Bioactive compounds in mothers milk affecting offspring outcomes: A narrative review

Brigid Gregg, Lindsay Ellsworth, Gregory Pavela, Kruti Shah, Paige K. Berger, Elvira Isganaitis, Sheri VanOmen, Ellen W. Demerath, David A. Fields

Research output: Contribution to journalReview articlepeer-review

15 Scopus citations


Background: Compared to the exhaustive study of transgenerational programming of obesity and diabetes through exposures in the prenatal period, postnatal programming mechanisms are understudied, including the potential role of breast milk composition linking maternal metabolic status (body mass index and diabetes) and offspring growth, metabolic health and future disease risk. Methods: This narrative review will principally focus on four emergent bioactive compounds [microRNA's (miRNA), lipokines/signalling lipids, small molecules/metabolites and fructose] that, until recently were not known to exist in breast milk. The objective of this narrative review is to integrate evidence across multiple fields of study that demonstrate the importance of these compositional elements of breast milk during lactation and the subsequent effect of breast milk components on the health of the infant. Results: Current knowledge on the presence of miRNA's, lipokines/signalling lipids, small molecules/metabolites and fructose in breast milk and their associations with infant outcomes is compelling, but far from resolved. Two themes emerge: (1) maternal metabolic phenotypes are associated with these bioactives and (2) though existing in milk at low concentrations, they are also associated with offspring growth and body composition. Conclusion: Breast milk research is gaining momentum though we must remain focused on understanding how non-nutritive bioactive components are affected by the maternal phenotype, how they subsequently impact infant outcomes. Though early, there is evidence to suggest fructose is associated with fat mass in the 1st months of life whereas 12,13 diHOME (brown fat activator) and betaine are negatively associated with early adiposity and growth.

Original languageEnglish (US)
Article numbere12892
JournalPediatric Obesity
Issue number7
StatePublished - Jul 2022

Bibliographical note

Funding Information:
David A. Fields, Ellen W. Demerath and Paige K. Berger are supported by the National Institute of Child Health and Human Development (NICHD) of the National Institutes of Health (NIH) under Award Numbers R01HD080444 and K99HD098288; while Brigid Gregg is supported by the National Institute for Diabetes, Digestive and Kidney Diseases of the NIH (NIDDK) under Award Number R56DK121787 and Elvira Isganaitis supported by NIDDK 5U01DK061230‐15 (PI: Drews/Zeitler) and (P30DK036836 –PI: George King). Lindsay Ellsworth, Kruti Shah, Sheri VanOmen and Gregory Pavela do not have any funding to report. The opinions expressed are those of the authors and do not necessarily represent those of the NIH or any other organization. Funding information

Publisher Copyright:
© 2022 World Obesity Federation


  • bioactives
  • growth
  • lactation
  • metabolic programming
  • milk
  • obesity

PubMed: MeSH publication types

  • Journal Article
  • Review
  • Research Support, N.I.H., Extramural


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