Breastfeeding may benefit cardiometabolic health of children exposed to increased gestational glycemia in utero
Breastfeeding may benefit cardiometabolic health of children exposed to increased gestational glycemia in utero
Purpose: There is altered breastmilk composition among mothers with gestational diabetes and conflicting evidence on whether breastfeeding is beneficial or detrimental to their offspring’s cardiometabolic health. We aimed to investigate associations between breastfeeding and offspring’s cardiometabolic health across the range of gestational glycemia. Methods: We included 827 naturally conceived, term singletons from a prospective mother–child cohort. We measured gestational (26–28 weeks) fasting plasma glucose (FPG) and 2-h plasma glucose (2 hPG) after an oral glucose tolerance test as continuous variables. Participants were classified into 2 breastfeeding categories (high/intermediate vs. low) according to their breastfeeding duration and exclusivity. Main outcome measures included magnetic resonance imaging (MRI)-measured abdominal fat, intramyocellular lipids (IMCL), and liver fat, quantitative magnetic resonance (QMR)-measured body fat mass, blood pressure, blood lipids, and insulin resistance at 6 years old (all continuous variables). We evaluated if gestational glycemia (FPG and 2 hPG) modified the association of breastfeeding with offspring outcomes after adjusting for confounders using a multiple linear regression model that included a ‘gestational glycemia × breastfeeding’ interaction term. Results: With increasing gestational FPG, high/intermediate (vs. low) breastfeeding was associated with lower levels of IMCL (p-interaction = 0.047), liver fat (p-interaction = 0.033), and triglycerides (p-interaction = 0.007), after adjusting for confounders. Specifically, at 2 standard deviations above the mean gestational FPG level, high/intermediate (vs. low) breastfeeding was linked to lower adjusted mean IMCL [0.39% of water signal (0.29, 0.50) vs. 0.54% of water signal (0.46, 0.62)], liver fat [0.39% by weight (0.20, 0.58) vs. 0.72% by weight (0.59, 0.85)], and triglycerides [0.62 mmol/L (0.51, 0.72) vs. 0.86 mmol/L (0.75, 0.97)]. 2 hPG did not significantly modify the association between breastfeeding and childhood cardiometabolic risk. Conclusion: Our findings suggest breastfeeding may confer protection against adverse fat partitioning and higher triglyceride concentration among children exposed to increased glycemia in utero.
Adiposity, Breastfeeding, Cardiometabolic risk, Fat partitioning, Gestational diabetes, Glycemia
2383-2395
Ong, Yi Ying
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Pang, Wei Wei
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Huang, Jonathan Y.
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Aris, Izzuddin M.
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Sadananthan, Suresh Anand
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Mya, Tint
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Yuan, Wen Lun
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Chen, Ling-Wei
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Chan, Yiong Huak
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Karmani, Neerja
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Velan, Sendhil
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Fortier, Marielle V.
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Choo, Jonathan T.L.
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Ling, Lieng Hsi
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Shek, Lynette
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Tan, Kok Hian
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Gluckman, Peter D.
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Yap, Fabian
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Chong, Yap-Seng
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Godfrey, Keith
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Chong, Mary F.F.
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Chan, Shiao-Yng
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Eriksson, Johan G.
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Wlodek, Mary E.
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Lee, Yung Seng
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Michael, Navin
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August 2022
Ong, Yi Ying
a474cc8c-f956-4d25-a06b-c0b655347823
Pang, Wei Wei
6bfc8a33-62c1-4c3b-81a3-baaa14210f8d
Huang, Jonathan Y.
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Aris, Izzuddin M.
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Sadananthan, Suresh Anand
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Mya, Tint
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Yuan, Wen Lun
bd1a80dc-c82a-4387-b754-72e30dd603a7
Chen, Ling-Wei
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Chan, Yiong Huak
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Karmani, Neerja
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Velan, Sendhil
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Fortier, Marielle V.
8b9dc5de-429c-4f04-908c-5b4125fa019a
Choo, Jonathan T.L.
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Ling, Lieng Hsi
9c1c067f-3429-46a8-b5bc-c374bf5cd690
Shek, Lynette
9a77403c-0e0c-4536-a5ad-628ce94b279a
Tan, Kok Hian
4714c94d-334a-42ad-b879-f3aa3a931def
Gluckman, Peter D.
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Yap, Fabian
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Chong, Yap-Seng
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Godfrey, Keith
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Chong, Mary F.F.
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Chan, Shiao-Yng
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Eriksson, Johan G.
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Wlodek, Mary E.
f56b571a-c420-4bfe-b3d9-c2033e1f5495
Lee, Yung Seng
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Michael, Navin
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Ong, Yi Ying, Pang, Wei Wei, Huang, Jonathan Y., Aris, Izzuddin M., Sadananthan, Suresh Anand, Mya, Tint, Yuan, Wen Lun, Chen, Ling-Wei, Chan, Yiong Huak, Karmani, Neerja, Velan, Sendhil, Fortier, Marielle V., Choo, Jonathan T.L., Ling, Lieng Hsi, Shek, Lynette, Tan, Kok Hian, Gluckman, Peter D., Yap, Fabian, Chong, Yap-Seng, Godfrey, Keith, Chong, Mary F.F., Chan, Shiao-Yng, Eriksson, Johan G., Wlodek, Mary E., Lee, Yung Seng and Michael, Navin
(2022)
Breastfeeding may benefit cardiometabolic health of children exposed to increased gestational glycemia in utero.
European Journal of Nutrition, 61 (5), .
(doi:10.1007/s00394-022-02800-7).
Abstract
Purpose: There is altered breastmilk composition among mothers with gestational diabetes and conflicting evidence on whether breastfeeding is beneficial or detrimental to their offspring’s cardiometabolic health. We aimed to investigate associations between breastfeeding and offspring’s cardiometabolic health across the range of gestational glycemia. Methods: We included 827 naturally conceived, term singletons from a prospective mother–child cohort. We measured gestational (26–28 weeks) fasting plasma glucose (FPG) and 2-h plasma glucose (2 hPG) after an oral glucose tolerance test as continuous variables. Participants were classified into 2 breastfeeding categories (high/intermediate vs. low) according to their breastfeeding duration and exclusivity. Main outcome measures included magnetic resonance imaging (MRI)-measured abdominal fat, intramyocellular lipids (IMCL), and liver fat, quantitative magnetic resonance (QMR)-measured body fat mass, blood pressure, blood lipids, and insulin resistance at 6 years old (all continuous variables). We evaluated if gestational glycemia (FPG and 2 hPG) modified the association of breastfeeding with offspring outcomes after adjusting for confounders using a multiple linear regression model that included a ‘gestational glycemia × breastfeeding’ interaction term. Results: With increasing gestational FPG, high/intermediate (vs. low) breastfeeding was associated with lower levels of IMCL (p-interaction = 0.047), liver fat (p-interaction = 0.033), and triglycerides (p-interaction = 0.007), after adjusting for confounders. Specifically, at 2 standard deviations above the mean gestational FPG level, high/intermediate (vs. low) breastfeeding was linked to lower adjusted mean IMCL [0.39% of water signal (0.29, 0.50) vs. 0.54% of water signal (0.46, 0.62)], liver fat [0.39% by weight (0.20, 0.58) vs. 0.72% by weight (0.59, 0.85)], and triglycerides [0.62 mmol/L (0.51, 0.72) vs. 0.86 mmol/L (0.75, 0.97)]. 2 hPG did not significantly modify the association between breastfeeding and childhood cardiometabolic risk. Conclusion: Our findings suggest breastfeeding may confer protection against adverse fat partitioning and higher triglyceride concentration among children exposed to increased glycemia in utero.
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Accepted/In Press date: 6 January 2022
Published date: August 2022
Additional Information:
Funding Information:
This work was supported by the Singapore National Research Foundation under its Translational and Clinical Research (TCR) Flagship Programme and administered by the Singapore Ministry of Health’s National Medical Research Council (NMRC), Singapore [NMRC/TCR/004-NUS/2008, NMRC/TCR/012-NUHS/2014]. Additional funding is provided by the Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore. KMG is supported by the UK Medical Research Council (MC_UU_12011/4), the National Institute for Health Research [NIHR Senior Investigator (NF-SI-0515-10042), NIHR Southampton 1000DaysPlus Global Nutrition Research Group (17/63/154) and NIHR Southampton Biomedical Research Centre (IS-BRC-1215-20004)], the European Union (Erasmus + Programme Early Nutrition eAcademy Southeast Asia-573651-EPP-1-2016-1-DE-EPPKA2-CBHE-JP and ImpENSA 598488-EPP-1-2018-1-DE-EPPKA2-CBHE-JP) and the British Heart Foundation (RG/15/17/3174).
Funding Information:
We thank all GUSTO participants as well as the GUSTO study group, which includes Allan Sheppard, Amutha Chinnadurai, Anne Eng Neo Goh, Anne Rifkin-Graboi, Anqi Qiu, Arijit Biswas, Bee Wah Lee, Birit F.P. Broekman, Boon Long Quah, Borys Shuter, Chai Kiat Chng, Cheryl Ngo, Choon Looi Bong, Christiani Jeyakumar Henry, Claudia Chi, Cornelia Yin Ing Chee, Yam Thiam Daniel Goh, Doris Fok, E Shyong Tai, Elaine Tham, Elaine Quah Phaik Ling, Evelyn Chung Ning Law, Evelyn Xiu Ling Loo, Falk Mueller-Riemenschneider, George Seow Heong Yeo, Helen Chen, Heng Hao Tan, Hugo P S van Bever, Iliana Magiati, Inez Bik Yun Wong, Ivy Yee-Man Lau, Jeevesh Kapur, Jenny L. Richmond, Jerry Kok Yen Chan, Joanna D. Holbrook, Joanne Yoong, Joao N. Ferreira., Jonathan Y. Bernard, Joshua J. Gooley, Kenneth Kwek, Krishnamoorthy Niduvaje, Kuan Jin Lee, Leher Singh, Lin Lin Su, Lourdes Mary Daniel, Mark Hanson, Mary Rauff, Mei Chien Chua, Melvin Khee-Shing Leow, Michael Meaney, Ngee Lek, Oon Hoe Teoh, P. C. Wong, Paulin Tay Straughan, Pratibha Agarwal, Queenie Ling Jun Li, Rob M. van Dam, Salome A. Rebello, Seang-Mei Saw, See Ling Loy, Seng Bin Ang, Shang Chee Chong, Sharon Ng, Shirong Cai, Shu-E Soh, Sok Bee Lim, Stella Tsotsi, Chin-Ying Stephen Hsu, Sue Anne Toh, Swee Chye Quek, Victor Samuel Rajadurai, Walter Stunkel, Wayne Cutfield, Wee Meng Han, and Yin Bun Cheung.
Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.
Keywords:
Adiposity, Breastfeeding, Cardiometabolic risk, Fat partitioning, Gestational diabetes, Glycemia
Identifiers
Local EPrints ID: 454961
URI: http://eprints.soton.ac.uk/id/eprint/454961
ISSN: 1436-6207
PURE UUID: 1db2c801-1cd2-459c-9b9e-51dda3fca650
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Date deposited: 02 Mar 2022 17:58
Last modified: 17 Mar 2024 07:08
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Contributors
Author:
Yi Ying Ong
Author:
Wei Wei Pang
Author:
Jonathan Y. Huang
Author:
Izzuddin M. Aris
Author:
Suresh Anand Sadananthan
Author:
Tint Mya
Author:
Wen Lun Yuan
Author:
Ling-Wei Chen
Author:
Yiong Huak Chan
Author:
Neerja Karmani
Author:
Sendhil Velan
Author:
Marielle V. Fortier
Author:
Jonathan T.L. Choo
Author:
Lieng Hsi Ling
Author:
Lynette Shek
Author:
Kok Hian Tan
Author:
Peter D. Gluckman
Author:
Fabian Yap
Author:
Yap-Seng Chong
Author:
Mary F.F. Chong
Author:
Shiao-Yng Chan
Author:
Johan G. Eriksson
Author:
Mary E. Wlodek
Author:
Yung Seng Lee
Author:
Navin Michael
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