Impact of the maternal diet and the intervention with fructooligosaccharide on thehuman milk microbiota

Human milk is recognized as the main component for growth, metabolism, and immune development in infants. Furthermore, during lactation, human milk is an important source of microorganisms for the intestinal colonization of newborns. Mother-related factors have been associated with the human milk microbiota composition. Nevertheless, apparently, there has not been any study in which the maternal diet was evaluated as a modulator of the human milk microbiota. Therefore, the aim of this study was to investigate the impact of the maternal diet on the human milk microbiota composition of healthy women, and subsequently, to evaluate the effect of fructooligosaccharides supplementation on the human milk microbiota. This study consisted of two parts; the first was a cross-sectional study, including 94 lactating women recruited at the University Hospital of the University of São Paulo (HU/USP), to investigate the association between the maternal nutrient intake during pregnancy and lactation over the first month and the human milk microbiota. The second part consisted of a randomized, placebo-controlled clinical trial with 53 lactating, classified as FOS group (n = 28), which received 4.5 g of fructooligosaccharides + 2 g of maltodextrin or placebo group (n = 25), which received 2 g of maltodextrin, over a period of 20 days. The DNA was isolated and used as template for amplification and sequencing by the Illumina MiSeq® System. Overall, the maternal diet during lactation (\"short-term\" food intake) influenced specific bacterial groups, including positive correlations between polyunsaturated fatty acids/linoleic fatty acids and Bifidobacterium. However, only the maternal diet during pregnancy (\"long-term\" food intake) was statistically significant (p = 0.02) for the clustering analyzes (community structure analyzes), in which higher levels of vitamin C intake during pregnancy was related to cluster 2, driven by the Staphylococcus genus. After the intervention period on the maternal diet, no differences were found for relative abundance of genera between the placebo and the FOS groups. However, the distances of the trajectories covered by the samples from the beginning to the end of the supplementation was higher for the FOS group (p = 0.0007). According to our results, the maternal age affects the response for FOS supplementation (p = 0.02), though no patterns in the differences of relative abundances were found between the groups. Our results suggest that the maternal diet may influence the human milk microbiota, and the diet during pregnancy is a stronger factor over the bacterial community structure. Minor changes were found by the maternal short-term food intake or the maternal intervention with the prebiotic, and the changes seem to be individual-dependent and influenced by the maternal age, particularly in the intervention study. (AU)