Yi Ying Ong1, Wei Wei Pang2, Jonathan Y Huang3, Izzuddin M Aris4, Suresh Anand Sadananthan3, Mya-Thway Tint2,3, Wen Lun Yuan1, Ling-Wei Chen3, Yiong Huak Chan5, Neerja Karnani3, S Sendhil Velan3,6, Marielle V Fortier3,7, Jonathan Choo8, Lieng Hsi Ling9, Lynette Shek1,3,10, Kok Hian Tan11,12, Peter D Gluckman3,13, Fabian Yap8,11, Yap-Seng Chong2,3, Keith M Godfrey14, Mary F-F Chong3,15, Shiao-Yng Chan2,3, Johan G Eriksson2,3,16,17, Mary E Wlodek2,3,18, Yung Seng Lee19,20,21, Navin Michael22,23. 1. Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. 2. Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. 3. Brenner Centre for Molecular Medicine, Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, 30 Medical Drive, Singapore, 117609, Singapore. 4. Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA. 5. Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. 6. Singapore Bioimaging Consortium, Agency for Science Technology and Research, Singapore, Singapore. 7. Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, Singapore, Singapore. 8. Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore. 9. Department of Cardiology, National University Heart Centre, Singapore, Singapore. 10. Division of Paediatric Endocrinology, Department of Paediatrics, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore. 11. Duke-NUS Medical School, Singapore, Singapore. 12. Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, Singapore. 13. Liggins Institute, University of Auckland, Auckland, New Zealand. 14. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. 15. Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore. 16. Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland. 17. Folkhälsan Research Center, Helsinki, Finland. 18. Department of Physiology, University of Melbourne, Melbourne, Australia. 19. Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. paeleeys@nus.edu.sg. 20. Brenner Centre for Molecular Medicine, Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, 30 Medical Drive, Singapore, 117609, Singapore. paeleeys@nus.edu.sg. 21. Division of Paediatric Endocrinology, Department of Paediatrics, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore. paeleeys@nus.edu.sg. 22. Brenner Centre for Molecular Medicine, Singapore Institute for Clinical Science, Agency for Science, Technology, and Research, 30 Medical Drive, Singapore, 117609, Singapore. navin_michael@sics.a-star.edu.sg. 23. , 1E Kent Ridge Road, NUHS Tower Block Level 12, Singapore, 119228, Singapore. navin_michael@sics.a-star.edu.sg.
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.
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.
Authors: Izzuddin M Aris; Shu E Soh; Mya Thway Tint; Seang Mei Saw; Victor S Rajadurai; Keith M Godfrey; Peter D Gluckman; Fabian Yap; Yap Seng Chong; Yung Seng Lee Journal: Eur J Nutr Date: 2015-09-28 Impact factor: 5.614
Authors: Jian Ma; Yijuan Qiao; Pei Zhao; Wei Li; Peter T Katzmarzyk; Jean-Philippe Chaput; Mikael Fogelholm; Rebecca Kuriyan; Estelle V Lambert; Carol Maher; Jose Maia; Victor Matsudo; Timothy Olds; Vincent Onywera; Olga L Sarmiento; Martyn Standage; Mark S Tremblay; Catrine Tudor-Locke; Gang Hu Journal: Matern Child Nutr Date: 2020-03-05 Impact factor: 3.092