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Maternal Human Milk Oligosaccharide Profile Modulates the Impact of an Intervention with Iron and Galacto-Oligosaccharides in Kenyan Infants

1
Laboratory of Human Nutrition, Department of Health Sciences and Technology, ETH Zurich, 8092 Zurich, Switzerland
2
Department of Medical Epidemiology, College of Health Sciences, Jomo Kenyatta University of Agriculture and Technology, 00200 Nairobi, Kenya
3
NIZO Food Research BV, 6718 ZB Ede, The Netherlands
4
Department of Physiology and Zurich Center for Integrative Human Physiology, University of Zurich, 8057 Zurich, Switzerland
*
Author to whom correspondence should be addressed.
Nutrients 2019, 11(11), 2596; https://doi.org/10.3390/nu11112596
Received: 24 September 2019 / Revised: 21 October 2019 / Accepted: 23 October 2019 / Published: 29 October 2019
There is little data on human milk oligosaccharide (HMO) composition in Sub-Saharan Africa. Iron fortificants adversely affect the infant gut microbiota, while co-provision of prebiotic galacto-oligosaccharides (GOS) mitigates most of the adverse effects. Whether variations in maternal HMO profile can influence the infant response to iron and/or GOS fortificants is unknown. The aim of this study was to determine HMO profiles and the secretor/non-secretor phenotype of lactating Kenyan mothers and investigate their effects on the maternal and infant gut microbiota, and on the infant response to a fortification intervention with 5 mg iron (2.5 mg as sodium iron ethylenediaminetetraacetate and 2.5 mg as ferrous fumarate) and 7.5 g GOS. We studied mother–infant pairs (n = 80) participating in a 4-month intervention trial in which the infants (aged 6.5–9.5 months) received daily a micronutrient powder without iron, with iron or with iron and GOS. We assessed: (1) maternal secretor status and HMO composition; (2) effects of secretor status on the maternal and infant gut microbiota in a cross-sectional analysis at baseline of the intervention trial; and (3) interactions between secretor status and intervention groups during the intervention trial on the infant gut microbiota, gut inflammation, iron status, growth and infectious morbidity. Secretor prevalence was 72% and HMOs differed between secretors and non-secretors and over time of lactation. Secretor status did not predict the baseline composition of the maternal and infant gut microbiota. There was a secretor-status-by-intervention-group interaction on Bifidobacterium (p = 0.021), Z-scores for length-for-age (p = 0.022) and weight-for-age (p = 0.018), and soluble transferrin receptor (p = 0.041). In the no iron group, longitudinal prevalence of diarrhea was higher among infants of non-secretors (23.8%) than of secretors (10.4%) (p = 0.001). In conclusion, HMO profile may modulate the infant gut microbiota response to fortificant iron; compared to infants of secretor mothers, infants of non-secretor mothers may be more vulnerable to the adverse effect of iron but also benefit more from the co-provision of GOS. View Full-Text
Keywords: human milk oligosaccharides; infant; iron; Africa; Kenya; prebiotic; galacto-oligosaccharides; gut microbiota; secretor; micronutrient powder human milk oligosaccharides; infant; iron; Africa; Kenya; prebiotic; galacto-oligosaccharides; gut microbiota; secretor; micronutrient powder
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Paganini, D.; Uyoga, M.A.; Kortman, G.A.; Boekhorst, J.; Schneeberger, S.; Karanja, S.; Hennet, T.; Zimmermann, M.B. Maternal Human Milk Oligosaccharide Profile Modulates the Impact of an Intervention with Iron and Galacto-Oligosaccharides in Kenyan Infants. Nutrients 2019, 11, 2596.

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