Associations of maternal diet with nutritional and chemical exposure markers in human milk from the LACTACOL cohort of preterm infants

Abstract

Purpose: Maternal diet may impact human milk composition. Our objective was to characterize the association between maternal diet and the presence of nutritional and chemical exposure markers of human milk in the context of prematurity.

Methods: One hundred and three mothers of preterm infants, recruited in the west of France near the Atlantic coast, completed a food frequency questionnaire to assess daily food intake. Milk was sampled up to discharge for analysis of Fatty Acids (FAs), Human Milk Oligosaccharides (HMOs) and Persistent Organic Pollutants (POPs).

Results: Four dietary patterns were identified by principal component analysis coupled with hierarchical clustering. The pattern "Snack Eater" with the highest n-6:n-3 ratio in terms of polyunsaturated FA intake showed the lowest levels of n-3 FAs (e.g., DocosaHexaenoic Acid (DHA), p = 0.037) and POPs in milk. The highest level of dibenzodioxin was observed among the "Omnivores" pattern (p = 0.027). Butter intake was associated with FAs in milk, mainly saturated (e.g., 15:0, β = 59.2, 95%CI [30.0-88.5]) and some POPs (e.g., PCB138, β = 53.3, 95%CI [10.9-95.6]), but not with HMO. Fish intake was associated with POPs in milk.

Conclusion: Maternal diet may be associated with the FAs and POPs composition of milk in mothers of preterm infants, as it is for full-term infants. To improve the nutritional composition of human milk, it would be advisable to avoid the "Snack-eater" pattern and to favour the consumption of nutrient-rich foods. Butter consumption has been identified as a major contributor of pollutants and saturated fatty acids, and should therefore be given particular attention.

Keywords: Dietary pattern; Fatty acid; Food intake; Human milk; Human milk oligosaccharide; Maternal diet; Persistent organic pollutant; Preterm infant.