Weight Status and Visceral Adiposity Mediate the Relation between Exclusive Breastfeeding Duration and Skin Carotenoids in Later Childhood

Background: Breastfeeding is associated with healthier weight and nutrient status in early life. However, the impact of breastfeeding on carotenoid status beyond infancy, and the influence of adiposity, are unknown. Objectives: The aim of the study was to retrospectively investigate the relation between breastfeeding and carotenoid status, and the mediating effect of weight status and adiposity on this relation, among school-age children. Methods: This was a secondary analysis of baseline data collected from a randomized-controlled clinical trial. Children 7-12 y old (n = 81) were recruited from East-Central Illinois. DXA was used to assess visceral adipose tissue (VAT) and whole-body total fat percentage (%Fat; i.e., whole-body adiposity). Weight was obtained to calculate children's BMI percentiles. Skin carotenoids were assessed via reflection spectroscopy. Macular carotenoids were assessed as macular pigment optical density (MPOD). Dietary, birth, and breastfeeding information was self-reported by parents. Results: Skin carotenoids were inversely related to %Fat (P < 0.01), VAT (P < 0.01), and BMI percentile (P < 0.01). VAT and BMI percentile significantly mediated this relation between exclusive breastfeeding duration and skin carotenoids, after adjustment for dietary carotenoids, energy intake, and mother education. Conclusions: Weight status and adipose tissue distribution mediate the positive correlation between exclusive breastfeeding duration and skin carotenoids among children aged 7-12 y. The results indicate the need to support breastfeeding and healthy physical growth in childhood for optimal carotenoid status. This trial was registered at clinicaltrials.gov as NCT03521349. Curr Dev Nutr 2021;5:nzab010. Keywords: human milk, reflection spectroscopy, body mass index, adiposity, carotenoids, macular pigment, adolescents, pediatric