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Ren Q, Li K, Li J, Pan J, Liu Y, Chen Y, Xu Y, Xie Q. Longitudinal Changes in Human Milk Minerals and Vitamins in the Chinese Population: A Scoping Review. Nutrients 2024; 16:1710. [PMID: 38892644 PMCID: PMC11174910 DOI: 10.3390/nu16111710] [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: 04/17/2024] [Revised: 05/24/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024] Open
Abstract
This scoping review aims to investigate longitudinal changes in minerals and vitamins concentrations in human milk among the Chinese population. Following the PRISMA-ScR guidelines, a comprehensive and systematic literature search was conducted using both English and Chinese databases. Data were extracted and categorized into six defined lactation stages. We found that the concentration of most minerals decreased throughout the lactation period, although calcium (Ca) and magnesium (Mg) fluctuated slightly across lactation periods. Fat-soluble vitamins also showed a decline throughout the lactation period, while water-soluble vitamins exhibited an increasing trend. However, folic acid, biotin, and pantothenic acid demonstrated a downward trend. Overall, this review has identified the longitudinal changes in minerals and vitamins concentrations in human milk among the Chinese population. In order to conduct a more in-depth examination of maternal characteristics and nutritional factors of the composition of human milk, it is recommended to utilize standardized protocols for the collection and analysis of human milk samples.
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Affiliation(s)
- Qiqi Ren
- Heilongjiang Feihe Dairy Co., Ltd., C-16, 10A Jiuxianqiao Rd., Chaoyang, Beijing 100015, China; (Q.R.); (K.L.); (J.L.); (J.P.)
- PKUHSC—China Feihe Joint Research Institute of Nutrition and Healthy Lifespan Development, Xueyuan Road 38, Haidian, Beijing 100083, China
| | - Kaifeng Li
- Heilongjiang Feihe Dairy Co., Ltd., C-16, 10A Jiuxianqiao Rd., Chaoyang, Beijing 100015, China; (Q.R.); (K.L.); (J.L.); (J.P.)
- PKUHSC—China Feihe Joint Research Institute of Nutrition and Healthy Lifespan Development, Xueyuan Road 38, Haidian, Beijing 100083, China
| | - Jufang Li
- Heilongjiang Feihe Dairy Co., Ltd., C-16, 10A Jiuxianqiao Rd., Chaoyang, Beijing 100015, China; (Q.R.); (K.L.); (J.L.); (J.P.)
- PKUHSC—China Feihe Joint Research Institute of Nutrition and Healthy Lifespan Development, Xueyuan Road 38, Haidian, Beijing 100083, China
| | - Jiancun Pan
- Heilongjiang Feihe Dairy Co., Ltd., C-16, 10A Jiuxianqiao Rd., Chaoyang, Beijing 100015, China; (Q.R.); (K.L.); (J.L.); (J.P.)
- PKUHSC—China Feihe Joint Research Institute of Nutrition and Healthy Lifespan Development, Xueyuan Road 38, Haidian, Beijing 100083, China
| | - Yang Liu
- Heilongjiang Feihe Dairy Co., Ltd., C-16, 10A Jiuxianqiao Rd., Chaoyang, Beijing 100015, China; (Q.R.); (K.L.); (J.L.); (J.P.)
- PKUHSC—China Feihe Joint Research Institute of Nutrition and Healthy Lifespan Development, Xueyuan Road 38, Haidian, Beijing 100083, China
| | - Yong Chen
- Heilongjiang Feihe Dairy Co., Ltd., C-16, 10A Jiuxianqiao Rd., Chaoyang, Beijing 100015, China; (Q.R.); (K.L.); (J.L.); (J.P.)
- PKUHSC—China Feihe Joint Research Institute of Nutrition and Healthy Lifespan Development, Xueyuan Road 38, Haidian, Beijing 100083, China
| | - Yajun Xu
- PKUHSC—China Feihe Joint Research Institute of Nutrition and Healthy Lifespan Development, Xueyuan Road 38, Haidian, Beijing 100083, China
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Xueyuan Road 38, Haidian, Beijing 100083, China
- Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, Xueyuan Road 38, Haidian, Beijing 100083, China
| | - Qinggang Xie
- Heilongjiang Feihe Dairy Co., Ltd., C-16, 10A Jiuxianqiao Rd., Chaoyang, Beijing 100015, China; (Q.R.); (K.L.); (J.L.); (J.P.)
- PKUHSC—China Feihe Joint Research Institute of Nutrition and Healthy Lifespan Development, Xueyuan Road 38, Haidian, Beijing 100083, China
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Nouzha DO, Louise G, Claudia SB, Héloïse FM, Laurence L, Joël P, Virginie R. Trace elements status in human breast milk of mothers from Île-de-France region. J Trace Elem Med Biol 2023; 80:127317. [PMID: 37864918 DOI: 10.1016/j.jtemb.2023.127317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 09/18/2023] [Accepted: 10/09/2023] [Indexed: 10/23/2023]
Abstract
Breastfeeding is the main source of nutrition during first months of life. Its composition varies according to parameters like mother's diet and health, living area, number of pregnancies and lactation duration… Trace-elements concentration in breastmilk is then an important parameter that can affect infant's health, growth or immune system and organ functions. Few data are available on this topic, and results are often very variable. The aim of this work is to determine reference values of Copper (Cu), Zinc (Zn), Selenium (Se), Cobalt (Co), Iron (Fe) and Iodine (I) in human breastmilk according to lactation duration and to study influencing parameters on its elementary composition. Regional Human Milk Bank of Necker Enfants Malades Hospital provided samples that came from breastfeeding woman involved in voluntary milk donation and epidemiologic data. Two hundred thirty-two breastmilk were analysed. After nitric acid mineralization of milk samples, Cu, Zn, Se, Co and I were determined by Inductively Coupled Plasma Mass Spectrometry (ICP-MS) in a standard mode. Fe was measured by Inductively Coupled Plasma Optical Emission Spectroscopy (ICP-OES). Both assays were validated in terms of sensitivity, repeatability and accuracy.Studied breast milks came from mothers with an average age of 32 years and donation time ranged from one day after childbirth to 974 days (> 2.5 years); mean lactation duration is 59 days (> 8 weeks) while median duration is 29 days (around 4 weeks). In all studied samples, mean results and reference values are for Cu: 6.02 (1.71-13.23), Zn: 43.86 (7.3-107.0), Se: 0.12 (0.07-0.24), I: 0.29 (0.07-1.01) and Fe: 4.72 (1.25-11.49) µmol/L and for Co: 12.28 (5.27-25.82) nmol/L. Important number of studied milks allowed their distribution into seven classes of lactation durations. Samples were divided into four successive classes of fifteen days after childbirth, two other classes corresponding to the 3rd and 4th months and a last class for milks sampled after 4 months of lactation. Results were analysed in each class allowing study of evolution during lactation. That was particularly interesting for Zn, that presented an important variability in the total population (4-132 µmol/L) explained by variation along lactation evolution decreasing from 48 to 17 µmol/L in first and last duration classes respectively. In addition, Cu and Fe concentrations were also significantly correlated with lactation duration while Se and I were in a lesser extent (p = 0.002). In this study, we present reference values for studied trace elements at different lactation stages, allowing a fine interpretation of future breast milk samples results according to their sampling time. By continuing this study, we plan to increase number of samples in some of the classes and to study the influence of premature birth or twin pregnancy on breast milk elementary composition.
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Affiliation(s)
| | - Gütter Louise
- Toxicology Department, Lariboisière University Hospital, AP-HP, Paris, France
| | | | | | - Labat Laurence
- Toxicology Department, Lariboisière University Hospital, AP-HP, Paris, France; INSERM UMRS1144, Université de Paris, France
| | - Poupon Joël
- Toxicology Department, Lariboisière University Hospital, AP-HP, Paris, France
| | - Rigourd Virginie
- Neonatal Intensive Care Unit, Necker Enfants Malades Hospital, AP-HP, Paris, France; Regional lactarium of Île-de-France, Necker Enfants Malades Hospital, AP-HP, Paris, France
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Aarsland TE, Solvik BS, Bakken KS, Sleire SN, Kaldenbach S, Holten-Andersen MN, Nermo KR, Fauskerud IT, Østvedt TH, Lohne S, Gjengedal ELF, Strand TA. Iodine Nutrition in Children ≤2 years of Age in Norway. J Nutr 2023; 153:3237-3246. [PMID: 37742796 PMCID: PMC10687616 DOI: 10.1016/j.tjnut.2023.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 09/14/2023] [Accepted: 09/19/2023] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND As a component of the thyroid hormones (THs), iodine is vital for normal neurodevelopment during early life. However, both deficient and excess iodine may affect TH production, and data on iodine status in young children are scarce. OBJECTIVES To describe iodine nutrition (iodine status and intake) in children ≤2 y of age in Innlandet County (Norway) and to describe the associations with maternal iodine nutrition. METHODS A cross-sectional study was performed in a representative sample of mother-child pairs selected from 30 municipalities from November 2020 until October 2021. Iodine status [child urinary iodine concentration (UIC), maternal UIC, and breast milk iodine concentration (BMIC)] was measured. Child's iodine intake was estimated using 2 24-h dietary recalls (24-HR) and a food frequency questionnaire. The Multiple Source Method was used to estimate the usual iodine intake distributions from the 24-HR assessments. RESULTS The median UIC in 333 children was 145 μg/L, indicating adequate iodine status according to the WHO cutoff (100 μg/L). The median usual iodine intake was 83 μg/d. Furthermore, 35% had suboptimal usual iodine intakes [below the proposed Estimated average requirement (72 μg/d)], whereas <1% had excessive usual iodine intakes [above the Upper intake level (200 μg/d)]. There was a positive correlation between children's iodine intake and BMIC (Spearman rank correlation coefficient r = 0.67, P < 0.001), and between children's UIC and BMIC (r = 0.43, P < 0.001), maternal UIC (r = 0.23, P = 0.001), and maternal iodine intake (r = 0.20, P = 0.004). CONCLUSION Despite a median UIC above the cutoff for iodine sufficiency, more than a third of the children had suboptimal usual iodine intakes. Our findings suggest that many children will benefit from iodine fortification and that risk of iodine excess in this age group is low.
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Affiliation(s)
- Tonje E Aarsland
- Center of International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Women's Clinic at Lillehammer Hospital, Innlandet Hospital Trust, Lillehammer, Norway.
| | - Beate S Solvik
- Center of International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Women's Clinic at Lillehammer Hospital, Innlandet Hospital Trust, Lillehammer, Norway
| | - Kjersti S Bakken
- Center of International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Women's Clinic at Lillehammer Hospital, Innlandet Hospital Trust, Lillehammer, Norway
| | - Synnøve Næss Sleire
- Seafood, Nutrition and Environmental State, Institute of Marine Research, Bergen, Norway
| | - Siri Kaldenbach
- Department of Paediatric and Adolescent Medicine, Innlandet Hospital Trust, Lillehammer, Norway; Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Mads N Holten-Andersen
- Department of Paediatric and Adolescent Medicine, Innlandet Hospital Trust, Lillehammer, Norway; Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Kristina R Nermo
- Center of International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Department of Microbiology, Innlandet Hospital Trust, Lillehammer, Norway
| | - Ingunn T Fauskerud
- Department of Microbiology, Innlandet Hospital Trust, Lillehammer, Norway
| | - Thobias H Østvedt
- Faculty of Environmental Sciences and Natural Resource Management, Norwegian University of Life Sciences, Ås, Norway
| | - Solfrid Lohne
- Faculty of Environmental Sciences and Natural Resource Management, Norwegian University of Life Sciences, Ås, Norway
| | - Elin L F Gjengedal
- Faculty of Environmental Sciences and Natural Resource Management, Norwegian University of Life Sciences, Ås, Norway
| | - Tor A Strand
- Center of International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Department of Research, Innlandet Hospital Trust, Lillehammer, Norway
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Infant iodine status and associations with maternal iodine nutrition, breast-feeding status and thyroid function. Br J Nutr 2023; 129:854-863. [PMID: 35535981 PMCID: PMC9975782 DOI: 10.1017/s0007114522001465] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Adequate iodine nutrition during infancy is required for normal thyroid function and, subsequently, brain development. However, data on infant iodine status in the first year of life are scarce. This study aimed to describe infant iodine status and further explore its associations with maternal iodine nutrition, breast-feeding status and thyroid function. In this cohort study, 113 infants were followed up at ages 3, 6 and 11 months in Norway. Infant and maternal urinary iodine concentration (UIC), maternal iodine intake, breast milk iodine concentration (BMIC), breast-feeding status and infant thyroid function tests were measured. The median infant UIC was 82 µg/l at the age of 3 months and below the WHO cut-off of 100 µg/l. Infant UIC was adequate later in infancy (median 110 µg/l at ages 6 and 11 months). Infant UIC was associated positively with maternal UIC (β = 0·33, 95 % CI (0·12, 0·54)), maternal iodine intake (β = 0·30, 95 % CI (0·18, 0·42)) and BMIC (β = 0·46, 95 % CI (0·13, 0·79)). Breastfed infants had lower median UIC compared with formula-fed infants at ages 3 months (76 v. 190 µg/l) and 6 months (105 v. 315 µg/l). Neither infant UIC nor BMIC were associated with infant thyroid function tests. In conclusion, breastfed infants in Norway are at risk of insufficient iodine intake during the first months of life. Maternal iodine nutrition is important for providing sufficient iodine intake in infants, and awareness of promoting adequate iodine nutrition for lactating women should be prioritised.
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Wang X, Liu J, Lu W, Jia W, Li Q, Traoré SS, Lyu Q. Iodine Deficiency of Breastfeeding Mothers and Infants from 2012 to 2019 in Zhengzhou, China. Biol Trace Elem Res 2022:10.1007/s12011-022-03531-w. [PMID: 36538209 PMCID: PMC10350439 DOI: 10.1007/s12011-022-03531-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
To investigate iodine status and characteristics of breastfeeding women and infants in Zhengzhou after the implementation of the new national standard of iodine in edible salt, so as to provide the basis for formulating prevention and control measures. Urine samples from 28,730 infants aged 0-2 years and 17,977 breastfeeding women who received preventive health care in 12 districts/cities of Zhengzhou from 2012 to 2019 were collected to measure urinary iodine concentration (UIC). A total of 350 pairs of unweaned infants and their mothers were included in this study. After the implementation of the new national standard of iodine in edible salt, the iodine deficiency of infants aged 0-2 years showed a trend of decreasing first and then increasing, but generally the iodine nutrition of infants aged 0-2 years was at the appropriate level in 8 years. There was a gradual decrease in iodine deficiency among breastfeeding women over an 8-year period. And the median UIC of breastfeeding women in 8 years was at iodine nutrition appropriate level. In addition, the UIC of breastfeeding mothers was positively associated with that of infants (r = 0.104, P = 0.004). After the implementation of the new national standard of iodine in edible salt, breastfeeding women and infants in Zhengzhou generally were at an appropriate level of iodine nutrition, and there was a significant positive correlation between the UIC of breastfeeding mothers and infants.
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Affiliation(s)
- Xinyi Wang
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China
| | - Jianghua Liu
- Zhengzhou Center for Disease Control and Prevention, Zhengzhou, 450006, China
| | - Weixia Lu
- Zhengzhou Center for Disease Control and Prevention, Zhengzhou, 450006, China
| | - Weihua Jia
- Zhengzhou Center for Disease Control and Prevention, Zhengzhou, 450006, China
| | - Qingzhi Li
- Zhengzhou Center for Disease Control and Prevention, Zhengzhou, 450006, China
| | - Stanislav S Traoré
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China
| | - Quanjun Lyu
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China.
- Department of Nutrition, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
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Andersson M, Braegger CP. The Role of Iodine for Thyroid Function in Lactating Women and Infants. Endocr Rev 2022; 43:469-506. [PMID: 35552681 PMCID: PMC9113141 DOI: 10.1210/endrev/bnab029] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Indexed: 12/18/2022]
Abstract
Iodine is a micronutrient needed for the production of thyroid hormones, which regulate metabolism, growth, and development. Iodine deficiency or excess may alter the thyroid hormone synthesis. The potential effects on infant development depend on the degree, timing, and duration of exposure. The iodine requirement is particularly high during infancy because of elevated thyroid hormone turnover. Breastfed infants rely on iodine provided by human milk, but the iodine concentration in breast milk is determined by the maternal iodine intake. Diets in many countries cannot provide sufficient iodine, and deficiency is prevented by iodine fortification of salt. However, the coverage of iodized salt varies between countries. Epidemiological data suggest large differences in the iodine intake in lactating women, infants, and toddlers worldwide, ranging from deficient to excessive intake. In this review, we provide an overview of the current knowledge and recent advances in the understanding of iodine nutrition and its association with thyroid function in lactating women, infants, and toddlers. We discuss risk factors for iodine malnutrition and the impact of targeted intervention strategies on these vulnerable population groups. We highlight the importance of appropriate definitions of optimal iodine nutrition and the need for more data assessing the risk of mild iodine deficiency for thyroid disorders during the first 2 years in life.
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Affiliation(s)
- Maria Andersson
- Nutrition Research Unit, University Children's Hospital Zurich, CH-8032 Zürich, Switzerland
| | - Christian P Braegger
- Nutrition Research Unit, University Children's Hospital Zurich, CH-8032 Zürich, Switzerland
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Breast Milk Iodine Concentration (BMIC) as a Biomarker of Iodine Status in Lactating Women and Children <2 Years of Age: A Systematic Review. Nutrients 2022; 14:nu14091691. [PMID: 35565659 PMCID: PMC9104537 DOI: 10.3390/nu14091691] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/28/2022] [Accepted: 04/01/2022] [Indexed: 01/01/2023] Open
Abstract
Background: Iodine is needed for the production of thyroid hormones, which are essential for infant growth and development. Given that there are wide variations in breast milk iodine concentration (BMIC) and urinary iodine concentration (UIC), it is unclear if BMIC is associated with UIC in populations residing in iodine sufficient or deficient areas. Aim: To investigate if BMIC can be used as a biomarker for iodine status in lactating women and children <2 years of age. Methods: Electronic databases; PubMed, Web of Science and Scopus were searched until year 2021, for studies investigating the relationship between BMIC and UIC. Studies were reviewed for eligibility, according to inclusion and exclusion criteria, followed by data extraction, according to the PRISMA guidelines. Results: Overall, 51 studies met the criteria for inclusion in the systematic review. BMIC ranged from 18 to 1153 µg/L. In iodine-deficient and iodine-sufficient lactating women, BMIC ranged from 26 to 185 µg/L and 15 to 1006 µg/L, respectively. In most studies, the categorisation of iodine status assessed by median UIC was consistent with the categorisation of iodine status assessed by median BMIC cut off of ≥100 µg/L, to determine iodine sufficiency in lactating women and children <2 years of age. Conclusions: The systematic review indicated that BMIC is a promising biomarker of iodine status in lactating women and children <2 years of age. However, these data need to be interpreted cautiously, given the study limitations in the included studies. Future studies should consider investigating the optimal median BMIC, as there is a lack of high-quality observational and intervention studies in lactating women and infants.
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Assessment of the contribution of industrially processed foods to salt and iodine intake in Thailand. PLoS One 2021; 16:e0253590. [PMID: 34228736 PMCID: PMC8259997 DOI: 10.1371/journal.pone.0253590] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 06/08/2021] [Indexed: 11/30/2022] Open
Abstract
Iodization of food grade salt has been mandated in Thailand since 1994. Currently, processed food consumption is increasing, triggered by higher income, urbanization, and lifestyle changes, which affects the source of salt and potentially iodized salt among the population. However, adequate information about the use of iodized salt in processed foods in Thailand is still lacking. Therefore, this study aimed to assess iodine intake through salt-containing processed foods and condiments which were identified using national survey data. Potential iodine intake from iodized salt in food products was modelled using consumption data and product salt content from food labelling and laboratory analysis. Fish sauce, soy sauce and seasoning sauces (salty condiments) have alternative regulation allowing for direct iodization of the final product, therefore modelling was conducted including and excluding these products. Daily salt intake from household salt and food industry salt (including salty condiments) was estimated to be 2.4 g for children 0–5 years of age, 4.6 g for children 6–12 years of age, and 11.5 g for adults. The use of iodized salt in processed foods (excluding salty condiments) met approximately 100% of the estimated average requirement (EAR) for iodine for non-pregnant adults and for children 6 to 12 years of age, and 50% of the EAR for iodine for children aged 0 to 5 years of age. In all cases, iodine intake from processed food consumption was greater than from estimated household iodized salt consumption. Findings suggest that iodized salt from processed foods is an important source of iodine intake, especially in adults. The use of iodized salt by the food industry should be enforced along with population monitoring to ensure sustainability of optimal iodine intake. Currently, the addition of iodine into fish sauce, soy sauce and seasoning sauces has an important role in achieving and sustaining optimal iodine intake.
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Mandiá N, Bermejo-Barrera P, Herbello P, López-Suárez O, Fraga JM, Fernández-Pérez C, Couce ML. Human Milk Concentrations of Minerals, Essential and Toxic Trace Elements and Association with Selective Medical, Social, Demographic and Environmental Factors. Nutrients 2021; 13:nu13061885. [PMID: 34072740 PMCID: PMC8228089 DOI: 10.3390/nu13061885] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 05/25/2021] [Accepted: 05/27/2021] [Indexed: 12/03/2022] Open
Abstract
This study aims to quantify concentrations of minerals and trace elements in human milk (HM) and infant formula (IF) and evaluate associations with medical, social, environmental, and demographic variables. A prospective, case series study of 170 nursing mothers was made. HM samples were obtained from full-term (colostrum, intermediate and mature HM) and preterm (mature HM) mothers. Variables of interest were assessed by a questionnaire. For comparison, IF samples (n = 30) were analyzed in a cross-sectional study. Concentrations of 35 minerals, essential and toxic trace elements were quantified, 5 for the first time: thallium in HM and IF; strontium in preterm HM; and gallium, lithium and uranium in IF. In preterm and full-term HM, levels of selenium (p < 0.001) were significantly lower than recommended and were associated with low birth weight (p < 0.002). Cesium and strontium concentrations were significantly higher than recommended (p < 0.001). Associations were observed between arsenic and residence in an urban area (p = 0.013), and between lead and smoking (p = 0.024) and well-water consumption (p = 0.046). In IF, aluminum, vanadium, and uranium levels were higher than in HM (p < 0.001); uranium, quantified for the first time, was 100 times higher in all types of IF than in HM. Our results indicate that concentrations of most trace elements were within internationally accepted ranges for HM and IF. However, preterm infants are at increased risk of nutritional deficiencies and toxicity. IF manufacturers should reduce the content of toxic trace elements.
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Affiliation(s)
- Natalia Mandiá
- Department of Neonatology, University Clinical Hospital of Santiago de Compostela, 15704 Santiago de Compostela, Spain;
- IDIS-Health Research Institute of Santiago de Compostela, 15704 Santiago de Compostela, Spain;
- Faculty of Medicine, University of Santiago de Compostela, 15704 Santiago de Compostela, Spain
- Correspondence: (N.M.); (M.L.C.); Tel.: +34-618-079-100 (N.M.); +34-981-950-151 (M.L.C.)
| | - Pilar Bermejo-Barrera
- Group of Trace Elements, Speciation and Spectroscopy (GETEE), Strategic Grouping in Materials (AEMAT), Department of Analytical Chemistry, Nutrition and Bromatology, Faculty of Chemistry, University of Santiago de Compostela, Avenida das Ciencias, s/n, 15782 Santiago de Compostela, Spain; (P.B.-B.); (P.H.)
| | - Paloma Herbello
- Group of Trace Elements, Speciation and Spectroscopy (GETEE), Strategic Grouping in Materials (AEMAT), Department of Analytical Chemistry, Nutrition and Bromatology, Faculty of Chemistry, University of Santiago de Compostela, Avenida das Ciencias, s/n, 15782 Santiago de Compostela, Spain; (P.B.-B.); (P.H.)
| | - Olalla López-Suárez
- Department of Neonatology, University Clinical Hospital of Santiago de Compostela, 15704 Santiago de Compostela, Spain;
- IDIS-Health Research Institute of Santiago de Compostela, 15704 Santiago de Compostela, Spain;
- Faculty of Medicine, University of Santiago de Compostela, 15704 Santiago de Compostela, Spain
| | - Jose M. Fraga
- IDIS-Health Research Institute of Santiago de Compostela, 15704 Santiago de Compostela, Spain;
- Faculty of Medicine, University of Santiago de Compostela, 15704 Santiago de Compostela, Spain
| | - Cristina Fernández-Pérez
- Department of Preventive Medicine, University Hospital of Santiago de Compostela, Santiago de Compostela University, 15704 Santiago de Compostela, Spain;
| | - María L. Couce
- Department of Neonatology, University Clinical Hospital of Santiago de Compostela, 15704 Santiago de Compostela, Spain;
- IDIS-Health Research Institute of Santiago de Compostela, 15704 Santiago de Compostela, Spain;
- Faculty of Medicine, University of Santiago de Compostela, 15704 Santiago de Compostela, Spain
- MetabERN, via Pozzuolo 330, 33100 Udine, Italy
- Correspondence: (N.M.); (M.L.C.); Tel.: +34-618-079-100 (N.M.); +34-981-950-151 (M.L.C.)
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Vegetarian and Vegan Weaning of the Infant: How Common and How Evidence-Based? A Population-Based Survey and Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134835. [PMID: 32635592 PMCID: PMC7370013 DOI: 10.3390/ijerph17134835] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 06/30/2020] [Accepted: 07/02/2020] [Indexed: 12/16/2022]
Abstract
Background: Vegetarian and vegan weaning have increasing popularity among parents and families. However, if not correctly managed, they may lead to wrong feeding regimens, causing severe nutritional deficiencies requiring specific nutritional support or even the need for hospitalization. Aim: To assess the prevalence of vegetarian and vegan weaning among Italian families and to provide an up-to-date narrative review of supporting evidence. Materials and methods: We investigated 360 Italian families using a 40-item questionnaire. The narrative review was conducted searching scientific databases for articles reporting on vegetarian and vegan weaning. Results: 8.6% of mothers follow an alternative feeding regimen and 9.2% of infants were weaned according to a vegetarian or vegan diet. The breastfeeding duration was longer in vegetarian/vegan infants (15.8 vs. 9.7 months; p < 0.0001). Almost half of parents (45.2%) claim that their pediatrician was unable to provide sufficient information and adequate indications regarding unconventional weaning and 77.4% of parents reported the pediatrician’s resistance towards alternative weaning methods. Nine studies were suitable for the review process. The vast majority of authors agree on the fact that vegetarian and vegan weaning may cause severe nutritional deficiencies, whose detrimental effects are particularly significant in the early stages of life. Discussion and conclusion: Our results show that alternative weaning methods are followed by a significant number of families; in half of the cases, the family pediatrician was not perceived as an appropriate guide in this delicate process. To date, consistent findings to support both the safety and feasibility of alternative weaning methods are still lacking. Since the risk of nutritional deficiencies in the early stages of life is high, pediatricians have a pivotal role in guiding parents and advising them on the most appropriate and complete diet regimen during childhood. Efforts should be made to enhance nutritional understanding among pediatricians as an unsupervised vegetarian or vegan diet can cause severe nutritional deficiencies with possible detrimental long-term effects.
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Ellsworth L, McCaffery H, Harman E, Abbott J, Gregg B. Breast Milk Iodine Concentration Is Associated with Infant Growth, Independent of Maternal Weight. Nutrients 2020; 12:E358. [PMID: 32019065 PMCID: PMC7071233 DOI: 10.3390/nu12020358] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 01/26/2020] [Accepted: 01/27/2020] [Indexed: 12/22/2022] Open
Abstract
In breastfed infants, human milk provides the primary source of iodine to meet demands during this vulnerable period of growth and development. Iodine is a key micronutrient that plays an essential role in hormone synthesis. Despite the importance of iodine, there is limited understanding of the maternal factors that influence milk iodine content and how milk iodine intake during infancy is related to postnatal growth. We examined breast milk samples from near 2 weeks and 2 months post-partum in a mother-infant dyad cohort of mothers with pre-pregnancy weight status defined by body mass index (BMI). Normal (NW, BMI < 25.0 kg/m2) is compared to overweight/obesity (OW/OB, BMI ≥ 25.0 kg/m2). The milk iodine concentration was determined by inductively coupled plasma mass spectrometry. We evaluated the associations between iodine content at 2 weeks and infant anthropometrics over the first year of life using multivariable linear mixed modeling. Iodine concentrations generally decreased from 2 weeks to 2 months. We observed no significant difference in iodine based on maternal weight. A higher iodine concentration at 2 weeks was associated with a larger increase in infant weight-for-age and weight-for-length Z-score change per month from 2 weeks to 1 year. This pilot study shows that early iodine intake may influence infant growth trajectory independent of maternal pre-pregnancy weight status.
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Affiliation(s)
- Lindsay Ellsworth
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Harlan McCaffery
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Emma Harman
- School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Jillian Abbott
- Metals Laboratory, Division of Clinical Biochemistry and Immunology, Mayo Clinic, Rochester, MN 55905, USA;
| | - Brigid Gregg
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Michigan, Ann Arbor, MI 48109, USA
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Vegan Nutrition for Mothers and Children: Practical Tools for Healthcare Providers. Nutrients 2018; 11:nu11010005. [PMID: 30577451 PMCID: PMC6356233 DOI: 10.3390/nu11010005] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 12/12/2018] [Accepted: 12/17/2018] [Indexed: 12/18/2022] Open
Abstract
As the number of subjects choosing vegan diets increases, healthcare providers must be prepared to give the best advice to vegan patients during all stages of life. A completely plant-based diet is suitable during pregnancy, lactation, infancy, and childhood, provided that it is well-planned. Balanced vegan diets meet energy requirements on a wide variety of plant foods and pay attention to some nutrients that may be critical, such as protein, fiber, omega-3 fatty acids, iron, zinc, iodine, calcium, vitamin D, and vitamin B12. This paper contains recommendations made by a panel of experts from the Scientific Society for Vegetarian Nutrition (SSNV) after examining the available literature concerning vegan diets during pregnancy, breastfeeding, infancy, and childhood. All healthcare professionals should follow an approach based on the available evidence in regard to the issue of vegan diets, as failing to do so may compromise the nutritional status of vegan patients in these delicate periods of life.
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