National Childhood Obesity Month: the links between infant feeding and obesity Part 1

Photo credit: WIC Image Gallery

Worldwide, obesity has nearly tripled since 1975.  Anthropologist Daniel Sellen of the University of Toronto reminded participants at the “Nutrition and Nurture in Infancy and Childhood: Bio-Cultural Perspectives” conference that no country has yet managed to avoid the occurrence of childhood obesity. Sellen pointed out that 90 percent of countries experience the double burden of malnutrition; simultaneously experiencing inadequate food access and obesity.

This National Childhood Obesity Month, in two installments, let’s zero in on what obesity looks like in the U.S. and how infant and young child feeding (IYCF) and other perinatal factors influence the obesity epidemic. Here’s a round-up of Our Milky Way contributors’ work around childhood obesity. 

Breastfeeding socializes taste. As Penny Van Esterik, Professor Emerita, York University, Toronto and Adjunct Professor, University of Guelph pointed out in Breastfeeding: where healthy and sustainable food systems begin, infant feeding can set up children for the “industrial palate” contributing to the obesity pandemic.  Dr. Julie Mennella’s research on flavor learning has shown that sensory experiences, beginning early in life, can shape preferences. “Mothers who consume diets rich in healthy foods can get children off to a good start because flavors are transmitted from the maternal diet to amniotic fluid and mother’s milk, and breastfed infants are more accepting of these flavors,” Mennella writes in Ontogeny of taste preferences: basic biology and implications for health. “In contrast, infants fed formula learn to prefer its unique flavor profile and may have more difficulty initially accepting flavors not found in formula, such as those of fruit and vegetables.”

Photo credit: WIC Image Gallery

Healthy Children Project’s Cindy Turner-Maffei shared her notes from Nutrition During Pregnancy and Lactation: Exploring New Evidence – A Workshop. Specifically,  Kjersti Aagaard of Baylor College of Medicine reported on the impact of maternal diet on the developing infant microbiome. Turner-Maffei noted:

    • The diversity of vaginal microbes decreases in pregnancy. The neonate’s early biome looks very different than that of the vagina. 
    • The neonate’s microbiome may reflect the amount of fat in the mother’s diet. High fat diet (>35% of calories as fat) is more correlated with infant dysbiosis* than with maternal obesity. (This difference persists—it seems irreversible with dietary changes later.) [*dysbiosis=imbalance in the microbiome—a less than desirable microbial community]
    • We should stop focusing on treating obesity in pregnancy/lactation and focus instead on supporting dietary change. Within days of changing the diet (less added sugar and fat and more fiber), the mother’s metabolic markers and those in her milk change for the better. 
    • Similarly, “we must come to value nutrition over weight.” 
    • Encourage nutrient quality: “fresh from the source produce” is best. Address equity issues in access to fresh produce.
    • Today’s research does not show that giving probiotics in pregnancy protects mother or infant.
    • Fun fact: Did you know that “there are Pseudomonas species that can exist solely on caffeine”???!!!
Photo credit: WIC Image Gallery

The microbiome comes into play in Sylvia Metzger’s, MPH, MSN, RN, CNL, IBCLC, LCCE work with The Human Microbiome Project— a National Institute of Health initiative with the goal to study microbiota. “We have plenty, almost 5 pounds of our body weight,” Metzger points out. Microbiota have a shockingly significant impact on human health and disease. “Our gut microbiota work for us really hard,” Metzger continues.  “They [affect] our immunity, metabolism, endocrine system, and even our neural pathways.  I had no idea that an obese patient can have very different gut bacteria than a lean counterpart, and that these microbiota can epigenetically influence the patient’s metabolism.  The wrong bacteria can literally reprogram our metabolism towards obesity.  I look forward to learning more about how to feed our microbiota right – for now, my understanding is that they love to munch on prebiotics… Breastmilk serves as an excellent prebiotic and is full of human milk oligosaccharides, which can, for example, decrease the risk of necrotizing enterocolitis, a devastating condition affecting predominantly premature infants.  The therapeutic potential in treating illness with underlying dysbiosis through manipulation of the enteric microbiome, which would also include autoimmune conditions (Crohn’s, diabetes type I) may be tremendous.

Stay tuned for Part 2 next week.

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