Exposure to per- and polyfluoroalkyl substances associates with an altered lipid composition of breast milk.

Santosh Lamichhane,Jarno Honkanen,Matej Orešič,Mikael Knip,Heli Siljander,Suvi M Virtanen,Tuulia Hyötyläinen,Daniel Duberg

doi:10.1016/j.envint.2021.106855

Abstract

The composition of human breast milk is highly variable inter- and intra-individually. Environmental factors are suspected to contribute to such compositional variation, however, their impact on breast milk composition is currently poorly understood. We sought to (1) define the impact of maternal exposure to per- and polyfluoroalkyl substances (PFAS) on lipid composition of human breast milk, and (2) to study the combined impact of maternal PFAS exposure and breast milk lipid composition on the growth of the infants.In a mother-infant study (n=44) we measured the levels of PFAS and lipids in maternal serum and conducted lipidomics analysis of breast milk collect 2-4days after the delivery and at 3months of infant age, by using ultra high performance liquid chromatography combined with quadrupole-time-of-flight mass spectrometry. Gastrointestinal biomarkers fecal calprotectin and human beta defensin 2 were measured in the stool samples at the age of 3, 6, 9, and 12months. Maternal diet was studied by a validated food frequency questionnaire. PFAS levels were inversely associated with total lipid levels in the breast milk collected after the delivery. In the high exposure group, the ratio of acylated saturated and polyunsaturated fatty acids in triacylglycerols was increased. Moreover, high exposure to PFAS associated with the altered phospholipid composition, which was indicative of unfavorable increase in the size of milk fat globules. These changes in the milk lipid composition were further associated with slower infant growth and with elevated intestinal inflammatory markers. Our data suggest that the maternal exposure to PFAS impacts the nutritional quality of the breast milk, which, in turn, may have detrimental impact on the health and growth of the children later in life.

Highlights

Breast milk (BM) is an optimal source of nutrition for infants for the first 6 months of life, a crucial period for immune system development, metabolic and endocrine programming for growth, development, and lifelong health (Yeruva et al 2021)
Lipidomic profiles of BM and blood were measured at both time points. 261 lipids were identified from the samples, with triacylglycerols (TG) being the most abundant group
The levels of several BM Cer and PEs were higher at the 3-month time point as compared to 0-months, while cholesterol esters (CE), phosphatidyl cholines (PC), HexCer, and TGs with polyunsaturated fatty acyls were significantly lower at the later time point

Summary

Introduction

Breast milk (BM) is an optimal source of nutrition for infants for the first 6 months of life, a crucial period for immune system development, metabolic and endocrine programming for growth, development, and lifelong health (Yeruva et al 2021). The chemical composition of BM changes from colostrum to late lactation, and varies within feeds, diurnally, and between mothers (Ballard and Morrow 2013; Lee et al 2018). It is being influenced by both maternal and environmental factors and showing high inter- and intra-individual variability (Samuel et al 2020). Differences in diet may explain some of the find ings, it is likely that there are other underlying factors that drives the differences in BM composition One of these factors may be the environmental toxins that the mother has been exposed to, mainly via her diet

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Results

Discussion

Conclusion