Selenium content of Spanish infant formulae and human milk: influence of protein matrix, interactions with other trace elements and estimation of dietary intake by infants

Selenium in selected samples of infant formulas and milk commercialized in Belgium and Brazil: Total content, speciation and estimated intake

Total selenium (Se) and Se species concentrations were determined in 50 infant formulas and milk samples commercialized in Brazil and Belgium. Infant formula categories were starter, follow-up, specialized and plant-based (soy and rice), while milk samples included whole, skimmed, semi-skimmed and plant-based products. Total Se content was determined by Inductively Coupled Plasma Mass Spectrometry (ICP-MS), after microwave digestion. An enzymatic extraction method was applied to evaluate the Se species, mostly selenomethionine (SeMet), Se(IV) and Se(VI), through High Performance Liquid Chromatography coupled to ICP-MS (LC-ICP-MS). Starters and follow-up samples presented the highest total Se concentrations and values up to 30 µg/kg were observed in the reconstituted product. The lowest level (below the LOQ = 10 µg/kg) was verified in an anti-regurgitation specialized formula. The relative agreement between the measured total Se and the Se content declared on the label varied from 55 % to 317 %. Concentrations in infant formulas were not markedly different from concentrations in milk except for rice and oat milk samples that showed values below the LOQ. SeMet was the main species found in milks, while in infant formulas the species concentrations varied according to the product. The daily intake (DI) of Se via infant formula consumption was calculated and compared with the Adequate Intake (AI) value and the Dietary Reference Intake (DRI) established by the EFSA NDA Panel and ANVISA, respectively. Estimated maximum intakes of total Se obtained for reconstituted infant formula were 40.6 mg/day, corresponding to 400 % and 202 % of the DRI and AI, respectively.

Human Milk Concentrations of Minerals, Essential and Toxic Trace Elements and Association with Selective Medical, Social, Demographic and Environmental Factors

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.

Association between Breast Milk Mineral Content and Maternal Adherence to Healthy Dietary Patterns in Spain: A Transversal Study

The composition of breast milk is influenced by many factors, some of which dependent on the mother and others on the child. Changes in lactation and other factors depending on the mother's physiology and anthropometric characteristics, as well as her nutritional status and diet, are of key importance. Breast milk minerals have been extensively studied with highly uneven results. In this work, a comparison will made with data across the world. To understand the factors that might explain the disparity, several minerals (Na, K, Ca, P, Mg, Fe, Se and I) have been analyzed using ICP-MS in a set of human milk samples (n = 75). The samples had an identical geographical origin (Galicia, in northwestern Spain) but different lactation circumstances, including maternal anthropometric data, lactating time, newborn sex and maternal adherence to healthy dietary patterns (Mediterranean Diet, MD, or Atlantic Diet, AD). The required concentrations of essential elements reported in the literature are similar to those found in these Spanish women. A univariate approach revealed that factors such as lactating time, body mass index (BMI) and newborn sex have a significant influence in breastmilk mineral content. According to multivariate linear regression analysis, minerals in milk are particularly associated with lactating time, but also with newborn sex, maternal BMI, age and diet pattern in some cases. More precisely, these results suggest that the iron and selenium concentrations in the milk of Galician donors may be positively influenced by maternal adherence to AD and MD, respectively.

Micronutrients in Human Milk: Analytical Methods

Exclusive breastfeeding is recommended by the WHO for the first 6 mo of life because human milk protects against gastrointestinal infections and supplies balanced and adequate nutrient contents to the infant. However, reliable data on micronutrient concentrations in human milk are sparse, especially because some micronutrients are affected by maternal diet. Microbiological and competitive protein-binding assays, nuclear magnetic resonance or inductively coupled plasma spectroscopy, and chromatographic analyses are among the methods that have been applied to human-milk micronutrient analysis. However, the validation or evaluation of analytical methods in terms of their suitability for the complex human-milk matrix has been commonly ignored in reports, even though the human-milk matrix differs vastly from blood, plasma, or urine matrixes. Thus, information on the validity, accuracy, and sensitivity of the methods is essential for the estimation of infant and maternal intake requirements to support and maintain adequate milk micronutrient concentrations for healthy infant growth and development. In this review, we summarize current knowledge on methods used for analyzing water- and fat-soluble vitamins as well as iron, copper, zinc, iodine, and selenium in human milk and their different forms in milk; the tools available for quality control and assurance; and guidance for preanalytical considerations. Finally, we recommend preferred methodologic approaches for analysis of specific milk micronutrients.

LINE-1 methylation is positively associated with healthier lifestyle but inversely related to body fat mass in healthy young individuals

With the goal of investigating if epigenetic biomarkers from white blood cells (WBC) are associated with dietary, anthropometric, metabolic, inflammatory and oxidative stress parameters in young and apparently healthy individuals. We evaluated 156 individuals (91 women, 65 men; age: 23.1±3.5 years; body mass index: 22.0±2.9 kg/m(2)) for anthropometric, biochemical and clinical markers, including some components of the antioxidant defense system and inflammatory response. DNA methylation of LINE-1, TNF-α and IL-6 and the expression of some genes related to the inflammatory process were analyzed in WBC. Adiposity was lower among individuals with higher LINE-1 methylation. On the contrary, body fat-free mass was higher among those with higher LINE-1 methylation. Individuals with higher LINE-1 methylation had higher daily intakes of calories, iron and riboflavin. However, those individuals who presented lower percentages of LINE-1 methylation reported higher intakes of copper, niacin and thiamin. Interestingly, the group with higher LINE-1 methylation had a lower percentage of current smokers and more individuals practicing sports. On the other hand, TNF-α methylation percentage was negatively associated with waist girth, waist-to-hip ratio and waist-to-stature ratio. Plasma TNF-α levels were lower in those individuals with higher TNF-α methylation. This study suggests that higher levels of LINE-1 and TNF-α methylation are associated with better indicators of adiposity status in healthy young individuals. In addition, energy and micronutrient intake, as well as a healthy lifestyle, may have a role in the regulation of DNA methylation in WBC and the subsequent metabolic changes may affect epigenetic biomarkers.

Modulators of erythrocyte glutathione peroxidase activity in healthy adults: an observational study

The aim of this study was to investigate the potential modulators of erythrocyte glutathione peroxidase (GPx) activity in young and apparently healthy individuals. One hundred one individuals (53 women and 48 men) were evaluated for anthropometric measurements, biochemical markers, clinical, dietary, and endogenous and exogenous components of the antioxidant defense system. Statistical analysis was performed to detect differences among subjects by the median of GPx activity. A linear regression model and Spearman correlation coefficients were used to screen the associations between GPx activity and interest variables. Individuals with higher GPx enzymatic activity were older and higher circulating levels of oxidized low-density lipoprotein (ox-LDL) values, but conversely lower nail concentrations of selenium and copper (P < 0.05). The GPx activity was positively correlated to truncal fat percentage values (r = 0.24, P = 0.016), circulating levels of ox-LDL (r = 0.28, P = 0.004), and daily vitamin C intake (r = 0.28, P = 0.007), and negatively correlated to the nail concentration of selenium (r = -0.24, P = 0.026). Interesting, it was noticed that the truncal fat percentage and circulating levels of ox-LDL explained 5.9 and 7.4% of the GPx enzymatic activity. Thus, preventive measures such as adequate antioxidant intake and proper fat percentage would be a priority in the nutritional care of young and apparently healthy individuals.

Maternal diet and selenium concentration in human milk from an Italian population

Background

Low selenium (Se) status is associated with several diseases. International organizations have proposed intakes of Se for general populations, including infants. Studies of the association of Se concentration in breast milk and maternal diet have yielded inconsistent results. We evaluated the relation between the intake of food items during pregnancy and Se concentration in human milk after delivery and compared infant intake of Se from breast milk with the recommended intakes.

Methods

This cross-sectional study was part of the baseline assessment of a prospective cohort of Italian mother–child pairs enrolled in 1999–2001. Se concentration was measured in the milk of 100 women included in the cohort and correlated with the intake of food items during pregnancy and lactation as reported in a food frequency questionnaire.

Results

Among foods consumed in pregnancy, only eggs had a positive, but weak, correlation with Se concentration in milk (r = 0.20, P = 0.04). Fish intake during lactation was also weakly correlated with Se in milk (r = 0.21, P = 0.04). Se content of breast milk in our population was lower than that noted in other international studies; however, very few children who were exclusively breastfed were estimated not to have met the recommended Se intake.

Conclusions

Future research should aim to verify whether infants in this part of Italy still meet the recommended nutrient intake of Se and to assess the influence of the concurrent diet of lactating mothers on the Se content of their milk.

Relationship of oxidized low density lipoprotein with lipid profile and oxidative stress markers in healthy young adults: a translational study

Background

Despite oxidized low density lipoprotein (ox-LDL) plays important roles in the pro-inflammatory and atherosclerotic processes, the relationships with metabolic and oxidative stress biomarkers have been only scarcely investigated in young adult people. Thus, the aim of this study was to assess plasma ox-LDL concentrations and the potential association with oxidative stress markers as well as with anthropometric and metabolic features in healthy young adults.

Methods

This study enrolled 160 healthy subjects (92 women/68 men; 23 ± 4 y; 22.0 ± 2.9 kg/m²). Anthropometry, body composition, blood pressure, lifestyle features, biochemical data, and oxidative stress markers were assessed with validated tools. Selenium, copper, and zinc nail concentrations were measured by atomic absorption spectrophotometry.

Results

Total cholesterol (TC), LDL-c and uric acid concentrations, TC-to-HDL-c ratio, and glutathione peroxidase (GPx) activity were positive predictors of ox-LDL concentrations, while nail selenium level (NSL) was a negative predictor, independently of gender, age, smoking status, physical activity. Those individuals included in the highest tertile of GPx activity (≥611 nmol/[mL/min]) and of NSL (≥430 ng/g of nail) had higher and lower ox-LDL concentrations, respectively, independently of the same covariates plus truncal fat or body mass index, and total cholesterol or LDL-c concentrations.

Conclusions

Ox-LDL concentrations were significantly associated with lipid biomarkers, GPx activity, uric acid concentration, and NSL, independently of different assayed covariates, in young healthy adults. These findings jointly suggest the early and complex relationship between lipid profile and redox status balance.

Nail antioxidant trace elements are inversely associated with inflammatory markers in healthy young adults

Antioxidant intake may be linked to a reduction of the chronic low-grade inflammatory state related to obesity and several accompanying disorders such as insulin resistance, cardiovascular diseases, and metabolic syndrome. So, the aim of this study was to evaluate the potential associations between nail trace elements and several indicators in healthy young adults, emphasizing on the putative effect of antioxidant trace element intake on inflammation-related marker concentrations. This study enrolled 149 healthy young adults, whose anthropometrical and blood pressure values as well as lifestyle features were analyzed. Fasting blood samples were collected for the biochemical and inflammation-related measurements (C-reactive protein, tumor necrosis factor-alpha (TNF-alpha), interleukin (IL)-6, IL-18, and homocysteine). Nail samples were collected for the analysis of selenium, zinc, and copper concentrations. Our results showed that nail selenium was negatively associated with IL-18; nail zinc concentrations were inversely related to circulating IL-6, IL-18, and TNF-alpha, whereas nail copper (Cu) and Cu/selenium values were negatively correlated with homocysteine levels and the Cu/zinc ratio was unaffected. In conclusion, nail content on some trace elements related to antioxidant defense mechanisms seems to be associated with several inflammation-related markers linked to chronic diseases in apparently healthy young adults, which is of interest to understand the role of antioxidant intake.

Dietary Selenium for the counteraction of oxidative damage: fortified foods or supplements?

Since any significant modification in the Se status, leading to changes in the activity of the seleno-enzymes, may have important consequences on the susceptibility of tissues to oxidative stress, considerable efforts have been made upon increasing Se dietary intake. In this respect, an important debate is still open about the bioavailability and the effectiveness of Se, and more generally nutrients, in supplements compared with foods. Using male Wistar rats, we have compared the effectiveness of two different diets in which an adequate Se content (0.1 mg/kg) was achieved by adding the element as sodium selenite or as component of a lyophilized Se-enriched food, in the counteraction of an oxidative stress induced by intraperitoneal administration of adriamycin. Both Se-enriched diets were able to reduce the consequences of the oxidative stress in liver, mainly by increasing glutathione peroxidase activity. This increase was more evident in rats fed on the diet enriched with the lyophilized food, probably due to the different chemical forms of Se, or to other components of the food itself. Although further studies are needed, data herein presented may contribute to the characterization of the effectiveness of Se from different sources, foods or supplements, in the light of dietary advice to the population concerning improvement of Se intake.

Vitamin B6 deficiency and dietary fats: effects on lipid composition and glutathione peroxidase activity in rat liver

Dietary selenium, vitamin B6 and fatty acids modulate both tissue acyl composition by regulating polyunsaturated fatty acid metabolism and antioxidant defences by influencing glutathione peroxidase activity. Alteration in the intake of one of them could therefore lead to different results depending on the intake of the others. To clarify this complex relationship, in the present study we have evaluated the modifications occurring in fatty acid composition and glutathione peroxidase activity in total liver and liver microsomes of rats fed diets containing the same amount of selenium, but different vitamin B6 content and fatty acid composition. Our data indicate that both acyl composition and glutathione peroxidase activity are greatly influenced not only by vitamin B6 deficiency, but also by the diet unsaturation degree. This study underlines that not only selenium availability but also other nutrients can modulate glutathione peroxidase activity.

Counteraction of adriamycin-induced oxidative damage in rat heart by selenium dietary supplementation

Many reports indicate that dietary selenium, potentially increasing the activity of glutathione peroxidase, could offer protection against free-radical-induced damage. The effects of diets moderately enriched in selenium, as sodium selenite or as a lyophilized selenium-rich food, were studied in rats. Adriamycin, an anticancer drug causing a free-radical-mediated cardiotoxicity, was administered intraperitoneally to some rats. The onset of an oxidative damage was indicated by the increase in the plasma level of reactive oxygen metabolites coupled to a decrease in the total antioxidant activity but without modification of glutathione peroxidase activity, which were observed in all rats, independent of the dietary treatment. On the contrary, in the heart, selenium supplementation caused an increase in the total antioxidant activity, glutathione concentration, and glutathione peroxidase and catalase activities leading to a decreased generation of reactive oxygen metabolites. These results clearly indicate that a moderate Se dietary supplementation counteracts adriamycin-induced cardiotoxicity by preservation of endogenous antioxidants.

Lead levels in retail samples of Spanish infant formulae and their contribution to dietary intake of infants

Lead concentrations in 82 different types of infant formulae (cow's milk and soy based) marked in Spain were analysed by acid-microwave decomposition and anodic stripping voltammetry. Dietary lead intake from infant formula and tap water used for powder formula reconstitution were estimated in comparison with the provisional tolerable weekly intake (PTWI). Additionally, the influence of physical state (powder and ready-to-use formulae), the type of container used and the impact of the industrial process from different manufacturers on lead levels were evaluated. According to the results, lead exposure from drinking water was negligible with respect to formulae investigated; where soya formulae contributed the highest intake (58-73% PTWI), non-adapted starter and specialized formulae gave an moderate intake (31-42 and 26-37% PTWI, respectively), and, finally, pre-term, adapted starter and follow-up formulae provided the lowest lead intake (22-25, 22-26 and 16-22% PTWI, respectively). Based on the current state of knowledge about lead toxicity, manufacturers are called to make an additional effort in order to keep a maximum lead level at 20 microg l-1 for all infant formulae, although it is recommendable that these formulations supply the upper limit (5 microg l-1) of 'normal' human milk.

Chemical forms of selenium for cancer prevention

Cancer is becoming an increasingly significant disease worldwide. Currently, more than 7 million people die each year from cancer. With the existing knowledge, at least one-third of worldwide cancer cases could be prevented. Searching for naturally occurring agents in routinely consumed foods that may inhibit cancer development, although challenging, constitutes a valuable and plausible approach to the control and prevention of cancer. To date, the use of the micronutrient selenium (Se) in human clinical trials is limited, but the outcome indicates that Se is among the most promising agents. Although it is convenient to describe the effects of Se in terms of the element, it must always be kept in mind that the chemical form of Se and the dose are determinants of its biological activities. Hyphenated techniques based on coupling chromatographic separation with inductively coupled plasma mass spectrometric (ICP-MS) detection are now established as the most realistic and potent analytical tools available for real-life speciation analysis. These speciation investigations provide evidence that the Se compounds, which can generate monomethylated Se (e.g., Se-methylselenocysteine and methylseleninic acid), are more efficacious than other Se compounds because of their chemoprevention activity.