Association of maternal diet with human milk fatty acid and macronutrient composition: a Saudi cohort study

Maternal nutrition influences human milk (HM) composition, particularly its fatty acid (FA) profile. However, evidence from Middle Eastern populations, including Saudi Arabia, remains limited. This study aimed to investigate the association between maternal diet and HM composition in a Saudi population.

In this secondary analysis of a prospective cohort of Saudi breastfeeding mothers, a subsample of 40 women was selected. Maternal characteristics, dietary intake, and HM samples were collected between 4 and 13 weeks postpartum. Dietary intake was assessed using a 24-h dietary recall and a food frequency questionnaire. HM macronutrients and FA composition were analyzed, and associations with maternal dietary intake were examined using correlation analyses.

HM macronutrient concentrations were relatively stable and showed minimal associations with maternal dietary intake, except for a positive correlation between maternal monounsaturated FA intake and milk protein (r = 0.384, p < 0.05). In contrast, HM FA composition-particularly omega-3 (n-3) polyunsaturated FAs-was significantly associated with maternal diet. Maternal energy intake was positively correlated with milk eicosapentaenoic acid (r = 0.527, p < 0.01) and total n-3 (r = 0.489, p < 0.01) and inversely correlated with the n-6/n-3 ratio (r = -0.410, p < 0.01). Maternal n-3 intake was positively correlated with corresponding HM n-3 levels.

Distinct dietary patterns observed in this Saudi cohort, potentially shaped by cultural traditions during pregnancy and the postpartum period, may contribute to variability in HM FA composition. In this sample, both maternal n-3 intake and HM n-3 levels were low compared with global averages, suggesting a potential role for culturally appropriate dietary strategies to improve maternal and infant n-3 status.