Breastfeeding, Childhood Obesity, Childhood Obesity Prevention, Exercise, Lactation, Physical Activity, Pregnancy
Conditions
Keywords
Lactation, Breastfeeding, Breast milk, Pregnancy, Exercise
Brief summary
The purpose of this study is to learn how exercise and physical activity during pregnancy and after pregnancy may affect the composition of breastmilk. Certain changes in breast milk after exercise may have an impact on how infants use energy. Understanding this process may improve public health recommendations for exercise during and after pregnancy. This study can help investigators learn more about how maternal exercise patterns may affect body growth and obesity risk in infants who are breastfed. This research may help identify how different factors can influence healthy weight and early development in infants.
Detailed description
Epidemiological studies suggest that breastfeeding protects against risk of obesity, diabetes, asthma, and other childhood diseases. However, the specific compounds within breastmilk that are responsible for its protective effects are not fully understood. Moreover, prior work from this investigative team has shown that human milk composition varies substantially between individuals according to factors such as body mass index (BMI), diabetes status, diet, and physical activity. Gaining a better understanding of how modifiable risk factors may impact human milk composition would have the potential to identify strategies to enhance the health-promoting benefits of human milk. In this project, the investigators will study the impact of maternal exercise on human milk composition. The central hypothesis is that maternal exercise induces changes in breast milk metabolites and lipids that result in activation of infant brown fat, increased infant energy expenditure, and reduced obesity risk. The study will include assessments of habitual activity during pregnancy and the postpartum period, supervised bouts acute moderate exercise, as well as analysis of human milk composition, infant growth and body composition, and infant energy expenditure.
Interventions
BEHAVIORALActive group
For participants randomized to the Active group, there will be weekly phone calls with study staff during which step counts and exercise bouts from the previous week will be reviewed, and exercise goals for the following week will be gradually increased.
Sponsors
Joslin Diabetes Center
University of Oklahoma
National Institutes of Health (NIH)
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 45 Years
Healthy volunteers
Yes
Inclusion criteria
* 18-45 y of age at the time of enrollment * Pre-gravid or first trimester BMI 18.5 -40 kg/m2 * Uncomplicated singleton pregnancy * Intention to exclusively breastfeed for \>3 months and, if parity \>1, that they successfully breastfed a previous pregnancy * Term pregnancy (gestational age 37 to \<42 weeks) * Infant with birth weight \>10th percentile of weight for gestational age
Exclusion criteria
* Any obstetric contra-indication to exercise at 1 month * Diagnosis of uncontrolled (HbA1c \>7%) type 1 or type 2 diabetes, or gestational diabetes managed with insulin * Intrauterine growth restriction * Pre-eclampsia or other pregnancy complications * Alcohol, cannabis or tobacco use * Known congenital metabolic, endocrine disease, or congenital illness affecting infant feeding/growth * Major fetal anomalies * Musculoskeletal issues that would make exercise difficult
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Altered breast milk lipidome | 8 weeks | Milk composition measured through lipidomics |
| Altered breast milk metabolome | 8 weeks | Human milk composition measured via metabolomics |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Infant body composition | 3 months, 6 months, and 12 months | Infant body composition will be measured using air-displacement plethysmography (ADP; i.e., PeaPod) at 1 and 3-mo and by DXA at 6 and 12-mo: percentage fat, total fat mass. |
| Infant body mass index (BMI) | 3 months, 6 months, and 12 months | Body mass index (BMI) z-score for age and sex, usual range \[-4,4\]; lower BMI z-score represents lower adiposity |
| Infant resting metabolic rate | 3 months of age | Infant Resting Metabolic Rate |
Countries
United States
Contacts
CONTACTElvira M Isganaitis, MD, MPH
CONTACTStudy Coordinator
Outcome results
None listed