmed: 7554015
Cold Spring Harb Perspect Med. 2013 Jul 01;3(7):
pubmed: 23613366
Eur J Clin Nutr. 2016 Feb;70(2):250-6
pubmed: 26419197
Am J Hum Biol. 2010 Jul-Aug;22(4):546-56
pubmed: 20309883
J Hum Lact. 2004 May;20(2):153-8; quiz 159-63
pubmed: 15117513
Am J Hum Biol. 2012 Jul-Aug;24(4):533-40
pubmed: 22434662
Breastfeed Med. 2009 Dec;4(4):189-95
pubmed: 19366313
Proc Nutr Soc. 2014 Feb;73(1):1-8
pubmed: 24169363
Breastfeed Med. 2015 Nov;10(9):433-6
pubmed: 26171573
J Immunol Methods. 2010 Oct 31;362(1-2):112-20
pubmed: 20850446
Clin Infect Dis. 2002 Jan 15;34(2):260-6
pubmed: 11740716
J Nutr. 2003 Jun;133(6):1997S-2002S
pubmed: 12771353
Life Sci. 2011 Sep 26;89(13-14):417-21
pubmed: 21821056
Am J Clin Nutr. 1991 Feb;53(2):457-65
pubmed: 1989413
Evolution. 1977 Mar;31(1):177-199
pubmed: 28567732
Soc Sci Med. 2004 Jun;58(12):2485-98
pubmed: 15081199
Am J Hum Biol. 2014 Nov-Dec;26(6):796-802
pubmed: 25130535
Am J Phys Anthropol. 2013 May;151(1):144-50
pubmed: 23446791
Am J Clin Nutr. 2007 Mar;85(3):778-87
pubmed: 17344500
Clin Infect Dis. 1997 Oct;25(4):888-95
pubmed: 9356804
Breastfeed Med. 2012 Jun;7(3):179-88
pubmed: 22166069
Cell Host Microbe. 2013 May 15;13(5):509-519
pubmed: 23684303
Early Hum Dev. 1997 Oct 29;49 Suppl:S7-28
pubmed: 9363415
Annu Rev Nutr. 2001;21:167-92
pubmed: 11375434
J Pediatr Gastroenterol Nutr. 1990 Aug;11(2):229-39
pubmed: 2395063
J Clin Epidemiol. 1994 Jan;47(1):23-33
pubmed: 8283191
J Perinatol. 1999 Jul-Aug;19(5):343-6
pubmed: 10685254
Nutrients. 2017 Sep 19;9(9):
pubmed: 28925980
J Hum Lact. 2012 Nov;28(4):529-34
pubmed: 22956742
Nutr Res Pract. 2015 Aug;9(4):433-8
pubmed: 26244084
Am J Hum Biol. 2017 Jul 8;29(4):
pubmed: 28094879
Am J Phys Anthropol. 2016 Feb;159(2):233-43
pubmed: 26397954
Br Med J. 1978 Apr 22;1(6119):1018-20
pubmed: 638579
Science. 2012 Nov 9;338(6108):768-72
pubmed: 23139325
Hum Ecol. 1990 Dec;18(4):385-402
pubmed: 12285380
Am J Clin Nutr. 1978 Mar;31(3):492-515
pubmed: 343567
J Matern Fetal Neonatal Med. 2013 Aug;26(12):1223-7
pubmed: 23414395
Am J Obstet Gynecol. 2001 Aug;185(2):438-43
pubmed: 11518906
Am J Hum Biol. 2009 Mar-Apr;21(2):172-9
pubmed: 18949769
Pediatr Clin North Am. 2013 Feb;60(1):49-74
pubmed: 23178060
J Nutr. 2000 Aug;130(8):1950-7
pubmed: 10917907
J Pediatr Gastroenterol Nutr. 1984 Nov;3(5):713-20
pubmed: 6502372
Am J Hum Biol. 2013 Jan-Feb;25(1):1-11
pubmed: 23109280
Clin Infect Dis. 2008 May 15;46(10):1582-8
pubmed: 18419494
Circulation. 2000 Apr 18;101(15):1785-91
pubmed: 10769278
Am J Phys Anthropol. 2017 Nov;164(3):586-597
pubmed: 28832929