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Qin J, Zhou Y, Li H, Meng Y, Tanumihardjo SA, Liu J. A Correlation Study of Plasma and Breast Milk Retinol Concentrations in Breastfeeding Women in China. Nutrients 2023; 15:5085. [PMID: 38140344 PMCID: PMC10745653 DOI: 10.3390/nu15245085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 12/10/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023] Open
Abstract
Retinol in breast milk is related to plasma concentration among breastfeeding women, but the linear or curvilinear relationships between the two remains unclear. We conducted a cross-sectional study in 403 Chinese breastfeeding women at 42 ± 7 days postpartum. Plasma and breast milk samples were assayed using high performance liquid chromatography to determine the concentration of retinol. Partial Spearman correlation and multivariable fractional polynomial regression were used to examine the relationships between the two retinol concentrations and between plasma retinol concentration and milk-to-plasma (M/P) retinol. The median (interquartile range, IQR) of the retinol concentration in the plasma was 1.39 (1.21, 1.63) μmol/L and 1.15 (0.83, 1.49) μmol/L in the breast milk, respectively. The partial correlation coefficient between them was 0.17 (p < 0.01). A linear relationship was observed with an adjusted regression coefficient of 0.34 (95% CI: 0.19, 0.49). The relationship between the plasma retinol and M/P ratio was nonlinear and segmented at 1.00 μmol/L of plasma retinol. The regression coefficients, below and above the segmented point, were -1.69 (95% CI: -2.75, -0.62) and -0.29 (95% CI: -0.42, -0.16), respectively. Plasma and breast milk retinol were positively correlated, whereas women with a low concentration of plasma retinol showed a stronger capacity of transferring retinol to breast milk.
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Affiliation(s)
- Jing Qin
- National Health Commission Key Laboratory of Reproductive Health/Institute of Reproductive and Child Health, Peking University Health Science Center, Beijing 100191, China; (J.Q.); (H.L.); (Y.M.)
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Yubo Zhou
- National Health Commission Key Laboratory of Reproductive Health/Institute of Reproductive and Child Health, Peking University Health Science Center, Beijing 100191, China; (J.Q.); (H.L.); (Y.M.)
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Hongtian Li
- National Health Commission Key Laboratory of Reproductive Health/Institute of Reproductive and Child Health, Peking University Health Science Center, Beijing 100191, China; (J.Q.); (H.L.); (Y.M.)
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Ying Meng
- National Health Commission Key Laboratory of Reproductive Health/Institute of Reproductive and Child Health, Peking University Health Science Center, Beijing 100191, China; (J.Q.); (H.L.); (Y.M.)
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Sherry A. Tanumihardjo
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI 53706, USA;
| | - Jianmeng Liu
- National Health Commission Key Laboratory of Reproductive Health/Institute of Reproductive and Child Health, Peking University Health Science Center, Beijing 100191, China; (J.Q.); (H.L.); (Y.M.)
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
- Center for Intelligent Public Health, Institute for Artificial Intelligence, Peking University, Beijing 100191, China
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Xi Y, Wang X, Liu K, Zhang H, Ren X, Zhao A, Yang Y, Lai J, Xiao R. Vitamin E concentration in breast milk in different periods of lactation: Meta-analysis. Front Nutr 2022; 9:1050011. [PMID: 36438759 PMCID: PMC9691403 DOI: 10.3389/fnut.2022.1050011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 10/26/2022] [Indexed: 11/11/2022] Open
Abstract
ObjectiveThis study systematized information about vitamin E concentration in healthy breast milk during different stages of lactation in order to support the strategies of protecting postpartum women and infants.MethodsStudies published before April 30th, 2021, which detected vitamin E concentration in breast milk of healthy women by High Performance Liquid Chromatography (HPLC) or Ultra High Performance Liquid Chromatographic (UHPLC), were evaluated. The databases of CNKI (Chinese), WanFang Data (Chinese), VIP (Chinese), PubMed, Cochrane Library, Web of Science and Embase were searched. The random effect models were used to conduct meta-analysis by the statistical software package Stata 14.0.ResultsIn all 4,791 searched publications, 53 with full text were selected, which included 46 descriptive studies, 1 case-control study, 1 non-randomized controlled trial, and 5 randomized controlled trials. The pooled mean of vitamin E concentration was 10.57 mg α-TE/L (95%CI 8.94–12.20) in colostrum, 4.03 mg α-TE/L (95%CI 3.29–4.77) in transitional milk and 3.29 mg α-TE/L (95%CI 2.95–3.64) in mature milk. Subgroup analysis showed that vitamin E concentration of colostrum in Asian countries was lower than that in Western countries in colostrum and transitional milk.ConclusionsVitamin E concentration in breast milk decreased during lactation until the mature milk was produced. The vitamin E concentration of colostrum in Asian countries was evidently lower than that in Western countries. The vitamin E concentration in mature milk is similar in different regions. The concentration of vitamin E in breast milk started to be stable from about 2 to 3 weeks postpartum until 4 or 6 months postpartum, but it needs additional evidence to support.
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Affiliation(s)
- Yuandi Xi
- Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, Beijing, China
- China-DRIs Research Group on Human Milk Composition, Beijing, China
| | - Xianyun Wang
- Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, Beijing, China
| | - Kuo Liu
- Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, Beijing, China
| | - Huanmei Zhang
- China-DRIs Research Group on Human Milk Composition, Beijing, China
- National Institute for Nutrition and Health, Chinese Center for Disease Control, Beijing, China
- Key Laboratory of Human Milk Science, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiangnan Ren
- China-DRIs Research Group on Human Milk Composition, Beijing, China
- National Institute for Nutrition and Health, Chinese Center for Disease Control, Beijing, China
- Key Laboratory of Human Milk Science, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ai Zhao
- China-DRIs Research Group on Human Milk Composition, Beijing, China
- Wanke School of Public Health, Tsinghua University, Beijing, China
| | - Yuexin Yang
- China-DRIs Research Group on Human Milk Composition, Beijing, China
- National Institute for Nutrition and Health, Chinese Center for Disease Control, Beijing, China
| | - Jianqiang Lai
- China-DRIs Research Group on Human Milk Composition, Beijing, China
- National Institute for Nutrition and Health, Chinese Center for Disease Control, Beijing, China
- Key Laboratory of Human Milk Science, Chinese Center for Disease Control and Prevention, Beijing, China
- *Correspondence: Jianqiang Lai
| | - Rong Xiao
- Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, Beijing, China
- Rong Xiao
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Prevalence of vitamin A deficiency in women of childbearing age in Brazil: a systematic review and meta-analysis. Br J Nutr 2022; 129:1765-1775. [PMID: 35670044 DOI: 10.1017/s0007114522001714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Vitamin A is an essential micronutrient, especially during pregnancy. We aimed to assess the prevalence of vitamin A deficiency in Brazilian women of childbearing age. We conducted a systematic review with meta-analysis of studies that assessed vitamin A deficiency in women of childbearing age following the registered protocol (CRD42020171856). Independent peer researchers selected the studies retrieved from MEDLINE, Embase, Scopus and other sources. Data from the eligible studies were extracted in pairs and assessed for methodological quality. The prevalence of vitamin A deficiency (< 0·70 µmol/l or <0·20 µg/dl) and 95 % CI was combined by meta-analysis, and heterogeneity was estimated by I2. Out of 3610 screened records, thirty-two studies were included, which assessed 12 577 women from 1965 to 2017, mostly in maternity hospitals. Main limitations of the studies were in sample frame (30/32) and sampling method (29/32). Deficiency occurred in 13 % (95 % CI 9·4, 17·2 %; I² = 97 %) of all women and was higher in pregnant women (16·1 %; 95 % CI 5·6, 30·6 %; I² = 98 %) than non-pregnant women (12·3 %; 95 % CI 8·4, 16·8 %; I² = 96 %). The prevalence increased according to the decade, from 9·5 % (95 % CI 1·9–21·6 %; I² = 98 %) up to 1990, 10·8 % (95 % CI 7·9, 14·2 %; I² = 86 %) in the 2000s and 17·8 % (95 % CI 8·7, 29·0 %; I² = 98 %) in the 2010s. Over 10 % of Brazilian women in childbearing age were deficient in vitamin A. Higher prevalence was observed in pregnant women, and deficiency seemed to be increasing over the decades. Low representativeness of the studies, mainly based on convenience sampling that included pregnant, postpartum, lactating and non-pregnant women, as well as high heterogeneity, limits the findings.
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Keikha M, Shayan-Moghadam R, Bahreynian M, Kelishadi R. Nutritional supplements and mother's milk composition: a systematic review of interventional studies. Int Breastfeed J 2021; 16:1. [PMID: 33397426 PMCID: PMC7780633 DOI: 10.1186/s13006-020-00354-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 12/14/2020] [Indexed: 12/31/2022] Open
Abstract
Background This study aims to systematically review the effects of maternal vitamin and/or mineral supplementation on the content of breast milk. Methods We systematically searched electronic databases including Medline via PubMed, Scopus and ISI Web of Science till May 24, 2018. The following terms were used systematically in all mentioned databases: (“human milk” OR “breast milk” OR “breast milk composition” OR “human breast milk composition” OR “composition breast milk” OR “mother milk” OR “human breast milk” OR “maternal milk”) AND (“vitamin a” OR “retinol” OR “retinal” OR “retinoic acid” OR “beta-carotene” OR “beta carotene” OR “ascorbic acid” OR “l-ascorbic acid” OR “l ascorbic acid” OR “vitamin c” OR “vitamin d” OR “cholecalciferol” OR “ergocalciferol” OR “calciferol” OR “vitamin e” OR “tocopherol” OR “tocotrienol” OR “alpha-tocopherol” OR “alpha tocopherol” OR “α-tocopherol” OR “α tocopherol” OR “vitamin k” OR “vitamin b” OR “vitamin b complex” OR “zinc” OR “iron” OR “copper” Or “selenium” OR “manganese” OR “magnesium”) and we searched Medline via Medical subject Headings (MeSH) terms. We searched Google Scholar for to increase the sensitivity of our search. The search was conducted on human studies, but it was not limited to the title and abstract. Methodological quality and risk of bias of included studies were evaluated by Jadad scale and Cochrane risk of bias tools, respectively. Results This review included papers on three minerals (zinc, iron, selenium) and 6 vitamins (vitamin A, B, D, C, E and K) in addition to multi-vitamin supplements. Although studies had different designs, e.g. not using random allocation and/or blinding, our findings suggest that maternal use of some dietary supplements, including vitamin A, D, vitamin B1, B2 and vitamin C might be reflected in human milk. Vitamin supplements had agreater effect on breast milk composition compared to minerals. Higher doses of supplements showed higher effects and they were reflected more in colostrum than in the mature milk. Conclusion Maternal dietary vitamin and/or mineral supplementation, particularly fat- soluble vitamins, vitamin B1, B2 and C might be reflected in the breast milk composition. No difference was found between mega dose and single dose administration of minerals.
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Affiliation(s)
- Mojtaba Keikha
- Department of Public Health, Sirjan School of Medical Sciences, Sirjan, Iran
| | - Ramin Shayan-Moghadam
- Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Bahreynian
- Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. .,Department of Nutrition, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Roya Kelishadi
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
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Lucchetta RC, Cavicchioli SDA, Gini ALR, Forgerini M, Varallo FR, de Nadai MN, Fernandez-Llimos F, Mastroianni PDC. Deficiency of vitamins C and E in women of childbearing age in Brazil: a systematic review and meta-analysis. SAO PAULO MED J 2021; 139:545-555. [PMID: 34586287 PMCID: PMC9634837 DOI: 10.1590/1516-3180.2020.0799.r1.0904221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 04/09/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Despite the several options available for supplements containing vitamins C and E, evidence regarding the prevalence of deficiency or insufficiency of these vitamins is weak. OBJECTIVES To estimate the prevalence of deficiency or insufficiency of vitamins C and E and associated factors among women of childbearing age, in Brazil. DESIGN AND SETTING Systematic review and meta-analysis conducted at a Brazilian public university. METHODS A search from index inception until May 2020 was conducted. Meta-analyses were performed using inverse variance for fixed models, with summary proportions calculation using Freeman-Tukey double arcsine (base case). Reporting and methodological quality were assessed using the Joanna Briggs Institute tool for prevalence studies. RESULTS Our review identified 12 studies, comprising 1,316 participants, especially breastfeeding women. There was at least one quality weakness in all studies, mainly regarding sampling method (i.e. convenience sampling) and small sample size. The prevalence of vitamin C deficiency ranged from 0% to 40%. Only vitamin E deficiency was synthetized in meta-analyses, with mean prevalences of 6% regardless of the alpha-tocopherol cutoff in plasma, and 5% and 16% for cutoffs of < 1.6-12.0 mmol/l and < 16.2 mmol/l, respectively. The cumulative meta-analysis suggested that a trend to lower prevalence of vitamin E deficiency occurred in recent studies. CONCLUSIONS Although the studies identified in this systematic review had poor methodological and reporting quality, mild-moderate vitamin C and E deficiencies were identified, especially in breastfeeding women. Thus, designing and implementing policies does not seem to be a priority, because the need has not been properly dimensioned among women of childbearing age in Brazil. REGISTRATION NUMBER IN PROSPERO CRD42020221605.
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Affiliation(s)
- Rosa Camila Lucchetta
- PhD. Pharmacist and Postdoctoral Researcher, Department of Drugs and Medicines, School of Pharmaceutical Sciences, Universidade Estadual Paulista (UNESP), São Paulo (SP), Brazil.
| | | | - Ana Luísa Rodriguez Gini
- Undergraduate Student, Department of Drugs and Medicines, School of Pharmaceutical Sciences, Universidade Estadual Paulista (UNESP), São Paulo (SP), Brazil.
| | - Marcela Forgerini
- Pharmacist and Doctoral Student, Department of Drugs and Medicines, School of Pharmaceutical Sciences, Universidade Estadual Paulista (UNESP), São Paulo (SP), Brazil.
| | - Fabiana Rossi Varallo
- PhD. Pharmacist and Professor, Department of Pharmaceutical Sciences, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo (FCFRP-USP), Ribeirão Preto (SP), Brazil.
| | - Mariane Nunes de Nadai
- MD, PhD. Professor, Faculdade de Odontologia de Bauru, Universidade de São Paulo (FOB-USP), Bauru (SP), Brazil.
| | - Fernando Fernandez-Llimos
- PhD. Pharmacist and Professor, CINTESIS - Center for Health Technology and Services Research, Laboratory of Pharmacology, Department of Drug Sciences, Faculty of Pharmacy, Universidade do Porto, Porto, Portugal.
| | - Patricia de Carvalho Mastroianni
- PhD. Pharmacist and Professor, Department of Drugs and Medicines, School of Pharmaceutical Sciences, Universidade Estadual Paulista (UNESP), São Paulo (SP), Brazil.
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Kuchan MJ, Moulton CJ, Dyer RA, Jensen SK, Schimpf KJ, Innis SM. RRR-α-Tocopherol Is the Predominant Stereoisomer of α-Tocopherol in Human Milk. Curr Dev Nutr 2018; 2:nzy055. [PMID: 30140787 PMCID: PMC6101621 DOI: 10.1093/cdn/nzy055] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 04/26/2018] [Accepted: 06/12/2018] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The naturally occurring α-tocopherol (α-T) stereoisomer, RRR-α-tocopherol (RRR-α-T), is known to be more bioactive than all-rac-α-tocopherol (all-rac-α-T), a synthetic racemic mixture of 8 stereoisomers. There is widespread use of all-rac-α-T in maternal supplements. OBJECTIVE The aim of the study was to thoroughly describe the α-T stereoisomer profile of human milk. METHODS We measured the α-T stereoisomer profile in milk from 2 cohorts of women: a cohort of 121 women who provided milk on days 30 and 60 of lactation (study 1) and a separate cohort of 51 women who provided milk on days 10, 21, 71, and 120 of lactation (study 2). RESULTS RRR-α-T was the predominant stereoisomer (P < 0.0001) in all samples in both studies despite a large intrasubject range in total α-T (0.7-22 μg/mL). On average, RRR-α-T comprised 73-76% of total α-T, but average values for the synthetic stereoisomers were RRS, 8-14%; RSR, 6-8%; RSS, 5-6%; and the sum of 2S stereoisomers (Σ2S), 3-5%. Despite the predominance of RRR-α-T, the sum of the synthetic stereoisomers comprised as much as 48% of total α-T. We calculated the ratio of RRR to the sum of the synthetic 2R (RRS + RSR + RSS) stereoisomers (s2R) to assess the degree to which RRR is favored in milk. Consistent with discrimination among 2R stereoisomers in mammary tissue, RRR/s2R values ranged from 2.8 to 3.6, as opposed to the expected ratio of 0.33 if there was no discrimination. However, the RRR to s2R ratio did not correlate with milk α-T concentration, but both components of the ratio did. CONCLUSIONS RRR-α-T is the predominant stereoisomer in human milk, concentrations of synthetic 2R stereoisomers were notable, and the relation between milk total α-T and stereoisomer profile is complex. Due to the wide range found in milk α-T stereoisomer profile, investigation into its impact on α-T status and functional outcomes in breastfed infants is warranted.
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Affiliation(s)
- Matthew J Kuchan
- Discovery Research and Development, Abbott Nutrition, Columbus, OH
| | | | - Roger A Dyer
- BC Children's Hospital Research Institute, Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Soren K Jensen
- Department of Animal Science, Aarhus University, Tjele, Denmark
| | - Karen J Schimpf
- Analytical Research and Development, Abbott Nutrition, Columbus, OH
| | - Sheila M Innis
- BC Children's Hospital Research Institute, Department of Pediatrics, University of British Columbia, Vancouver, Canada
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Y de Vries J, Pundir S, Mckenzie E, Keijer J, Kussmann M. Maternal Circulating Vitamin Status and Colostrum Vitamin Composition in Healthy Lactating Women-A Systematic Approach. Nutrients 2018; 10:E687. [PMID: 29843443 PMCID: PMC6024806 DOI: 10.3390/nu10060687] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 05/21/2018] [Accepted: 05/24/2018] [Indexed: 12/18/2022] Open
Abstract
Colostrum is the first ingested sole nutritional source for the newborn infant. The vitamin profile of colostrum depends on the maternal vitamin status, which in turn is influenced by diet and lifestyle. Yet, the relationship between maternal vitamin status and colostrum vitamin composition has not been systematically reviewed. This review was conducted with the aim to generate a comprehensive overview on the relationship between maternal serum (plasma) vitamin concentration and corresponding colostrum composition. Three electronic databases, Embase (Ovid), Medline (Ovid), and Cochrane, were systematically searched based on predefined inclusion and exclusion criteria. Finally, a total of 11 eligible publications were included that examined the vitamins A, C, D, E, and K in both biological fluids. Maternal vitamin A, D, E, and K blood levels were unrelated to colostrum content of the respective vitamins, and serum vitamin A was inversely correlated with colostrum vitamin E. Colostrum versus maternal serum vitamins were higher for vitamins A, C, and K, lower for vitamin D, and divergent results were reported for vitamin E levels. Colostrum appears typically enriched in vitamin A, C, and K compared to maternal serum, possibly indicative of active mammary gland transport mechanisms. Inter-individual and inter-study high variability in colostrum's vitamin content endorses its sensitivity to external factors.
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Affiliation(s)
- Jasmijn Y de Vries
- Physiology, Wageningen University, De Elst 1, Building 122, 6708 WD Wageningen, The Netherlands.
| | - Shikha Pundir
- Liggins Institute, University of Auckland, 85 Park Road, Grafton, Private Bag 92019, Auckland 1142, New Zealand.
| | - Elizabeth Mckenzie
- Liggins Institute, University of Auckland, 85 Park Road, Grafton, Private Bag 92019, Auckland 1142, New Zealand.
| | - Jaap Keijer
- Human and Animal Physiology, Wageningen University, De Elst 1, Building 122, 6708 WD Wageningen, The Netherlands.
| | - Martin Kussmann
- Liggins Institute, University of Auckland, 85 Park Road, Grafton, Private Bag 92019, Auckland 1142, New Zealand.
- New Zealand National Science Challenge "High-Value Nutrition", University of Auckland, Auckland 1142, New Zealand.
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Abstract
The WHO recommends exclusive breastfeeding for the first 6 mo of life to promote optimal infant health and development. Understanding the micro- and macronutrient concentrations of human milk and how each nutrient fluctuates with lactational stage, maternal factors, and supplementation is imperative for supporting good breastfeeding practices. Where maternal undernutrition compromises human milk quality, a thorough awareness of the effectiveness of interventions can direct efforts to achieve both maternal and infant nutrient sufficiency. This review of current knowledge covers trends in nutrient concentrations over the course of lactation and describes the influence of maternal intake, status, supplementation, and other factors on human milk concentrations of each nutrient.
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Affiliation(s)
- Daphna K Dror
- US Department of Agriculture, Agricultural Research Service, Western Human Nutrition Research Center, Davis, CA
| | - Lindsay H Allen
- US Department of Agriculture, Agricultural Research Service, Western Human Nutrition Research Center, Davis, CA
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Lira LQ, Gurgel CSS, de Sousa AL, da Silva AGA, Padovam JC, Moia MN, Silva RLM, Dimenstein R. Effect of RRR-α-tocopherol supplementation on serum of breastfeeding women up to 60 days after delivery: a randomised controlled trial. J Hum Nutr Diet 2017; 30:771-778. [PMID: 28544241 DOI: 10.1111/jhn.12482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Maternal supplementation is a viable strategy to combat vitamin E deficiency in newborns, although a protocol for maternal vitamin E supplementation has not been defined. The present study assessed the effect of maternal supplementation in a single dose on the serum of postpartum women up to 60 days after delivery. METHODOLOGY Fifty healthy breastfeeding women were recruited at two maternity hospitals both located in Natal, RN, Brazil. The participants were randomly allocated to a control group and a treatment group in a 1 : 1 ratio. Serum was collected 1, 20, 30 and 60 days after delivery. Immediately after the first collection, the treatment group received a single dose of 400 IU of RRR-α-tocopherol. α-Tocopherol was quantified by high-performance liquid chromatography. The usual dietary vitamin E intake was determined using four 24-h recalls, and intake adequacy was assessed based on the estimated average requirements for lactating women (16 mg day-1 ). RESULTS The mean dietary vitamin E intakes of the both groups were similar (P > 0.05) and inadequate. The serum levels of α-tocopherol assessed at 1, 20, 30 and 60 days indicated adequate vitamin E status in both the control group (1194.6, 907.7, 910 and 748.6 μg dL-1 , respectively) and treatment group (1183.7, 956.0, 935.9 and 766.4 μg dL-1 , respectively). The comparison at each day showed no difference between treatments (P > 0.05). CONCLUSIONS A single vitamin E supplement did not change the mean serum level of α-tocopherol in breastfeeding women; thus, it does not improve their vitamin E status in the first 60 days after delivery.
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Affiliation(s)
- L Q Lira
- Department of Biochemistry, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - C S S Gurgel
- Department of Biochemistry, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - A L de Sousa
- Department of Nutrition, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - A G A da Silva
- Department of Nutrition, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - J C Padovam
- Department of Nutrition, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - M N Moia
- Department of Nutrition, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - R L M Silva
- Department of Nutrition, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - R Dimenstein
- Department of Biochemistry, Federal University of Rio Grande do Norte, Natal, RN, Brazil
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Melo LRMD, Clemente HA, Bezerra DF, Dantas RCS, Ramalho HMM, Dimenstein R. Effect of maternal supplementation with vitamin E on the concentration of α‐tocopherol in colostrum. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2017. [DOI: 10.1016/j.jpedp.2016.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Effect of maternal supplementation with vitamin E on the concentration of α-tocopherol in colostrum. J Pediatr (Rio J) 2017; 93:40-46. [PMID: 27327566 DOI: 10.1016/j.jped.2016.03.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 03/11/2016] [Accepted: 03/23/2016] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE To evaluate the effect of maternal supplementation with vitamin E on the concentration of α-tocopherol in colostrum and its supply to the newborn. METHOD This randomized clinical trial enrolled 99 healthy adult pregnant women; of these, 39 were assigned to the control group and 60 to the supplemented group. After an overnight fast, 5mL of blood and 2mL of colostrum were collected. After the first sampling (0h milk), the supplemented group received 400IU of supplementary vitamin E. Another 2mL milk aliquot was collected in both groups 24h after supplementation (24h milk). The samples were analyzed by high-performance liquid chromatography. The α-tocopherol content provided by colostrum was calculated by considering a daily intake of 396mL of milk and comparing the resulting value to the recommended daily intake for infants aged 0-6 months (4mg/day). RESULTS The initial mean concentration of α-tocopherol in colostrum was 1509.3±793.7μg/dL in the control group and 1452.9±808.6μg/dL in the supplemented group. After 24h, the mean α-tocopherol concentration was 1650.6±968.7μg/dL in the control group (p>0.05) and 2346.9±1203.2μg/dL in the supplemented group (p<0.001), increasing the vitamin E supply to the newborn to 9.3mg/day. Initially, 18 women in the supplemented group provided colostrum α-tocopherol contents below 4mg/day; after supplementation only six continued to provide less than the recommended amount. CONCLUSION Maternal vitamin E supplementation increases the supply of the vitamin to the infant by providing more than twice the Recommended Daily Intake.
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Grilo EC, Medeiros WF, Silva AGA, Gurgel CSS, Ramalho HMM, Dimenstein R. Maternal supplementation with a megadose of vitamin A reduces colostrum level of α-tocopherol: a randomised controlled trial. J Hum Nutr Diet 2016; 29:652-61. [PMID: 27231056 DOI: 10.1111/jhn.12381] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Maternal supplementation with vitamin A is one of the strategies for controlling its deficiency in the mother-child dyad, although studies with animals showed that supplementation with high doses of vitamin A reduces the levels of α-tocopherol (vitamin E) in the mother's serum and milk. The objective of the present study was to assess the influence of maternal supplementation with vitamin A on the concentration of retinol and α-tocopherol in human milk. METHODS Healthy puerperal women were randomly distributed into a control group (n = 44) and a supplemented group (n = 44). Blood and colostrum samples were collected after delivery, and mature milk samples were collected 30 days later. The supplemented group received 200 000 IU of retinyl palmitate after the first colostrum collection. The retinol and α-tocopherol levels in the samples were determined by high-performance liquid chromatography. RESULTS The mean (SD) retinol and α-tocopherol levels in the maternal serum were considered adequate at 46.4 (15.9) and 1023.6 (380.4) μg dL(-1) , respectively. The colostrum retinol levels of the supplemented group increased significantly 24 h after the intervention (P < 0.001). However, the retinol levels in the mature milk of both groups did not differ (P > 0.05). Moreover, after maternal supplementation with vitamin A, the colostrum α-tocopherol level decreased by 16.4%, which is a significant reduction (P < 0.05). However, vitamin A supplementation did not affect the α-tocopherol level of mature milk (P > 0.05). CONCLUSIONS Maternal supplementation with high doses of vitamin A increased the colostrum level of this nutrient but reduced the bioavailability of α-tocopherol, which may harm the newborn's health because newborns have limited vitamin E reserves.
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Affiliation(s)
- E C Grilo
- Department of Biochemistry, Biosciences Center, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil.
| | - W F Medeiros
- Department of Biochemistry, Biosciences Center, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
| | - A G A Silva
- Department of Biochemistry, Biosciences Center, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
| | - C S S Gurgel
- Department of Biochemistry, Biosciences Center, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
| | - H M M Ramalho
- Department of Biotechnology, School of Health, Potiguar University (UnP), Laurate International Universities, Natal, Brazil
| | - R Dimenstein
- Department of Biochemistry, Biosciences Center, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
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Retinol and Alpha-tocopherol in the Colostrum of Lactating Tunisian Women Delivering Prematurely: Associations with Maternal Characteristics. Pediatr Neonatol 2016; 57:120-6. [PMID: 26293321 DOI: 10.1016/j.pedneo.2015.06.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 05/12/2015] [Accepted: 06/15/2015] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND This study aims to assess vitamin A and E concentrations in the premature colostrum of lactating Tunisian women and to identify maternal characteristics that may affect these concentrations. METHODS Human colostrum was obtained from 105 mothers who gave birth prematurely in the Centre for Maternity and Neonatology of Tunis (Tunisia). Retinol and alpha-tocopherol were analyzed in the colostrum and in plasma by high-performance liquid chromatography. RESULTS Retinol and alpha-tocopherol concentrations were 57.5 ± 50.1 μg/dL and 1222 ± 772 μg/dL in the colostrum, respectively, and 51.7 ± 20.0 μg/dL and 1351 ± 772 μg/dL in plasma, respectively. Concentrations of each vitamin in the colostrum were positively correlated with their respective concentrations in plasma (r = 0.415, p = 0.001 for retinol and r = 0.392, p = 0.003 for alpha-tocopherol). In multivariate analysis, colostrum vitamin A was associated with plasma vitamin A and preeclampsia, while colostrum vitamin E was associated with plasma vitamin E, gestational age, and preeclampsia. CONCLUSION In Tunisian women, colostrum vitamin A and E levels are close to the average values reported in the literature. The levels are too low to cover the needs of very low birth weight (VLBW) infants, particularly in women with plasma vitamin deficiencies, preeclampsia, or very premature delivery. Given the undeniable beneficial effects of human colostrum, whenever feasible, VLBW infants should be fed colostrum. Infant vitamin A and E requirements should be met by milk fortification or supplementation.
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Abstract
BACKGROUND In areas where vitamin A deficiency (VAD) is a public health concern, the maternal dietary intake of vitamin A may be not sufficient to meet either the maternal nutritional requirements, or those of the breastfed infant, due the low retinol concentrations in breast milk. OBJECTIVES To evaluate the effects of vitamin A supplementation for postpartum women on maternal and infant health. SEARCH METHODS We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (8 February 2016), LILACS (1982 to December 2015), Web of Science (1945 to December 2015), and the reference lists of retrieved studies. SELECTION CRITERIA Randomised controlled trials (RCTs) or cluster-randomised trials that assessed the effects of vitamin A supplementation for postpartum women on maternal and infant health (morbidity, mortality and vitamin A nutritional status). DATA COLLECTION AND ANALYSIS Two review authors independently assessed trials for inclusion, conducted data extraction, assessed risk of bias and checked for accuracy. We assessed the quality of the evidence using the GRADE approach. MAIN RESULTS Fourteen trials of mainly low or unclear risk of bias, enrolling 25,758 women and infant pairs were included. The supplementation schemes included high, single or double doses of vitamin A (200,000 to 400,000 internation units (IU)), or 7.8 mg daily beta-carotene compared with placebo, no treatment, other (iron); or higher (400,000 IU) versus lower dose (200,000 IU). In all trials, a considerable proportion of infants were at least partially breastfed until six months. Supplement (vitamin A as retinyl, water-miscible or beta-carotene) 200,000 to 400,000 IU versus control (placebo or no treatment) Maternal: We did not find evidence that vitamin A supplementation reduced maternal mortality at 12 months (hazard ratio (HR) 1.01, 95% confidence interval (CI) 0.44 to 2.21; 8577 participants; 1 RCT, moderate-quality evidence). Effects were less certain at six months (risk ratio (RR) 0.50, 95% CI 0.09 to 2.71; 564 participants; 1 RCT; low-quality evidence). The effect on maternal morbidity (diarrhoea, respiratory infections, fever) was uncertain because the quality of evidence was very low (50 participants, 1 RCT). We found insufficient evidence that vitamin A increases abdominal pain (RR 1.28, 95% CI 0.95 to 1.73; 786 participants; 1 RCT; low-quality evidence). We found low-quality evidence that vitamin A supplementation increased breast milk retinol concentrations by 0.20 µmol/L at three to three and a half months (mean difference (MD) 0.20 µmol/L, 95% CI 0.08 to 0.31; 837 participants; 6 RCTs). Infant: We did not find evidence that vitamin A supplementation reduced infant mortality at two to 12 months (RR 1.08, 95% CI 0.77 to 1.52; 6090 participants; 5 RCTs; low-quality evidence). Effects on morbidity (gastroenteritis at three months) was uncertain (RR 6.03, 95% CI 0.30 to 121.82; 84 participants; 1 RCT; very low-quality evidence). There was low-quality evidence for the effect on infant adverse outcomes (bulging fontanelle at 24 to 48 hours) (RR 2.00, 95% CI 0.61 to 6.55; 444 participants; 1 RCT). Supplement (vitamin A as retinyl) 400,000 IU versus 200,000 IUThree studies (1312 participants) were included in this comparison. None of the studies assessed maternal mortality, maternal morbidity or infant mortality. Findings from one study showed that there may be little or no difference in infant morbidity between the doses (diarrhoea, respiratory illnesses, and febrile illnesses) (312 participants, data not pooled). No firm conclusion could be drawn on the impact on maternal and infant adverse outcomes (limited data available).The effect on breast milk retinol was also uncertain due to the small amount of information available. AUTHORS' CONCLUSIONS There was no evidence of benefit from different doses of vitamin A supplementation for postpartum women on maternal and infant mortality and morbidity, compared with other doses or placebo. Although maternal breast milk retinol concentrations improved with supplementation, this did not translate to health benefits for either women or infants. Few studies reported on maternal and infant mortality and morbidity. Future studies should include these important outcomes.
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Affiliation(s)
- Julicristie M Oliveira
- School of Applied Sciences, University of CampinasRua Pedro Zaccaria, 1300LimeiraSão PauloBrazil13484‐350
| | - Roman Allert
- Medical Center ‐ University of FreiburgCochrane GermanyBerliner Allee 29FreiburgBWGermany79110
- University Hospital Frankfurt, Goethe UniversityDepartment of Obstetrics and GynaecologyTheodor‐Stern‐Kai 7FrankfurtHessenGermany60596
| | - Christine E East
- Monash University/Monash HealthSchool of Nursing and Midwifery/Maternity Services246 Clayton RoadClaytonVictoriaAustralia3168
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α-Tocopherol in breast milk of women with preterm delivery after a single postpartum oral dose of vitamin E. Br J Nutr 2016; 115:1424-30. [PMID: 26931347 DOI: 10.1017/s0007114516000477] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
We evaluated the effect of maternal vitamin E supplementation on the α-tocopherol concentrations of colostrum, transitional milk and mature milk of women who had given birth prematurely. This longitudinal randomised-controlled trial divided eighty-nine women into two groups: a control group and a supplemented group. Blood and breast milk were collected from all the participants after delivery. Next, each woman in the supplemented group received 400 IU of RRR-α-tocopheryl acetate. Further breast milk samples were collected 24 h after the first collection, as well as 7 and 30 d after delivery. α-Tocopherol concentrations were determined by HPLC. The baseline α-tocopherol concentrations in the maternal serum of the two groups were similar: 1159·8 (sd 292·4) μg/dl (27·0 (SD 6·8) μmol/l) for the control group and 1128·3 (sd 407·2) μg/dl (26·2 (SD 9·5) μmol/l) for the supplemented group. None of the women was vitamin E deficient. Breast milk α-tocopherol concentrations increased by 60 % 24 h after supplementation in the intervention group and did not increase at all in the control group. α-Tocopherol concentration of the transitional milk in the supplemented group was 35 % higher compared with the control group. α-Tocopherol concentrations of the mature milk in both groups were similar. Maternal supplementation with 400 IU of RRR-α-tocopherol increased the vitamin E concentrations of the colostrum and transitional milk, but not of the mature milk. This study presents relevant information for the design of strategies to prevent and combat vitamin E deficiency in the risk group of preterm infants.
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da Silva Ribeiro KD, Lima MSR, Medeiros JFP, de Sousa Rebouças A, Dantas RCS, Bezerra DS, Osório MM, Dimenstein R. Association between maternal vitamin E status and alpha-tocopherol levels in the newborn and colostrum. MATERNAL AND CHILD NUTRITION 2016; 12:801-7. [PMID: 26924492 DOI: 10.1111/mcn.12232] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 09/11/2015] [Accepted: 09/21/2015] [Indexed: 12/01/2022]
Abstract
Vitamin E is important because of its antioxidant activity in situations of oxidative stress, especially postnatally. Hence, the objective was to verify whether maternal alpha-tocopherol level is associated with the alpha-tocopherol levels of the newborn and colostrum. This is a cross-sectional study of 58 women and their term newborns from a public hospital. Blood and colostrum were collected to measure alpha-tocopherol levels by high-performance liquid chromatography. Mothers with serum alpha-tocopherol levels <16.2 mmol L(-1) and newborns <11.6 mmol L(-1) were indicative of deficiency or low levels. Mothers were divided into two groups: <16.2 mmol L(-1) and those with levels ≥16.2 mmol L(-1) . The mean (95% confidence interval) serum alpha-tocopherol levels of mothers, umbilical cords and colostrum were 28 (24-32), 6 (5-8) and 39 mmol L(-1) (32-45), respectively (P < 0.001); 19% of the women and 90% of the newborns had low alpha-tocopherol levels. Maternal alpha-tocopherol level was associated with that of the umbilical cord. Newborns from mothers at risk of deficiency had low alpha-tocopherol levels (P < 0.001). Colostrum levels of vitamin E were not influenced by maternal serum. Maternal deficiency influenced the vitamin E level of the umbilical cord but does not in the colostrum, evidencing distinct transfer mechanisms via the mammary gland.
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Affiliation(s)
| | - Mayara Santa Rosa Lima
- Department of Biochemistry, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | | | | | | | - Danielle Soares Bezerra
- Faculdade de Ciências Médicas do Trairi, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Mônica Maria Osório
- Department of Nutrition, Federal University of Pernambuco, Recife, PE, Brazil
| | - Roberto Dimenstein
- Department of Biochemistry, Federal University of Rio Grande do Norte, Natal, RN, Brazil
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Jiang J, Xiao H, Wu K, Yu Z, Ren Y, Zhao Y, Li K, Li J, Li D. Retinol and α-tocopherol in human milk and their relationship with dietary intake during lactation. Food Funct 2016; 7:1985-91. [DOI: 10.1039/c5fo01293g] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Human milk is considered as an optimal nutrition source for neonates, and vitamins A and E improve oxidative stress in offspring through breast milk.
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Affiliation(s)
- Jiajing Jiang
- Department of Food Science and Nutrition
- Zhejiang University
- Hangzhou
- China
- APCNS Centre of Nutrition and Food Safety
| | - Hailong Xiao
- Department of Food Science and Nutrition
- Zhejiang University
- Hangzhou
- China
- Department of Hangzhou Food and Drug Inspection
| | - Kejian Wu
- Department of Food Science and Nutrition
- Zhejiang University
- Hangzhou
- China
- APCNS Centre of Nutrition and Food Safety
| | - Zuxun Yu
- Department of Fine Chemical
- Zhejiang University
- Hangzhou
- China
| | - Yiping Ren
- Zhejiang Provincial Center for Disease Prevention and Control
- Hangzhou
- China
| | - Yiming Zhao
- Department of Food Science and Nutrition
- Zhejiang University
- Hangzhou
- China
- APCNS Centre of Nutrition and Food Safety
| | - Kelei Li
- Department of Food Science and Nutrition
- Zhejiang University
- Hangzhou
- China
- APCNS Centre of Nutrition and Food Safety
| | - Jiaomei Li
- Department of Food Science and Nutrition
- Zhejiang University
- Hangzhou
- China
- APCNS Centre of Nutrition and Food Safety
| | - Duo Li
- Department of Food Science and Nutrition
- Zhejiang University
- Hangzhou
- China
- APCNS Centre of Nutrition and Food Safety
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Grilo EC, Lira LQD, Dimenstein R, Ribeiro KDDS. Influence of prematurity and birth weight on the concentration of α-tocopherol in colostrum milk. REVISTA PAULISTA DE PEDIATRIA 2015; 31:473-9. [PMID: 24473952 PMCID: PMC4183043 DOI: 10.1590/s0103-05822013000400009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 06/12/2013] [Indexed: 11/21/2022]
Abstract
OBJECTIVE: To assess vitamin E levels in the breast milk, analyzing the prematurity and the
birth weight influence in α-tocopherol concentration of colostrum milk. METHODS: Cross-sectional study, in which the colostrum was collected from 93 nursing
mothers in a public maternity of Natal, Rio Grande do Norte, Northeast Brazil. The
newborns were classified based on gestational age and birth weight. The analysis
of α-tocopherol in the milk was carried out by high performance liquid
chromatography. RESULTS: The α-tocopherol concentration in the colostrum of lactating women whose children
were born at term was 1,093.6±532.4µg/dL; for preterm infants,
the concentration was 1,321.6±708.5µg/dL (p=0.109). In the
preterm group, the α-tocopherol concentration in the colostrum of lactating women
whose children were born with low and normal birth weight was 1,316.0±790.7 and
1,327.2±655.0µg/dL, respectively (p=0.971). In the term group,
the α-tocopherol levels were higher in mothers of children with birth weight
>4000g, being 1,821.0±575.4µg/dL, compared to 869.5±532.1µg/dL and
1,039.6±477.5µg/dL with low and adequate birth weight, respectively
(p>0.05). CONCLUSIONS: Prematurity did not influence α-tocopherol levels in the colostrum milk. Mothers
who had macrossomic term neonates presented increased α-tocopherol levels. These
results indicate that birth weight can influence α-tocopherol leves in the
colostrum milk.
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Lima MSR, Dimenstein R, Ribeiro KDS. Vitamin E concentration in human milk and associated factors: a literature review. J Pediatr (Rio J) 2014; 90:440-8. [PMID: 24953721 DOI: 10.1016/j.jped.2014.04.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 04/04/2014] [Accepted: 04/15/2014] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To systematize information about vitamin E concentration in human milk and the variables associated with this composition in order to find possible causes of deficiency, supporting strategies to prevent it in postpartum women and infants. SOURCE Studies published between 2004 and 2014 that assayed alpha-tocopherol in human milk of healthy women by high performance liquid chromatography were evaluated. The keywords used were "vitamin E", "alpha-tocopherol", "milk, human", "lactation", and equivalents in Portuguese, in the BIREME, CAPES, PubMed, SciELO, ISI Web of Knowledge, HighWire Press, Ingenta, and Brazilian Digital Library of Theses and Dissertations databases. SUMMARY OF THE FINDINGS Of the 41 publications found on the subject, 25 whose full text was available and met the inclusion criteria were selected. The alpha-tocopherol concentrations found in milk were similar in most populations studied. The variable phase of lactation was shown to influence vitamin E content in milk, which is reduced until the mature milk appears. Maternal variables parity, anthropometric nutritional status, socioeconomic status, and habitual dietary intake did not appear to affect the alpha-tocopherol levels in milk. However, the influence of the variables maternal age, gestational age, biochemical nutritional status in alpha-tocopherol, and maternal supplementation with vitamin E had conflicting results in the literature. CONCLUSION Alpha-tocopherol concentration in milk decreases during lactation, until the mature milk appears. To confirm the influence of some maternal and child variables on milk vitamin E content, further studies with adequate design are needed.
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Affiliation(s)
- Mayara S R Lima
- Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil.
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Lima MS, Dimenstein R, Ribeiro KD. Vitamin E concentration in human milk and associated factors: a literature review. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2014. [DOI: 10.1016/j.jpedp.2014.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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de Lira LQ, Lima MSR, de Medeiros JMS, da Silva IF, Dimenstein R. Correlation of vitamin A nutritional status on alpha-tocopherol in the colostrum of lactating women. MATERNAL & CHILD NUTRITION 2013; 9:31-40. [PMID: 22099335 PMCID: PMC6860850 DOI: 10.1111/j.1740-8709.2011.00376.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
The adequate supply of vitamins A and E to newborns is essential. However, factors such as maternal nutritional status and nutrient interaction may limit its bioavailability. The aim of this study was to establish nutritional status for vitamins A and E and evaluate the correlation of retinol on colostrum alpha-tocopherol in lactating women. A total of 103 lactating women were recruited at a Brazilian public maternity hospital. Fasting serum and colostrum samples were collected in the immediate post-partum. Retinol and alpha-tocopherol levels were determined by high-performance liquid chromatography and nutritional status for these vitamins was defined from specific cut-off points for serum and colostrum. Mean serum and colostrum retinol (1.49 µmol L(-1) , 2.18 µmol L(-1) ) and alpha-tocopherol (26.4 µmol L(-1) , 26.1 µmol L(-1) ) indicated satisfactory biochemical status. However, we found a prevalence of subclinical deficiency of vitamin A and vitamin E in serum (15.5% and 16%) and colostrum (50% and 60%). Lactating women with serum retinol ≥ 1.05 µmol L(-1) showed an inverse correlation between serum retinol and alpha-tocopherol concentration in the colostrum (P = 0.008, r = -0.28). This association was not observed in serum level < 1.05 µmol L(-1) . The nutritional status of lactating women for vitamins A and E was adequate, although there is a risk of subclinical deficiency. The negative correlation of serum retinol on alpha-tocopherol concentration in the colostrum must be carefully evaluated in situations of vitamin A supplementation, because alpha-tocopherol bioavailability in maternal milk may be compromised.
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Affiliation(s)
- Larissa Queiroz de Lira
- Postgraduate Program in Biochemistry and Molecular Biology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Mayara Santa Rosa Lima
- Department of Nutrition, Health Science Center, Federal University of Rio Grande do Norte, Natal, Brazil
| | | | - Isabelle Ferreira da Silva
- Postgraduate Program in Biochemistry and Molecular Biology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Roberto Dimenstein
- Department of Biochemistry at the Federal University of Rio Grande do Norte, Natal, Brazil
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Rapid sample preparation procedure for determination of retinol and α-tocopherol in human breast milk. Talanta 2012; 93:147-52. [DOI: 10.1016/j.talanta.2012.01.065] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2011] [Revised: 01/27/2012] [Accepted: 01/31/2012] [Indexed: 11/23/2022]
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Lira LQD, Ribeiro PPC, Grilo EC, Freitas JKCO, Dimenstein R. Perfil de retinol no soro e colostro de puérperas atendidas em maternidade pública Brasileira e sua associação com características maternas e obstétricas. REVISTA PAULISTA DE PEDIATRIA 2011. [DOI: 10.1590/s0103-05822011000400008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Definir o estado nutricional e estabelecer a prevalência de deficiência de vitamina A (DVA) em puérperas atendidas em maternidade pública brasileira, além de avaliar a influência de características maternas e obstétricas sobre os níveis de retinol no soro e no colostro nessa população. MÉTODOS: Participaram do estudo de corte transversal 97 puérperas saudáveis classificadas quanto à idade, estado nutricional, paridade, via de parto, peso ao nascer e idade gestacional do recém-nascido. Três amostras de colostro e uma de soro foram coletadas em jejum no pós-parto imediato. O retinol foi analisado por cromatografia líquida de alta eficiência. Para caracterizar o estado nutricional em vitamina A, foi adotado ponto de corte para retinol no soro de 30µg/dL e, no colostro, de 60µg/dL. RESULTADOS: No grupo total de puérperas, a concentração média de 60µg/dL de retinol no colostro e 43µg/dL no soro indicou estado bioquímico adequado. No entanto, ao se avaliar individualmente, constatou-se alta prevalência de DVA subclínica no soro (15%) e no colostro (50%). Não foi verificada influência das características maternas, obstétricas e do neonato sobre os níveis de retinol no soro e no colostro das mulheres (p>0,05). CONCLUSÕES: O risco de DVA pode ocorrer em gestantes/puérperas independentemente das características maternas e obstétricas consideradas. Esse fato reforça a necessidade da atenção especial ao acompanhamento pré-natal de todas as mulheres, a fim de prevenir a instalação da DVA e garantir a redução dos índices de morbimortalidade infantil e materna.
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