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By Jennifer Couzin-Frankel
Despite feeding babies for millennia, the alchemy of human breast milk remains a mystery. One unknown is how the ingredients in milk, which vary depending on a mother’s diet and environment, can affect a baby’s health. Now, after examining the makeup of milk produced by humans and mice, researchers report that an ingredient – a type of amino acid in whole-grain foods called betaine – appears to improve long-term metabolic health by promoting the growth of beneficial bacteria in the newborn. intestine.
Carles Lerin, who studies pediatric obesity at Sant Joan de Déu Children’s Hospital in Barcelona, began researching breast milk out of frustration: he longed for new ways to tackle childhood obesity and, ultimately, to prevent it. Some studies have shown a slight increase in the risk of obesity in formula-fed babies, and Lerin wondered if certain ingredients in breast milk could make a difference.
With then–Graduate student Sílvia Ribó and obesity researcher David Sánchez-Infantes at the same institution, Lerin turned to an existing study that included 34 mother-baby pairs from Oklahoma; all babies had been exclusively breastfed, and other researchers had kept samples of breast milk and taken detailed records of their growth and health during infancy. Lerin and his colleagues hoped to identify substances that could be associated with rapid early growth, which has been linked to later obesity. One stands out: betaine, which is linked to this unwanted growth when levels are low.
To determine if betaine could actually control the growth of newborns, Lerin and his colleagues switched to mice. The mice that had just given birth were randomly assigned to a normal diet or a diet with betaine supplementation, which passed into breast milk. The puppies that got the betaine-fortified milk weighed slightly less than the control animals, and the difference lasted into adulthood: at about 6 months, those given the extra betaine weighed about 10% less than the puppies. witnesses, report researchers today. Scientific translational medicine.
The effect was most pronounced in puppies whose mothers were obese. Just like in human babies, mouse puppies born to obese mothers are at a higher risk of being overweight, so this finding suggests that a betaine supplement could be especially helpful for these puppies, leading to healthier growth.
As the researchers tried to figure out why betaine might be good for the metabolism, they found something intriguing: In puppy mice, the substance led to a temporary increase in healthy gut bacteria called Akkerrmansia. A second group of 109 babies and mothers, from Valencia, Spain, strengthened that connection. More betaine in breast milk was associated with more Akkerrmansia in fecal samples from babies at 12 months. Other studies have shown lower levels of Akkermansia in humans and animal models are associated with obesity and other metabolic conditions.
The results suggest that breast milk influences species beyond those that swallow it – namely the microbes in the gut, says EA Quinn, a biological anthropologist at the University of Washington in St. Louis, who studies how the high altitude can affect the composition of breast milk. “I think the most exciting thing about this article for me is that it is really starting to show that breast milk is such a complex system. … We are in the early stages of understanding all of this, ”she said.
Does “The Composition of Breast Milk” Program “A Child’s Metabolism?” wonders Elvira Isganaitis, a pediatric endocrinologist involved in the Oklahoma breast milk study and co-author of the new article. A handful of previous studies have suggested that the ingredients in breast milk can affect the gut of an offspring. Another found that in mice, maternal exercise increases healthy carbohydrates, called oligosaccharides, in breast milk.
Quinn also wonders if the apparent effects of betaine on Akkermansia could also explain some benefits in adults of the Mediterranean diet, which is abundant in cereals high in betaine like quinoa. A recent study suggested that betaine might prevent obesity in adult mice by modulating healthy gut microbes, although a small 2018 trial offering betaine supplements to obese people with prediabetes didn’t show much. ‘benefits.
For Lerin, the key question is whether the effects in mice are sustained in babies. He recently started a small clinical trial that aims to recruit 50 overweight or obese breastfeeding mothers, along with their babies, and randomize mothers to betaine supplements or a placebo. Although Lerin does not recommend that new mothers take a run on betaine supplements, “I would recommend eating whole grains and quinoa,” he says – a diet that has no downsides even though betaine does. turns out to be less powerful than he hopes.
Another important question is how to support formula fed babies. It might be possible to add betaine to formula milk, he says, but since such a study involves directly modifying a baby’s diet rather than the mother’s, it’s more complicated to ethically and logistically, and will likely have to wait for current clinical trials to show results.
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