Babies in ketosis?

[ncrocker]

Are breastfed babies in ketosis? High fat, low carbs . . . just curious. Then again, their brains are growing like crazy! It makes sense! Hard to get a baby to pee in a cup.

[Stavia]

Are breastfed babies in ketosis? High fat, low carbs . . . just curious. Then again, their brains are growing like crazy! It makes sense! Hard to get a baby to pee in a cup.

Yes they are, if they are exclusively breastfed.

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[TheresaB]

Children also enter ketosis easier than adults.

From Fuel Metabolism in Starvation by George F Cahill Jr, https://www.annualreviews.org/doi/full/ ... 505.111258

ketones in kids cahill graph.JPG

Note there’s a separation in the x-axis. BHB levels rise in short order in children, it takes days for adults.

[Julie G]

FWIW, I've read that 40-50% of human breast milk is typically comprised of MCT. My guess is that would lead to a ketotic state.

[apod]

Are breastfed babies in ketosis? High fat, low carbs . . . just curious. Then again, their brains are growing like crazy! It makes sense! Hard to get a baby to pee in a cup.

Yes they are, if they are exclusively breastfed.

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My sister's kid is on formula... I just have to say, it's crazy what goes in this stuff these days. The ingredients list Corn Syrup Solids first, followed by Partially Hydrolyzed Nonfat Milk, Dehydrated Powdered Milk Solids, Vegetable oil (soybean, palm), and a handful of cheap synthetic vitamins like Folic Acid (my sister is ++ C677T MTHFR), calcium carbonate, calcium phosphate, (racemic?) vitamin E acetate, etc. But, you really can't tell people how to feed their kids.

[Julie G]

My sister's kid is on formula... I just have to say, it's crazy what goes in this stuff these days. The ingredients list Corn Syrup Solids first, followed by Partially Hydrolyzed Nonfat Milk, Dehydrated Powdered Milk Solids, Vegetable oil (soybean, palm), and a handful of cheap synthetic vitamins like Folic Acid (my sister is ++ C677T MTHFR), calcium carbonate, calcium phosphate, (racemic?) vitamin E acetate, etc. But, you really can't tell people how to feed their kids.

Yikes! I've read that lots of formulas include MCT to mimic breast milk. Uncle apod could bring over a case of the good stuff (at least better stuff) next time he visits

[woleile]

Mothers' milk is *not* low carb! You have only to taste it--it's sweeter than any juice, soda--anything--I've ever tasted. I'd also question whether it's high fat. It's thin and bluish, looks a lot like nonfat cows' milk.

I don't see how a naturally-fed baby could possibly be in ketosis, or put another way, how ketosis could possibly be appropriate for them given the nature of their food.

[TheresaB]

I don't see how a naturally-fed baby could possibly be in ketosis, or put another way, how ketosis could possibly be appropriate for them given the nature of their food.

Mother’s milk has a good proportion of fat and carbs, so I guess it can’t be considered low-carb, that doesn’t mean babies are not in ketosis.

Fetuses use ketones, the placenta is filled with beta hydroxybutyrate. Look at the graph I provided above. Since they are born in a state accustomed to using ketones, babies get into ketosis MUCH faster than adults. They are not adults, they don’t need a carb restricted diet as adults do.

The human brain is mostly fat and an energy hog consuming a disproportionate percentage of the body’s total energy needs. Ever notice that baby’s head in comparison to an adult's head is disproportionately larger than the rest of its body. That’s because a baby’s brain is developing tremendously in its first two years and needs fat for that development.

Babies have baby fat. That baby fat is brown fat. Adults who are producing ketones (re) develop brown fat. White fat is intent on storing fat, brown fat is intent on thermoregulation, using that fat. Ever notice how when you bathe a baby they don’t shiver?

Edit addition: Compared to other species, human babies are waaaay fatter than other animal babies. What separates humans from other animals? The brain! I just re-listened to a talk where I learned some of what I just cited, unfortunately there is not a link that can be shared here, but in the presentation it was stated that human babies use 60% of their energy for their brain. That compares to humans who use about 20-30% of the energy for the brain.

I see that ketosis is very appropriate for a baby.

[woleile]

Theresa,

The article (Fuel Metabolism in Starvation) does mention ketosis in infants, during the two or three days it takes for the mother's milk supply to be established. After that it disappears (the ketosis, not the milk!).

Human adults are adapted to food scarcity: we switch to burning fat when sugar is unavailable. It appears nature took another road with infants: the high sugar content of human milk and the round-the-clock pattern and long duration of primate nursing all act to *prevent* a drop in blood sugar, rather than equip them to cope with such a drop if it happens.

The chart shows high ketones in a baby who has gone 6+ hours without being fed. A fasted adult with high ketones is in an appropriate state, but you can't say the same for an infant. In my work with babies with feeding problems, I've seen how very quickly they become too weak to feed or even cry to be fed. Their ketones may be high, but they're in real trouble. The same vulnerability to an interruption in food supply can be seen in utero, in the more-than-doubled rate of premature birth in Israel during the Yom Kippur fast.

[TheresaB]

I just found this interesting paper that not only explains that babies are in ketosis while being breast fed, but after being weaned as part of brain development and WHY/HOW.

The paper is: Energetic and nutritional constraints on infant brain development: Implications for brain expansion during human evolution by Stephen C. Cunnane and Michael A. Crawford, published in 2014.

The paper is very interesting, if interested it's available in its entirety here: https://www.ihmc.us/wp-content/uploads/ ... l-2014.pdf

However, as it pertains to this thread, here is an excerpt, I added the bold to highlight what I keyed into:

In non-human mammals, more rapid absorption of short- and medium-chain fatty acids is presumably important only during lactation because these fatty acids are very rare in nature outside of mammalian milk (Sarda et al., 1987). Unlike long chain fatty acids, only small amounts of medium-chain (and no short-chain) fatty acids are stored in fat because they are highly ketogenic and used rapidly as a fuel source. The importance of short- and medium chain fatty acids during lactation is that, as the main precursors to ketones, they complement glucose in helping newborn mammals become autonomous, thereby increasing their chances of survival. To a greater extent than in other mammals and despite the intake of ketogenic fatty acids, the human neonate is still heavily dependent on the mother after weaning because the brain is not sufficiently developed. Also unlike other mammals, the human neonate has its own fat stores containing 8-10% short- and medium-chain fatty acids (Sarda et al., 1987), which prolong ketogenesis well beyond weaning. Fourth, the beta-oxidation of ketogenic fatty acids for energy involves a biochemical process that is simpler and more direct than for long chain fatty acids. The common long chain fatty acids (16 and 18 carbons) making up most of dietary fat need to be ‘activated’ by the enzyme carnitine palmitoyl transferase (CPT) before they can be beta-oxidized or burned as fuels. This extra step in the conversion of long chain fatty acids into energy is not required for those fatty acids under 14 carbons in length, which are all more ketogenic than long chain fatty acids. The infant consuming maternal milk is therefore more easily able to sustain mild ketosis from the short and medium-chain fatty acids in milk than can the adult whose only source of fatty acids for ketogenesis is the long chain fatty acids in the diet or in body fat stores that need to be activated by CPT before yielding ketones. Therefore, not only does the storage of medium chain fatty acids in infant fat extend ketogenesis but the biochemical process involved in oxidizing fatty acids to make ketones is easier for medium-chain than long-chain fatty acids. Hence, a combination of evolving subcutaneous fat in the human fetus and neonate with simpler absorption and oxidation of ketogenic fatty acids were key elements in permitting ketogenesis from stored medium chain fatty acids to be extended beyond weaning. These processes were key components in breaking through the energetic constraint on brain expansion.

Fascinating.