Maternal BMI is positively associated with human milk fat : a systematic review and meta-regression analysis
© The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition..
BACKGROUND: Lack of robust estimates of human-milk nutrient composition and influential maternal factors, such as body composition, are barriers to informing nutrition policies and programs.
OBJECTIVE: The objective was to understand the relation between maternal BMI and human-milk energy, fat, and/or total protein.
METHODS: Four electronic databases (MEDLINE, Embase, CINAHL, and Web of Science) were searched. Outcomes assessed were human-milk energy (kcal/L), fat (g/L), and total protein (g/L) from mothers 1 to 6 mo postpartum. Studies with data on maternal BMI or weight and height that quantified human-milk energy, fat, or protein between 1 and 6 mo postpartum were eligible. Random-effects meta-regression weighted by the inverse of the study-level SE was completed for each of the 3 outcomes. The certainty of evidence for each outcome was assessed using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach.
RESULTS: A total of 11,373 titles and abstracts were identified, and after full-text screening, 69 articles of 66 studies were included. Meta-regression results showed a positive association between maternal BMI and human-milk fat (β: 0.56 g/L; 95% CI: 0.034, 1.1; P = 0.04; I2 = 93.7%, n = 63 datapoints). There was no significant association between maternal BMI and human-milk energy (β: 3.9 kcal/L; 95% CI: -1.6, 9.5; P = 0.16, I2 = 93.3%, n = 40 datapoints) or total protein (β: 0.13 g/L; 95% CI: -0.16, 0.41; P = 0.37, I2 = 99.1%, n = 40 datapoints). The certainty of evidence for human-milk energy was low and the certainty of evidence for fat and total protein was very low.
CONCLUSIONS: Meta-regression analysis of available literature suggested an association between maternal BMI and human-milk fat between 1 and 6 mo postpartum. Future studies are needed to confirm the relation between maternal BMI; variation in human-milk energy, fat, and protein content; and the implications for child growth and development. This review is registered with International Prospective Register of Systematic Reviews (PROSPERO 2018 CRD42018098808) at https://www.crd.york.ac.uk/prospero/.
| Errataetall: |
CommentIn: Am J Clin Nutr. 2021 Apr 6;113(4):772-774. - PMID 33742200 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:113 |
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| Enthalten in: |
The American journal of clinical nutrition - 113(2021), 4 vom: 06. Apr., Seite 1009-1022 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Daniel, Allison I [VerfasserIn] |
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| Links: |
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| Themen: |
BMI |
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| Anmerkungen: |
Date Completed 20.04.2021 Date Revised 11.11.2023 published: Print CommentIn: Am J Clin Nutr. 2021 Apr 6;113(4):772-774. - PMID 33742200 Citation Status MEDLINE |
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| doi: |
10.1093/ajcn/nqaa410 |
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| Förderinstitution / Projekttitel: |
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| 245 | 1 | 0 | |a Maternal BMI is positively associated with human milk fat |b a systematic review and meta-regression analysis |
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| 500 | |a Date Completed 20.04.2021 | ||
| 500 | |a Date Revised 11.11.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a CommentIn: Am J Clin Nutr. 2021 Apr 6;113(4):772-774. - PMID 33742200 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition. | ||
| 520 | |a BACKGROUND: Lack of robust estimates of human-milk nutrient composition and influential maternal factors, such as body composition, are barriers to informing nutrition policies and programs | ||
| 520 | |a OBJECTIVE: The objective was to understand the relation between maternal BMI and human-milk energy, fat, and/or total protein | ||
| 520 | |a METHODS: Four electronic databases (MEDLINE, Embase, CINAHL, and Web of Science) were searched. Outcomes assessed were human-milk energy (kcal/L), fat (g/L), and total protein (g/L) from mothers 1 to 6 mo postpartum. Studies with data on maternal BMI or weight and height that quantified human-milk energy, fat, or protein between 1 and 6 mo postpartum were eligible. Random-effects meta-regression weighted by the inverse of the study-level SE was completed for each of the 3 outcomes. The certainty of evidence for each outcome was assessed using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach | ||
| 520 | |a RESULTS: A total of 11,373 titles and abstracts were identified, and after full-text screening, 69 articles of 66 studies were included. Meta-regression results showed a positive association between maternal BMI and human-milk fat (β: 0.56 g/L; 95% CI: 0.034, 1.1; P = 0.04; I2 = 93.7%, n = 63 datapoints). There was no significant association between maternal BMI and human-milk energy (β: 3.9 kcal/L; 95% CI: -1.6, 9.5; P = 0.16, I2 = 93.3%, n = 40 datapoints) or total protein (β: 0.13 g/L; 95% CI: -0.16, 0.41; P = 0.37, I2 = 99.1%, n = 40 datapoints). The certainty of evidence for human-milk energy was low and the certainty of evidence for fat and total protein was very low | ||
| 520 | |a CONCLUSIONS: Meta-regression analysis of available literature suggested an association between maternal BMI and human-milk fat between 1 and 6 mo postpartum. Future studies are needed to confirm the relation between maternal BMI; variation in human-milk energy, fat, and protein content; and the implications for child growth and development. This review is registered with International Prospective Register of Systematic Reviews (PROSPERO 2018 CRD42018098808) at https://www.crd.york.ac.uk/prospero/ | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a BMI | |
| 650 | 4 | |a breast milk | |
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| 650 | 4 | |a meta-analysis | |
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| 650 | 7 | |a Lactose |2 NLM | |
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| 700 | 1 | |a Kiss, Alex |e verfasserin |4 aut | |
| 700 | 1 | |a Mwangome, Martha |e verfasserin |4 aut | |
| 700 | 1 | |a Bandsma, Robert H J |e verfasserin |4 aut | |
| 700 | 1 | |a O'Connor, Deborah L |e verfasserin |4 aut | |
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