Marissa Uhlhorn11/3/15“I have not given, received, or used any unauthorized assistance”____Marissa Uhlhorn_____Consumer News Article: Published on Wednesday, October 28th, 2015Primary Research Journal Article: Published on September 24th, 2015

Consumer Article: Preidt, R. Breast Milk Makeup May Influence Child’s Later Weight, Study Says: Naturally occurring complex carbohydrates could play a role in obesity. HealthDay. October 28th 2015. http://consumer.healthday.com/women-s-health-information-34/breast-feeding-news-82/breast-milk-makeup-influences-child-s-later-weight-study-says-704642.html. Acessed 11/2/15

Journal Article: Alderete, T L, et al. Associations between human milk oligosaccharides and infant body composition in the first 6 mo of life. Am J Clin Nutr. 2015; 102(5): 1-8. doi: 0.3945/ajcn.115.115451http://ajcn.nutrition.org/content/early/2015/10/28/ajcn.115.115451.full.pdf+html

Key Points:Consumer Article

The link between obese mothers and their overweight children is not clear. In the study referenced, 25 mothers and infants led the researchers to understand that

the variation in carbohydrates found in breast milk can play a role in an infant’s risk of obesity and way in which they grow.

Specifically the research team looked at human milk oligosaccharides (HMOs) which aid in immune system development for the infant.

Higher levels of specific HMOs found in breast milk correlated with an increase in the infant’s fat mass by 6 months of age.

Other specific HMOs found to have protective properties, such as lowering the infant’s fat mass by 6 months of age.

This showed that each mother’s composition of breast milk plays a larger role in prediction of their infant’s possible development of obesity than the mother’s weight or weight gain throughout pregnancy.

The article mentions that further research needs to be done in this area, such as specifically determining which HMOs aid in prevention of obesity.

This could also have a future impact on supplements given to both breast-fed and formula fed infants.

Journal Article

Study Purpose: o To determine if infant growth at 1 month and 6 months is affected by breast milk

composition- specifically human milk oligosaccharides (HMOs)

Type of Research/Research Design:o Primary Research- Initial study with follow-up 6 months later

Study Participants – How many individuals? What were their characteristics? : o Thirty seven mother infant pairs were involved in the 1 month studyo Thirty one mother infant pairs returned in the 6 month follow-up studyo No formula supplementation was usedo Maternal age of 18-45 y/oo Gestation > or equal to 47 weekso Singleton birtho Postpartum hospital stay for mother and infant of < 3 dayso Could not be using tobaccoo Alcohol consumption must be < 1 drink/weeko Could not have type 1 or type 2 diabetes during or before pregnancyo Could not have an infant with presumed or known congenital birth defects

Types of data collected (methods) – surveys? Interventions? Etc. :o Mother’s age, BMI, pregnancy weight gain, gestational age, presence of secretoro Infant’s sex, age, birth weight, birth length, weight at 1 month, length at 1

month, fat mass, total fat mass, lean mass, total trunk fat masso Same as above but measured at 6 monthso Breast milk composition (HMOs) for analysis- mothers encouraged to pump milk

from a single breast entirely HMO concentration and specific types of HMOs

Results (what are the primary outcomes from this research?):o Mothers were ~29.5 y/o, overweight (BMI: 27.9 +/- 7.5) before conception,

gained an average of 10.8 kg during pregnancyo Infants length, weight, fat, and lean mass increased over 6 month period (as

expected)o Higher HMO varieties at 1 month resulted in a lower total and percentage of fat

mass in the infant

o Specifically an increase in lacto-N-fucopentaose (LNFP) corresponded with a 0.40 kg lower infant weight at 1 month and 1.11 kg lower weight and 0.85 kg lower lean mass at 6 months.

o An increase in LNFPI corresponded with a 0.79 g lower fat mass at 6 monthso An increase in disialyl-lacto-N-tetraose and LNFPII corresponded with a 1.92g

and 0.42 g greater fat mass at 6 monthso An increase in fucosyl-disialyl-lacto-N-hexaose and lacto-N-neotetraose

corresponded with a 0.04% higher and 0.03% lower body fat at 6 months.

Conclusions drawn by the researchers about their results:o The original hypothesis that variation in HMOs found in mother’s breast milk are

associated with the infants overall growth and body composition was supported through this study.

o Specifically: 6 month increase in LNFPII and DSLNT was associated with a 16% and 35% increase in fat mass (compared to the average fat mass at 6 months)

o Altogether LNFPI, DSLNT, and FDSLNH showed 33% more variance in fat mass of infants than did sex, prepregnancy BMI, weight gain throughout pregnancy, and the 6 month age of the infant.

o Specifically: An increase in LNFPI was associated with a 677 g lower weight, a 519 g lower lean mass, and a 482 g lower fat mass.

o At 1 and 6 months- LNFPI showed 18% and 5% more variance than did the other maternal factors (BMI, weight gain, etc.)

Strengths/Weaknesses:Consumer Article

This article’s topic and content was appropriate for being found in a HealthDay News article. An average person, looking to read new information from recent research, would be able to understand this content, but may not feel content with what is provided. The consumer article is very brief, vague, and inconclusive. There wasn’t necessarily one “side” being presented by the author, nor was there consistency in the way the information was presented. The article is written in 12 choppy paragraphs/sentences, giving bits and pieces of information found in the primary journal article.

I think it was important for the author to not go into specific numbers or long names of HMOs that were discussed in the corresponding journal article. This gives the reader a general idea that HMOs found in breast milk could either have a positive or negative correspondence with the infant’s weight, fat mass, or lean mass. I also think it was necessary to include that further research needs to be done in this area. It is important to let the readers know that this specific topic has not been fully studied. The journal article provides a brief introduction, detailed methods, results, conclusions, and discussions along with a variety of charts and graphs. The consumer article does not go into much detail at all, which can be beneficial, but also may result in an unclear summary presented in the consumer article.

Journal ArticleThe purpose of this study was to either support or decline the researchers’ original

hypothesis that HMO variation could be associated with infant’s weight gain, lean mass, and fat mass. This objective is rather broad, but it seems to be one of the first studies to research and observe this particular area of nutrition. Therefore the study aims are worth investigating, due to the newness of this field.

The sample size was fairly small, with only 37 mother-infant pairs in the 1 month study and 31 mother-infant pairs in the follow-up 6 month study. For this type of research, though, I would think the variation among mother’s HMO composition found in breast milk would be slight. It may have been useful to include women who had BMIs that categorized them as being underweight and see how that may have affected the infant’s weight gain, lean mass, and fat mass over a 6 month period. Although the sample size was small, there were significant statistical conclusions in regards to HMO variation. The article did not mention a specific race/ethic group being studied, but had both inclusive and exclusive criteria that must be met for the women and infant pairs before enrolling in the study.

The analysis of the physical characteristics of the infants (weight gain, lean mass, fat mass) was explained, but the methods to milk composition analysis was unclear. The overall research was conducted in a well-controlled manner, following up with the same means of measurement at 6 months. The data is presented in a clear and concise fashion, making it easy to understand the overall results and conclusions gained from the study. I like that the discussion included statistics from other studies that were similar, and also pointed out that there needs to be further research done in this particular area. The authors provided significant statistics in their results section as well as in a variety of tables and graphs. There are both positive and negative associations between HMO composition and infant growth, weight, etc. presented throughout the results, conclusion, and discussion sections of the journal article.

Implications:Nutrition Professionals

The data presented in this article should not have too much of an impact on a nutrition professional due to the fact that there is little research in this area. It could be overwhelming to the client if inconclusive information was provided to them. On the other side, the dietitian could educate their breastfeeding mother clients about the benefits to incorporating fibrous plants and beans into their diet (containing oligosaccharides). With further research, the dietitian could find out sources for the particular HMOs that show positive associations with an infant’s weight gain, lean mass, and fat mass.

Consumers

The overall message that the consumer news article provides is that some HMOs are associated with an increase in fat mass and some are associated with a decrease in infant fat mass. This vague information will not necessarily benefit the reader in a significant way. In fact, the reader may be a bit confused and frustrated that there is no major take away message. The article also states that there should be further research done in this particular field of nutrition. The consumer may be interested in this topic, ask a dietitian for further information, and/or continue looking up similar articles about HMOs and their impact on infants when breastfeeding. In addition, the article suggests there is no significant link with obese mothers and increased fat mass among their infants over time. This may intrigue the reader, especially if they are an obese mother possibly worried about the impact this may have on their infant.