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Commentary : Heal the mother, heal the baby: Epigenetics, breastfeeding and the human microbiome

March 2014
Breastfeeding review: professional publication of the Australian Breastfeeding Association 22(1):7-9

Source
PubMed

Authors:

Jennifer Tow

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Breastfeeding Review • VOLUME 22 • NUMBER 1 • MARCH 2014 7

Jennifer Tow

Commentary

Heal the mother, heal the baby:

epigenetics, breastfeeding and the human microbiome

Keywords: breastfeeding, more keywords?

Breastfeeding Review 2014; 22(1): 7

–

Epigenetics is undoubtedly the fastest-growing area of









      

     

        

       



        





held that in mapping the human genome we could identify



       

     

      

        



   C. elegans 



          

      

        

        

      

       

       

     

       

of the human phenotype (the outward appearance or



        



   

         



be associated with pathology does not mean that disease

       

        

       

     





      

    

       

 

       

system and the integrity of the gut-brain and gut-

        



  

      

   







       

   





8 Breastfeeding Review • VOLUME 22 • NUMBER 1 • MARCH 2014







        

  

      

        

        

        

caesarean placed at much greater risk for chronic disease



      

      

        



        

      

       

to pathogens and infection than breastfed infants

  

 

       

 

undersold breastfeeding by focusing primarily on its



is the microbiome that its symbiotic role within the human

 



   









        

    

       

      

        

          



       

       



       

       

       

   

irresponsible to continue to argue that a poor maternal





         

       

how breastfeeding may become the pathway for healing

       

  

      

not far-fetched by any means when you consider that



  



Manipulating breastfeeding by healing the gut of the

  

       





rewards as both mothers and their infants are healing

    



  





feeding it will be abundantly clear that breastfeeding has

  



 

  



        

       

         

   

        









         











  





  

     

       

       



  

the maternal-infant microbiome and thus on the multi-

generational genomic programming that directs the well-



        

     





   



Breastfeeding Review • VOLUME 22 • NUMBER 1 • MARCH 2014 9

    





      



         

     

make a conscious choice in the direction of human

 

of the infant’s internal terrain may well present the most

        



harness its immense potential to heal the breastfeeding



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

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Rolph T, Seidman JG, Gabriel S, Cox DR, Seidman CE, Groop

L, Altshuler D





Garfield CF, Dorsey ER, Zhu S, Huskamp HA, Conti R,

Dusetzina SB, Higashi A, Perrin JM, Kornfield R, Alexander

GC

ambulatory diagnosis and medical treatment in the United



Hillier LW, Coulson A, Murray JI, Bao Z, Sulston JE,

Waterston RH



Lee YK, Mazmanian SK





Masterjohn C









Pertea M, Salzberg S





Reed RL, Battersby M, Osborne RH, Bond MJ, Howard SL,

Roeger L







Rigon G, Vallone C, Lucantoni V, Signore F





AUTHOR

Jennifer Tow



Nursing Mothers: A History of the Australian

Breastfeeding Association 1964–2014 was launched

13 February 2014 in Melbourne, the date of the 50th

anniversary of our Association. Pictured at the launch

are the first and current editors of BFR, Hilary (Pixie)

Endacott on the left and Jenni James on the right. In the

middle is Judy Gifford, National Publications Manager

who was NMAA President when BFR first appeared in

1982 and is still closely involved with its production.

Photo courtesy Bridget Laird

Adult Patients who were Breastfed are Less Anxious but Suffer More Frequently of Non-Diarrheic Functional Bowel Disorders

Article

Dec 2019

Introduction. Functional gastrointestinal disorders are pathologies of multifactorial origin. A shorter duration of breastfeeding has been found to enhance the prevalence of irritable bowel syndrome (IBS) in adulthood. The present observational study aims mainly to evaluate if breastfeeding is associated with IBS only or with other functional gastrointestinal disorders (FGIDs). Patients and methods. 1106 consecutive FGID patients (70% female) aged 48.4±16.6 years (M±SD), (BMI 26.9±11.0 kg/m²) filled both a Rome III questionnaire, a psychological evaluation and a questionnaire about breastfeeding. The backwards selection procedure was used for model selection during multivariate logistic regression. Results. Breastfed patients are older (P=0.039), and have lower state anxiety (P=0.004; HR=0.986; 95% CI=[0.976-0.995]). They suffer more frequently of IBS with constipation (P=0.028; HR=1.866; 95% CI=[1.069-3.256]), mixed IBS (P=0.006; HR=2.181; 95% CI=[1.254-3.792]), functional constipation (P=0.006; HR=1.909; 95% CI=[1.199-3.040]), and bloating (P=0.039; HR=1.624; 95% CI=[1.026-2.571]).. In contrast to esophageal, gastroduodenal and anorectal disorders which were not associated to the fact of having been breastfed or not. Conclusion. Our results support the presence of an association between breastfeeding and non-diarrheic functional bowel disorders (IBS, IBS with constipation, mixed IBS, functional constipation and bloating) in FGIDs patients, but it also demonstrates that these people are less acutely anxious.

Breastfeeding effects on DNA methylation in the offspring: A systematic literature review

Article

Full-text available

Mar 2017
PLOS ONE

Background Breastfeeding benefits both infants and mothers. Recent research shows long-term health and human capital benefits among individuals who were breastfed. Epigenetic mechanisms have been suggested as potential mediators of the effects of early-life exposures on later health outcomes. We reviewed the literature on the potential effects of breastfeeding on DNA methylation. Methods Studies reporting original results and evaluating DNA methylation differences according to breastfeeding/breast milk groups (e.g., ever vs. never comparisons, different categories of breastfeeding duration, etc) were eligible. Six databases were searched simultaneously using Ovid, and the resulting studies were evaluated independently by two reviewers. Results Seven eligible studies were identified. Five were conducted in humans. Studies were heterogeneous regarding sample selection, age, target methylation regions, methylation measurement and breastfeeding categorisation. Collectively, the studies suggest that breastfeeding might be negatively associated with promoter methylation of LEP (which encodes an anorexigenic hormone), CDKN2A (involved in tumour suppression) and Slc2a4 genes (which encodes an insulin-related glucose transporter) and positively with promoter methylation of the Nyp (which encodes an orexigenic neuropeptide) gene, as well as influence global methylation patterns and modulate epigenetic effects of some genetic variants. Conclusions The findings from our systematic review are far from conclusive due to the small number of studies and their inherent limitations. Further studies are required to understand the actual potential role of epigenetics in the associations of breastfeeding with later health outcomes. Suggestions for future investigations, focusing on epigenome-wide association studies, are provided.

Exploring the contribution of maternal antibiotics and breastfeeding to development of the infant microbiome and pediatric obesity

Article

Jul 2016

Pediatric obesity, a significant public health concern, has been associated with adult premature mortality and the development of type 2 diabetes and cardiovascular disease. Evidence has suggested that the gut microbiota is associated with pediatric obesity. Establishment of the infant gut microbiome is dependent on a dynamic maternal-infant microbiota exchange during early life. The objective of this review is to describe maternal factors such as feeding practices and antibiotic use that may influence the infant gut microbiome and risk for obesity. The complex components in human milk have many nutritional benefits to the infant; however, the microbiome in human milk may be an important factor to help regulate the infant's weight. We discuss maternal antibiotics and the effects on breast milk as critical exposures that alter the infant's gut microbiome and influence the risk of pediatric obesity.

Growth in exclusively breastfed infants

Article

Full-text available

Mar 2019

Elsa Regina Justo Giugliani

Objective To address the growth of full‐term children in the first 6 months of life in exclusive breastfeeding. Source of data A non‐systematic review was carried out by searching the MEDLINE/PubMed, Web of Science, and Cochrane Library databases and the World Health Organization website for articles and documents on the growth of exclusively breastfed infants and their monitoring. Those documents considered to be the most relevant by the author were selected. Data synthesis Exclusively breastfeed infants show differentiated growth when compared to formula‐fed infants. Weight loss in the first four days of life is due more to loss of fat mass rather than lean mass, including body water, and is usually lower in exclusively breastfed infants. In turn, the time for recovery of the birth weight may be longer in these infants. Formula‐fed infants gain weight and increase their BMI more rapidly in the first three to six months of life than infants in exclusive or predominant breastfeeding due to a progressive increase in lean mass. The World Health Organization growth curves, which use the growth pattern of breastfed children as their standard, are used to monitor growth. Conclusions Exclusively breastfed infants have differentiated growth when compared with formula‐fed infants. This should be considered when monitoring the infant's growth. It should be emphasized that the growth pattern currently used as reference is that of the exclusively breastfed infant.

Growth in exclusively breastfed infants

Article

Full-text available

Dec 2018
J Pediatr

Elsa Regina Justo Giugliani

Objective: To address the growth of full-term children in the first 6 months of life in exclusive breastfeeding. Source of data: A non-systematic review was carried out by searching the MEDLINE/PubMed, Web of Science, and Cochrane Library databases and the World Health Organization website for articles and documents on the growth of exclusively breastfed infants and their monitoring. Those documents considered to be the most relevant by the author were selected. Data synthesis: Exclusively breastfeed infants show differentiated growth when compared to formula-fed infants. Weight loss in the first four days of life is due more to loss of fat mass rather than lean mass, including body water, and is usually lower in exclusively breastfed infants. In turn, the time for recovery of the birth weight may be longer in these infants. Formula-fed infants gain weight and increase their BMI more rapidly in the first three to six months of life than infants in exclusive or predominant breastfeeding due to a progressive increase in lean mass. The World Health Organization growth curves, which use the growth pattern of breastfed children as their standard, are used to monitor growth. Conclusions: Exclusively breastfed infants have differentiated growth when compared with formula-fed infants. This should be considered when monitoring the infant's growth. It should be emphasized that the growth pattern currently used as reference is that of the exclusively breastfed infant.

Epigenética e Psicologia: Uma Possibilidade de Encontro entre o Social e o Biológico

Article

Full-text available

Nov 2018

O presente artigo tem o objetivo de mostrar a possibilidade da relação entre os campos da psicologia e da epigenética e como considerações secundárias, a possível relação entre psicopatologias - especialmente, a esquizofrenia - e epigenética. Com esse intuito, foram utilizados como base artigos científicos e livros que permeiam os temas da psicologia, psicopatologias, epigenética e esquizofrenia. A partir disso, foi delineado o percurso de formação da psicologia e do campo da epigenética, incluindo a forma como o último pode impactar o primeiro e gerar novas formas de compreensão sobre a prática do psicólogo. Com base nesta revisão, pode-se afirmar que a epigenética possui grande relevância para a psicologia e é capaz de proporcionar uma nova perspectiva para o campo de psicopatologias, seja sobre suas causas ou na constituição de direções de tratamento.

An Exploration of the Short and Long Term Health Outcomes of Neonatal Skin-to-Skin with Mother

Thesis

Full-text available

Dec 2015

Mary Marine

Assessing the phenotypic effects in the general population of rare variants in genes for a dominant Mendelian form of diabetes

Article

Full-text available

Oct 2013
Nat Genet

Genome sequencing can identify individuals in the general population who harbor rare coding variants in genes for Mendelian disorders and who may consequently have increased disease risk. Previous studies of rare variants in phenotypically extreme individuals display ascertainment bias and may demonstrate inflated effect-size estimates. We sequenced seven genes for maturity-onset diabetes of the young (MODY) in well-phenotyped population samples (n = 4,003). We filtered rare variants according to two prediction criteria for disease-causing mutations: reported previously in MODY or satisfying stringent de novo thresholds (rare, conserved and protein damaging). Approximately 1.5% and 0.5% of randomly selected individuals from the Framingham and Jackson Heart Studies, respectively, carry variants from these two classes. However, the vast majority of carriers remain euglycemic through middle age. Accurate estimates of variant effect sizes from population-based sequencing are needed to avoid falsely predicting a substantial fraction of individuals as being at risk for MODY or other Mendelian diseases.

Maternal Factors Pre- and During Delivery Contribute to Gut Microbiota Shaping in Newborns

Article

Full-text available

Jul 2012

Human gut microbiome viewed across age and geography

Article

Full-text available

Jun 2012
NATURE

Gut microbial communities represent one source of human genetic and metabolic diversity. To examine how gut microbiomes differ among human populations, here we characterize bacterial species in fecal samples from 531 individuals, plus the gene content of 110 of them. The cohort encompassed healthy children and adults from the Amazonas of Venezuela, rural Malawi and US metropolitan areas and included mono- and dizygotic twins. Shared features of the functional maturation of the gut microbiome were identified during the first three years of life in all three populations, including age-associated changes in the genes involved in vitamin biosynthesis and metabolism. Pronounced differences in bacterial assemblages and functional gene repertoires were noted between US residents and those in the other two countries. These distinctive features are evident in early infancy as well as adulthood. Our findings underscore the need to consider the microbiome when evaluating human development, nutritional needs, physiological variations and the impact of westernization.

Epigenetics: A New Bridge between Nutrition and Health

Article

Full-text available

Nov 2010

Nutrients can reverse or change epigenetic phenomena such as DNA methylation and histone modifications, thereby modifying the expression of critical genes associated with physiologic and pathologic processes, including embryonic development, aging, and carcinogenesis. It appears that nutrients and bioactive food components can influence epigenetic phenomena either by directly inhibiting enzymes that catalyze DNA methylation or histone modifications, or by altering the availability of substrates necessary for those enzymatic reactions. In this regard, nutritional epigenetics has been viewed as an attractive tool to prevent pediatric developmental diseases and cancer as well as to delay aging-associated processes. In recent years, epigenetics has become an emerging issue in a broad range of diseases such as type 2 diabetes mellitus, obesity, inflammation, and neurocognitive disorders. Although the possibility of developing a treatment or discovering preventative measures of these diseases is exciting, current knowledge in nutritional epigenetics is limited, and further studies are needed to expand the available resources and better understand the use of nutrients or bioactive food components for maintaining our health and preventing diseases through modifiable epigenetic mechanisms.

Between a chicken and a grape: Estimating the number of human genes

Article

Full-text available

May 2010

Many people expected the question 'How many genes in the human genome?' to be resolved with the publication of the genome sequence in 2001, but estimates continue to fluctuate.

The Emerging Global Epidemic of Type 1 Diabetes

Article

Sep 2013
Curr Diabetes Rep

Jaakko Tuomilehto

Type 1 diabetes mellitus (T1D) can occur at any age, with a peak in incidence around puberty. Classification between T1D and type 2 diabetes becomes more challenging with increasing age of onset of T1D over time develops in genetically predisposed individuals. The main susceptibility is conferred with human leukocyte antigen (HLA) genes. Some of the geographic variation in incidence and familial aggregation is explained by differences in HLA haplotypes. In many populations, the incidence is somewhat higher in males than in females, and a 1.3- to 2.0-fold male excess in incidence after about 15 years of age exists in most populations. The incidence of childhood-onset T1D varies markedly among countries. East Asian and native American populations have low incidences (approximately 0.1-8 per 100 000/year), while the highest rates are found in Finland (>60 per 100 000/year), Sardinia (40 per 100 000/year), and Sweden (47 per 100 000/year). The risk is highest in European-derived populations. About 10 %-20 % of newly diagnosed childhood cases of T1D have an affected first-degree relative. Those with an affected sibling or parent have a cumulative risk of 3 %-7 % up to about 20 years of age, as compared with <1 % in the general population. The cumulative incidence among the monozygotic co-twins of persons with T1D is less than 50 %. Thus, the majority of genetically predisposed people do not develop T1D. Studies assessing temporal trends have shown that the incidence of childhood-onset T1D has increased in all parts of the world. The average relative increase is 3 %-4 % per calendar year. For instance, in Finland, the incidence today is 5 times higher than 60 years ago. At the same time, the age at onset of T1D in children has become younger. It is strongly believed that nongenetic factors are important for the development of T1D and its increase, but the causative evidence is missing. The causes for this increasing trend and current epidemic still remain unknown.

Trends in Attention Deficit Hyperactivity Disorder Ambulatory Diagnosis and Medical Treatment in the United States, 2000–2010

Article

Feb 2012

Because of several recent clinical and regulatory changes regarding attention deficit-hyperactivity disorder (ADHD) in the United States, we quantified changes in the diagnosis of ADHD and its pharmacologic treatment from 2000 through 2010. We used the IMS Health National Disease and Therapeutic Index, a nationally representative audit of office-based providers, to examine aggregate trends among children and adolescents younger than 18 years of age. We also quantified how diagnosis and treatment patterns have evolved on the basis of patient and physician characteristics and the therapeutic classes used. From 2000 to 2010, the number of physician outpatient visits in which ADHD was diagnosed increased 66% from 6.2 million (95% confidence interval 5.5-6.9M) to 10.4 million visits (95% confidence interval 9.3-11.6 million). Of these visits, psychostimulants have remained the dominant treatment; they were used in 96% of treatment visits in 2000 and 87% of treatment visits in 2010. Atomoxetine use decreased from 15% of treatment visits upon product launch in 2003 to 6% of treatment visits by 2010. The use of potential substitute therapies-clonidine, guanfacine, and bupropion-remained relatively constant (between 5% and 9% of treatment visits) during most of the period examined. During this period, the management of ADHD shifted away from pediatricians and towards psychiatrists (from 24% to 36% of all visits) without large changes in illness severity or the proportion of ADHD treatment visits accounted for by males (73%-77%). In 10 years, the ambulatory diagnosis of ADHD increased by two-thirds and is increasingly managed by psychiatrists. The effects of these changing treatment patterns on children's health outcomes and their families are unknown.

Protocol for a randomised controlled trial of chronic disease self-management support for older Australians with multiple chronic diseases

Article

Aug 2011

The prevalence of older Australians with multiple chronic diseases is increasing and now accounts for a large proportion of total health care utilisation. Chronic disease self-management support (CDSMS) has become a core service component of many community based health programs because it is considered a useful tool in improving population health outcomes and reducing the financial burden of chronic disease care. However, the evidence base to justify these support programs is limited, particularly for older people with multiple chronic diseases. We describe an ongoing trial examining the effectiveness of a particular CDSMS approach called the Flinders Program. The Flinders Program is a clinician-led generic self-management intervention that provides a set of tools and a structured process that enables health workers and patients to collaboratively assess self-management behaviours, identify problems, set goals, and develop individual care plans covering key self-care, medical, psychosocial and carer issues. A sample of 252 older Australians that have two or more chronic conditions will be randomly assigned to receive either CDSMS or an attention control intervention (health information only) for 6 months. Outcomes will be assessed using self-reported health measures taken at baseline and post-intervention. This project will be the first comprehensive evaluation of CDSMS in this population. Findings are expected to guide consumers, clinicians and policymakers in the use of CDSMS, as well as facilitate prioritisation of public monies towards evidence-based services.

Has the Microbiota Played a Critical Role in the Evolution of the Adaptive Immune System?

Article

Dec 2010
SCIENCE

A Gutsy Analysis Efforts to sequence the human microbiome—the genomes of all the microbes that inhabit our bodies—have demonstrated its enormous diversity. Analyses to probe the various functions of the microbiota, particularly of those that reside in the gut, have revealed that our microbiota has a profound impact on the development and function of our immune systems. Lee and Mazmanian (p. 1768 ) review how the microbiota influences the development of the adaptive immune system. Specific species and families of microbiota support the differentiation of particular populations of T cells, and alterations in intestinal microbiota affect the development of inflammation and autoimmunity.

Epigenetic Inheritance and the Missing Heritability Problem

Article

Jun 2009

Montgomery Slatkin

Epigenetic phenomena, and in particular heritable epigenetic changes, or transgenerational effects, are the subject of much discussion in the current literature. This article presents a model of transgenerational epigenetic inheritance and explores the effect of epigenetic inheritance on the risk and recurrence risk of a complex disease. The model assumes that epigenetic modifications of the genome are gained and lost at specified rates and that each modification contributes multiplicatively to disease risk. The potentially high rate of loss of epigenetic modifications causes the probability of identity in state in close relatives to be smaller than is implied by their relatedness. As a consequence, the recurrence risk to close relatives is reduced. Although epigenetic modifications may contribute substantially to average risk, they will not contribute much to recurrence risk and heritability unless they persist on average for many generations. If they do persist for long times, they are equivalent to mutations and hence are likely to be in linkage disequilibrium with SNPs surveyed in genomewide association studies. Thus epigenetic modifications are a potential solution to the problem of missing causality of complex diseases but not to the problem of missing heritability. The model highlights the need for empirical estimates of the persistence times of heritable epialleles.