JAI La Leche League Epigenetics and Breastfeeding: The Longterm Impact of Breastmilk on Health Disclosure Why am I interested in epigenetics?

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1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 JAI La Leche League Epigenetics and Breastfeeding: The Longterm Impact of Breastmilk on Health By Laurel Wilson, IBCLC, CLE, CCCE, CLD Author of The Greatest Pregnancy Ever and The Attachment Pregnancy Disclosure Why am I interested in epigenetics? It s About History and Herstory Traditional Thinking How does epigenetics work? EU Project Epigenome.org How Does Epigenetics Work What is epigenetics? Nature and Nurture? The Epigenetic Switch What is epigenetics? Gene Switch How does epigenetics work? ì DNA Methylation ì Histone Modification ì mrna ì Phosphorylation ì Ubiquitylation ì Sumolyation Methylation ì @30 million CpG Nucleotides that exist in a state of methylation 1

ì @30 million CpG Nucleotides that exist in a state of methylation 16 17 18 19 20 See It In Action Histone Modification ì 50 trillion cells in body ì 6 linear feet of DNA in each one Histone Modification Histone Modification ì Deacelylated, condensed genes, difficult to access ì Acetylated, decompressed, easy access to genes 21 22 Histone Modification ì Other Histone modification forms: ì Enzymes ì RNA ì microrna ì Interfering RNAs messenger RNA ì Messenger between DNA and Proteins that express genes through down regulation or translation 23 24 25 26 Epigenome as Translator ì Translator How do cells differentiate the DNA? ì The Epigenome! Let s Get Visual Epigenome as Translator Epigenetic Marks Imprinting 2

27 28 29 30 31 Imprinting Epigenetics and Metabolism How does this affect the babies? Understanding the Epigenome Further Nutrigenomics ì Nutrients can directly or via hormonal activity influence the expression of genes ì An entire new field now called nutrigenomics ì What is the most important first food? 32 33 34 35 36 Epigenetics at Work ì Food that goes in changes the enzymes in the gut ì Fermentation of proteins of polysaccharides ì Methyls and Acetyl Groups Breastmilk and the microbiome ì Artificial milk fed infants have completely different ph. Changes ph (from an acidic base of 5.1-5.4 to more alkaline of 5.9-7.3 which allows putrefactive bacteria) ì Change the fermentation process and methyl groups available to body Breastmilk and the microbiome ì Optimal digestion/immune support the following is required: ì Amino acids cystein and methionine ì Uptake of selenium Breastfeeding and the Phenotype Epigenome and Genetic Memory ì Memory of the environment experienced is passed down ì Demonstrated in animal research up to 10 generations out 3

ì Demonstrated in animal research up to 10 generations out ì Human epigenetic studies for five generations 37 Epigenomic Inheritance ì Human research - influence beyond three generations HongerWinter winter 1944-spring 1945 ì 30% nutrition ì Early pregnancy or late pregnancy ì Specific epigenetic tags for diabetes 38 Epigenetic Animal Studies ì Mouse studies ì What we are fed ì Agouti mice (Waterland and Jirtle, 2004) 39 How does epigenetics work? ì Are you what you eat? ì You are what your mother and grandmother ate. ì Diet of grandparents linked to longevity and disease variants in offspring for many generations ì This includes BREASTMILK!!!!! 40 Why does it work? ì We are constantly adapting for optimal survival. ì The fetus is preparing for optimal survival outside the womb. ì The newborn is managing its new environment and adjusting to cues. 41 Breastfeeding and Epigenetics ì Pregnancy/early postpartum life babies are programmed nutritionally to adapt to their environment. 4

nutritionally to adapt to their environment. 42 Unique Microbiome/ Nutritionally Impacted 43 44 45 46 47 48 49 50 Breastmilk s Epigenetic Influence Studies in Review The Epigenome Helps Breast Tissue Remember Reminder! ì Association is not Causation ì We are just now peering into the darkness. 1 Mammary Growth Yields ì Rats on compensatory nutrition program ì Energy restriction (all essential nutrients but caloric reduction) has significant biological impact on animals ì Retardation of aging ì Reduction of cancer ì Reduction late life disease ì Energy restriction shifts physiology to energy-conserving and away from energy-wasteful metabolic pathways ì Refeeding then causes accelerated anabolism, increased growth 51 1 Mammary Growth Yields ì Role of Compensatory Mammary Growth in Epigenetic Control of Gene Expression Chung 2005 ì Majority of mammary growth occurs in developmental phase of neonate ì Dairy industry has been practicing this for years, called stairstepping ì Energy restriction followed by refeeding during pre-puberty, puberty and gestation. Increases yields by up to 10% 5

ì Energy restriction followed by refeeding during pre-puberty, puberty and gestation. Increases yields by up to 10% ì Two groups in trial Rats (mammary secretory cells) ì Group One-dietary restrictions for first 10 days gestation ì Same minerals, protein and vitamin, just energy restriction at 60% of mean intake ì Group Two ì Regular diet 52 1 Mammary Growth Yields ì Restricted energy led to: 53 1 Duration of Breastfeeding and LEP ì DNA methylation of LEP ì Responsible for appetite regulation and fat metabolism ì Formula feeding dims down the Leptin producing gene 54 1 Duration of Breastfeeding and LEP ì Obermann-Borst 55 2 Milk Kinship and Epigenetics ì Does wet nursing or milk sharing cause consanguinity? 56 ì Why is this a possibility? ì Exosomes in breastmilk ì Tiny endosome-derived membrane vesicles that are released into the extracellular environment 6

released into the extracellular environment ì Genetic material such as microrna 57 2 Milk Kinship and Epigenetics ì Stem Cells MaSC (Mammary Stem Cell) ì Active during all stages of mammogenesis ì Ingests thousands to millions with each feeding ì Can turn into many types of cells - bone, fat, liver, insulin ì Stem cells gradually get methylated (turning off parts) until they are very specific become one type of cell 58 59 60 61 3 mirna in Breastmilk ì High levels of mirna in breastmilk in first six months of lactation ì Approximately 1.3 10 7 copies/liter/day of mir-181a ì Allow for transfer of genetic material (outside sexual reproduction) 3 mirna in Breastmilk 3 mirna in Breastmilk ì Influence is Strongest Before age of 2 ì Inadequacy of immune system to reject genetic material ì Increased plasticity ì Increased vulnerability of epigenome during developmental period Epigenetic Influence- It Is Also How We Mother 62 Not Just the Milk!!! ì Maternal Licked and Arched Backed Nursing Show More Moderate Stress response ì Changes hippocampus development and release of Glucocorticoid Receptor Expression 7

Glucocorticoid Receptor Expression 63 Prenatal Bond and MotherBaby Bond 64 65 66 67 68 69 Birth and Bonding Ultimately Human Milk Is Important ì Human Milk Banking Ultimately Human Milk Is Important ì Share Milk Systems ì Wet nursing??? Questions to Ponder ì Nutrition/breastfeeding has epigenetic impact, and is multigenerational. ì What can YOU do to change things in your community? Thank You! ì Questions, handouts, resources: ì info@motherjourney.com ì www.motherjourney.com ì www.theattachmentpregnancy.com 8