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Montana AV, Mildon A, Daniel AI, Pitino MA, Baxter JAB, Beggs MR, Unger SL, O'Connor DL, Walton K. Is Maternal Body Weight or Composition Associated with Onset of Lactogenesis II, Human Milk Production, or Infant Consumption of Mother's Own Milk? A Systematic Review and Meta-Analysis. Adv Nutr 2024; 15:100228. [PMID: 38609047 PMCID: PMC11163153 DOI: 10.1016/j.advnut.2024.100228] [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: 01/09/2024] [Revised: 04/05/2024] [Accepted: 04/09/2024] [Indexed: 04/14/2024] Open
Abstract
Maternal adiposity impacts lactation performance, but the pathways are unclear. We conducted a systematic review to understand whether maternal adiposity (body mass index [BMI] or percentage fat mass) is associated with onset of lactogenesis II (copious milk; hours), human milk production (expressed volume/24 h), and infant consumption of mother's own milk (volume/24 h). We used random-effects standard meta-analyses to compare the relative risk (RR) of delayed lactogenesis II (>72 h) between mothers classified as underweight (BMI <18.5 kg/m2), healthy weight (BMI, 18.5-24.9 kg/m2), and overweight/obese (BMI ≥25 kg/m2) and random-effects meta-regressions to examine associations with hours to lactogenesis II and infant milk consumption. The certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation approach. We included 122 articles. Mothers with underweight (RR: 0.64; 95% CI: 0.49, 0.83; I2 = 39.48%; 8 articles/data points) or healthy weight status (RR: 0.67; 95% CI: 0.57, 0.79; I2 = 70.91%; 15 articles/data points) were less likely to experience delayed lactogenesis II than mothers with overweight/obesity. We found no association between maternal BMI and time to onset of lactogenesis II (β: 1.45 h; 95% CI: -3.19, 6.09 h; P = 0.52, I2 = 0.00%; 8 articles, 17 data points). Due to limited data, we narratively reviewed articles examining BMI or percentage fat mass and milk production (n = 6); half reported an inverse association and half no association. We found no association between maternal BMI (β: 6.23 mL; 95% CI: -11.26, 23.72 mL; P = 0.48, I2 = 47.23%; 58 articles, 75 data points) or percentage fat mass (β: 7.82 mL; 95% CI: -1.66, 17.29 mL; P = 0.10, I2 = 28.55%; 30 articles, 41 data points) and infant milk consumption. The certainty of evidence for all outcomes was very low. In conclusion, mothers with overweight/obesity may be at risk of delayed lactogenesis II. The available data do not support an association with infant milk consumption, but the included studies do not adequately represent mothers with obesity. This study was registered in PROSPERO as 285344.
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Affiliation(s)
- Amanda V Montana
- Translational Medicine, The Hospital for Sick Children, Toronto ON, Canada; Department of Nutritional Sciences, University of Toronto, Toronto ON, Canada
| | - Alison Mildon
- Department of Nutritional Sciences, University of Toronto, Toronto ON, Canada
| | | | - Michael A Pitino
- Translational Medicine, The Hospital for Sick Children, Toronto ON, Canada; Department of Nutritional Sciences, University of Toronto, Toronto ON, Canada
| | - Jo-Anna B Baxter
- Department of Nutritional Sciences, University of Toronto, Toronto ON, Canada
| | - Megan R Beggs
- Translational Medicine, The Hospital for Sick Children, Toronto ON, Canada; Department of Nutritional Sciences, University of Toronto, Toronto ON, Canada
| | - Sharon L Unger
- Department of Nutritional Sciences, University of Toronto, Toronto ON, Canada; Paediatrics, Mount Sinai Hospital, Toronto ON, Canada; Division of Neonatology, The Hospital for Sick Children, Toronto ON, Canada
| | - Deborah L O'Connor
- Translational Medicine, The Hospital for Sick Children, Toronto ON, Canada; Department of Nutritional Sciences, University of Toronto, Toronto ON, Canada; Paediatrics, Mount Sinai Hospital, Toronto ON, Canada
| | - Kathryn Walton
- Translational Medicine, The Hospital for Sick Children, Toronto ON, Canada; Department of Family Relations & Applied Nutrition, University of Guelph, Guelph, ON, Canada.
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Basrowi RW, Zulfiqqar A, Sitorus NL. Anemia in Breastfeeding Women and Its Impact on Offspring's Health in Indonesia: A Narrative Review. Nutrients 2024; 16:1285. [PMID: 38732532 PMCID: PMC11085192 DOI: 10.3390/nu16091285] [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: 03/28/2024] [Revised: 04/18/2024] [Accepted: 04/23/2024] [Indexed: 05/13/2024] Open
Abstract
Anemia in breastfeeding women is a neglected global health issue with significant implications for maternal and child health. Despite its widespread occurrence and adverse effects, this problem remains largely unknown and overlooked on the global health agenda. Despite efforts to improve health access coverage and provide iron and folic acid supplementation, anemia persists. This underscores the need for a comprehensive approach to address the problem. Urgent action must be taken to prioritize education and awareness campaigns, ensure access to nutritious food, and enhance healthcare services. Education programs should focus on promoting iron-rich diets, dispelling cultural myths, and providing practical guidance. Improving healthcare services requires increasing availability, ensuring a consistent supply of iron supplements, and providing adequate training for healthcare providers. A successful implementation relies on a strong collaboration between the government, healthcare providers, and community. It is crucial that we acknowledge that high coverage alone is insufficient for solving the issue, emphasizing the importance of targeted interventions and a strategic implementation. By adopting a comprehensive approach and addressing the underlying causes of anemia, Indonesia can make significant progress in reducing its prevalence and improving the overall health of its population, particularly among breastfeeding women.
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Affiliation(s)
- Ray Wagiu Basrowi
- Danone Specialized Nutrition Indonesia, Jakarta 12940, Indonesia;
- Occupational Medicine Program, Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta 12300, Indonesia
| | - Andy Zulfiqqar
- Division of Urology, Department of Surgery, Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta 55281, Indonesia;
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Petersohn I, Hellinga AH, van Lee L, Keukens N, Bont L, Hettinga KA, Feskens EJM, Brouwer-Brolsma EM. Maternal diet and human milk composition: an updated systematic review. Front Nutr 2024; 10:1320560. [PMID: 38352250 PMCID: PMC10862141 DOI: 10.3389/fnut.2023.1320560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/28/2023] [Indexed: 02/16/2024] Open
Abstract
Context Exclusive breastfeeding for 6 months after birth provides infants with the best start for life. A review by Bravi et al. summarized the importance of maternal diet as a determinant of human milk composition based on data up to 2015, but evidence on nutrient intake level was limited. Objective We updated the review by Bravi et al., critically assessed differences in study designs and sampling methods, and graphically visualized trends and associations. Data sources PubMed was systematically searched for articles published between January 2015 and March 2021. Data extraction Article screening, selection, and data extraction was done by two independent researchers, including a risk of bias assessment based on 11 criteria. Articles were eligible when including: quantitative information, commonly used effect estimates, healthy mother-infant dyads. Results Twenty seven observational and five intervention studies were identified (n = 7,138) and combined with results of Bravi et al. Fatty acids were still the most studied human milk components in relation to maternal diet (n = 17 studies) with maternal fish intake being predominantly positively associated with milk ALA (r = 0.28-0.42), DHA (r = 0.24-0.46), and EPA (r = 0.25-0.28) content. PUFAs from diet were generally positively correlated with their concentrations in milk, while SFA intake was negatively associated with several fatty acids in milk. Studies on associations with maternal diet and milk carbohydrates, proteins, vitamins and minerals were limited in number and varied in methods and results. Conclusion This updated review shows that evidence on the association between maternal diet and human milk fatty acids is rapidly increasing, but still diversified in methodology and results. Further studies, preferably intervention studies, assessing diet and milk carbohydrates, proteins, vitamins and minerals are needed to be able draw conclusions on the importance of maternal diet for human milk composition as a whole.
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Affiliation(s)
- Inga Petersohn
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
- Ausnutria BV, Zwolle, Netherlands
| | - Anneke H. Hellinga
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht, Netherlands
| | | | - Nicole Keukens
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Louis Bont
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht, Netherlands
- Department of Paediatric Immunology and Infectious Diseases, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, Netherlands
- ReSViNET Foundation, Zeist, Netherlands
| | - Kasper A. Hettinga
- Division of Food Quality and Design, Wageningen University and Research, Wageningen, Netherlands
| | - Edith J. M. Feskens
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Elske M. Brouwer-Brolsma
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
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Ureta-Velasco N, Montealegre-Pomar A, Keller K, Escuder-Vieco D, Fontecha J, Calvo MV, Megino-Tello J, Serrano JCE, García-Lara NR, Pallás-Alonso CR. Associations of Dietary Intake and Nutrient Status with Micronutrient and Lipid Composition in Breast Milk of Donor Women. Nutrients 2023; 15:3486. [PMID: 37571421 PMCID: PMC10421487 DOI: 10.3390/nu15153486] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/01/2023] [Accepted: 08/05/2023] [Indexed: 08/13/2023] Open
Abstract
The influence of the diet and nutritional status of milk donors on the nutritional composition of donor human milk (DHM) is unknown. The present study aimed to determine the nutritional profile of DHM and the associations between donors' dietary intake and nutritional status and the micronutrient and lipid composition in DHM. For this purpose, 113 donors completed a food frequency questionnaire, provided a five-day weighed dietary record, and collected milk for five consecutive days. Nutrient determinations in donors' erythrocytes, plasma, urine, and milk were performed. Multiple linear regressions were conducted for the evaluation of the associations. We highlight the following results: DHM docosahexaenoic acid (DHA) was positively associated with donors' plasma DHA content and donors' DHA intake (R2 0.45, p < 0.001). For every 1 g/day DHA intake, an increase of 0.38% in DHA content and 0.78% in total omega-3 content was observed in DHM (R2 0.29, p < 0.001). DHM saturated fatty acids were positively associated with erythrocyte dimethyl acetals, plasma stearic acid, trans fatty acids intake, and breastfeeding duration and negatively associated with erythrocyte margaroleic acid (R2 0.34, p < 0.01). DHM cholecalciferol was associated with plasma cholecalciferol levels and dairy intake (R2 0.57, p < 0.01). Other weaker associations were found for free thiamin, free riboflavin, pyridoxal, dehydroascorbic acid, and the lipid profile in DHM. In conclusion, the diet and nutritional status of donors influence the fatty acid profile and micronutrient content of DHM.
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Affiliation(s)
- Noelia Ureta-Velasco
- Department of Neonatology, 12 de Octubre University Hospital, 28041 Madrid, Spain; (N.R.G.-L.); (C.R.P.-A.)
- Research Institute i+12, 12 de Octubre University Hospital, 28041 Madrid, Spain; (K.K.); (D.E.-V.)
- Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain
| | - Adriana Montealegre-Pomar
- Epidemiología Clínica, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá 110231, Colombia;
| | - Kristin Keller
- Research Institute i+12, 12 de Octubre University Hospital, 28041 Madrid, Spain; (K.K.); (D.E.-V.)
- “Aladina-MGU”—Regional Human Milk Bank, 12 de Octubre University Hospital, 28041 Madrid, Spain
| | - Diana Escuder-Vieco
- Research Institute i+12, 12 de Octubre University Hospital, 28041 Madrid, Spain; (K.K.); (D.E.-V.)
- “Aladina-MGU”—Regional Human Milk Bank, 12 de Octubre University Hospital, 28041 Madrid, Spain
| | - Javier Fontecha
- Food Lipid Biomarkers and Health Group, Institute of Food Science Research (CIAL), CSIC-UAM, 28049 Madrid, Spain; (J.F.); (M.V.C.); (J.M.-T.)
| | - María V. Calvo
- Food Lipid Biomarkers and Health Group, Institute of Food Science Research (CIAL), CSIC-UAM, 28049 Madrid, Spain; (J.F.); (M.V.C.); (J.M.-T.)
| | - Javier Megino-Tello
- Food Lipid Biomarkers and Health Group, Institute of Food Science Research (CIAL), CSIC-UAM, 28049 Madrid, Spain; (J.F.); (M.V.C.); (J.M.-T.)
| | - José C. E. Serrano
- Department of Experimental Medicine, Faculty of Medicine, University of Lleida, 25008 Lleida, Spain;
| | - Nadia Raquel García-Lara
- Department of Neonatology, 12 de Octubre University Hospital, 28041 Madrid, Spain; (N.R.G.-L.); (C.R.P.-A.)
- Research Institute i+12, 12 de Octubre University Hospital, 28041 Madrid, Spain; (K.K.); (D.E.-V.)
- “Aladina-MGU”—Regional Human Milk Bank, 12 de Octubre University Hospital, 28041 Madrid, Spain
| | - Carmen R. Pallás-Alonso
- Department of Neonatology, 12 de Octubre University Hospital, 28041 Madrid, Spain; (N.R.G.-L.); (C.R.P.-A.)
- Research Institute i+12, 12 de Octubre University Hospital, 28041 Madrid, Spain; (K.K.); (D.E.-V.)
- Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain
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Ureta-Velasco N, Keller K, Escuder-Vieco D, Fontecha J, Calvo MV, Megino-Tello J, Serrano JCE, Romero Ferreiro C, García-Lara NR, Pallás-Alonso CR. Human Milk Composition and Nutritional Status of Omnivore Human Milk Donors Compared with Vegetarian/Vegan Lactating Mothers. Nutrients 2023; 15:nu15081855. [PMID: 37111074 PMCID: PMC10146700 DOI: 10.3390/nu15081855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 04/05/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023] Open
Abstract
Women of childbearing age in Western societies are increasingly adopting vegetarian diets. These women are sometimes rejected as milk donors, but little about the composition of their milk is known. The present study aimed to compare the intake, nutritional status, and nutritional composition of human milk from omnivore human milk donors (Donors) and vegetarian/vegan lactating mothers (Veg). Milk, blood, and urine samples from 92 Donors and 20 Veg were used to determine their fatty acid profiles, as well as vitamins and minerals. In a representative sample of both groups, we also determined the lipid class profile as a distribution of neutral and polar lipids, the molecular species of triacylglycerols, and the relative composition of phospholipids in their milk. A dietary assessment was conducted with a five-day dietary record (while considering the intake of supplements). We highlight the following results, expressed as the mean (SE), for the Veg vs. Donors: (1) Their docosahexaenoic acid (DHA) intake was 0.11 (0.03) vs. 0.38 (0.03) g/day; the plasma DHA was 0.37 (0.07) vs. 0.83 (0.06)%; and the milk DHA was 0.15 (0.04) vs. 0.33 (0.02)%. (2) Their milk B12 levels were 545.69 (20.49) vs. 482.89 (4.11) pM; 85% of the Veg reported taking B12 supplements (mean dose: 312.1 mcg/day); and the Veg group showed no differences with Donors in terms of total daily intake or plasma B12. (3) Their milk phosphatidylcholine levels were 26.88 (0.67) vs. 30.55 (1.10)%. (4) Their milk iodine levels were 126.42 (13.37) vs. 159.22 (5.13) mcg/L. In conclusion, the Vegs' milk was shown to be different from the Donors' milk, mainly due to its low DHA content, which is concerning. However, raising awareness and ensuring proper supplementation could bridge this gap, as has already been achieved for cobalamin.
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Affiliation(s)
- Noelia Ureta-Velasco
- Department of Neonatology, Research Institute i+12, 12 de Octubre University Hospital, Complutense University of Madrid, 28041 Madrid, Spain
| | - Kristin Keller
- "Aladina-MGU"-Regional Human Milk Bank, Research Institute i+12, 12 de Octubre University Hospital, 28041 Madrid, Spain
| | - Diana Escuder-Vieco
- "Aladina-MGU"-Regional Human Milk Bank, Research Institute i+12, 12 de Octubre University Hospital, 28041 Madrid, Spain
| | - Javier Fontecha
- Food Lipid Biomarkers and Health Group, Institute of Food Science Research (CIAL), CSIC-UAM, 28049 Madrid, Spain
| | - María V Calvo
- Food Lipid Biomarkers and Health Group, Institute of Food Science Research (CIAL), CSIC-UAM, 28049 Madrid, Spain
| | - Javier Megino-Tello
- Food Lipid Biomarkers and Health Group, Institute of Food Science Research (CIAL), CSIC-UAM, 28049 Madrid, Spain
| | - José C E Serrano
- Department of Experimental Medicine, Faculty of Medicine, University of Lleida, 25008 Lleida, Spain
| | - Carmen Romero Ferreiro
- Scientific Support Unit, Research Institute i+12, 12 de Octubre University Hospital, 28041 Madrid, Spain
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain
| | - Nadia Raquel García-Lara
- Department of Neonatology, Research Institute i+12, 12 de Octubre University Hospital, Complutense University of Madrid, 28041 Madrid, Spain
- "Aladina-MGU"-Regional Human Milk Bank, Research Institute i+12, 12 de Octubre University Hospital, 28041 Madrid, Spain
| | - Carmen R Pallás-Alonso
- Department of Neonatology, Research Institute i+12, 12 de Octubre University Hospital, Complutense University of Madrid, 28041 Madrid, Spain
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Agustina R, Rianda D, Lasepa W, Birahmatika FS, Stajic V, Mufida R. Nutrient intakes of pregnant and lactating women in Indonesia and Malaysia: Systematic review and meta-analysis. Front Nutr 2023; 10:1030343. [PMID: 37063336 PMCID: PMC10098007 DOI: 10.3389/fnut.2023.1030343] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 01/02/2023] [Indexed: 04/03/2023] Open
Abstract
IntroductionOptimizing dietary intake during pregnancy and lactation is crucial to the growth and development of children and their lifelong health. We performed a systematic review and meta-analysis to describe the nutrient intakes of pregnant and lactating women in Indonesia and Malaysia, countries that are experiencing rapid nutrition transition in Southeast Asia.MethodsWe screened 2,258 studies published between January 1980 and March 2021. The nutrient intakes of pregnant and lactating women were quantitatively analyzed to calculate the percentage of adequacy using national recommended daily allowances or nutrient intakes (RDA/RNI) and estimated average requirements (EAR) for micronutrients. Standardized mean differences (SMD) between dietary intake and RDA/RNI were determined for selected nutrients.ResultsFifty-three studies were included and showed that energy and macronutrient intakes among pregnant and lactating women in both countries were below the RDA/RNI. In addition, most studies reported that women failed to meet the EAR for vitamin D (<70% EAR), vitamin E (<50% EAR), and water-soluble vitamins (<80% EAR) except for vitamin C and A among Malaysians. Moreover, calcium, potassium, and iron intakes of pregnant women were <60% EAR in Indonesia and <80% EAR in Malaysia. Phosphorus intake among pregnant women in both countries and sodium intake among Malaysian pregnant women exceeded 100% EAR. Indonesian lactating women had <60% EAR for calcium and potassium intakes, while Malaysian women had more than 100% EAR. For 21 studies reporting overall protein intakes, the standard mean difference (SMD) was −2.26 (95% CI; −2.98, −1.54) below the RDA/RNI for pregnant women and −0.67 SMD (95% CI −15.7, −11.5) for lactating women. When the four studies from Malaysia were analyzed separately, protein intakes of pregnant women were above the RNI. Moreover, low intakes of vitamin D, vitamin C, calcium, and iron, but sufficient intakes in vitamin A, zinc, and phosphorus were observed in pregnant women in both countries.ConclusionDietary intakes of energy, macronutrients, and micronutrients (vitamin D, vitamin E, water-soluble vitamins, calcium, and iron) of pregnant and lactating women in Indonesia and Malaysia were below the recommendations. Important heterogeneities were observed even between these two countries for specific essential nutrient intakes. Innovative research and targeted programs to address specific deficiencies should be prioritized.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021252204, identifier: CRD42021252204.
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Affiliation(s)
- Rina Agustina
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
- *Correspondence: Rina Agustina ;
| | - Davrina Rianda
- Human Nutrition Research Center, Indonesian Medical Education, and Research Center (HNRC-IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Wanda Lasepa
- Human Nutrition Research Center, Indonesian Medical Education, and Research Center (HNRC-IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Fitya S. Birahmatika
- Human Nutrition Research Center, Indonesian Medical Education, and Research Center (HNRC-IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Vladimir Stajic
- Blackmores Institute, Blackmores Limited, Sydney, NSW, Australia
| | - Rachmi Mufida
- Human Nutrition Research Center, Indonesian Medical Education, and Research Center (HNRC-IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
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Karbasi S, Mohamadian M, Naseri M, Yahya Hanafi-Bojd M, Khorasanchi Z, Morovatdar N, Zarban A, Bahrami A, Ferns GA. The association of maternal food quality score (FQS) with breast milk nutrient content and antioxidant content of infant urine: a cross-sectional study. BMC Pregnancy Childbirth 2023; 23:126. [PMID: 36829155 PMCID: PMC9951474 DOI: 10.1186/s12884-023-05400-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 01/20/2023] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND Breast milk (BM) is a complex fluid with a variable composition within women over time and between women in the population. The BM compositional differences are likely to be partly due to maternal dietary patterns. This study aimed to evaluate food quality score (FQS) in lactating mothers and its association with quality indicators of BM and antioxidant content of infant urine. METHODS This cross-sectional study was undertaken in 350 lactating women aged 20 to 35 years. Data on dietary intake was collected using a validated food frequency questionnaire (FFQ) containing 65 food items. The FQS was calculated by integrating the scores obtained from healthy and unhealthy food groups. Subjects were categorized according to FQS adherence, with the greatest adherence being allocated to the third tertile and those with the lowest FQS in the first tertile. Antioxidant activity of the BM and infant urine samples was assessed using the Ferric reducing antioxidant power (FRAP), 2, 2'-diphenyl-1-picrylhydrazyl (DPPH), thiobarbituric acid reactive substances (TBARs), and Ellman's assay. The total content of BM protein, calcium, and triglyceride was measured using standard biochemical kits. RESULTS BM from mothers from the third tertile of FQS contained significantly higher DPPH, thiol, calcium, and protein levels compared to BM from those in the lowest tertile (p˂0.05). Infant urinary DPPH and FRAP was also significantly higher in the highest tertile vs. the lowest tertile (p˂0.05). CONCLUSION High maternal adherence to the FQS was associated with a high BM quality and antioxidant content of infant urine.
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Affiliation(s)
- Samira Karbasi
- grid.411701.20000 0004 0417 4622Department of Molecular Medicine, School of Medicine, Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Malihe Mohamadian
- grid.411701.20000 0004 0417 4622Cellular and Molecular Research Center, Department of Molecular Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Mohsen Naseri
- grid.411701.20000 0004 0417 4622Cellular and Molecular Research Center, Department of Molecular Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Mohammad Yahya Hanafi-Bojd
- grid.411701.20000 0004 0417 4622Cellular and Molecular Research Center, Department of Molecular Medicine, Birjand University of Medical Sciences, Birjand, Iran ,grid.411701.20000 0004 0417 4622Department of Pharmaceutics and Pharmaceutical Nanotechnology. School of Pharmacy, Birjand University of Medical Sciences, Birjand, Iran
| | - Zahra Khorasanchi
- grid.411583.a0000 0001 2198 6209Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Negar Morovatdar
- grid.411583.a0000 0001 2198 6209Clinical Research Development Unit, Faculty of Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Asghar Zarban
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran. .,Clinical Biochemistry Department, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran.
| | - Afsane Bahrami
- Clinical Research Development Unit, Faculty of Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. .,Clinical Research Development Unit of Akbar Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Gordon A. Ferns
- grid.414601.60000 0000 8853 076XBrighton and Sussex Medical School, Division of Medical Education, Falmer, Brighton, BN1 9PH Sussex UK
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Zhang H, Ren X, Yang Z, Lai J. Vitamin A Concentration in Human Milk: A Meta-Analysis. Nutrients 2022; 14:nu14224844. [PMID: 36432530 PMCID: PMC9699574 DOI: 10.3390/nu14224844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 11/09/2022] [Accepted: 11/11/2022] [Indexed: 11/18/2022] Open
Abstract
Humans require vitamin A (VA). However, pooled VA data in human milk is uncommon internationally and offers little support for dietary reference intake (DRIs) revision of infants under 6 months. As a result, we conducted a literature review and a meta-analysis to study VA concentration in breast milk throughout lactation across seven databases by August 2021. Observational or intervention studies involving nursing mothers between the ages of 18 and 45, with no recognized health concerns and who had full-term infants under 48 months were included. Studies in which retinol concentration was expressed as a mass concentration on a volume basis and determined using high-, ultra-, or ultra-fast performance liquid chromatography (HPLC, UPLC, or UFLC) were chosen. Finally, 76 papers involving 9171 samples published between 1985 and 2021 qualified for quantitative synthesis. Results from the random-effects model showed that the VA concentration of healthy term human milk decreased significantly as lactation progressed. VA (µg/L) with 95% CI at the colostrum, transitional, early mature and late mature stages being 920.7 (744.5, 1095.8), 523.7 (313.7, 733.6), 402.4 (342.5, 462.3) and 254.7 (223.7, 285.7), respectively (X2 = 71.36, p < 0.01). Subgroup analysis revealed no significant differences identified in VA concentration (µg/L) between Chinese and non-Chinese samples at each stage, being 1039.1 vs. 895.8 (p = 0.64), 505.7 vs. 542.2(p = 0.88), 408.4 vs. 401.2 (p = 0.92), 240.0 vs. 259.3 (p = 0.41). The findings have significant implications for the revision of DRIs for infants under six months.
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Affiliation(s)
- Huanmei Zhang
- Department of Maternal and Child Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
- China-DRIs Expert Committee on Human Milk Composition, Chinese Nutrition Society, Beijing 100050, China
| | - Xiangnan Ren
- Department of Maternal and Child Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
- China-DRIs Expert Committee on Human Milk Composition, Chinese Nutrition Society, Beijing 100050, China
| | - Zhenyu Yang
- Department of Maternal and Child Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
- China-DRIs Expert Committee on Human Milk Composition, Chinese Nutrition Society, Beijing 100050, China
| | - Jianqiang Lai
- China-DRIs Expert Committee on Human Milk Composition, Chinese Nutrition Society, Beijing 100050, China
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
- Correspondence:
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9
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Cai J, Peng J, Zang X, Feng J, Li R, Ren P, Zheng B, Wang J, Wang J, Yan M, Liu J, Deng R, Wang D. Mammary Leukocyte-Assisted Nanoparticle Transport Enhances Targeted Milk Trace Mineral Delivery. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2022; 9:e2200841. [PMID: 35773238 PMCID: PMC9475556 DOI: 10.1002/advs.202200841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 05/18/2022] [Indexed: 06/15/2023]
Abstract
Nanoparticles are applied as versatile platforms for drug/gene delivery in many applications owing to their long-retention and specific targeting properties in living bodies. However, the delivery mechanism and the beneficial effect of nanoparticle-retention in many organisms remain largely uncertain. Here, the transport and metabolism of mineral nanoparticles in mammary gland during lactation are explored. It is shown that maternal intravenous administration of iron oxide nanoparticles (IONPs; diameter: ≈11.0 nm, surface charge: -29.1 mV, surface area: 1.05 m2 g-1 ) provides elevated iron delivery to mammary gland and increased iron secretion into breast milk, which is inaccessible by classical iron-ion transport approaches such as the transferrin receptor-mediated endocytic pathway. Mammary macrophages and neutrophils are found to play dominant roles in uptake and delivery of IONPs through an unconventional leukocyte-assisted iron secretion pathway. This pathway bypasses the tight iron concentration regulation of liver hepcidin-ferroportin axis and mammary epithelial cells to increase milk iron-ion content derived from IONPs. This work provides keen insight into the metabolic pathway of nanoparticles in mammary gland while offering a new scheme of nutrient delivery for neonate metabolism regulation by using nanosized nutrients.
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Affiliation(s)
- Jie Cai
- Institute of Dairy ScienceCollege of Animal SciencesMOE Key Laboratory of Molecular Animal NutritionZhejiang UniversityHangzhou310029P. R. China
| | - Jie Peng
- School of Materials Science and EngineeringState Key Laboratory of Silicon MaterialsInstitute for Composites Science InnovationZhejiang UniversityHangzhou310027P. R. China
| | - Xinwei Zang
- Institute of Dairy ScienceCollege of Animal SciencesMOE Key Laboratory of Molecular Animal NutritionZhejiang UniversityHangzhou310029P. R. China
| | - Juan Feng
- Institute of Dairy ScienceCollege of Animal SciencesMOE Key Laboratory of Molecular Animal NutritionZhejiang UniversityHangzhou310029P. R. China
| | - Ruocheng Li
- Institute of Dairy ScienceCollege of Animal SciencesMOE Key Laboratory of Molecular Animal NutritionZhejiang UniversityHangzhou310029P. R. China
| | - Peng Ren
- Institute of Dairy ScienceCollege of Animal SciencesMOE Key Laboratory of Molecular Animal NutritionZhejiang UniversityHangzhou310029P. R. China
| | - Bingzhu Zheng
- School of Materials Science and EngineeringState Key Laboratory of Silicon MaterialsInstitute for Composites Science InnovationZhejiang UniversityHangzhou310027P. R. China
| | - Jiaying Wang
- Institute of Environmental HealthMOE Key Laboratory of Environmental Remediation and Ecosystem HealthCollege of Environmental & Resource SciencesZhejiang UniversityHangzhou310058P. R. China
| | - Juan Wang
- Institute of Environmental HealthMOE Key Laboratory of Environmental Remediation and Ecosystem HealthCollege of Environmental & Resource SciencesZhejiang UniversityHangzhou310058P. R. China
| | - Mi Yan
- School of Materials Science and EngineeringState Key Laboratory of Silicon MaterialsInstitute for Composites Science InnovationZhejiang UniversityHangzhou310027P. R. China
| | - Jianxin Liu
- Institute of Dairy ScienceCollege of Animal SciencesMOE Key Laboratory of Molecular Animal NutritionZhejiang UniversityHangzhou310029P. R. China
| | - Renren Deng
- School of Materials Science and EngineeringState Key Laboratory of Silicon MaterialsInstitute for Composites Science InnovationZhejiang UniversityHangzhou310027P. R. China
- Department of Medical OncologyThe First Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhou310003P. R. China
| | - Diming Wang
- Institute of Dairy ScienceCollege of Animal SciencesMOE Key Laboratory of Molecular Animal NutritionZhejiang UniversityHangzhou310029P. R. China
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10
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Diana A, Rahmannia S, Suhadi YZ, Luftimas DE, Rizqi H, Purnamasari AD, Jihadillah A, Ansari MB, Haq DAZ, Pratiwi AN, Scott S, Hampel D, Allen LH, Haszard JJ, Houghton LA, Gibson RS, Fahmida U. Chicken liver and eggshell crackers as a safe and affordable animal source food for overcoming micronutrient deficits during pregnancy and lactation in Indonesia: a double-blind, randomised placebo-controlled trial (SISTIK Growth Study). Wellcome Open Res 2022; 7:167. [PMID: 35865219 PMCID: PMC9270652 DOI: 10.12688/wellcomeopenres.17879.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Indonesia ranks fifth in terms of the number of stunted children and there has been little change in the stunting prevalence in the last decade. In earlier observational studies conducted in 2014-2015, we identified several key underlying problems with the potential to impact stunting in Sumedang district, West Java, Indonesia. Deficits in intakes of growth-limiting micronutrients were observed, most notably calcium, iron, zinc, and vitamin A, emphasizing the need for a food-based intervention to overcome these micronutrient deficits in the diets of mothers and their infants. Methods: A double-blind placebo-controlled cluster randomised trial comparing the effect of daily consumption of 75 grams of locally produced micronutrient-enriched crackers (MEC) (intervention group) compared to placebo crackers (control group) by mothers at two-time intervals: (i) from the 8-14 weeks of pregnancy to delivery (i.e., 28-34 weeks of consumption of MEC) on birth length, and (ii) from the 8-14 weeks of pregnancy to 5 months post-partum on attained linear growth and linear growth velocity of breast-fed infants. A total of 324 pregnant women from 28 clusters (villages) located in 3 sub-districts in Sumedang district, West Java, Indonesia, will be randomly assigned to either intervention (n=14 villages) or control (n=14 villages). Discussion: This will be the first study in Indonesia to use crackers based on powdered eggshells and chicken liver, in a form which is acceptable, safe, and has a long shelf life. If daily consumption of MEC for 6 months during pregnancy can enhance birth length, or their continued daily consumption for 5 months postpartum improves both attained and incremental linear growth at 5 months of age, then scaling-up in Indonesia may be considered. Trial Registration:
https://clinicaltrials.gov/ct2/show/NCT04564222; 25
th September 2020
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Affiliation(s)
- Aly Diana
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, 40161, Indonesia
- Nutrition Working Group, Faculty of Medicine, Universitas Padjadjaran, Bandung, 40161, Indonesia
- Southeast Asian Ministers of Education Organization Regional Center for Food and Nutrition (SEAMEO RECFON), Pusat Kajian Gizi Regional Universitas Indonesia, Jakarta, 13120, Indonesia
| | - Sofa Rahmannia
- Faculty of Medicine, Universitas Pasundan, Bandung, 40117, Indonesia
- School of Population and Global Health, University of Western Australia, Crawley, Western Australia, 6009, Australia
| | - Yenni Zuhairini Suhadi
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, 40161, Indonesia
- Nutrition Working Group, Faculty of Medicine, Universitas Padjadjaran, Bandung, 40161, Indonesia
| | - Dimas Erlangga Luftimas
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, 40161, Indonesia
- Nutrition Working Group, Faculty of Medicine, Universitas Padjadjaran, Bandung, 40161, Indonesia
| | - Haidar Rizqi
- Nutrition Working Group, Faculty of Medicine, Universitas Padjadjaran, Bandung, 40161, Indonesia
| | - Afini Dwi Purnamasari
- Nutrition Working Group, Faculty of Medicine, Universitas Padjadjaran, Bandung, 40161, Indonesia
| | - Ayunda Jihadillah
- Nutrition Working Group, Faculty of Medicine, Universitas Padjadjaran, Bandung, 40161, Indonesia
| | - Mohammad Brachim Ansari
- Nutrition Working Group, Faculty of Medicine, Universitas Padjadjaran, Bandung, 40161, Indonesia
| | - Dearly Ayu Zahrotun Haq
- Nutrition Working Group, Faculty of Medicine, Universitas Padjadjaran, Bandung, 40161, Indonesia
| | - Aisyah Nur Pratiwi
- Nutrition Working Group, Faculty of Medicine, Universitas Padjadjaran, Bandung, 40161, Indonesia
| | - Samuel Scott
- Poverty Health and Nutrition Division, International Food Policy Research Institute, Poverty Health and Nutrition Division, New Delhi, 110012, India
| | - Daniela Hampel
- Department of Nutrition, University of California, One Shields Ave, Davis, 95616, USA
- USDA, ARS-Western Human Nutrition Research Center, Davis, CA, 95616, USA
| | - Lindsay H Allen
- Department of Nutrition, University of California, One Shields Ave, Davis, 95616, USA
- USDA, ARS-Western Human Nutrition Research Center, Davis, CA, 95616, USA
| | - Jillian J Haszard
- Biostatistics Centre, University of Otago, Dunedin, 9054, New Zealand
| | - Lisa A Houghton
- Department of Human Nutrition, University of Otago, Dunedin, 9016, New Zealand
| | - Rosalind S Gibson
- Department of Human Nutrition, University of Otago, Dunedin, 9016, New Zealand
| | - Umi Fahmida
- Southeast Asian Ministers of Education Organization Regional Center for Food and Nutrition (SEAMEO RECFON), Pusat Kajian Gizi Regional Universitas Indonesia, Jakarta, 13120, Indonesia
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11
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Dai X, Yin H, Zhang J, Tian F, Cai X, Mao Y, Sun H, Wang H, Li X, Zhu HL, Zhang L, Chen J, Zhao Y. Carotenoid Profile in Maternal/Cord Plasma and Changes in Breast Milk along Lactation and Its Association with Dietary Intake: A Longitudinal Study in a Coastal City in Southern China. Nutrients 2022; 14:nu14091989. [PMID: 35565956 PMCID: PMC9100325 DOI: 10.3390/nu14091989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 04/11/2022] [Accepted: 05/06/2022] [Indexed: 01/27/2023] Open
Abstract
In this study, changes of carotenoids in breast milk were observed longitudinally for up to one year. Our study aimed to analyze the profile of carotenoids in breast milk and maternal/cord plasma and its correlation with dietary intake in Guangzhou. Plasma and breast milk samples of five stages during lactation (i.e., colostrum; transitional milk; and early, medium, and late mature milk) were collected from lactating mothers. The food frequency questionnaire (FFQ) was used for collecting data on dietary intake in the corresponding stages. Levels of lutein, zeaxanthin, β-cryptoxanthin, β-carotene, and lycopene were analyzed by high-performance liquid chromatography. We found that the total carotenoid level decreased gradually with the extension of lactation and eventually stabilized. Among them, the content of lutein increased from colostrum to transitional milk and decreased thereafter until it plateaued in the mature milk. Furthermore, lutein was reported as the dominant nutrient in maternal plasma, cord plasma, transitional milk, and mature milk at up to 400 days postpartum, while beta-carotene was predominant in colostrum. The content of β-carotenoid in middle and late mature breast milk was related to dietary intake (r = 1.690, p < 0.05). Carotenoid level in cord blood was lower than that in the mother’s plasma and was related to the carotenoid intake in the mother’s diet. Correlation of carotenoids between maternal and umbilical cord blood, breast milk, and maternal blood could well reflect the transport of carotenoids. These findings may help to guide mothers’ diets during breastfeeding.
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Affiliation(s)
- Xinyao Dai
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China; (X.D.); (H.Y.); (J.Z.); (H.S.); (H.W.); (L.Z.)
| | - Huanhuan Yin
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China; (X.D.); (H.Y.); (J.Z.); (H.S.); (H.W.); (L.Z.)
| | - Jing Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China; (X.D.); (H.Y.); (J.Z.); (H.S.); (H.W.); (L.Z.)
| | - Fang Tian
- Abbott Nutrition Research & Development Centre, Shanghai 200233, China; (F.T.); (X.C.); (Y.M.); (X.L.)
| | - Xiaokun Cai
- Abbott Nutrition Research & Development Centre, Shanghai 200233, China; (F.T.); (X.C.); (Y.M.); (X.L.)
| | - Yingyi Mao
- Abbott Nutrition Research & Development Centre, Shanghai 200233, China; (F.T.); (X.C.); (Y.M.); (X.L.)
| | - Hanxiao Sun
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China; (X.D.); (H.Y.); (J.Z.); (H.S.); (H.W.); (L.Z.)
| | - He Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China; (X.D.); (H.Y.); (J.Z.); (H.S.); (H.W.); (L.Z.)
| | - Xiang Li
- Abbott Nutrition Research & Development Centre, Shanghai 200233, China; (F.T.); (X.C.); (Y.M.); (X.L.)
| | - Hui-Lian Zhu
- Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China;
| | - Lishi Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China; (X.D.); (H.Y.); (J.Z.); (H.S.); (H.W.); (L.Z.)
| | - Jinyao Chen
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China; (X.D.); (H.Y.); (J.Z.); (H.S.); (H.W.); (L.Z.)
- Correspondence: (J.C.); (Y.Z.); Tel.: +86-028-85501275 (J.C.); +021-20822472 (Y.Z.); Fax: +86-028-85501275 (J.C.)
| | - Yanrong Zhao
- Abbott Nutrition Research & Development Centre, Shanghai 200233, China; (F.T.); (X.C.); (Y.M.); (X.L.)
- Correspondence: (J.C.); (Y.Z.); Tel.: +86-028-85501275 (J.C.); +021-20822472 (Y.Z.); Fax: +86-028-85501275 (J.C.)
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12
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OUP accepted manuscript. Nutr Rev 2022; 80:2029-2050. [DOI: 10.1093/nutrit/nuac018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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13
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Batalha MA, Ferreira ALL, Freitas-Costa NC, Figueiredo ACC, Carrilho TRB, Shahab-Ferdows S, Hampel D, Allen LH, Pérez-Escamilla R, Kac G. Factors associated with longitudinal changes in B-vitamin and choline concentrations of human milk. Am J Clin Nutr 2021; 114:1560-1573. [PMID: 34113959 DOI: 10.1093/ajcn/nqab191] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 05/17/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Little is known regarding the associations between maternal factors and B-vitamin and choline concentrations in early milk and the trajectories of these vitamins during lactation. OBJECTIVES In this hypothesis-generating study, we modeled the association between maternal and offspring factors and longitudinal changes in milk B-vitamin and choline concentrations throughout lactation. METHODS A hundred women were studied in a prospective birth cohort and milk samples from 52 women were collected at 2-8 d, 76 women at 28-50 d, and 42 women at 88-119 d postpartum. Maternal dietary intake during pregnancy and lactation was assessed by an FFQ. Linear mixed-effects models with interaction terms were used to evaluate changes in milk B-vitamin and choline concentrations over time based on maternal factors and the early postpartum concentrations of these micronutrients. RESULTS The women with higher early postpartum milk concentrations of niacin (βinteraction = -0.02; SE = 0.00; P < 0.001), pantothenic acid (βinteraction = -0.10; SE = 2.56; P < 0.001), vitamin B-12 (βinteraction= -0.10; SE = 0.03; P < 0.001), and choline (βinteraction= -0.90; SE = 0.18; P < 0.001) exhibited a decrease in their concentrations throughout lactation. The participants with overweight and obesity prepregnancy experienced an increase in milk vitamin B-12 concentrations over time (βinteraction = 0.04; SE = 0.02; P = 0.06). In contrast, a decrease in vitamin B-12 concentration was observed among women with vitamin B-12 intake below the RDA during pregnancy (βinteraction= -0.08; SE = 0.05; P = 0.07). The women with niacin intake below the RDA during lactation experienced an increase in milk concentrations over time (βinteraction = 0.01; SE = 0.01; P = 0.03). A gestational age at birth >40 wk was associated with an increase in milk choline concentration throughout lactation (βinteraction = 0.54; SE = 0.16; P< 0.01). CONCLUSIONS Changes in B-vitamin and choline concentrations in human milk over time may be associated with the early concentrations of these micronutrients in milk, maternal prepregnancy BMI, dietary intake, and gestational age at delivery.
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Affiliation(s)
- Mônica A Batalha
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | - Ana L L Ferreira
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | - Nathalia C Freitas-Costa
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | - Amanda C C Figueiredo
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | - Thais R B Carrilho
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | - Setareh Shahab-Ferdows
- USDA/Agricultural Research Service Western Human Nutrition Research Center, Davis, CA, USA
| | - Daniela Hampel
- USDA/Agricultural Research Service Western Human Nutrition Research Center, Davis, CA, USA.,Department of Nutrition, University of California, Davis, Davis, CA, USA
| | - Lindsay H Allen
- USDA/Agricultural Research Service Western Human Nutrition Research Center, Davis, CA, USA.,Department of Nutrition, University of California, Davis, Davis, CA, USA
| | - Rafael Pérez-Escamilla
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Gilberto Kac
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
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14
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Bzikowska-Jura A, Sobieraj P, Michalska-Kacymirow M, Wesołowska A. Investigation of Iron and Zinc Concentrations in Human Milk in Correlation to Maternal Factors: An Observational Pilot Study in Poland. Nutrients 2021; 13:nu13020303. [PMID: 33494328 PMCID: PMC7912200 DOI: 10.3390/nu13020303] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/18/2021] [Accepted: 01/19/2021] [Indexed: 12/22/2022] Open
Abstract
The aim of this study was to evaluate iron and zinc concentrations in the mature human milk (HM) and to investigate the relationship between these concentrations and maternal factors. HM samples were collected between 4–6 weeks postpartum from 32 healthy, exclusively breastfeeding mothers. The assessment of dietary intake during breastfeeding was based on a food frequency questionnaire and three-day dietary records. Nutritional status of participants was assessed with body mass index and body composition analysis, measured with bioelectrical impedance. HM intake was assessed with infants’ weighting, whereas iron and zinc contents in HM were determined by inductively coupled plasma mass spectrometer. The median intake of HM was 492.5 mL (466–528.5) and the concentrations of HM iron and zinc were 0.33 mg/L (0.26–0.46) and 2.12 mg/L (1.97–2.45), respectively. Maternal total zinc and iron intake (diet + supplementation) was positively correlated with their concentrations in HM. Consumption frequency of meat, vegetables and legumes was revealed to be a significant factor influencing zinc concentration in HM. Regarding iron, it was the consumption frequency of meat, fish and seafood, vegetables and legumes, nuts and seeds. The intake of iron from HM was low, and after assuming a mean fractional iron absorption, it was only 0.038 mg/d. Our results show that maternal diet influences iron and zinc content in HM, suggesting that adequate intake of food rich in investigated minerals may be a positive factor for their concentrations in HM.
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Affiliation(s)
- Agnieszka Bzikowska-Jura
- Department of Clinical Dietetics, Faculty of Health Sciences, Medical University of Warsaw, E Ciolka Str. 27, 01-445 Warsaw, Poland
- Correspondence: ; Tel.: +48-22-572-09-31
| | - Piotr Sobieraj
- Department of Internal Medicine, Hypertension and Vascular Diseases, Faculty of Medicine, Medical University of Warsaw, Banacha Str. 1a, 02-097 Warsaw, Poland;
| | - Magdalena Michalska-Kacymirow
- Faculty of Chemistry, Biological and Chemical Research Centre, University of Warsaw, Żwirki i Wigury Str. 101, 02-089 Warsaw, Poland;
| | - Aleksandra Wesołowska
- Laboratory of Human Milk and Lactation Research, Regional Human Milk Bank in Holy Family Hospital, Faculty of Health Science, Department of Medical Biology, Medical University of Warsaw, Litewska Str. 14/16, 00-575 Warsaw, Poland;
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15
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Leong C, Gibson RS, Diana A, Haszard JJ, Rahmannia S, Ansari MB, Inayah LS, Purnamasari AD, Houghton LA. Differences in Micronutrient Intakes of Exclusive and Partially Breastfed Indonesian Infants from Resource-Poor Households are Not Accompanied by Differences in Micronutrient Status, Morbidity, or Growth. J Nutr 2021; 151:705-715. [PMID: 33438018 PMCID: PMC7948196 DOI: 10.1093/jn/nxaa381] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/25/2020] [Accepted: 11/05/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND When maternal micronutrient intakes and statuses are compromised, reductions in micronutrient concentrations in neonatal stores and human milk may result in suboptimal micronutrient intakes, statuses, and functional outcomes of breastfed infants during the critical first 6-month period. OBJECTIVES We compared the adequacy of micronutrient intakes and statuses at 2 and/or 5 months and morbidity and growth faltering at 2, 5, and 12 months in a cohort of exclusively breastfed (EBF) and partially breastfed (PBF) infants from low-resource Indonesian households. METHODS At 2 and 5 months, the breastfeeding status and human milk intake of 212 infants were determined using the deuterium oxide dose-to-mother technique, and intakes were calculated from milk micronutrient concentrations and 3-d weighed food intakes. At 5 months, five infant micronutrient biomarkers, hemoglobin, C-reactive protein, and α-1-acid-glycoprotein were measured. Infant morbidity, weight, and length were measured at 2, 5, and 12 months. Means, medians, or proportions were reported for each group and differences between groups were statistically determined. RESULTS Median intakes of iron, thiamin, niacin, and vitamin B-12 were higher in PBF than EBF infants at 5 months (all P values < 0.05), but intakes in all infants were below adequate intakes. At 5 months, anemia was <20% in both groups, although fewer PBF versus EBF infants had vitamin B-12 deficiency (11.5% vs. 28.6%, respectively; P = 0.011). The mean ± SD length-for-age z-scores for EBF versus PBF infants at 2 months were 0.7 ± 0.9 versus -0.5 ± 1.1, respectively (P = 0.158), declining to -1.4 ± 0.9 versus -1.1 ± 1.2, respectively, at 12 months (P = 0.059). Reported morbidity rates were generally low, with no evidence of a difference between infant groups (all P values > 0.126). CONCLUSIONS Irrespective of exclusive or partial breastfeeding status, micronutrient intakes of infants were low, statuses were compromised, and growth faltering during the critical 6 months period of early infancy was present. The findings highlight the importance of improving maternal nutritional statuses and evaluating their impacts on infant outcomes.
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Affiliation(s)
- Claudia Leong
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - Rosalind S Gibson
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - Aly Diana
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand,Nutrition Working Group, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Jillian J Haszard
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - Sofa Rahmannia
- Nutrition Working Group, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia,Faculty of Medicine, Universitas Pasundan, Bandung, Indonesia
| | | | - Lina Sofiatul Inayah
- Nutrition Working Group, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Afini Dwi Purnamasari
- Nutrition Working Group, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
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