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American Journal of Clinical Nutrition, Vol. 85, No. 5, 1436-1437, May 2007
© 2007 American Society for Nutrition


LETTER TO THE EDITOR

Breastfeeding prevents type 2 diabetes mellitus: but, how and why?

Undurti N Das

UND Life Sciences
13800 Fairhill Road, no. 321
Shaker Heights, OH 44120
E-mail: undurti{at}hotmail.com

Dear Sir:

The conclusion of the recent systemic review of the published studies that breastfeeding in infancy is associated with a reduced risk of type 2 diabetes, with marginally lower insulin concentrations in later life, and with lower blood glucose and serum insulin concentrations in infancy (1) is interesting.

Human milk contains tumor necrosis factor {alpha} (TNF-{alpha}), interleukin (IL)-1, IL-6, transforming growth factor ß1 and ß2 (TGF-ß1 and TGF-ß2), chemokine growth-related oncogene protein {alpha}, monocyte chemoattractant protein-1, IL-8, IL-1 receptor antagonist, soluble forms of the receptors for TNF-{alpha}, the antiinflammatory cytokine IL-10, and RANTES (regulated upon activation, normal T cell expressed, and secreted) (25). Lysozyme present in human milk suppresses chemotaxis and respiratory burst activity in human polymorphonuclear leukocytes (6). The presence of an ascorbate-like material, uric acid, {alpha}-tocopherol, and ß-carotene in human milk ensures that phagocyte-produced oxidant molecules cannot persist, and this contributes to the antiinflammatory effects of milk. Thus, human milk exerts antiinflammatory effects and still exerts significant protective action against infections in breastfed infants. In addition, human breast milk is a good source of polyunsaturated fatty acids (PUFAs), especially of {gamma}-linolenic acid (GLA), arachidonic acid (AA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) (7).

Breastfed infants have a significantly higher percentage of DHA and other PUFAs in muscle phospholipids than do nonbreastfed infants. Higher PUFA concentrations in the skeletal muscle membrane are associated with lower fasting plasma glucose concentrations (8), whereas low concentrations of DHA and other PUFAs can result in insulin resistance. We showed that prior oral administration of pure GLA, AA, EPA, and DHA (which are present in human breast milk) prevents alloxan-induced diabetes mellitus by protecting pancreatic ß cells from the apoptotic actions of alloxan (9, 10) supports the conclusions made by Owen et al (1).

Early nutrition is an important environmental signal that can induce lifetime effects on metabolism, growth, and neurodevelopment and on major disease processes, such as diabetes mellitus (11). It is likely that breastfeeding ensures adequate nutrition and PUFAs that are essential for brain growth and development (7, 12). Recent studies indicate a significant role for brain insulin receptors in the control of insulin secretion and carbohydrate metabolism (12). It is likely that breastfeeding ensures an adequate supply of PUFAs, which, in turn, will lead not only to the growth and development of brain but also to adequate numbers of insulin receptors in the brain to maintain normal glucose metabolism (13). In view of this evidence, it will be interesting to study whether perinatal supplementation of PUFAs could prevent or postpone the development of diabetes mellitus in high-risk subjects (14, 15).

ACKNOWLEDGMENTS

The author had no conflict of interest.

REFERENCES

  1. Owen CG, Martin RM, Whincup CH, Smith GD, Cook DG. Does breastfeeding influence risk of type 2 diabetes in later life? A quantitative analysis of published evidence. Am J Clin Nutr 2006;84:1043–54.[Abstract/Free Full Text]
  2. Wallace JM, Ferguson SJ, Loane P, Kell M, Millar S, Gillmore WS. Cytokines in human breast milk. Br J Biomed Sci 1997;54:85–7.[Medline]
  3. Saito S, Yoshida M, Ichijo M, Ishizaka S, Tsujii T. Transforming growth factor-beta (TGF-ß) in human milk. Clin Exp Immunol 1993;94:220–4.[Medline]
  4. Garofalo R, Chheda S, Mei F, et al. Interleukin-10 in human milk. Pediatr Res 1995;37:444–9.[Medline]
  5. Buescher ES, Koeppen PM. Soluble TNFalpha receptors in colostrums bind to and neutralize TNF{alpha}. Pediatr Res 1997;41:80a(abstr).
  6. Kramer MS. Do breast-feeding and delayed introduction of solid foods protect against subsequent obesity? J Pediatr 1981;98:883–7.[Medline]
  7. Das UN. Essential fatty acids: biochemistry, physiology, and pathology. Biotech J 2006;1:420–39.
  8. Baur LA, O'Connor J, Pan DA, Kriketos AD, Storlien LH. The fatty acid composition of skeletal muscle membrane phospholipid: its relationship with the type of feeding and plasma glucose levels in young children. Metabolism 1998;47:106–12.[Medline]
  9. Suresh Y, Das UN. Long-chain polyunsaturated fatty acids and chemically induced diabetes mellitus: effect of {omega}-3 fatty acids. Nutrition 2003;19:213–28.[Medline]
  10. Suresh Y, Das UN. Long-chain polyunsaturated fatty acids and chemically-induced diabetes mellitus: effect of {omega}-6 fatty acids. Nutrition 2003;19:93–114.[Medline]
  11. Barker DJP, ed. Fetal and infant origins of adult disease. London, UK: BMJ Books, 1992.
  12. Darios F, Davletov B. Omega-3 and omega-6 fatty acids stimulate cell membrane expansion by acting on syntaxin 3. Nature 2006;440:813–7.[Medline]
  13. Das UN. Is type 2 diabetes mellitus a disorder of the brain? Nutrition 2002;18:667–72.[Medline]
  14. Das UN. Can perinatal supplementation of long-chain polyunsaturated fatty acids prevent diabetes mellitus? Eur J Clin Nutr 2003;57:218–26.[Medline]
  15. Das UN. A perinatal strategy for preventing adult diseases: the role of long-chain polyunsaturated fatty acids. Boston, MA: Kluwer Academic Publishers, 2002.




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