Being born vaginally, as opposed to delivery by Cesarean section, and breast-fed point your metabolism in the right direction by establishing a stable, metabolically healthy gut microflora environment. Researchers have found, for example, that babies delivered vaginally are immediately inoculated with their mother’s vaginal flora, which is dominated by healthy Lactobacillus and Prevotella strains. And scientists know that infant inoculation with maternal microflora is among the earliest and most powerful environmental variables molding our gut and hence our metabolism.
In contrast, babies born by C-section are inoculated by the more pathogenic bacteria, common to the skin and hospital air, such as Staphylococcus aureus and Clostridium difficile. Incidentally, studies link child and adult microflora profiles rich in these bacteria to obesity and possibly diabetes. Moreover, a recent study of 1,255 children found that the prevalence of obesity in children born via Cesarean section by age three is twice that of children born vaginally.
Evidence linking harmful intestine microflora in early life with metabolic dysfunction and obesity is continually emerging. For example, researchers in Finland reported that obese seven-year-olds have a twofold increased level of S. aureus in their stool when compared to lean children of the same age. Scientists in Sweden found that obese four-year-olds have significant increases in Enterobacteriaceae bacteria associated with obesity, compared to their lean peers.
In 2011, the Centers for Disease Control and Prevention (CDC) reported that 32.8 percent of babies were delivered by C-section, up from 20 percent just ten years earlier, and today a full 20 percent of children under the age of five are overweight. Is this a coincidence? I don’t think so.
Rather, I agree with many researchers who believe that birthing methods create a predisposition to obesity and underscore the importance of proper bacterial colonization early in life. Weight-loss studies in adults and children show that potentially harmful intestinal bacteria correlate with both early life events, such as breast-feeding, and the degree of weight loss or gain later in life, independent of calories.
In the last decade, many studies have found that specific components in breast milk—namely certain prebiotics (soluble fiber, for example)—act as “fertilizers” that encourage the proliferation of beneficial intestinal microflora, namely Bifidobacteria, and offer some protection against obesity.
Breast-fed infants also have increased levels of Bifidobacteria and Lactobacillus strains in their intestinal tract while formula-fed infants have lower amounts of these strains but greater numbers of endotoxin of Clostridium and Enterobacteria strains as well as Bacteroides. Research indicates that most Bifidobacteria and some Lactobacillus strains offer protection against obesity, diabetes, and inflammation.
A study of teenagers found that those who were breast-fed for at least six months weighed less and had less belly fat than their peers who were bottle-fed formula as infants. In contrast, infant formula, which has been pasteurized and lacks the obesity-fighting bacteria common to breast milk, and infants’ early introduction to solid foods appear to negatively influence the development of protective Bifidobacteria strains of intestinal microflora.
In fact, more than ten years ago, a German research team tracked 1,314 children for five years and found that infants who were exclusively breast-fed for six months had significantly lower body fat than their bottle-fed counterparts.
In 2011, the CDC endorsed breast-feeding as a prevention against obesity, suggesting that nine months of nursing can reduce the odds by 30 percent that the child will become an obese adult. Nevertheless, in the United States, of the 75 percent of new mothers who begin nursing their babies, 35 percent stop after three months.
Less than 15 percent are still nursing at six months. This is unfortunate since research shows that lack of breast-feeding appears to play a role in the fact that one in three American children are overweight or obese.
Breast-feeding may also transfer immunity to the baby and provide hormones—leptin, adiponectin, and ghrelin—that assist in energy balance and storage. Research suggests that the presence of these hormones in early life regulates growth and programs energy balance later in life. Pasteurized infant formula obtained from grain-fed cows probably doesn’t contain the same quantities of metabolic hormones.
The rapid increase in the prevalence of obesity in both adults and children over the last few decades hints that other confounding environmental factors are shifting our thrifty metabolic programming toward saving mode.
A low-calorie diet and exercise are not enough. An effective fat-loss program must also support the immune system, gut microflora, and intestinal barrier. Adjusting for early life events that negatively shape your inner microbial organ—including birthing method, breast feeding, and antibiotic exposure—will help achieve these goals.
Individuals born by cesarean section, given antibiotics in the first 6 months of life and/or fed formula will require extra gastrointestinal support in the form of prebiotics, probiotics, and herbal compounds like berberine, garlic, oregano, and peppermint oil.
2) Sartor, R. B. (2011). Key questions to guide a better understanding of host-commensal microbiota interactions in intestinal inflammation. Mucosal Immunology, 4(2), 127–132. doi:10.1038/mi.2010.87
3) van Nimwegen MSc, F. A., PhD, J. P., PhD, E. E. S., PhD, D. S. P. M., PhD, G. H. K. M., PhD, M. K. M., et al. (2011). Mode and place of delivery, gastrointestinal microbiota, and their influence on asthma and atopy. Journal of Allergy and Clinical Immunology, 128(5), 948–955.e3. doi:10.1016/j.jaci.2011.07.027
3) Collado, M. C., Isolauri, E., Laitinen, K., & Salminen, S. (2008). Distinct composition of gut microbiota during pregnancy in overweight and normal-weight women. Am J Clin Nutr, 88(4), 894–899.
4) Huh, S. Y., Rifas-Shiman, S. L., Zera, C. A., Edwards, J. W. R., Oken, E., Weiss, S. T., & Gillman, M. W. (2012). Delivery by caesarean section and risk of obesity in preschool age children: a prospective cohort study. Archives of Disease in Childhood, 97(7), 610–616. doi:10.1136/archdischild-2011-301141
5) Blustein, J., Attina, T., Liu, M., Ryan, A. M., Cox, L. M., Blaser, M. J., & Trasande, L. (2013). Association of caesarean delivery with child adiposity from age 6 weeks to 15 years. International Journal of Obesity, 37(7), 900–906. doi:10.1038/ijo.2013.49
6) Karlsson, C. L. J., Önnerfält, J., Xu, J., Molin, G., Ahrné, S., & Thorngren-Jerneck, K. (2012). The Microbiota of the Gut in Preschool Children With Normal and Excessive Body Weight. Obesity, 20(11), 2257–2261. doi:10.1038/oby.2012.110
7) Gueimonde, M., Laitinen, K., Salminen, S., & Isolauri, E. (2007). Breast Milk: A Source of Bifidobacteria for Infant Gut Development and Maturation? Neonatology, 92(1), 64–66.
8) Cani, P. D., Neyrinck, A. M., Fava, F., Knauf, C., Burcelin, R. G., Tuohy, K. M., et al. (2007). Selective increases of bifidobacteria in gut microflora improve high-fat-diet-induced diabetes in mice through a mechanism associated with endotoxaemia. Diabetologia, 50(11), 2374–2383. doi:10.1007/s00125-007-0791-0
9) Crume, T. L., Bahr, T. M., Mayer-Davis, E. J., Hamman, R. F., Scherzinger, A. L., Stamm, E., & Dabelea, D. (2012). Selective protection against extremes in childhood body size, abdominal fat deposition, and fat patterning in breastfed children. Archives of Pediatrics & Adolescent Medicine, 166(5), 437–443. doi:10.1001/archpediatrics.2011.1488
10) Bergmann, K. E., Bergmann, R. L., Kries, von, R., Böhm, O., Richter, R., Dudenhausen, J. W., & Wahn, U. (2003). Early determinants of childhood overweight and adiposity in a birth cohort study: role of breast-feeding. International Journal of Obesity, 27(2), 162–172. doi:10.1038/sj.ijo.802200