Abstract
The aim of this study was to evaluate the changes in the ghrelin, leptin, and fat levels in the foremilk and hindmilk and the possible relationship between these levels with the age and growth of term healthy infants. Sixty-two babies were subdivided (according to their nutrition) into breastfed (BF), formula-fed (FF), and BF plus FF (BF + FF) groups. The total and active ghrelin and tryglyceride levels and the total cholesterol levels in the foremilk and hindmilk were studied at the first and second visits (mean of the second and fifth months, respectively). At both visits, the total and active ghrelin and the total cholesterol levels were lower in the hindmilk than in the foremilk. However, the triglyceride levels were higher in the hindmilk than in the foremilk (p < 0.001). The leptin levels were also higher in the hindmilk, but this difference was not statistically significant. At the second visit, the mean total foremilk ghrelin (p < 0.01), leptin (p < 0.05), tryglyceride (p < 0.001), and cholesterol (p < 0.01) levels in the BF group were decreased compared with the levels at the first visit, whereas the active ghrelin levels increased (p < 0.001). At the second visit, we observed a 3.5% increase in the body mass index in BF infants, a 14.6% increase in FF infants, and an 11.8% increase in BF + FF infants (p < 0.01). The foremilk leptin levels were lower in the BF + FF group than in the BF group at both visits. In conclusion, at the first and second visits, the decreased ghrelin and increased tryglyceride and leptin levels in the hindmilk might be associated with the important role of self-control when feeding BF infants. The stable content of formulas might be associated with a lack of self-control during feeding and increased nutrition. Changing the breast milk ghrelin, leptin, and fat levels between the foremilk and hindmilk and between the first and second visits might explain the differences in the weight gain patterns of BF and FF infants.
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Agostini C, Grandi F, Gianni ML et al (1999) Growth patterns of breast fed and formula fed infants in the first 12 months of life: an Italian study. Arch Dis Child 81:395–399
Aydin S, Aydin S, Ozkan Y et al (2006) Ghrelin is present in human colostrum, transitional and mature milk. Peptides 27:878–882
Bartok CJ, Ventura AK (2009) Mechanisms underlying the association between breastfeeding and obesity. Int J Pediatr Obes 4:196–204
Beaumont NJ, Skinner VO, Tan TM et al (2003) Ghrelin can bind to a species of high density lipoprotein associated with paraoxonase. J Biol Chem 278:8877–8880
Beck B, Musse N, Stricker-Krongrad A (2002) Ghrelin macronutrient intake and dietary preferences in long-evans rats. Biochem Biophys Res Commun 292:1031–1035
Bedendi I, Alloatti G, Marcantoni A et al (2003) Cardiac effects of ghrlin and its endognous derivates des-octanoyl ghrelin and des-Gln14-ghrelin. Eur J Pharmacol 476:87–95
Blom WA, Stafleu A, de Graaf C et al (2005) Ghrelin response to carbohydrate-enriched breakfast is related to insulin. Am J Clin Nutr 81:367–375
Bluher S, Mantzoros CS (2004) The role of leptin in regulating neuroendocrine function in humans. J Nutr 134:2469–2474
Bonnet M, Delavaud C, Laud K et al (2002) Mammary leptin synthesis, milk leptin and their putative physiological roles. Reprod Nutr Dev 42:399–413
Broglio F, Gottero C, Prodam F et al (2004) Non-acylated ghrelin counteracts the metabolic but not the endocrine response to acylated ghrelin in humans. J Clin Endocrinol Metab 89:3062–3065
Cammisotto PG, Bendayan M (2007) Leptin secretion by white adipose tissue and gastric mucusa. Histol Histopathol 22:199–210
Casabiell X, Pineiro V, Tome MA (1997) Presence of leptin in colostrum and/or breast milk from lactating mothers: apotential role in the regülation of neonatal food intake. J Clin Endocrinol Metab 82:4270–4273
Claud EC, Savidge T, Walker WA (2003) Modulation of human intestinal epithelial cell IL-8 secretion by human milk factors. Pediatr Res 53:419–425
Considine RV, Sinha MK, Heiman ML et al (1996) Serum immunoreactive-leptin concentrations in normal-weight and obese humans. N Engl J Med 334:292–295
Davenport AP, Bonner TI, Foord SM et al (2005) International Union of Pharmacology. LVI. Ghrelin receptor nomenclature, distribution and function. Pharmacol Rev 57:541–546
Dewey KG, Heinig MJ, Nommsen LA et al (1992) Growth of breast-fed and formula-fed infants from 0 to 18 months: the DARLING study. Pediatrics 89:1035–1041
Dykes F, Williams C (1999) Falling by the wayside: a phenomenological exploration of perceived breast-milk inadequacy in lactating women. Midwifery 15:232–246
Emery WB 3rd, Canolty NL, Aitchison JM et al (1978) Influence of sampling on fatty acid composition of human milk. Am J Clin Nutr 31:1127–1130
Fry T (2003) The new "breast from birth" growth charts. An updated version of the paper given at the Primary Care Conference and Exhibition. J Fam Health Care 13:124–126
Hamosh M (2001) Bioactive factors in human milk. Pediatr Clin N Am 48:69–86
Hosoda H, Doi K, Nagaya N et al (2004) Optimum collection and storage conditions for ghrelin measurements: octanoyl modification of ghrelin is rapidly hydrolyzed to desacyl ghrelin in blood samples. Clin Chem 50:1077–1080
Hosoda H, Kojima M, Kangawa K (2006) Biological, physiological, and pharmacological aspects of ghrelin. J Pharmacol Sci 100:398–410
Houseknecht KL, McGuire MK, Portocarrero CP et al (1997) Leptin in present in human milk and is related to maternal plasma leptin concentrations and adiposity. Biochem Biophys Res Commun 240:742–747
Heinig MJ, Nommsen LA, Peerson JM et al (1993) Intake and growth of breast-fed and formula-fed infants in relation to the timing of introduction of complementary foods: the DARLING study. Acta Paediatr 82:999–1006
Ilcol YO, Hizli B (2007) Active and total ghrelin concentrations increase in breast milk during lactation. Acta Paediatr 96:1632–1639
Jeusette IC, Lhoest ET, Istasse LP et al (2005) Influence of obesity on plasma lipid and lipoprotein concentrations in dogs. Am J Vet Res 66:81–86
Kierson JA, Dimatteo DM, Locke RG et al (2006) Ghrelin and cholecystokinin in term and preterm human breast milk. Acta Paediatr 95:991–995
Kojima M, Kangawa K (2005) Ghrelin: structure and function. Physiol Rev 85:495–522
Lage M, Baldelli R, Camiña JP et al (2002) Presence of bovine leptin in edible commercial milk and infant formula. J Endocrinol Investig 25:670–674
Li R, Fein SB, Grummer-Strawn LM (2010) Do infants fed from bottles lack self-regulation of milk intake compared with directly breastfed infants? Pediatrics 125:1386–1393
Lyle RE, Kincaid SC, Bryant JC et al (2001) Human milk contains detectable levels of immunoreactive leptin. Adv Exp Med Biol 501:87–92
Mitoulas LR, Kent JC, Cox DB, Hartmann PE et al (2002) Variation in fat, lactose and protein in human milk over 24 h and throughout the first year of lactation. Br J Nutr 88:29–37
Mohammed-Ali V, Goodrick SJ, Stanner SA et al (1996) Adipose tissue leptin production at fasting and after a high carbohydrate meal (Abstract). Diabet Med 13:19
Nelson AM (2006) A metasynthesis of qualitative breastfeeding studies. J Midwifery Womens Health 51:13–20
Nommsen-Rivers LA, Dewey KG (2009) Growth of breastfed infants. Breastfeed Med 4:45–49
O'Connor D, Funanage V, Locke R et al (2003) Leptin is not present in infant formulas. J Endocrinol Investig 26:490
Pelleymounter MA, Cullen MJ, Baker MB et al (1995) Effects of the obese gene product on body weight regülation in ob/ob mice. Science 269:500–543
Petruchke T, Rotrig K, Hauner H (1994) Transforming growth factor beta inhibits the differentiation of human adipocyte precursor cells in primary culture. Int J Obes Metab Disord 18:532–536
Resto M, O’Connor D, Leef K et al (2001) Leptin levels in preterm human breast milk and infant formula. Pediatrics 108:15–18
Saarela T, Kokkonen J, Koivisto M (2005) Macronutrient and energy contents of human milk fractions during the first six months of lactation. Acta Paediatr 94:1176–1181
Savino F, Fissore MF, Liguori SA et al (2009) Can hormones contained in mothers' milk account for the beneficial effect of breast-feeding on obesity in children? Clin Endocrinol Oxf 71:757–765
Stocks RJ, Davies DP, Allen F et al (1985) Loss of breast milk nutrients during tube feeding. Arch Dis Child 60:164–166
Ucar B, Kirel B, Bor O et al (2000) Breast milk leptin concentrations in initial and terminal milk samples: relationships to maternal and infant plasma leptin concentrations, adiposity, serum glucose, insulin, lipid and lipoprotein levels. J Pediatr Endocrinol Metab 13:149–156
Woliński J, Zabielski R (2005) Presence of leptin in mammalian colostrum and milk and in artificial milk formulas. Med Wieku Rozwoj 9:629–636
Van der Lely AJ, Tschöp M, Heiman ML et al (2004) Biological, physiological, pathophysiological, and pharmacological aspects of ghrelin. Endocr Rev 25:426–457
Acknowledgments
This study is partly present as a poster in International Pediatric Association Congress in South Africa on 4–9 August 2010. We specially thank Ahmet Karatas, MD for helping in the collection of breast milk samples, Banu Aydin, MD for her suggestion about writing of this article, and Omer Kaya, MD for biochemical studies of samples.
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Karatas, Z., Durmus Aydogdu, S., Dinleyici, E.C. et al. Breastmilk ghrelin, leptin, and fat levels changing foremilk to hindmilk: is that important for self-control of feeding?. Eur J Pediatr 170, 1273–1280 (2011). https://doi.org/10.1007/s00431-011-1438-1
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DOI: https://doi.org/10.1007/s00431-011-1438-1