Field Notes

Chronic Inflammation May Lead to Low Milk Production in Breast‑Feeding Moms

A new study by researchers at Penn State and the University of Cincinnati showed that inflammation in lactating mothers with obesity may contribute to low milk production. The researchers found that obesity is a risk factor for insufficient milk production in lactating mothers. In people with obesity, chronic inflammation starts in the body’s fat and spreads via circulation to organs and systems throughout the body, according to the research team. Previous research showed that inflammation may disrupt the absorption of fatty acids from the blood into body tissues.

Fatty acids are essential to creating and accessing energy needed throughout the body. In lactating women, fatty acids serve as the building blocks for the fats needed to feed a growing infant. The researchers hypothesized that inflammation may negatively impact milk production by preventing absorption of the fatty acids into the milk-producing mammary glands.

To test this hypothesis, Rachel Walker, PhD, MS, postdoctoral fellow in nutritional sciences at Penn State, led a team of researchers that analyzed whether inflammation prevented the uptake of fatty acids. The researchers analyzed blood and milk from a study conducted at Cincinnati Children’s Hospital and the University of Cincinnati. In the original study, researchers recruited 23 mothers who had very low milk production despite frequent breast emptying (which is the standard medical practice for increasing milk production), 20 mothers with moderate milk production, and 18 mothers who were breast-feeding exclusively and served as a control group for the study. In the current study, the researchers analyzed fatty acid and inflammatory marker profiles in both blood and breast milk. Their results were published in The Journal of Nutrition.

Compared with those in the moderate milk production and exclusively breast-feeding groups, mothers with very low milk production had significantly higher obesity and biological markers of systemic inflammation. They also had lower proportions of long-chain fatty acids in their breast milk and disrupted association between blood and milk fatty acids. Milk and blood fatty acids were strongly correlated in controls but not in the very low or moderate milk production groups.

“Science has shown repeatedly that there’s a strong connection between the fatty acids you eat and the fatty acids in your blood,” Walker says. “If someone eats a lot of salmon, you will find more omega-3s in their blood. If someone else eats a lot of hamburgers, you will find more saturated fats in their blood.

“Our study was one of the first to examine whether the fatty acids in blood are also found in breast milk,” Walker continues. “For women who are exclusively breast-feeding, the correlation was very high; most of the fatty acids that appeared in blood also were present in the breast milk. But for women who had chronic inflammation and were struggling with milk production, that correlation was almost completely gone. This is strong evidence that fatty acids are not able to enter the mammary gland for women with chronic inflammation.”

For decades, research has shown that mothers with obesity are at increased risk of shortened breast-feeding duration. This study provides clues about the mechanisms that may account for this result.

“Breast-feeding has innumerable benefits for both the mother and child, including lower risk of chronic disease for mom and lower risk of infections for baby,” says Alison Gernand, an associate professor of nutritional sciences at Penn State, Walker’s postdoctoral mentor, and coauthor of this research. “This research helps us understand what might be happening in mothers with high weight status and inflammation, which down the road could lead to interventions or treatments that allow more moms that want to breast-feed to do so.”

— Source: Penn State University


One in 8 Americans Over 50 Shows Signs of Food Addictions

About 13% of people aged 50 to 80 showed signs of addiction to highly processed foods in the past year, the new data from the National Poll on Healthy Aging suggests.

The percentage is much higher among women than men—especially women in their 50s and early 60s. It also was higher in older adults who say they’re overweight, lonely, or in fair or poor physical or mental health.

The poll is based at the University of Michigan (U-M) Institute for Healthcare Policy and Innovation and supported by AARP and Michigan Medicine, U-M’s academic medical center.

The poll team and U-M psychologist Ashley Gearhardt, PhD, used a set of 13 questions to measure whether and how often older adults experienced the core indicators of addiction in their relationship with highly processed foods such as sweets, salty snacks, sugary drinks, and fast food. These addiction indicators include intense cravings, an inability to cut down on intake, and signs of withdrawal.

Based on their findings, Gearhardt suggests that the same set of standard questions should become part of screening at doctors’ offices. This could help identify older adults with addictive eating habits who could benefit from referrals to nutrition counseling or programs that help people address addictive eating or get affordable access to healthier foods.

Gearhardt, an associate professor in the U-M Department of Psychology and member of IHPI, codeveloped the standardized questionnaire used in the poll, called the Yale Food Addiction Scale.

“The word addiction may seem strong when it comes to food, but research has shown that our brains respond as strongly to highly processed foods, especially those highest in sugar, simple starches, and fat, as they do to tobacco, alcohol, and other addictive substances,” Gearhardt says.

 “Just as with smoking or drinking, we need to identify and reach out to those who have entered unhealthful patterns of use and support them in developing a healthier relationship with food.”

To meet the criteria for an addiction to highly processed food on the scale used in the poll, older adults had to report experiencing at least two of 11 symptoms of addiction in their intake of highly processed food, as well as report significant eating-related distress or life problems multiple times per week. These are the same criteria used to diagnose addiction-related problems with alcohol, tobacco, and other addictive substances.

By these criteria, addiction to highly processed foods was seen in the following:

• 17% of adults aged 50 to 64 and 8% of adults aged 65 to 80;

• 22% of women aged 50 to 64 and 18% of women aged 50 to 80;

• 32% of women who say their physical health is fair or poor, and 14% of men who say the same—more than twice as high as the percentages among those who say their physical health is excellent, very good, or good;

• 45% of women who say their mental health is fair or poor, and 23% of men who say the same—three times as high as the percentages among those who say their mental health is excellent, very good, or good;

• 17% of men who self-report say they’re overweight, compared with 1% of men who indicate they’re around the right weight;

• 34% of women who self-report say they’re overweight, compared with 4% who indicate they’re around the right weight; and

• 51% of women who say they often feel isolated from others, and 26% of men who say the same—compared with 8% of women and 4% of men who say they rarely feel isolated.

The most commonly reported symptom of addiction to highly processed foods in older adults was intense cravings. Almost 1 in 4 (24%) said that at least once per week, they had such a strong urge to eat a highly processed food that they couldn’t think of anything else. And 19% said that at least two to three times per week, they had tried and failed to cut down on, or stop eating, these kinds of foods.

Twelve percent said their eating behavior caused them a lot of distress two to three times per week or more.

“Clinicians need a better understanding of how food addiction and problematic eating intertwines with their patients’ physical and mental health, including chronic conditions such as diabetes, heart disease and certain types of cancer,” says poll director Jeffrey Kullgren, MD, MPH, MS, an associate professor of internal medicine at Michigan Medicine and physician and researcher at the VA Ann Arbor Healthcare System. “We need to understand that cravings and behaviors around food are rooted in brain chemistry and heredity, and that some people may need additional help just as they would to quit smoking or drinking.”

— Source: Michigan Medicine – University of Michigan