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Published on: December 16, 2015
Effect of dietary macronutrient composition under moderate hypocaloric intake on maternal adaptation during lactation
Mahmoud A Mohammad1, Agneta L Sunehag, Morey W Haymond
1Department of Pediatrics, Children's Nutrition Research Center, US Department of Agriculture, Agricultural Research Service, Baylor College of Medicine, Houston, TX 77030-2600, USA.
Background:
No evidence-based recommendations exist concerning what dietary macronutrient composition optimizes weight loss during lactation while maintaining milk production.
Objectives:
The study was designed to test the following hypotheses: compared with a reduced-calorie, high-carbohydrate (H-CHO) diet, an isonitrogenous, isocaloric high-fat (H-F) diet will decrease milk production and carbohydrate oxidation, increase gluconeogenesis and hexoneogenesis, and not affect energy balance.
Design:
Seven healthy lactating mothers and their infants were studied on 2 occasions in random order for 8 d separated by 1-2 wk. On one occasion, the subjects received the H-F (30% of energy as carbohydrate and 55% as fat) diet and on the other occasion received the H-CHO (60% of energy as carbohydrate and 25% as fat) diet. Milk production, infant intakes, and substrate and hormone concentrations were measured. Glucose rates of appearance, production, gluconeogenesis, glycogenolysis, and hexoneogenesis were measured by using stable-isotope gas chromatography-mass spectrometric techniques, and energy expenditure and substrate oxidation were measured by using indirect calorimetry.
Results:
Milk volume, lactose, and protein concentrations were unaffected. Milk fat, energy, and infant intakes were higher (P < 0.05) during the H-F diet. Neither gluconeogenesis nor hexoneogenesis was different. During the H-F diet, energy expenditure and fat and protein oxidation rates were higher (P < 0.05), and the daily energy balance deficit was greater (P < 0.01).
Conclusions:
Milk fat, energy output, and energy expenditure were higher during the H-F diet, which resulted in a greater negative energy balance. The lactating mothers adapted to a low carbohydrate intake by decreasing carbohydrate oxidation. Additional studies are warranted to determine whether a hypocaloric H-F diet might promote weight loss to a greater extent than the H-CHO diet while maintaining milk production.
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