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Schinkel ER, Nelson ER, Kim JH, Perrin MT, Dyer R, Elango R, Bode L, Dallas DC, Lueangsakulthai J, Briere CE, Taylor SN. Point-of-care human milk concentration by passive osmosis: comprehensive analysis of fresh human milk samples. J Perinatol 2024:10.1038/s41372-024-01988-2. [PMID: 38760580 DOI: 10.1038/s41372-024-01988-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/18/2024] [Accepted: 04/24/2024] [Indexed: 05/19/2024]
Abstract
OBJECTIVE Preterm infants need enrichment of human milk (HM) for optimal growth. This study evaluated a novel, point-of-care human milk concentration (HMC) process for water removal from fresh HM samples by passive osmotic concentration. STUDY DESIGN Nineteen fresh HM samples were concentrated by incubation with the HMC devices for 3 h at 4 °C. Pre- and post-concentration HM samples were compared by HM properties for: pH, osmolality, macronutrients, enzyme activity, bioactive, and total cell viability. RESULTS Passive osmotic concentration reduced HM volume by an average of 16.3% ± 3.8% without a significant effect on pH or cell viability. Ten of the 41 HM components did not differ significantly (p > 0.05) between pre- and post-concentration samples. Twenty-three increased within the expected range by volume reduction. Six increased more than expected, two less than expected, and none decreased significantly. CONCLUSION Passive osmotic concentration of fresh HM can concentrate HM components by selective removal of water. HM osmolality and pH remained within neonatal feeding parameters.
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Affiliation(s)
- Elizabeth R Schinkel
- Mother's Milk is Best Inc., R&D, 100 Business Park Drive, Unit #5, Tyngsboro, MA, 01879, USA.
| | - Elizabeth R Nelson
- Mother's Milk is Best Inc., R&D, 100 Business Park Drive, Unit #5, Tyngsboro, MA, 01879, USA.
| | - Jae H Kim
- Perinatal Institute, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, 45229, USA
| | - Maryanne T Perrin
- Department of Nutrition, University of North Carolina Greensboro, Greensboro, NC, 27412, USA
| | - Roger Dyer
- Analytical Core for Metabolomics and Nutrition, British Columbia Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, V5Z 4H4, Canada
| | - Rajavel Elango
- Analytical Core for Metabolomics and Nutrition, British Columbia Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, V5Z 4H4, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, BC, V6H, 3V4, Canada
| | - Lars Bode
- Bode Lab, Department of Pediatrics, School of Medicine, University of California, San Diego, San Diego, CA, 92093, USA
| | - David C Dallas
- Dallas Lab, Nutrition Program, College of Health, Oregon State University, Corvallis, OR, 97331, USA
| | - Jiraporn Lueangsakulthai
- Dallas Lab, Nutrition Program, College of Health, Oregon State University, Corvallis, OR, 97331, USA
| | - Carrie-Ellen Briere
- Briere Lab, Elaine Marieb College of Nursing, University of Massachusetts Amherst, Amherst, MA, 01003, USA
- Institute for Nursing Research and Evidence-Based Practice, Connecticut Children's, Hartford, CT, 06106, US
| | - Sarah N Taylor
- Division of Neonatology, Yale School of Medicine, New Haven, CT, 06520, USA
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Hochman VGA, Nascimento RCFDA, da Silva CBM, Quinderé PNA, Melo RX, Velarde LGC, Bueno AC, Vieira AA. Relationship Between Maternal Age and Macronutrient Content of Colostrum. J Hum Lact 2024; 40:286-295. [PMID: 38411139 DOI: 10.1177/08903344241233500] [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] [Indexed: 02/28/2024]
Abstract
BACKGROUND Little is known about the relationship between maternal age and the macronutrient content of colostrum. RESEARCH AIMS This study aimed to evaluate the relationship between maternal age and human milk macronutrient content by comparing the concentrations of lactose, proteins, and lipids in the colostrum of women with younger, moderate, and advanced maternal age. METHODS An observational, cross-sectional study was designed to compare the macronutrient concentrations in the colostrum of women aged < 20 years, 20 to 34 years, and > 34 years (younger, moderate, and advanced maternal age, respectively; n = 33 per group). For each participant, 3 ml of colostrum was collected by manual extraction from the right breast at 10 am, 39-48 hr after delivery, and analyzed using a Miris Human Milk Analyzer. Macronutrient concentrations were compared between the groups using analysis of variance. P < 0.05 was considered significant. RESULTS Mothers with moderate maternal age had a higher colostrum lipid concentration than those with younger or advanced maternal age (2.3 mg, SD = 1.4 mg vs. 1.5 mg, SD = 1.0 mg vs. 1.6 mg, SD = 0.9 mg, respectively; p = 0.007). Lactose and protein contents in the analyzed samples did not differ among the three study groups. CONCLUSION This study lends support to the potential variation of lipids in colostrum by maternal age and suggests individual adaptation to the nutritional components of milk to the needs of the infant may be beneficial.
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Affiliation(s)
| | | | | | | | - Raquel Ximenes Melo
- National Institute for Women's, Children's and Adolescent's Health Fernandes Figueira/ FIOCRUZ, Rio de Janeiro, Brazil
| | | | - Arnaldo Costa Bueno
- Faculty of Medicine, Maternal and Child Department, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Alan Araújo Vieira
- Faculty of Medicine, Maternal and Child Department, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
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Abidin SW, Citrakesumasari C, Bahar B, Jafar N, Hidayanti H, Hadju V. The effect of extra virgin olive oil (EVOO) on fat mass and fat-free mass for breastfeeding mothers (0-24 months) in Makassar City, Indonesia. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 13:127. [PMID: 38784279 PMCID: PMC11114483 DOI: 10.4103/jehp.jehp_907_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 10/19/2023] [Indexed: 05/25/2024]
Abstract
BACKGROUND Extra Virgin Olive Oil (EVOO) is a fat source classified as monounsaturated fatty acid. Previous studies have shown that 47.5% of breastfeeding mothers have less fat intake when compared to the Adequacy of Nutrition Rate (RDA). EVOO consumption can improve the composition of breast milk. However, no research has been found regarding the body composition of breastfeeding mothers after consuming EVOO. This study aims to determine the effect of EVOO on the body composition of breastfeeding mothers 0-24 months. MATERIALS AND METHODS The study was conducted at the Sudiang Raya and Tamalanrea Health Centers in Makassar City with a randomized clinical trial design from January to February 2023. The sample was breastfeeding mothers 0-24 months divided into the intervention group (EVOO and Nutrition Education, n = 17) and the control (Nutrition Education, n = 17). Instruments with Bioelectrical Impedence Analysis tools. Data analysis using t-test. RESULTS The sample is breastfeeding mothers aged between ≤19 and >35 years. The results of the analysis showed that the average pre-post test, % fat mass (FM) P = 0.426 and % fat free mass (FFM) P = 0.508 (P > 0.05), meant that there was no significant difference. Between the two groups there was no significant difference at the end of the study, %FM P = 0.469 and %FFM P = 0.529 (P > 0.05). CONCLUSIONS In the intervention group that was given EVOO, it was possible to maintain%FM and%FFM in the normal percentage range, while in the control group, there was a decrease from the normal to less/low range.
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Affiliation(s)
- Sri W. Abidin
- Master Program in Nutritional Sciences, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
| | | | - Burhanuddin Bahar
- Department of Nutrition, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
| | - Nurhaedar Jafar
- Department of Nutrition, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
| | - Healthy Hidayanti
- Department of Nutrition, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
| | - Veni Hadju
- Department of Nutrition, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
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van der Louw E, Trimmel-Schwahofer P, Devlin A, Armeno M, Thompson L, Cross JH, Auvin S, Dressler A. Human milk and breastfeeding during ketogenic diet therapy in infants with epilepsy: Clinical practice guideline. Dev Med Child Neurol 2024. [PMID: 38669468 DOI: 10.1111/dmcn.15928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/08/2024] [Accepted: 03/12/2024] [Indexed: 04/28/2024]
Abstract
Ketogenic diet therapy (KDT) is a safe and effective treatment for epilepsy and glucose transporter type 1 (GLUT1) deficiency syndrome in infancy. Complete weaning from breastfeeding is not required to implement KDT; however, breastfeeding remains uncommon. Barriers include feasibility concerns and lack of referrals to expert centres. Therefore, practical strategies are needed to help mothers and professionals overcome these barriers and facilitate the inclusion of breastfeeding and human milk during KDT. A multidisciplinary expert panel met online to address clinical concerns, systematically reviewed the literature, and conducted two international surveys to develop an expert consensus of practical recommendations for including human milk and breastfeeding in KDT. The need to educate about the nutritional benefits of human milk and to increase breastfeeding rates is emphasized. Prospective real-world registries could help to collect data on the implementation of breastfeeding and the use of human milk in KDT, while systematically including non-seizure-related outcomes, such as quality of life, and social and emotional well-being, which could improve outcomes for infants and mothers.
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Affiliation(s)
- Elles van der Louw
- Department of Internal Medicine, Division of Dietetics, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Petra Trimmel-Schwahofer
- Department of Pediatrics and Adolescent Medicine, Medical University Vienna, Vienna, Austria
- European Reference Network, EpiCARE
| | - Anita Devlin
- Paediatric Neurology, Great North Children's Hospital, Newcastle upon Tyne, UK
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Marisa Armeno
- Department of Nutrition, Hospital de Pediatria Prof. Dr. J.P. Garrahan, Buenos Aires, Argentina
| | - Lindsey Thompson
- Children's Mercy Hospital and Clinics, Kansas City, Missouri, USA
| | - J Helen Cross
- UCL NIHR BRC Great Ormond Street Institute of Child Health, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - Stéphane Auvin
- European Reference Network, EpiCARE
- APHP, Service de Neurologie Pédiatrique, Hôpital Robert Debré, Paris, France
- Université Paris-Cité, INSERM Neuro Diderot, Paris, France
- Institut Universitaire de France (IUF), Paris, France
| | - Anastasia Dressler
- Department of Pediatrics and Adolescent Medicine, Medical University Vienna, Vienna, Austria
- European Reference Network, EpiCARE
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Asiodu IV, Gay CL, Gates-Burgess B, Negrete G. Access to and interest in human milk research opportunities among Black pregnant and postpartum people. Front Nutr 2024; 11:1274833. [PMID: 38680532 PMCID: PMC11048474 DOI: 10.3389/fnut.2024.1274833] [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: 08/09/2023] [Accepted: 03/12/2024] [Indexed: 05/01/2024] Open
Abstract
Background Concerns exist regarding biomedical research participation in marginalized and historically disadvantaged communities. Objectives The purpose of this study was to understand critical barriers to participation in human milk research from the perspective of Black pregnant and postpartum people. Methods A national sample of Black pregnant and postpartum people (n = 104) was recruited to complete a cross-sectional online survey informed by the Life Course Perspective. Survey questions assessed research experiences and preferences, particularly related to human milk research, knowledge of historical events/policies targeting Black communities, and demographic characteristics. A socio-economic composite score was calculated as an indicator of socio-economic advantage. Survey data were summarized descriptively and potential correlates of research engagement were evaluated. Results Most (69%, n = 71) respondents reported previous participation in a research study, yet only 8 (8%) reported ever being asked to participate in a breastfeeding/chestfeeding or human milk study, and one respondent was unsure. Despite so few having been asked, 59% (n = 61) of respondents indicated they would donate breast/human milk to research if asked. Respondent characteristics associated with prior research participation included having greater socio-economic advantage (p = 0.027) and greater knowledge of discriminatory historical events/policies (p < 0.001). In contrast, the only respondent characteristic associated with willingness to donate human milk to research was younger age (p = 0.002). Conclusion Our findings suggest that Black pregnant and postpartum people are interested in biomedical research, specifically human milk and lactation research. However, greater intentionality and targeted recruitment of this underrepresented population is needed to increase diversity among human milk and lactation study samples. Structural and community-based interventions, informed by community members, are needed to address concerns and improve participant engagement.
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Affiliation(s)
- Ifeyinwa V. Asiodu
- Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, San Francisco, CA, United States
| | - Caryl L. Gay
- Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, San Francisco, CA, United States
| | | | - Gabriela Negrete
- Department of Human Ecology, Human Development & Family Studies, College of Agricultural and Environmental Sciences, University of California, Davis, Davis, CA, United States
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Neri D, Martínez Steele E, Rauber F, Santos Costa CD, D'Aquino Benicio MH, Bertazzi Levy R. Infants' Dietary Pattern Characterized by Ultraprocessed Foods Is Associated With Rapid Weight Gain and Overweight/Obesity Risk: National Health and Nutrition Examination Survey 2009-2018. J Acad Nutr Diet 2024:S2212-2672(24)00053-4. [PMID: 38331189 DOI: 10.1016/j.jand.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 01/28/2024] [Accepted: 02/01/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Global trends toward childhood obesity have been associated with several factors, including suboptimal infant feeding practices, the increasing availability of ultraprocessed foods in the world's food supply, and the corresponding changes in children's dietary patterns. OBJECTIVE To describe infants' dietary patterns and assess their associations with weight status outcomes in a nationally representative sample of US infants. DESIGN Cross-sectional analyses were performed on data collected from infants participating in the 2009-2018 National Health and Nutrition Examination Survey. PARTICIPANTS/SETTING Participants included 744 infants aged 6 to 12 months who had data from at least 1 day of valid 24-hour dietary recall data. MAIN OUTCOME MEASURES Rapid weight gain and overweight/obesity risk. STATISTICAL ANALYSES PERFORMED Principal component analysis was used to identify dietary patterns considering the energy intake of 39 Nova food subgroups (expressed in calories per day), including breast milk. Associations were evaluated using logistic regression adjusted for potential confounders. RESULTS A total of 42% infants experienced rapid weight gain, and 33% were at risk of overweight/obesity. Most infants (65.5%) were started on solid foods early. Three main dietary patterns were derived. The first pattern, labeled Natural or Minimally Processed Foods, had positive loadings for a variety of natural or minimally processed foods, some processed culinary ingredients, and a few processed and ultraprocessed foods. The second pattern, labeled Infant Formula, had high negative loading for breast milk, and high positive loading for infant formula and breakfast cereal. The third pattern, labeled Ultraprocessed Foods, had negative loadings for natural or minimally processed foods and processed culinary ingredients, positive loadings for other processed foods and for a variety of ultraprocessed foods, and negative loading for infant formula. Infants who adhere to the Ultraprocessed Foods dietary pattern were more likely to present rapid weight gain (adjusted odds ratio 1.3, 95% CI 1.1 to 1.5) and overweight/obesity risk (adjusted odds ratio 1.2, 95% CI 1.0 to 1.4). CONCLUSIONS Higher adherence to a dietary pattern characterized by ultraprocessed foods was associated with a greater likelihood of both rapid weight gain and overweight/obesity risk early in life. Promoting breastfeeding and increasing consumption of unprocessed/minimally processed foods during early infancy while restricting ultraprocessed foods are key components to reducing the growing burden of childhood obesity.
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Affiliation(s)
- Daniela Neri
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil; Center for Epidemiological Research in Nutrition and Health, School of Public Health, University of São Paulo, São Paulo, Brazil.
| | - Eurídice Martínez Steele
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil; Center for Epidemiological Research in Nutrition and Health, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Fernanda Rauber
- Center for Epidemiological Research in Nutrition and Health, School of Public Health, University of São Paulo, São Paulo, Brazil; Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Caroline Dos Santos Costa
- Center for Epidemiological Research in Nutrition and Health, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Maria Helena D'Aquino Benicio
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil; Center for Epidemiological Research in Nutrition and Health, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Renata Bertazzi Levy
- Center for Epidemiological Research in Nutrition and Health, School of Public Health, University of São Paulo, São Paulo, Brazil; Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
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7
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Brockway MM, Daniel AI, Reyes SM, Granger M, McDermid JM, Chan D, Refvik R, Sidhu KK, Musse S, Patel PP, Monnin C, Lotoski L, Geddes D, Jehan F, Kolsteren P, Allen LH, Hampel D, Eriksen KG, Rodriguez N, Azad MB. Human Milk Macronutrients and Child Growth and Body Composition in the First Two Years: A Systematic Review. Adv Nutr 2024; 15:100149. [PMID: 37981047 PMCID: PMC10831902 DOI: 10.1016/j.advnut.2023.100149] [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: 02/17/2023] [Revised: 10/16/2023] [Accepted: 11/14/2023] [Indexed: 11/21/2023] Open
Abstract
Among exclusively breastfed infants, human milk (HM) provides complete nutrition in the first mo of life and remains an important energy source as long as breastfeeding continues. Consisting of digestible carbohydrates, proteins, and amino acids, as well as fats and fatty acids, macronutrients in human milk have been well studied; however, many aspects related to their relationship to growth in early life are still not well understood. We systematically searched Medline, EMBASE, the Cochrane Library, Scopus, and Web of Science to synthesize evidence published between 1980 and 2022 on HM components and anthropometry through 2 y of age among term-born healthy infants. From 9992 abstracts screened, 57 articles reporting observations from 5979 dyads were included and categorized based on their reporting of HM macronutrients and infant growth. There was substantial heterogeneity in anthropometric outcome measurement, milk collection timelines, and HM sampling strategies; thus, meta-analysis was not possible. In general, digestible carbohydrates were positively associated with infant weight outcomes. Protein was positively associated with infant length, but no associations were reported for infant weight. Finally, HM fat was not consistently associated with any infant growth metrics, though various associations were reported in single studies. Fatty acid intakes were generally positively associated with head circumference, except for docosahexaenoic acid. Our synthesis of the literature was limited by differences in milk collection strategies, heterogeneity in anthropometric outcomes and analytical methodologies, and by insufficient reporting of results. Moving forward, HM researchers should accurately record and account for breastfeeding exclusivity, use consistent sampling protocols that account for the temporal variation in HM macronutrients, and use reliable, sensitive, and accurate techniques for HM macronutrient analysis.
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Affiliation(s)
- Meredith Merilee Brockway
- Manitoba Interdisciplinary Lactation Centre (MILC), Children's Hospital Research Institute of Manitoba, University of Manitoba, Canada; Department of Pediatrics and Child Health, University of Manitoba, Canada; Faculty of Nursing, University of Calgary, Canada
| | - Allison I Daniel
- Centre for Global Child Health, Hospital for Sick Children, Canada; Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Canada
| | - Sarah M Reyes
- Manitoba Interdisciplinary Lactation Centre (MILC), Children's Hospital Research Institute of Manitoba, University of Manitoba, Canada
| | - Matthew Granger
- Department of Food and Human Nutritional Sciences, University of Manitoba, Canada
| | | | - Deborah Chan
- Department of Pediatrics and Child Health, University of Manitoba, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Canada
| | - Rebecca Refvik
- Department of Food and Human Nutritional Sciences, University of Manitoba, Canada
| | - Karanbir K Sidhu
- Department of Food and Human Nutritional Sciences, University of Manitoba, Canada
| | - Suad Musse
- Department of Food and Human Nutritional Sciences, University of Manitoba, Canada
| | - Pooja P Patel
- Department of Public Health and Community Medicine, Tufts University School of Medicine, USA
| | - Caroline Monnin
- Neil John Maclean Health Sciences Library, University of Manitoba, Canada
| | - Larisa Lotoski
- Department of Pediatrics and Child Health, University of Manitoba, Canada
| | - Donna Geddes
- School of Molecular Sciences, The University of Western Australia, Australia
| | - Fyezah Jehan
- Department of Pediatrics, Aga Khan University, Pakistan
| | - Patrick Kolsteren
- Department of Food Safety and Food Quality, Ghent University, Belgium
| | - Lindsay H Allen
- Western Human Nutrition Research Center, Agriculture Research Service, United States Department of Agriculture, USA; Department of Nutrition, University of California, Davis, USA
| | - Daniela Hampel
- Western Human Nutrition Research Center, Agriculture Research Service, United States Department of Agriculture, USA; Department of Nutrition, University of California, Davis, USA
| | - Kamilla G Eriksen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark
| | - Natalie Rodriguez
- Manitoba Interdisciplinary Lactation Centre (MILC), Children's Hospital Research Institute of Manitoba, University of Manitoba, Canada; Department of Pediatrics and Child Health, University of Manitoba, Canada
| | - Meghan B Azad
- Manitoba Interdisciplinary Lactation Centre (MILC), Children's Hospital Research Institute of Manitoba, University of Manitoba, Canada; Department of Pediatrics and Child Health, University of Manitoba, Canada.
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8
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Casavale KO, Anderson-Villaluz D, Ahuja JK, Chakrabarti S, Gibbs K, Hopperton K, Parnel S, Pehrsson PR, Stanton M, Vargas AJ. Perspective: The Human Milk Composition Initiative - Filling Crucial Gaps in Data on and Related to Human Milk in the United States and Canada. Adv Nutr 2023; 14:1253-1254. [PMID: 37499981 PMCID: PMC10721460 DOI: 10.1016/j.advnut.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 07/20/2023] [Indexed: 07/29/2023] Open
Affiliation(s)
- Kellie O Casavale
- Center for Food Safety and Applied Nutrition, Food and Drug Administration, United States Department of Health and Human Services, College Park, MD, United States
| | - Dennis Anderson-Villaluz
- Office of Disease Prevention and Health Promotion, Office of the Assistant Secretary for Health, United States Department of Health and Human Services, Rockville, MD, United States
| | - Jaspreet K Ahuja
- Methods and Application of Food Composition Laboratory, Beltsville Human Nutrition Research Center, Agricultural Research Services, United States Department of Agriculture, Beltsville, MD, United States
| | - Subhadeep Chakrabarti
- Nutrition Premarket Assessment Division, Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Kimberlea Gibbs
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, United States
| | - Kathryn Hopperton
- Nutrition Premarket Assessment Division, Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Sophie Parnel
- Nutrition Premarket Assessment Division, Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Pamela R Pehrsson
- Methods and Application of Food Composition Laboratory, Beltsville Human Nutrition Research Center, Agricultural Research Services, United States Department of Agriculture, Beltsville, MD, United States
| | - Melanie Stanton
- Nutrition Premarket Assessment Division, Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Ashley J Vargas
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, United States.
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9
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Mohr AE, Senkus KE, McDermid JM, Berger PK, Perrin MT, Handu D. Human Milk Nutrient Composition Data is Critically Lacking in the United States and Canada: Results from a Systematic Scoping Review of 2017-2022. Adv Nutr 2023; 14:1617-1632. [PMID: 37758059 PMCID: PMC10721511 DOI: 10.1016/j.advnut.2023.09.007] [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: 04/18/2023] [Revised: 09/14/2023] [Accepted: 09/19/2023] [Indexed: 10/03/2023] Open
Abstract
Characterization of the nutrients in human milk is important to understand the dietary and developmental requirements of infants. The objective of this review was to summarize the state-of-the-science on the nutrient composition of human milk in the United States and Canada published from 2017 to 2022. Four databases were searched for randomized controlled studies and others given the scoping nature of this review. We limited type to mature milk collected 21 d postpartum and beyond from lactating individuals in the United States and Canada who gave birth at 37-wk gestation or later (full-term). Outcomes of interest included traditional macro- and micronutrients, including human milk oligosaccharides (HMOs), and milk volume. The publication date range was selected as January 1, 2017, to the day the literature search was performed. A total of 32 articles were included in the scoping review from primarily longitudinal cohort or cross-sectional designs. The most prevalent sample collection method was full-breast expression (n = 20) with most studies (n = 26) collecting samples from a single timepoint. Carbohydrates (HMOs [n = 12], glucose [n = 8], and lactose [n = 6]) and protein (n = 5) were the most frequently assessed nutrients in this body of work, with consensus among studies that glucose is present in limited concentrations compared to lactose (24-64 mg/dL compared with 6-7 g/dL) and that HMOs are influenced by temporality and secretor status. Included studies displayed an overall level of heterogeneity and sparsity paralleling previous reports and nutrient data in the USDA FoodData Central system. Much of the data extracted from retained articles generally provided analysis of a specific nutrient or group of nutrients. Moreover, many studies did not use the preferred analytical methods as outlined by the Human Milk Composition Initiative to increase measurement confidence. Up-to-date nutrient composition data of human milk is still greatly needed as it is paramount for the management of infant feeding, assessment of infant and maternal nutritional and health needs, and as a reference for infant formula development.
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Affiliation(s)
- Alex E Mohr
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States
| | - Katelyn E Senkus
- Department of Human Nutrition, The University of Alabama, Tuscaloosa, AL, United States
| | | | - Paige K Berger
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, MA, United States
| | - Maryanne T Perrin
- Department of Nutrition, University of North Carolina Greensboro, Greensboro, NC, United States
| | - Deepa Handu
- Evidence Analysis Center, Academy of Nutrition and Dietetics, Chicago, IL, United States.
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10
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Vass RA, Mikó É, Gál C, Kőszegi T, Vass CI, Bokor S, Molnár D, Funke S, Kovács K, Bódis J, Ertl T. The Effect of Holder Pasteurization and Different Variants on Breast Milk Antioxidants. Antioxidants (Basel) 2023; 12:1857. [PMID: 37891936 PMCID: PMC10604438 DOI: 10.3390/antiox12101857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/28/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND After birth, breast milk (BM) is a known essential source of antioxidants for infants. We analyzed the non-enzymatic total antioxidant capacity (TAC), oxygen radical absorbance capacity (ORAC), and glutathione, calcium, transferrin, and total protein levels of human breast milk before and after Holder pasteurization (HoP). METHODS The collected donor BM samples were pasteurized with HoP. RESULTS HoP decreased TAC (-12.6%), ORAC (-12.1%), transferrin (-98.3%), and total protein (-21.4%) levels; HoP did not influence the glutathione concentration, and it increased the total calcium (+25.5%) concentration. Mothers who gave birth via Cesarean section had significantly lower TAC in their BM. TAC and glutathione levels were elevated in the BM of mothers over the age of 30. BM produced in the summer had higher glutathione and calcium levels compared to BM produced in the winter. The glutathione concentration in term milk samples was significantly higher in the first two months of lactation compared to the period between the third and sixth months. The transferrin level of BM for female infants was significantly higher than the BM for boys, and mothers with a BMI above 30 had increased transferrin in their samples. CONCLUSIONS Antioxidant levels in human milk are influenced by numerous factors. Environmental and maternal factors, the postpartum age at breast milk collection, and Holder pasteurization of the milk influence the antioxidant intake of the infant.
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Affiliation(s)
- Réka Anna Vass
- Department of Obstetrics and Gynecology, Medical School University of Pécs, 7624 Pécs, Hungary
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
- Obstetrics and Gynecology, Magyar Imre Hospital, 8400 Ajka, Hungary
| | - Éva Mikó
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
- Department of Microbiology, Medical School University of Pécs, 7624 Pécs, Hungary
| | - Csenge Gál
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
| | - Tamás Kőszegi
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
- Department of Laboratory Medicine, Medical School University of Pécs, 7624 Pécs, Hungary
| | - Csaba I Vass
- Obstetrics and Gynecology, Magyar Imre Hospital, 8400 Ajka, Hungary
| | - Szilvia Bokor
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
- Department of Pediatrics, Medical School University of Pécs, 7624 Pécs, Hungary
| | - Dénes Molnár
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
- Department of Pediatrics, Medical School University of Pécs, 7624 Pécs, Hungary
| | - Simone Funke
- Department of Obstetrics and Gynecology, Medical School University of Pécs, 7624 Pécs, Hungary
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
| | - Kálmán Kovács
- Department of Obstetrics and Gynecology, Medical School University of Pécs, 7624 Pécs, Hungary
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
| | - József Bódis
- Department of Obstetrics and Gynecology, Medical School University of Pécs, 7624 Pécs, Hungary
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
- HUN-REN-PTE Human Reproduction Research Group, 7624 Pécs, Hungary
| | - Tibor Ertl
- Department of Obstetrics and Gynecology, Medical School University of Pécs, 7624 Pécs, Hungary
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
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11
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Peña‐Ruiz LS, Unar‐Munguía M, Colchero MA, Alarid‐Escudero F, Pérez‐Escamilla R. Breastfeeding is associated with the intelligence of school-age children in Mexico. MATERNAL & CHILD NUTRITION 2023; 19:e13534. [PMID: 37218453 PMCID: PMC10483941 DOI: 10.1111/mcn.13534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 04/28/2023] [Accepted: 05/05/2023] [Indexed: 05/24/2023]
Abstract
Breastfeeding has been consistently associated with higher intelligence since childhood. However, this relation could be confounded due to maternal selection bias. We estimated the association between predominant breastfeeding and intelligence in school-age children considering potential selection bias and we simulated the intelligence gap reduction between low versus higher socioeconomic status children by increasing breastfeeding. We analysed predominant breastfeeding practices (breastmilk and water-based liquids) of children 0-3 years included in the Mexican Family Life Survey (MxFLS-1). Intelligence was estimated as the z-score of the abbreviated Raven score, measured at 6-12 years in the MxFLS-2 or MxFLS-3. We predicted breastfeeding duration among children with censored data with a Poisson model. We used the Heckman selection model to assess the association between breastfeeding and intelligence, correcting for selection bias and stratified by socioeconomic status. Results show after controlling for selection bias, a 1-month increase in predominant breastfeeding duration was associated with a 0.02 SD increase in the Raven z-score (p < 0.05). The children who were predominantly breastfed for 4-6 months versus <1 month had 0.16 SD higher Raven z-score (p < 0.05). No associations were found using multiple linear regression models. Among low socioeconomic status children, increasing predominantly breastfeeding duration to 6 months would increase their mean Raven z-score from -0.14 to -0.07 SD and reduce by 12.5% the intelligence gap with high socioeconomic status children. In conclusion, predominant breastfeeding duration was significantly associated with childhood intelligence after controlling for maternal selection bias. Increased breastfeeding duration may reduce poverty-driven intelligence inequities.
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Affiliation(s)
- Lidia Sarahi Peña‐Ruiz
- Department of Maternal, Child and Adolescent Nutrition, Center for Research on Health and NutritionNational Institute of Public HealthCuernavacaMorelosMexico
| | - Mishel Unar‐Munguía
- Department of Maternal, Child and Adolescent Nutrition, Center for Research on Health and NutritionNational Institute of Public HealthCuernavacaMorelosMexico
| | - Mónica Arantxa Colchero
- Department of Health Economics, Center for Research on Health SystemsNational Institute of Public HealthCuernavacaMorelosMexico
| | - Fernando Alarid‐Escudero
- Department of Health Policy, School of MedicineStanford UniversityCAUS
- Center for Health PolicyFreeman Spogli Institute, Stanford UniversityCAUS
| | - Rafael Pérez‐Escamilla
- Department of Social and Behavioral ScienceYale School of Public Health, Yale UniversityNew HavenConnecticutUSA
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12
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Herrick KA, Lerman JL, Pannucci TE, Zimmer M, Shams-White MM, Mathieu KM, Stoody EE, Reedy J. Continuity, Considerations, and Future Directions for the Healthy Eating Index-Toddlers-2020. J Acad Nutr Diet 2023; 123:1298-1306. [PMID: 37209963 PMCID: PMC10765420 DOI: 10.1016/j.jand.2023.05.012] [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: 07/01/2022] [Revised: 04/20/2023] [Accepted: 05/09/2023] [Indexed: 05/22/2023]
Abstract
The Dietary Guidelines for Americans, 2020-2025 includes guidance for infants and toddlers aged birth to 24 months. To assess alignment with this new guidance, the Healthy Eating Index (HEI)-Toddlers-2020 was developed for toddlers 12 through 23 months old. This monograph focuses on the continuity, considerations, and future directions of this new index for toddlers in the context of evolving dietary guidance. There is considerable continuity between the HEI-Toddlers-2020 and previous versions of the HEI. The same process, guiding principles, and features (with caveats) are repeated in the new index. However, there are unique considerations for measurement, analysis, and interpretation for the HEI-Toddlers-2020 that this article addresses, while identifying future directions for the HEI-Toddlers-2020. The continued evolution of dietary guidance for infants, toddlers, and young children will provide additional opportunities for index-based metrics: considering inclusion of multidimensional layers in dietary patterns, defining a healthy eating trajectory, bridging healthy eating across different life stages, and communicating the constructs of balance among dietary constituents.
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Affiliation(s)
- Kirsten A Herrick
- U.S. Department of Health and Human Services, National Cancer Institute, Bethesda, MD.
| | - Jennifer L Lerman
- U.S. Department of Health and Human Services, National Cancer Institute, Bethesda, MD
| | - TusaRebecca E Pannucci
- Nutrition and Economics Analysis Branch, US Department of Agriculture, Food and Nutrition Service, Alexandria, VA
| | - Meghan Zimmer
- U.S. Department of Health and Human Services, National Cancer Institute, Bethesda, MD
| | - Marissa M Shams-White
- U.S. Department of Health and Human Services, National Cancer Institute, Bethesda, MD
| | - Kevin Meyers Mathieu
- Nutrition and Economics Analysis Branch, US Department of Agriculture, Food and Nutrition Service, Alexandria, VA
| | - Eve E Stoody
- Nutrition Guidance and Analysis Division, US Department of Agriculture, Food and Nutrition Service, Alexandria, VA
| | - Jill Reedy
- U.S. Department of Health and Human Services, National Cancer Institute, Bethesda, MD
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13
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McCune S, Khwajazada S, Yerabandi N, Bode L, Belfort M, Todd D, Perrin MT. The Influence of Oligosaccharides when Measuring Lactose and Total Carbohydrates in Human Milk and Comparison of Methods. J Nutr 2023; 153:2117-2124. [PMID: 37149285 PMCID: PMC10375504 DOI: 10.1016/j.tjnut.2023.05.004] [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: 02/21/2023] [Revised: 04/11/2023] [Accepted: 05/02/2023] [Indexed: 05/08/2023] Open
Abstract
BACKGROUND Understanding how human milk impacts growth requires valid analytical methods for quantifying the composition. Lactose, the most abundant constituent in human milk and a predominant source of energy, is often assessed using methods borrowed from the bovine dairy industry. However, the carbohydrate matrices of bovine and human milk are quite different, especially as they relate to human milk oligosaccharides (HMOs), each with a terminal lactose unit that may influence analytical methods. OBJECTIVES Our goals were to determine the extent to which HMOs influence common analytical methods for measuring carbohydrates in human milk and to compare common methods for measuring lactose. METHODS Two sets of experiments were performed. In the first set, native and HMO-spiked human milk samples (n = 16 each) were assessed and compared using 4 methods: AOAC 2006.06 (based on the Megazyme enzymatic assay), BioVision enzymatic assay, ultraperformance LC with MS, and infrared analysis. In the second set, human milk samples (n = 20) were assessed using 2 methods approved for measuring lactose in bovine milk: AOAC 984.22 that uses high-performance LC and refractive index detection and AOAC 2006.06 prepared using both volume and weighted dilutions. RESULTS Native and HMO-spiked samples were not significantly different in lactose using AOAC 2006.06 and ultraperformance LC with MS but were significantly different using BioVision (mean difference = 0.2 g/dL; 95% CI: 0.1, 0.4; P = 0.005). Total carbohydrate measurements assessed using infrared were also higher after HMO spiking (mean difference = 0.4 g/dL; 95% CI: 0.3, 0.6; P < 0.001). Only AOAC methods 984.22 and 2006.06 for measuring lactose were very highly correlated (r > 0.90, P < 0.001). CONCLUSIONS AOAC methods 984.22 and 2006.06 are comparable for measuring lactose in human milk and are not influenced by HMOs. HMOs influence other enzymatic methods as well as infrared analysis, which leads to an overestimate of energy values. J Nutr 2023;x:xx.
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Affiliation(s)
- Sydney McCune
- Department of Nutrition, University of North Carolina Greensboro, Greensboro, NC, United States
| | - Sadaf Khwajazada
- Department of Pediatrics, University of California, San Diego, La Jolla, CA, United States; Mother-Milk-Infant Center of Research Excellence, University of California, San Diego, La Jolla, CA, United States
| | - Nikhila Yerabandi
- Department of Pediatrics, University of California, San Diego, La Jolla, CA, United States; Mother-Milk-Infant Center of Research Excellence, University of California, San Diego, La Jolla, CA, United States
| | - Lars Bode
- Department of Pediatrics, University of California, San Diego, La Jolla, CA, United States; Mother-Milk-Infant Center of Research Excellence, University of California, San Diego, La Jolla, CA, United States
| | - Mandy Belfort
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Daniel Todd
- Department of Chemistry, University of North Carolina Greensboro, Greensboro, NC, United States
| | - Maryanne T Perrin
- Department of Nutrition, University of North Carolina Greensboro, Greensboro, NC, United States.
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14
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Rios-Leyvraz M, Yao Q. Calcium, zinc, and vitamin D in breast milk: a systematic review and meta-analysis. Int Breastfeed J 2023; 18:27. [PMID: 37264448 PMCID: PMC10233556 DOI: 10.1186/s13006-023-00564-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 05/20/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Global estimates of calcium, zinc and vitamin D content in breastmilk are lacking. The objective of this systematic review was to determine the calcium, zinc, and vitamin D content in breast milk. METHODS A systematic search of the online databases Embase, MEDLINE, and CENTRAL was conducted in November 2022 and complemented by searches of the African Journals Online database and the LILACS database, and reference lists. Studies reporting the calcium, zinc and vitamin D content in breast milk of apparently healthy mothers and infants were included. Random effects meta-analyses were conducted. The effect of influencing factors were investigated with sub-group analyses and meta-regressions. RESULTS A total of 154 studies reporting on breast milk calcium were identified, with a mean calcium concentration in breast milk of 261 mg/L (95% CI: 238, 284). Calcium concentration was influenced by maternal health and decreased linearly over the duration of lactation. Calcium concentration at a specific time during lactation could be estimated with the equation: calcium concentration [mg/L] = 282 - 0.2331 ✕ number of days since birth. A total of 242 studies reporting on breast milk zinc were identified, with a mean zinc concentration of 2.57 mg/L (95% CI: 2.50, 2.65). Zinc concentration was influenced by several factors, such as maternal age, gestational age, and maternal diet. Zinc concentration started high in the first weeks post-partum followed by a rapid decrease over the first months. Zinc concentration at a specific time during lactation could be estimated with the equation: zinc concentration [mg/L] = 6 + 0.0005 ✕ days - 2.0266 ✕ log(days). A total of 43 studies reporting on breast milk vitamin D were identified, with a mean total antirachitic activity of breast milk of 58 IU/L (95% CI: 45, 70), which consisted mostly of 25OHD3, and smaller amounts of vitamin D3, 25OHD2 and vitamin D2. Vitamin D concentration showed wide variations between studies and was influenced by vitamin D supplementation, continent and season. CONCLUSIONS This review provides global estimates of calcium, zinc and vitamin D content in breast milk, as well as indications on changes over time and depending on influencing factors.
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Affiliation(s)
- Magali Rios-Leyvraz
- Consultant, Department of Nutrition and Food Safety, World Health Organization, Geneva, Switzerland
| | - Qisi Yao
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, USA
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15
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Daniels F, Sawangkum A, Kumar A, Coombs K, Louis-Jacques A, Ho TT. Skin to Skin Contact Correlated with Improved Production and Consumption of Mother's Own Milk. Breastfeed Med 2023; 18:483-488. [PMID: 37335327 PMCID: PMC10282785 DOI: 10.1089/bfm.2022.0297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
Background: Human milk diet, preferably mother's own milk (MOM) over donor milk (DM), is recommended for preterm infants. Expression of MOM in proximity to preterm infants, especially during or immediately after skin-to-skin contact (SSC), is associated with greater milk production. However, the correlation between SSC and MOM production during hospital admission in preterm infants has not yet been studied. Our study investigated the relationship between SSC and MOM production and consumption in preterm infants during the first postnatal month of life. Materials and Methods: This was a prospective cohort study. Mothers and their preterm infants born at <35 weeks by gestational age (GA) and eligible for SSC within the first 5 postnatal days were eligible for the study. Mothers were given a binder to document pumped breast milk volumes and SSC sessions. Pumped breast milk volumes, enteral feeding type and volume, and SSC duration and frequency were collected daily over the first 28 days of life, along with demographic, perinatal, and feeding data from electronic medical records (EMR). Results: Mean birth GA and weight were 30 ± 3 weeks and 1,443 ± 576 g, respectively. SSC duration was inversely correlated with GA and weight. The SSC duration was positively correlated with ingested MOM volume after correcting for birth GA. The SSC duration was predictive of increased volumes of pumped MOM. Conclusion: Our findings suggest that SSC duration is associated with improved MOM production and consumption. SSC can be a useful tool to increase MOM exposure and improve long-term health outcomes in preterm infants.
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Affiliation(s)
- Felicia Daniels
- Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Amornrat Sawangkum
- Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Ambuj Kumar
- Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Kelsey Coombs
- Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Adetola Louis-Jacques
- Department of Obstetrics and Gynecology, University of Florida, Gainesville, Florida, USA
| | - Thao T.B. Ho
- Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
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16
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Tanaka M, Date M, Miura K, Ito M, Mizuno N, Mizuno K. Protein and Immune Component Content of Donor Human Milk in Japan: Variation with Gestational and Postpartum Age. Nutrients 2023; 15:nu15102278. [PMID: 37242161 DOI: 10.3390/nu15102278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/02/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023] Open
Abstract
Donor human milk (DHM) is the second-best nutrition for preterm infants when their own mother's milk is unavailable. The nutrient content of human milk is influenced by various factors, including gestational and postpartum age, but there are no data regarding DHM composition in Japan. The aim of this study was to determine the protein and immune component content of DHM in Japan and to elucidate the effects of gestational and postpartum age on nutrient composition. From September 2021 to May 2022, 134 DHM samples were collected from 92 mothers of preterm and term infants. Protein concentrations in preterm DHM (n = 41) and term DHM (n = 93) were analyzed using a Miris Human Milk Analyzer. The concentrations of secretory immunoglobulin A (sIgA) and lactoferrin, major immune components, were measured using enzyme-linked immunosorbent assays. Preterm DHM exhibited higher protein content than term DHM (1.2 g/dL and 1.0 g/dL, respectively, p < 0.001), whereas sIgA content was higher in term DHM than in preterm DHM (110 μg/mL and 68.4 μg/mL, respectively, p < 0.001). Gestational age was negatively correlated with protein levels and positively correlated with sIgA and lactoferrin levels. Furthermore, a negative correlation was found between postpartum week and protein, sIgA, and lactoferrin concentrations. Our data suggest that gestational and postpartum age affects protein, sIgA, and lactoferrin concentrations in DHM. These results indicate the importance of nutritional analysis for the appropriate use of DHM in preterm infants.
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Affiliation(s)
- Miori Tanaka
- The Nippon Foundation Human Milk Bank, 17-10 Nihonbashi-koamicho, Chuo-ku, Tokyo 103-0016, Japan
| | - Midori Date
- The Nippon Foundation Human Milk Bank, 17-10 Nihonbashi-koamicho, Chuo-ku, Tokyo 103-0016, Japan
| | - Kumiko Miura
- The Nippon Foundation Human Milk Bank, 17-10 Nihonbashi-koamicho, Chuo-ku, Tokyo 103-0016, Japan
- Faculty of Medicine, Oita University, 1-1 Hasamamachiidaigaoka, Yufu-shi, Oita 879-5593, Japan
| | - Mizuho Ito
- The Nippon Foundation Human Milk Bank, 17-10 Nihonbashi-koamicho, Chuo-ku, Tokyo 103-0016, Japan
- School of Medicine, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan
| | - Noriko Mizuno
- Japan Human Milk Bank Association, 4-4 Nihonbashi-hisamatsucho, Chuo-ku, Tokyo 103-8480, Japan
| | - Katsumi Mizuno
- The Nippon Foundation Human Milk Bank, 17-10 Nihonbashi-koamicho, Chuo-ku, Tokyo 103-0016, Japan
- Japan Human Milk Bank Association, 4-4 Nihonbashi-hisamatsucho, Chuo-ku, Tokyo 103-8480, Japan
- Department of Pediatrics, School of Medicine, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan
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17
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Young MF, Faerber EC, Mehta RV, Ranjan S, Shetty SA, Ramakrishnan U, Rangiah K, Bose B, Devi S, Dwarkanath P, Kurpad AV, Taneja S, Martorell R. Maternal nutritional status and milk volume and composition in India: an observational study. Am J Clin Nutr 2023; 117:830-837. [PMID: 36773786 DOI: 10.1016/j.ajcnut.2023.02.002] [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: 08/03/2022] [Revised: 01/27/2023] [Accepted: 02/02/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Human milk provides essential nutrition for infants, and its benefits are well established. We lack data on the influence of maternal nutritional status on milk volume and composition in low-middle income countries. OBJECTIVE We aimed to 1) assess lactation performance (human milk volume, macronutrient composition, and infant energy intake) in Indian females and 2) examine the associations between maternal anthropometry (BMI, percentage body fat) and lactation performance. METHODS We conducted an observational study among 232 mother-infant dyads, 2 to 4 mo postpartum in Haryana, India. We used deuterium oxide dose-to-mother technique to measure milk volume and maternal percentage body fat and collected human milk samples to determine macronutrient and energy concentrations. Adjusted multiple linear regression models were used to examine the associations between maternal anthropometry and lactation performance. RESULTS The mean BMI and percentage body fat of mothers were 21.7 ± 3.6 kg/m2 and 29.5 ± 7.7, respectively. Milk volume and macronutrient composition were similar to the reference values (means ± standard deviations: milk volume, 724 ± 184 mL/d; median (25th, 75th percentile); protein, 9.9 (8.3, 11.7) g/L; fat, 41.0 ± 15.2 g/L; energy density, 0.71 ± 0.14 kcal/g; lactose, 65.5 (55.3, 71.3) g/L). Maternal BMI and percentage body fat were not significantly associated with macronutrient composition. Both maternal BMI and percentage body fat were negatively associated with milk volume (-7.0, 95% CI: -12.4, -1.6 mL/d; -3.5, 95% CI: -6.0, -1.1mL/d, respectively) but there were no effects on the total energy intake of infants after adjusting for covariates. CONCLUSION Most mothers had a normal BMI and milk of similar composition and volume to reference values. Future work in populations with a greater burden of underweight and/or obesity are needed to examine the underlying mechanisms between maternal body composition and milk volume. This trial was registered at The Clinical Trials Registry- India as CTRI/2017/01/007636.
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Affiliation(s)
- Melissa F Young
- Hubert Department of Global Health, Emory University, Atlanta, United States
| | - Emily C Faerber
- Hubert Department of Global Health, Emory University, Atlanta, United States
| | - Rukshan V Mehta
- Hubert Department of Global Health, Emory University, Atlanta, United States; Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada
| | - Samriddhi Ranjan
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Sweekruthi A Shetty
- Food Safety and Analytical Quality Control Laboratory, CSIR-CFTRI, Karnataka, India
| | - Usha Ramakrishnan
- Hubert Department of Global Health, Emory University, Atlanta, United States
| | - Kannan Rangiah
- Food Safety and Analytical Quality Control Laboratory, CSIR-CFTRI, Karnataka, India; Institute of Bioinformatics, Bangalore, India and Manipal Academy of Higher Education, Manipal
| | - Beena Bose
- Division of Nutrition, St. John's Research Institute, Bangalore, Karnataka, India
| | - Sarita Devi
- Department of Physiology, St. John's Medical College, Bengaluru, Karnataka, India
| | - Pratibha Dwarkanath
- Division of Nutrition, St. John's Research Institute, Bangalore, Karnataka, India
| | - Anura V Kurpad
- Department of Physiology, St. John's Medical College, Bengaluru, Karnataka, India
| | - Sunita Taneja
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India.
| | - Reynaldo Martorell
- Hubert Department of Global Health, Emory University, Atlanta, United States
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18
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[Variation in the level of the biocomponents immunoglobulin A and lactoferrin in human milk after Holder pasteurization]. NUTR HOSP 2023. [PMID: 36748426 DOI: 10.20960/nh.04218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND breast milk is the ideal food for newborns and infants, but there are factors that can prevent the practice of breastfeeding. Human milk banks (BLH) are a strategy to increase breastfeeding coverage; the donated milk is subjected to Holder pasteurization to guarantee its innocuousness, undergoing large changes in temperature and a decrease in the concentrations of biocomponents such as Immunoglobulin A (IgA) and lactoferrin (LF). This article describes the results of recent studies on the impact of Holder pasteurization on IgA and LF in human milk. MATERIAL AND METHODS a search for research articles related to the topic of interest was carried out in various databases and in accordance with inclusion criteria that considered the type of study, date of publication and quality of the journal. RESULTS the impact of Holder pasteurization on IgA and LF concentrations is not clear, given that the literature reports a variety of protocols and different results; however, the percentage reductions of both biocomponents are significant and consistent in the studies reviewed, suggesting the importance of establishing a standard protocol for their quantification. CONCLUSIONS Holder pasteurization guarantees the microbiological quality of the milk distributed in HMB, but affects the amount of beneficial biocomponents for the final recipient. Government entities that regulate HMBs should evaluate the possibility of using other techniques that reduce the impact on biocomponents while preserving the microbiological quality of the product.
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19
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Chi ZH, Goodyer CG, Hales BF, Bayen S. Characterization of different contaminants and current knowledge for defining chemical mixtures in human milk: A review. ENVIRONMENT INTERNATIONAL 2023; 171:107717. [PMID: 36630790 DOI: 10.1016/j.envint.2022.107717] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 06/17/2023]
Abstract
Hundreds of xenobiotics, with very diverse origins, have been detected in human milk, including contaminants of emerging concern, personal care products and other current-use substances reflecting lifestyle. The routes of exposure to these chemicals include dermal absorption, ingestion and inhalation. Specific families of chemicals are dominant among human milk monitoring studies (e.g., organochlorine pesticides, bisphenol A, dioxins), even though other understudied families may be equally toxicologically relevant (e.g., food-processing chemicals, current-use plasticizers and flame retardants, mycotoxins). Importantly, the lack of reliable human milk monitoring data for some individual chemicals and, especially, for complex mixtures, is a major factor hindering risk assessment. Non-targeted screening can be used as an effective tool to identify unknown contaminants of concern in human milk. This approach, in combination with novel methods to conduct risk assessments on the chemical mixtures detected in human milk, will assist in elucidating exposures that may have adverse effects on the development of breastfeeding infants.
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Affiliation(s)
- Zhi Hao Chi
- Department of Food Science and Agricultural Chemistry, McGill University, 21111 Lakeshore Road, Ste-Anne-de-Bellevue, QC H9X 3V9, Canada
| | - Cindy Gates Goodyer
- Department of Pediatrics, Division of Experimental Medicine, McGill University Health Centre, Montreal, QC, Canada
| | - Barbara F Hales
- Department of Pharmacology & Therapeutics, McGill University, Montreal, QC, Canada
| | - Stéphane Bayen
- Department of Food Science and Agricultural Chemistry, McGill University, 21111 Lakeshore Road, Ste-Anne-de-Bellevue, QC H9X 3V9, Canada.
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20
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Zielinska-Pukos MA, Bryś J, Wesolowska A, Hamulka J. Breastmilk PUFA strongly associated with maternal dietary intake but not anthropometric parameters and breastmilk carotenoids. Prostaglandins Leukot Essent Fatty Acids 2022; 186:102505. [PMID: 36279603 DOI: 10.1016/j.plefa.2022.102505] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 07/26/2022] [Accepted: 10/06/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Long chain polyunsaturated fatty acids (PUFA) and the optimal n-6/n-3 fatty acids ratio are essential for proper neurodevelopment in infancy. This study aimed to evaluate the association between breastmilk fatty acid intake and maternal dietary intake, anthropometrics and breastmilk carotenoid levels. METHODS This observational, prospective study included 44 women in the first, third, and sixth month of lactation. At each study visit, maternal anthropometric measures were assessed and breastmilk samples were collected and assessed for fatty acids and carotenoids. At the third and sixth month, maternal diet was evaluated by three-day foods record. RESULTS Mean breastmilk docosahexaenoic (DHA) was 0.58%, 0.47%, and 0.49%, respectively at the 1, 3, and 6 month (p ≤ 0.05). Mean DHA intake were higher in month 3 compared to 6: 357 vs. 169 mg/day. Pre-pregnancy BMI was associated with SFA, PUFA, and n-6 PUFA at 1 month, whereas current BMI to SFA at months 1 and 3. DHA was correlated with lycopene, total carotenoids at 1 month and total carotenoids at month 3, whereas n-3 PUFA to lycopene at 1 month. DHA, n-3 PUFA, n-6 PUFA and saturated (SFA) levels were associated with its dietary intake both at months 3 and 6, AA/DHA and LA/ALA ratios only at month 3. CONCLUSIONS Maternal intake of PUFA and n-6/n-3 ratios were a good predictor of its breastmilk composition, whereas pre-pregnancy and current BMI, as well as breastmilk carotenoids had a limited influence.
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Affiliation(s)
- M A Zielinska-Pukos
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences - SGGW, Nowoursynowska St. 159, 02-776 Warsaw, Poland.
| | - J Bryś
- Department of Chemistry, Institute of Food Sciences, Warsaw University of Life Sciences - SGGW, Nowoursynowska St. 159, 02-776 Warsaw, Poland.
| | - A Wesolowska
- Laboratory of Human Milk and Lactation Research, Regional Human Milk Bank in Holy Family Hospital, Department of Medical Biology, Faculty of Health Science, Medical University of Warsaw, 14/16 Litewska St., 00-575 Warsaw, Poland.
| | - J Hamulka
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences - SGGW, Nowoursynowska St. 159, 02-776 Warsaw, Poland.
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21
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Hamner HC, Nelson JM, Sharma AJ, Jefferds MED, Dooyema C, Flores-Ayala R, Bremer AA, Vargas AJ, Casavale KO, de Jesus JM, Stoody EE, Scanlon KS, Perrine CG. Improving Nutrition in the First 1000 Days in the United States: A Federal Perspective. Am J Public Health 2022; 112:S817-S825. [PMID: 36122314 PMCID: PMC9612192 DOI: 10.2105/ajph.2022.307028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2022] [Indexed: 11/04/2022]
Abstract
The first 1000 days begins with pregnancy and ends at the child's second birthday. Nutrition throughout the life course, and especially during the first 1000 days, supports maternal health and optimal growth and development for children. We give a high-level summary of the state of nutrition in the first 1000 days in the United States. We provide examples where continued efforts are needed. We then discuss select opportunities to strengthen federal research and surveillance, programs, and communication and dissemination efforts aimed at improving nutrition and positively, and equitably, influencing the health and well-being of mothers and children. (Am J Public Health. 2022;112(S8):S817-S825. https://doi.org/10.2105/AJPH.2022.307028).
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Affiliation(s)
- Heather C Hamner
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Jennifer M Nelson
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Andrea J Sharma
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Maria Elena D Jefferds
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Carrie Dooyema
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Rafael Flores-Ayala
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Andrew A Bremer
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Ashley J Vargas
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Kellie O Casavale
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Janet M de Jesus
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Eve E Stoody
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Kelley S Scanlon
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | - Cria G Perrine
- Heather C. Hamner, Jennifer M. Nelson, Andrea J. Sharma, Maria Elena D. Jefferds, Carrie Dooyema, Rafael Flores-Ayala, and Cria G. Perrine are with the Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA. Andrew A. Bremer and Ashley J. Vargas are with the Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Kellie O. Casavale is with the Office of Nutrition and Food Labeling, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD. Janet M. de Jesus is with the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD. Eve E. Stoody is with the Center for Nutrition Policy and Promotion, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA. Kelley S. Scanlon is with the Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
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22
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Ahuja JKC, Casavale KO, Li Y, Hopperton KE, Chakrabarti S, Hines EP, Brooks SPJ, Bondy GS, MacFarlane AJ, Weiler HA, Wu X, Borghese MM, Ahluwalia N, Cheung W, Vargas AJ, Arteaga S, Lombo T, Fisher MM, Hayward D, Pehrsson PR. Perspective: Human Milk Composition and Related Data for National Health and Nutrition Monitoring and Related Research. Adv Nutr 2022; 13:2098-2114. [PMID: 36084013 PMCID: PMC9776678 DOI: 10.1093/advances/nmac099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 04/18/2022] [Accepted: 09/07/2022] [Indexed: 01/28/2023] Open
Abstract
National health and nutrition monitoring is an important federal effort in the United States and Canada, and the basis for many of their nutrition and health policies. Understanding of child exposures through human milk (HM) remains out of reach due to lack of current and representative data on HM's composition and intake volume. This article provides an overview of the current national health and nutrition monitoring activities for HM-fed children, HM composition (HMC) and volume data used for exposure assessment, categories of potential measures in HM, and associated variability factors. In this Perspective, we advocate for a framework for collection and reporting of HMC data for national health and nutrition monitoring and programmatic needs, including a shared vision for a publicly available Human Milk Composition Data Repository (HMCD-R) to include essential metadata associated with HMC. HMCD-R can provide a central, integrated platform for researchers and public health officials for compiling, evaluating, and sharing HMC data. The compiled compositional and metadata in HMCD-R would provide pertinent measures of central tendency and variability and allow use of modeling techniques to approximate compositional profiles for subgroups, providing more accurate exposure assessments for purposes of monitoring and surveillance. HMC and related metadata could facilitate understanding the complexity and variability of HM composition, provide crucial data for assessment of infant and maternal nutritional needs, and inform public health policies, food and nutrition programs, and clinical practice guidelines.
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Affiliation(s)
- Jaspreet K C Ahuja
- Methods and Application of Food Composition Laboratory, Beltsville Human Nutrition Research Center, Agricultural Research Services, US Department of Agriculture, Beltsville, Maryland, USA.
| | - Kellie O Casavale
- Center for Food Safety and Applied Nutrition, Food and Drug Administration, US Department of Health and Human Services, College Park, Maryland, USA
| | - Ying Li
- Methods and Application of Food Composition Laboratory, Beltsville Human Nutrition Research Center, Agricultural Research Services, US Department of Agriculture, Beltsville, Maryland, USA
| | - Kathryn E Hopperton
- Nutrition Premarket Assessment Division, Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Subhadeep Chakrabarti
- Nutrition Premarket Assessment Division, Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Erin P Hines
- Reproductive and Developmental Toxicology Branch, Public Health and Integrated Toxicology Division, US Environmental Protection Agency, Chapel Hill, North Carolina, USA
| | - Stephen P J Brooks
- Nutrition Research Division, Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Genevieve S Bondy
- Bureau of Chemical Safety, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Amanda J MacFarlane
- Nutrition Research Division, Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Hope A Weiler
- Nutrition Research Division, Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Xianli Wu
- Methods and Application of Food Composition Laboratory, Beltsville Human Nutrition Research Center, Agricultural Research Services, US Department of Agriculture, Beltsville, Maryland, USA
| | - Michael M Borghese
- Environmental Health Sciences and Research Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Namanjeet Ahluwalia
- National Center for Health Statistics, Centers for Disease Control and Prevention, Department of Health and Human Services, Hyattsville, Maryland, USA
| | - Winnie Cheung
- Nutrition Premarket Assessment Division, Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Ashley J Vargas
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA
| | - Sonia Arteaga
- Environmental influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health, Bethesda, Maryland, USA
| | - Tania Lombo
- Maternal Adolescent Pediatric Research Branch, Prevention Science Program, Division of AIDS, National Institute of Allergy and Infectious Diseases (NIAID), Bethesda, Maryland, USA
| | - Mandy M Fisher
- Environmental Health Sciences and Research Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Deborah Hayward
- Nutrition Premarket Assessment Division, Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Pamela R Pehrsson
- Methods and Application of Food Composition Laboratory, Beltsville Human Nutrition Research Center, Agricultural Research Services, US Department of Agriculture, Beltsville, Maryland, USA
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23
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Li X, Siviroj P, Ruangsuriya J, Yousaibua N, Ongprasert K. Effects of the thawing rate and heating temperature on immunoglobulin A and lysozyme activity in human milk. Int Breastfeed J 2022; 17:52. [PMID: 35799170 PMCID: PMC9264520 DOI: 10.1186/s13006-022-00487-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 06/17/2022] [Indexed: 11/12/2022] Open
Abstract
Background The percentage of infants receiving frozen human milk (HM) is increasing. The effects of thawing and warming on the secretory immunoglobulin A (SIgA) level and lysozyme activity in frozen HM should be investigated to identify optimal methods for preserving immune factors in frozen HM. Methods Milk samples were collected from 40 mothers with healthy full-term infants who had been lactating for one to six months. The baseline samples were analyzed within 24 h after collection, and the other samples were frozen at -18 °C before analyses. We compared two methods: placing the container overnight in a refrigerator at 4 °C before warming (slow thawing) and immediately thawing in warm water after removing the sample from the freezer (rapid thawing). Additionally, we investigated the effects of the warming temperature by comparing room temperature (25 °C) and physiological temperature (37 °C). The SIgA concentrations and lysozyme activities in the milk samples were determined using ELISA kits and fluorometric lysozyme activity assay kits, respectively. Results The SIgA concentrations and lysozyme activity in frozen HM were 16.5–52.1% and 16.8–39.3% lower than those in fresh HM, respectively. The SIgA concentrations in frozen HM were stable during slow thawing at 37 °C (p = 0.072) compared with those in fresh HM. The SIgA concentrations and lysozyme activity were maintained at significantly higher levels during slow thawing than during rapid thawing at 25 °C (p = 0.002 and p < 0.001, respectively). Slow thawing preserved higher SIgA concentrations and lysozyme activity than rapid thawing at 37 °C, but the difference was not significant. Conclusions The SIgA level in HM frozen at -18 °C for two months was stable after overnight thawing in the refrigerator (4 °C for 12 h) before warming to 37 °C compared with that in fresh milk. The thawing of HM in the refrigerator overnight (and then warming to 25 °C or 37 °C for 30 min) has the potential to preserve the SIgA concentration and lysozyme activity to a greater extent than heating immediately after removal from the freezer. Broader temperature ranges should be analyzed to determine the temperature that minimizes the losses in SIgA concentration and lysozyme activity in HM.
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Affiliation(s)
- Xuejing Li
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, 110 Intrawarorot Road, Si Phum Subdistrict, Amphoe Mueang, Chiang Mai, 50200, Thailand
| | - Penprapa Siviroj
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, 110 Intrawarorot Road, Si Phum Subdistrict, Amphoe Mueang, Chiang Mai, 50200, Thailand
| | - Jetsada Ruangsuriya
- Department of Biochemistry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | - Krongporn Ongprasert
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, 110 Intrawarorot Road, Si Phum Subdistrict, Amphoe Mueang, Chiang Mai, 50200, Thailand.
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24
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Gallo S, Gahche J, Kitsantas P, Makwana P, Wang Y, Chen X, Rajbhandari-Thapa J. Vitamin D Intake and Meeting Recommendations Among Infants Participating in WIC Nationally. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:499-509. [PMID: 35288058 PMCID: PMC9149040 DOI: 10.1016/j.jneb.2021.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 11/18/2021] [Accepted: 11/20/2021] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To report and examine associations with infant vitamin D intake and meeting recommendations among a national sample participating in Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). DESIGN Secondary analysis from the 2013-2015 WIC Infant Toddler Feeding Practices Study-2. PARTICIPANTS US Infants. VARIABLES MEASURED Total reported vitamin D intake from diet and supplementation at the time of data collection. ANALYSIS Descriptive statistics and generalized estimating equations. RESULTS The median total vitamin D intake ranged from 5.43 (95% confidence interval, 5.40-5.46) mcg/d at month 1 to 8.18 (95% confidence interval, 8.11-8.20) mcg/d at month 13, with 16% to 36% of infants meeting the infant vitamin D recommendation over that time. Overall, 6% to 12% of all participants reported supplementation across all time points. Although most (between 78% to 98%) of supplemented breastfed infants met the recommendation, very few were supplemented as a group. Hence, breastfed infants were less likely to meet the recommendation than those who were formula fed across at time points except month 1 (P < 0.001 for all). Whereas infant age, feeding type, and/or their interaction were significant predictors of both receiving supplementation and meeting the recommendation, mother/caregiver nativity (P = 0.006) and parity (P = 0.01 and P < 0.001) predicted receiving supplementation, and child sex (P < 0.001) and mother/caregiver race/ethnicity (P < 0.001) predicted meeting the recommendation. CONCLUSIONS AND IMPLICATIONS Among a national sample of infants participating in WIC between 2013-2015, a high proportion were not meeting the current vitamin D recommendation. The WIC program is 1 resource for promoting strategies for increasing the number of American infants meeting D recommendations, but a coordinated approach involving other health care providers is likely needed. Future research exploring the reason for lack of supplementation, from both the perspective of parents and providers and the clinical impact of low vitamin D intake, is warranted.
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Affiliation(s)
- Sina Gallo
- Department of Nutritional Sciences, University of Georgia, Athens, GA.
| | - Jaime Gahche
- Office of Dietary Supplements, National Institutes of Health, Bethesda, MD
| | - Panagiota Kitsantas
- Department of Health Administration and Policy, George Mason University, Fairfax, VA
| | - Priyal Makwana
- Department of Health Administration and Policy, George Mason University, Fairfax, VA
| | - Yu Wang
- Department of Statistics, University of Georgia, Athens, GA
| | - Xianyan Chen
- Department of Statistics, University of Georgia, Athens, GA
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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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Breastfed and mixed fed infants who do not consume infant cereal are at risk for inadequate iron intake:data from the feeding infants and toddlers study 2016, a cross-sectional survey. BMC Pediatr 2022; 22:219. [PMID: 35459123 PMCID: PMC9034552 DOI: 10.1186/s12887-022-03104-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 12/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND According to the Feeding Infants and Toddlers Study (FITS), the percentage of older infants consuming infant cereal has declined from 72% of 6-11.9 month old infants in 2002 to 52% in 2016. This is especially concerning for breastfed and mixed fed infants because of their increased need for dietary sources of iron. This study explored the association between infant cereal consumption and nutrient intakes among breastfed and mixed fed infants. METHODS FITS 2016 is the largest cross-sectional survey of food and nutrient intakes among caregivers of children less than 4 years old in the United States. For this analysis, we evaluated 24 h dietary recalls for infants 6-11.9 months who were either breastfed (no infant formula provided, n = 296) or mixed fed (breastmilk and infant formula provided, n = 102). Infants were further categorized as infant cereal consumers or non-consumers. Nutrient intakes were compared with Adequate Intakes or Estimated Average Requirements when available. Differences between cereal consumers and non-consumers were calculated using unpaired T-tests. RESULTS Significantly fewer breastfed cereal consumers had intakes below the Estimated Average Requirement for iron (19% vs. 96%) and zinc (61% vs. 16%, p < 0.0001). Additionally, significantly more breastfed cereal consumers had intakes above the Adequate Intake level for 12 other nutrients compared to non-consumers. Among mixed fed infants, significantly fewer cereal consumers had intakes below the Estimated Average Requirement for iron compared to non-consumers (5% vs. 70%), but differences in other nutrients were not observed. CONCLUSIONS Almost all (96%) of the breastfed infants who did not consume infant cereal had inadequate iron intakes. Even among mixed fed infants, significantly fewer infant cereal consumers had inadequate iron intakes compared to non-cereal consumers. Infant cereal is an important source of iron and other key nutrients, especially for infants receiving breastmilk.
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Glycoproteomic and Lipidomic Characterization of Industrially Produced Whey Protein Phospholipid Concentrate with Emphasis on Antimicrobial Xanthine Oxidase, Oxylipins and Small Milk Fat Globules. DAIRY 2022. [DOI: 10.3390/dairy3020022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This work investigates the composition of whey protein phospholipid concentrate (WPPC), an underutilized dairy stream, and reveals that it is a source of many bioactive compounds that can benefit the immune system and gut health. Our glycoproteomics approach uncovered that proteins derived from the milk fat globule membrane (MFGM) represent 23% of the total protein relative abundance and identified 85 N-glycans. Released sialic acid, an additional marker of glycosylation, ranged from 1.2 to 2% of the total weight. Xanthine oxidase, a glycosylated marker of MFG bioactivity, was found in high abundance and displayed higher antimicrobial activity than bovine milk, despite its similar fat and solids content. An average MFG diameter of 2.64 ± 0.01 µm was found in liquid WPPC, compared to 4.78 ± 0.13 µm in bovine milk, which likely explains the unusually high presence of glycosylated membrane-bound proteins and phospholipids, whose total fatty acids accounted for 20% of the WPPC total fatty acid pool. Free and bound oxylipins (mainly derived from linoleic acid) were also identified, together with other less abundant anti-inflammatory lipid mediators derived from eicosapentaenoic acid and docosahexaenoic acid. Our study demonstrates that WPPC represents a promising starting material for bioactive compound extraction and a functional vehicle for the delivery of small MFGs.
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28
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Bayraktar S, Tanyeri-Bayraktar B, Kılıç Ü. Increased Colostral Concentration of Macrophage Migration Inhibitory Factor in Mothers with Premature Rupture of Membranes. Breastfeed Med 2022; 17:189-193. [PMID: 35049342 DOI: 10.1089/bfm.2021.0190] [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] [Indexed: 11/13/2022]
Abstract
Objective: The colostrum contains macrophage migration inhibitory factor (MIF), which plays an important role in protecting newborns from infections. As such, colostrum may be specifically important to prevent early onset neonatal sepsis among neonates born after premature rupture of membranes (PROM). However, the effect of PROM on the colostral MIF concentration has not been previously described. The aim of this study is to compare the concentration of MIF in the colostrum of mothers with and without PROM. Methods: The study group consisted of 44 women, 22 of whom had PROM. Colostrum was expressed and collected within 72 hours of birth. MIF concentration was measured using the enzyme-linked immunosorbent assay method and compared between mothers with and without PROM. Results: There were no differences between the two groups (PROM group n = 22, control group n = 22) with regard to the age of mothers, mode of delivery, neonatal gestational age, birth weight, and sex of the infants (p > 0.05). The colostral MIF concentration was significantly higher among mothers with than without PROM (p = 0.0001). There was a positive and significant correlation between the colostral MIF concentration and PROM duration (r = 0.314, p = 0.038). Conclusions: PROM was associated with a higher colostral MIF concentration, with this concentration being positively correlated with the duration of PROM. This increased concentration may be important in offering these neonates additional protection against early onset infections, which is a risk associated with PROM.
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Affiliation(s)
- Süleyman Bayraktar
- Department of Pediatric Intensive Care, Bezmialem Vakif University Faculty of Medicine, Istanbul, Turkey
| | | | - Ülkan Kılıç
- Department of Medical Biology, University of Health Sciences Turkey, Istanbul, Turkey
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Ezekiel CN, Abia WA, Braun D, Šarkanj B, Ayeni KI, Oyedele OA, Michael-Chikezie EC, Ezekiel VC, Mark BN, Ahuchaogu CP, Krska R, Sulyok M, Turner PC, Warth B. Mycotoxin exposure biomonitoring in breastfed and non-exclusively breastfed Nigerian children. ENVIRONMENT INTERNATIONAL 2022; 158:106996. [PMID: 34991256 DOI: 10.1016/j.envint.2021.106996] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 11/19/2021] [Accepted: 11/20/2021] [Indexed: 06/14/2023]
Abstract
A multi-specimen, multi-mycotoxin approach involving ultra-sensitive LC-MS/MS analysis of breast milk, complementary food and urine was applied to examine mycotoxin co-exposure in 65 infants, aged 1-18 months, in Ogun state, Nigeria. Aflatoxin M1 was detected in breast milk (4/22 (18%)), while six other classes of mycotoxins were quantified; including dihydrocitrinone (6/22 (27%); range: 14.0-59.7 ng/L) and sterigmatocystin (1/22 (5%); 1.2 ng/L) detected for the first time. Seven distinct classes of mycotoxins including aflatoxins (9/42 (21%); range: 1.0-16.2 µg/kg) and fumonisins (12/42 (29%); range: 7.9-194 µg/kg) contaminated complementary food. Mycotoxins covering seven distinct classes with diverse structures and modes of action were detected in 64/65 (99%) of the urine samples, demonstrating ubiquitous exposure. Two aflatoxin metabolites (AFM1 and AFQ1) and FB1 were detected in 6/65 (9%), 44/65 (68%) and 17/65 (26%) of urine samples, respectively. Mixtures of mycotoxin classes were common, including 22/22 (100%), 14/42 (33%) and 56/65 (86%) samples having 2-6, 2-4, or 2-6 mycotoxins present, for breast milk, complementary food and urine, respectively. Aflatoxin and/or fumonisin was detected in 4/22 (18%), 12/42 (29%) and 46/65 (71%) for breast milk, complimentary foods and urine, respectively. Furthermore, the detection frequency, median concentrations and occurrence of mixtures were typically greater in urine of non-exclusively breastfed compared to exclusively breastfed infants. The study provides novel insights into mycotoxin co-exposures in early-life. Albeit a small sample set, it highlights transition to higher levels of infant mycotoxin exposure as complementary foods are introduced, providing impetus to mitigate during this critical early-life period and encourage breastfeeding.
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Affiliation(s)
- Chibundu N Ezekiel
- Department of Microbiology, Babcock University, Ilishan Remo, Ogun State, Nigeria; University of Natural Resources and Life Sciences, Vienna, Department of Agrobiotechnology, IFA-Tulln, Institute of Bioanalytics and Agro-Metabolomics, Konrad-Lorenz-Strasse 20, 3430 Tulln an der Donau, Austria.
| | - Wilfred A Abia
- University of Natural Resources and Life Sciences, Vienna, Department of Agrobiotechnology, IFA-Tulln, Institute of Bioanalytics and Agro-Metabolomics, Konrad-Lorenz-Strasse 20, 3430 Tulln an der Donau, Austria; Queen's University Belfast, School of Biological Sciences, Institute for Global Food Security, University Road, Belfast BT7 1NN, Northern Ireland, UK; Laboratory of Pharmacology and Toxicology, Department of Biochemistry, Faculty of Science, University of Yaounde I, P.O. Box 812, Yaounde, Cameroon
| | - Dominik Braun
- University of Vienna, Faculty of Chemistry, Department of Food Chemistry and Toxicology, Währinger Str. 38, A-1090 Vienna, Austria
| | - Bojan Šarkanj
- University of Natural Resources and Life Sciences, Vienna, Department of Agrobiotechnology, IFA-Tulln, Institute of Bioanalytics and Agro-Metabolomics, Konrad-Lorenz-Strasse 20, 3430 Tulln an der Donau, Austria; Department of Food Technology, University North, Center Koprivnica, Trg dr. Zarka Dolinara 1, HR, 48000 Koprivnica, Croatia
| | - Kolawole I Ayeni
- Department of Microbiology, Babcock University, Ilishan Remo, Ogun State, Nigeria
| | | | - Emmanuel C Michael-Chikezie
- Clifford University, Owerrinta (Ihie Campus), Abia State, Nigeria; Benjamin Carson (Snr.) School of Medicine, Babcock University, Ilishan Remo, Ogun State, Nigeria
| | | | - Beatrice N Mark
- Department of Community Health, Babcock University Teaching Hospital, Ilishan Remo, Ogun State, Nigeria
| | - Chinonso P Ahuchaogu
- Department of Clinical Sciences, Babcock University Teaching Hospital, Ilishan Remo, Ogun State, Nigeria
| | - Rudolf Krska
- University of Natural Resources and Life Sciences, Vienna, Department of Agrobiotechnology, IFA-Tulln, Institute of Bioanalytics and Agro-Metabolomics, Konrad-Lorenz-Strasse 20, 3430 Tulln an der Donau, Austria; Queen's University Belfast, School of Biological Sciences, Institute for Global Food Security, University Road, Belfast BT7 1NN, Northern Ireland, UK
| | - Michael Sulyok
- University of Natural Resources and Life Sciences, Vienna, Department of Agrobiotechnology, IFA-Tulln, Institute of Bioanalytics and Agro-Metabolomics, Konrad-Lorenz-Strasse 20, 3430 Tulln an der Donau, Austria
| | - Paul C Turner
- MIAEH, School of Public Health, University of Maryland, College Park, MD 20742, USA
| | - Benedikt Warth
- University of Vienna, Faculty of Chemistry, Department of Food Chemistry and Toxicology, Währinger Str. 38, A-1090 Vienna, Austria.
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Miolski J, Raus M, Radusinović M, Zdravković V. Breast milk components and factors that may affect lactation success. ACTA FACULTATIS MEDICAE NAISSENSIS 2022. [DOI: 10.5937/afmnai39-31436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction. Breastfeeding is the most important way to feed a newborn, infant and a young child. Lactogenesis is the ability of secreting milk from the mammary gland and includes secretory initiation and activation. The birth of the placenta and decrease in progesterone levels stimulate an increase in prolactin levels and the secretion of milk from the breast. Human milk contains carbohydrates, lipids, proteins, vitamins, minerals, fatty acids, amino acids and trace elements. In addition, numerous cells, macrophages, bacteria, chemokines, cytokines, immunoglobulins, hormones, growth factors, and mucin are present. The composition of milk differs depending on the phase of secretion. Colostrum is secreted for the first five days after birth, then comes transitional milk, and mature milk two weeks after birth. During the very act of breastfeeding, there is a difference between pre-milk and last milk. In pre-milk, the fat content is low and increases with the duration of lactation, and in breast milk it is relatively high. Aim: To point out the importance of milk composition and factors that are influential for breastfeeding. Conclusion: Maternal parity, age or socioeconomic status and education can affect the concentration of certain components of breast milk. Adequate social policy and support, along with education related to early breastfeeding experiences, can be the key factors in initiating and maintaining breastfeeding. Besides the mother and the child, the entire social community would benefit from that.
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31
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Zeynali L, Nourizadeh R, Khalili AF, Hosseini M, Khalili A, Hakimi S. Effect of Vaginal Delivery on Lactose Content of Human Milk. Curr Pediatr Rev 2022; 18:138-143. [PMID: 34872478 DOI: 10.2174/1573396317666211206123648] [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: 01/18/2021] [Revised: 06/13/2021] [Accepted: 09/21/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The macronutrients of human milk are considered essential nutritional sources in the first few months of a newborn's life. The present study aimed to investigate the effect of delivery mode on the macronutrients of human milk. METHODS This retrospective cohort study was conducted on 102 women who gave birth by cesarean section or vaginal delivery between September 2019 and November 2019. The participants were requested to provide their milk samples on day 15 ± 1 after childbirth. RESULTS There were no significant differences between the two groups (cesarean and vaginal delivery) regarding the sociodemographic characteristics and intake of fat, carbohydrate, protein, and energy. The lactose level was significantly higher in women who gave birth by vaginal delivery (adjusted mean difference, 1.2 (95 % CI 0.02- 1.82)). For other macronutrients, there were no statistically significant differences between the two groups. CONCLUSION The vaginal delivery might influence the mature milk lactose level.
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Affiliation(s)
- Leila Zeynali
- Students Research Committee, Tabriz University of Medical Science, Tabriz, Iran
| | - Roghaiyeh Nourizadeh
- Faculty of Nursing and Midwifery, Midwifery Department, Tabriz University of Medical Science, Tabriz, Iran
| | - Azizeh Farshbaf Khalili
- Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Tabriz University of Medical Science, Tabriz, Iran
| | | | - Assef Khalili
- Department of Basic Sciences, Faculty of Allied Medical Science, Tabriz University of Medical Science, Tabriz Iran
| | - Sevil Hakimi
- Faculty of Nursing and Midwifery, Research Center of Psychiatry and Behavioral Science, Tabriz University of Medical Science, Tabriz, Iran
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Tyebally Fang M, Chatzixiros E, Grummer-Strawn L, Engmann C, Israel-Ballard K, Mansen K, O'Connor DL, Unger S, Herson M, Weaver G, Biller-Andorno N. Developing global guidance on human milk banking. Bull World Health Organ 2021; 99:892-900. [PMID: 34866685 PMCID: PMC8640695 DOI: 10.2471/blt.21.286943] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/17/2021] [Accepted: 09/21/2021] [Indexed: 11/27/2022] Open
Abstract
Donor human milk is recommended by the World Health Organization both for its advantageous nutritional and biological properties when mother’s own milk is not available and for its recognized support for lactation and breastfeeding when used appropriately. An increasing number of human milk banks are being established around the world, especially in low- and middle-income countries, to facilitate the collection, processing and distribution of donor human milk. In contrast to other medical products of human origin, however, there are no minimum quality, safety and ethical standards for donor human milk and no coordinating global body to inform national policies. We present the key issues impeding progress in human milk banking, including the lack of clear definitions or registries of products; issues around regulation, quality and safety; and ethical concerns about commercialization and potential exploitation of women. Recognizing that progress in human milk banking is limited by a lack of comparable evidence, we recommend further research in this field to fill the knowledge gaps and provide evidence-based guidance. We also highlight the need for optimal support for mothers to provide their own breastmilk and establish breastfeeding as soon as and wherever possible after birth.
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Affiliation(s)
- Mirriam Tyebally Fang
- Institute of Biomedical Ethics and History of Medicine, University of Zurich, Winterthurerstrasse 30, 8006 Zurich, Switzerland
| | - Efstratios Chatzixiros
- Department of Health Product Policy and Standards, World Health Organization, Geneva, Switzerland
| | | | | | | | | | - Deborah L O'Connor
- Department of Nutritional Sciences, University of Toronto, Toronto, Canada
| | | | - Marisa Herson
- School of Medicine, Deakin University, Geelong, Australia
| | | | - Nikola Biller-Andorno
- Institute of Biomedical Ethics and History of Medicine, University of Zurich, Winterthurerstrasse 30, 8006 Zurich, Switzerland
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33
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Gates A, Marin T, De Leo G, Waller JL, Stansfield BK. Nutrient composition of preterm mother's milk and factors that influence nutrient content. Am J Clin Nutr 2021; 114:1719-1728. [PMID: 34293087 PMCID: PMC10157816 DOI: 10.1093/ajcn/nqab226] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 06/11/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Breast milk feedings are the optimal feeding choice for premature infants. Clinicians depend on accurate nutrient profiles of the breast milk in order to make informed decisions regarding the need for nutrient supplementation. Existing data for nutrient composition of preterm breast milk are dated and not representative of the current population of women delivering prematurely in the United States. OBJECTIVES The purpose of this prospective, longitudinal, single-center observational study was to measure the macronutrient and micronutrient composition of breast milk expressed by mothers, including women who self-identify as black, delivering preterm infants at ≤33 completed weeks of gestation. METHODS We collected breast milk samples from mothers of preterm infants admitted to the neonatal intensive care unit at Augusta University Medical Center from January 2019 through November 2019. Mother's milk samples were collected on postpartum days 7, 14, 21, and 28 and analyzed for macronutrients (energy, fat, protein, and carbohydrates) and micronutrients (sodium, potassium, chloride, calcium, phosphorus, magnesium, vitamin D, and zinc). RESULTS Thirty-eight mothers, mean age 27 ± 5.1 y and majority black (66%), provided milk for the study. The mean estimated gestational age and birth weight were 28.2 ± 2.8 weeks of gestation and 1098 ± 347 g, respectively, with 42% of mothers in the cohort delivering before week 28 of pregnancy. Differences in protein, sodium, potassium, calcium, phosphorus, and zinc concentrations based on race, day, and milk volume were identified. Dilution effects for protein, sodium, chloride, and vitamin D concentrations over time were identified. CONCLUSIONS Our study is among the first to characterize breast milk composition from women who delivered extremely preterm infants and adds to the evidence that race, gestational age, and volume influence the composition of preterm mother's milk. These factors should be considered when designing mother's milk-based feeds for premature infants.
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Affiliation(s)
- Amy Gates
- College of Allied Health Sciences, Augusta University, Augusta, GA, USA
| | - Terri Marin
- College of Nursing, Augusta University, Augusta, GA, USA
| | - Gianluca De Leo
- College of Allied Health Sciences, Augusta University, Augusta, GA, USA
| | - Jennifer L Waller
- Division of Biostatistics and Data Science, Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Brian K Stansfield
- Department of Pediatrics, Medical College of Georgia, Augusta University, Augusta, GA, USA
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Caroli M, Vania A, Tomaselli MA, Scotese I, Tezza G, Verga MC, Di Mauro G, Antignani A, Miniello A, Bergamini M. Breastfed and Formula-Fed Infants: Need of a Different Complementary Feeding Model? Nutrients 2021; 13:nu13113756. [PMID: 34836012 PMCID: PMC8624840 DOI: 10.3390/nu13113756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 10/20/2021] [Accepted: 10/20/2021] [Indexed: 01/01/2023] Open
Abstract
Suboptimal nutrient quality/quantity during complementary feeding (CF) can impact negatively on infants’ healthy growth, even with adequate energy intake. CF must supplement at best human milk (HM) or formulas, which show nutritional differences. Considering this, a differentiated CF is probably advisable to correctly satisfy the different nutritional needs. To assess whether current needs at 6–24 months of age can still be met by one single CF scheme or different schemes are needed for breastfed vs. formula/cow’s milk (CM) fed infants, protein, iron and calcium intakes were assessed from daily menus using the same type and amount of solid food, leaving same amounts of HM and follow-up formula at 9 and again 18 months of age, when unmodified CM was added. Depending on the child’s age, calcium- and iron-fortified cereals or common retail foods were used. The single feeding scheme keeps protein intake low but higher than recommended, in HM-fed children while in formula/CM-fed ones, it achieves much higher protein intakes. Iron Population Recommended Intake (PRI) and calcium Adequate Intakes (AI) are met at the two ages only when a formula is used; otherwise, calcium-fortified cereals are needed. ESPGHAN statements on the futility of proposing different CF schemes according to the milk type fed do not allow to fully meet the nutritional recommendations issued by major Agencies/Organizations/Societies for all children of these age groups.
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Affiliation(s)
- Margherita Caroli
- Independent Researcher, Francavilla Fontana, 72021 Brindisi, Italy
- Correspondence: (M.C.); (A.V.); Tel.: +39-3284-504-945 (M.C.); +39-3473-385-641 (A.V.)
| | - Andrea Vania
- Independent Researcher, 00162 Rome, Italy
- Correspondence: (M.C.); (A.V.); Tel.: +39-3284-504-945 (M.C.); +39-3473-385-641 (A.V.)
| | - Maria Anna Tomaselli
- Nutrition Unit, Department of Prevention, Azienda Sanitaria Locale Brindisi, 72100 Brindisi, Italy;
| | | | | | | | | | - Angelo Antignani
- Department of Food Science, University of Naples Federico II, 80100 Napoli, Italy;
| | - Andrea Miniello
- School of Allergology and Immunology, University of Bari, 70124 Bari, Italy;
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Untargeted Metabolomic Analysis of Human Milk from Mothers of Preterm Infants. Nutrients 2021; 13:nu13103604. [PMID: 34684605 PMCID: PMC8540315 DOI: 10.3390/nu13103604] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 10/05/2021] [Accepted: 10/09/2021] [Indexed: 12/11/2022] Open
Abstract
The application of metabolomics in neonatology offers an approach to investigate the complex relationship between nutrition and infant health. Characterization of the metabolome of human milk enables an investigation into nutrients that affect the neonatal metabolism and identification of dietary interventions for infants at risk of diseases such as necrotizing enterocolitis (NEC). In this study, we aimed to identify differences in the metabolome of breast milk of 48 mothers with preterm infants with NEC and non-NEC healthy controls. A minimum significant difference was observed in the human milk metabolome between the mothers of infants with NEC and mothers of healthy control infants. However, significant differences in the metabolome related to fatty acid metabolism, oligosaccharides, amino sugars, amino acids, vitamins and oxidative stress-related metabolites were observed when comparing milk from mothers with control infants of ≤1.0 kg birth weight and >1.5 kg birth weight. Understanding the functional biological features of mothers’ milk that may modulate infant health is important in the future of tailored nutrition and care of the preterm newborn.
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Abduljalil K, Pansari A, Ning J, Jamei M. Prediction of drug concentrations in milk during breastfeeding, integrating predictive algorithms within a physiologically-based pharmacokinetic model. CPT Pharmacometrics Syst Pharmacol 2021; 10:878-889. [PMID: 34213088 PMCID: PMC8376129 DOI: 10.1002/psp4.12662] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/21/2021] [Accepted: 05/12/2021] [Indexed: 12/19/2022] Open
Abstract
There is a risk of exposure to drugs in neonates during the lactation period due to maternal drug intake. The ability to predict drugs of potential hazards to the neonates would be useful in a clinical setting. This work aimed to evaluate the possibility of integrating milk-to-plasma (M/P) ratio predictive algorithms within the physiologically-based pharmacokinetic (PBPK) approach and to predict milk exposure for compounds with different physicochemical properties. Drug and physiological milk properties were integrated to develop a lactation PBPK model that takes into account the drug ionization, partitioning between the maternal plasma and milk matrices, and drug partitioning between the milk constituents. Infant dose calculations that take into account maternal and milk physiological variability were incorporated in the model. Predicted M/P ratio for acetaminophen, alprazolam, caffeine, and digoxin were 0.83 ± 0.01, 0.45 ± 0.05, 0.70 ± 0.04, and 0.76 ± 0.02, respectively. These ratios were within 1.26-fold of the observed ratios. Assuming a daily milk intake of 150 ml, the predicted relative infant dose (%) for these compounds were 4.0, 6.7, 9.9, and 86, respectively, which correspond to a daily ingestion of 2.0 ± 0.5 mg, 3.7 ± 1.2 µg, 2.1 ± 1.0 mg, and 32 ± 4.0 µg by an infant of 5 kg bodyweight. Integration of the lactation model within the PBPK approach will facilitate and extend the application of PBPK models during drug development in high-throughput screening and in different clinical settings. The model can also be used in designing lactation trials and in the risk assessment of both environmental chemicals and maternally administered drugs.
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Affiliation(s)
| | | | - Jia Ning
- Simcyp DivisionCertara UK LimitedSheffieldUK
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Monitoring Human Milk β-Casein Phosphorylation and O-Glycosylation Over Lactation Reveals Distinct Differences between the Proteome and Endogenous Peptidome. Int J Mol Sci 2021; 22:ijms22158140. [PMID: 34360914 PMCID: PMC8347866 DOI: 10.3390/ijms22158140] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/20/2021] [Accepted: 07/22/2021] [Indexed: 12/15/2022] Open
Abstract
Human milk is a vital biofluid containing a myriad of molecular components to ensure an infant’s best start at a healthy life. One key component of human milk is β-casein, a protein which is not only a structural constituent of casein micelles but also a source of bioactive, often antimicrobial, peptides contributing to milk’s endogenous peptidome. Importantly, post-translational modifications (PTMs) like phosphorylation and glycosylation typically affect the function of proteins and peptides; however, here our understanding of β-casein is critically limited. To uncover the scope of proteoforms and endogenous peptidoforms we utilized mass spectrometry (LC-MS/MS) to achieve in-depth longitudinal profiling of β-casein from human milk, studying two donors across 16 weeks of lactation. We not only observed changes in β-casein’s known protein and endogenous peptide phosphorylation, but also in previously unexplored O-glycosylation. This newly discovered PTM of β-casein may be important as it resides on known β-casein-derived antimicrobial peptide sequences.
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Pace RM, Williams JE, Robertson B, Lackey KA, Meehan CL, Price WJ, Foster JA, Sellen DW, Kamau-Mbuthia EW, Kamundia EW, Mbugua S, Moore SE, Prentice AM, Kita DG, Kvist LJ, Otoo GE, Ruiz L, Rodríguez JM, Pareja RG, McGuire MA, Bode L, McGuire MK. Variation in Human Milk Composition Is Related to Differences in Milk and Infant Fecal Microbial Communities. Microorganisms 2021; 9:1153. [PMID: 34072117 PMCID: PMC8230061 DOI: 10.3390/microorganisms9061153] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 05/21/2021] [Accepted: 05/24/2021] [Indexed: 12/11/2022] Open
Abstract
Previously published data from our group and others demonstrate that human milk oligosaccharide (HMOs), as well as milk and infant fecal microbial profiles, vary by geography. However, little is known about the geographical variation of other milk-borne factors, such as lactose and protein, as well as the associations among these factors and microbial community structures in milk and infant feces. Here, we characterized and contrasted concentrations of milk-borne lactose, protein, and HMOs, and examined their associations with milk and infant fecal microbiomes in samples collected in 11 geographically diverse sites. Although geographical site was strongly associated with milk and infant fecal microbiomes, both sample types assorted into a smaller number of community state types based on shared microbial profiles. Similar to HMOs, concentrations of lactose and protein also varied by geography. Concentrations of HMOs, lactose, and protein were associated with differences in the microbial community structures of milk and infant feces and in the abundance of specific taxa. Taken together, these data suggest that the composition of human milk, even when produced by relatively healthy women, differs based on geographical boundaries and that concentrations of HMOs, lactose, and protein in milk are related to variation in milk and infant fecal microbial communities.
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Affiliation(s)
- Ryan M. Pace
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, ID 83844, USA;
| | - Janet E. Williams
- Department of Animal, Veterinary and Food Sciences, University of Idaho, Moscow, ID 83844, USA; (J.E.W.); (M.A.M.)
| | - Bianca Robertson
- Larsson-Rosenquist Foundation Mother-Milk-Infant Center of Research Excellence, Univeristy of California San Diego, La Jolla, CA 92093, USA; (B.R.); (L.B.)
- Department of Pediatrics, Univeristy of California San Diego, La Jolla, CA 92093, USA
| | - Kimberly A. Lackey
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, ID 83844, USA;
| | - Courtney L. Meehan
- Department of Anthropology, Washington State University, Pullman, WA 99164, USA;
| | - William J. Price
- Statistical Programs, College of Agricultural and Life Sciences, University of Idaho, Moscow, ID 83844, USA;
| | - James A. Foster
- Department of Biological Sciences, University of Idaho, Moscow, ID 83844, USA;
| | - Daniel W. Sellen
- Department of Anthropology, University of Toronto, Toronto, ON M5S 1A8, Canada;
| | | | - Egidioh W. Kamundia
- Department of Human Nutrition, Egerton University, Nakuru 20115, Kenya; (E.W.K.-M.); (E.W.K.); (S.M.)
| | - Samwel Mbugua
- Department of Human Nutrition, Egerton University, Nakuru 20115, Kenya; (E.W.K.-M.); (E.W.K.); (S.M.)
| | - Sophie E. Moore
- Department of Women and Children’s Health, King’s College London, London WC2R 2LS, UK;
- MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara P.O. Box 273, Gambia;
| | - Andrew M. Prentice
- MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara P.O. Box 273, Gambia;
| | - Debela G. Kita
- Department of Anthropology, Hawassa University, Hawassa P.O. Box 27601, Ethiopia;
| | - Linda J. Kvist
- Faculty of Medicine, Lund University, 221 00 Lund, Sweden;
| | - Gloria E. Otoo
- Department of Nutrition and Food Science, University of Ghana, Accra 00233, Ghana;
| | - Lorena Ruiz
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC), 33300 Villaviciosa, Spain;
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
| | - Juan M. Rodríguez
- Department of Nutrition and Food Science, Complutense University of Madrid, 28040 Madrid, Spain;
| | | | - Mark A. McGuire
- Department of Animal, Veterinary and Food Sciences, University of Idaho, Moscow, ID 83844, USA; (J.E.W.); (M.A.M.)
| | - Lars Bode
- Larsson-Rosenquist Foundation Mother-Milk-Infant Center of Research Excellence, Univeristy of California San Diego, La Jolla, CA 92093, USA; (B.R.); (L.B.)
- Department of Pediatrics, Univeristy of California San Diego, La Jolla, CA 92093, USA
| | - Michelle K. McGuire
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, ID 83844, USA;
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Raiten DJ, Combs GF, Steiber AL, Bremer AA. Perspective: Nutritional Status as a Biological Variable (NABV): Integrating Nutrition Science into Basic and Clinical Research and Care. Adv Nutr 2021; 12:1599-1609. [PMID: 34009250 PMCID: PMC8483963 DOI: 10.1093/advances/nmab046] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 01/26/2021] [Accepted: 03/18/2021] [Indexed: 01/02/2023] Open
Abstract
The field of nutrition has evolved from one focused primarily on discovery of the identities, metabolic functions, and requirements for essential nutrients to one focused on the application of that knowledge to the development and implementation of dietary recommendations to promote health and prevent disease. This evolution has produced a deeper appreciation of not only the roles of nutrients, but also factors affecting their functions in increasingly complex global health contexts. The intersection of nutrition with an increasingly more complex global health context necessitates a view of nutritional status as a biological variable (NABV), the study of which includes an appreciation that nutritional status is: 1) not limited to dietary exposure; 2) intimately and inextricably involved in all aspects of human health promotion, disease prevention, and treatment; and 3) both an input and an outcome of health and disease. This expanded view of nutrition will inform future research by facilitating considerations of the contexts and variability associated with the many interacting factors affecting and affected by nutritional status. It will also demand new tools to study multifactorial relations to the end of increasing precision and the development of evidence-based, safe, and effective standards of health care, dietary interventions, and public health programs.
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Affiliation(s)
| | - Gerald F Combs
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA,
USA
| | | | - Andrew A Bremer
- Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
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Longitudinal Changes in the Concentration of Major Human Milk Proteins in the First Six Months of Lactation and Their Effects on Infant Growth. Nutrients 2021; 13:nu13051476. [PMID: 33925556 PMCID: PMC8147063 DOI: 10.3390/nu13051476] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 04/26/2021] [Accepted: 04/26/2021] [Indexed: 12/13/2022] Open
Abstract
Our knowledge related to human milk proteins is still limited. The present study determined the changes in multiple human milk proteins during the first six months of lactation, investigated the influencing factors of milk proteins, and explored the impact of milk proteins on infant growth. A total of 105 lactating women and their full-term infants from China were prospectively surveyed in this research. Milk samples were collected at 1–5 days, 8–14 days, 1 month, and 6 months postpartum. Concentrations of total protein and α-lactalbumin were measured in all milk samples, and concentrations of lactoferrin, osteopontin, total casein, β-casein, αs−1 casein, and κ-casein were measured in milk from 51 individuals using ultra performance liquid chromatography coupled with mass spectrometry. The concentration of measured proteins in the milk decreased during the first six months of postpartum (p-trend < 0.001). Maternal age, mode of delivery, maternal education, and income impacted the longitudinal changes in milk proteins (p-interaction < 0.05). Concentrations of αs−1 casein in milk were inversely associated with the weight-for-age Z-scores of the infants (1 m: r −0.29, p 0.038; 6 m: r −0.33, p 0.020). In conclusion, the concentration of proteins in milk decreased over the first six months postpartum, potentially influenced by maternal demographic and delivery factors. Milk protein composition may influence infant weights.
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Christian P, Smith ER, Lee SE, Vargas AJ, Bremer AA, Raiten DJ. The need to study human milk as a biological system. Am J Clin Nutr 2021; 113:1063-1072. [PMID: 33831952 PMCID: PMC8106761 DOI: 10.1093/ajcn/nqab075] [Citation(s) in RCA: 86] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 02/25/2021] [Indexed: 12/24/2022] Open
Abstract
Critical advancement is needed in the study of human milk as a biological system that intersects and interacts with myriad internal (maternal biology) and external (diet, environment, infections) factors and its plethora of influences on the developing infant. Human-milk composition and its resulting biological function is more than the sum of its parts. Our failure to fully understand this biology in a large part contributes to why the duration of exclusive breastfeeding remains an unsettled science (if not policy). Our current understanding of human-milk composition and its individual components and their functions fails to fully recognize the importance of the chronobiology and systems biology of human milk in the context of milk synthesis, optimal timing and duration of feeding, and period of lactation. The overly simplistic, but common, approach to analyzing single, mostly nutritive components of human milk is insufficient to understand the contribution of either individual components or the matrix within which they exist to both maternal and child health. There is a need for a shift in the conceptual approach to studying human milk to improve strategies and interventions to support better lactation, breastfeeding, and the full range of infant feeding practices, particularly for women and infants living in undernourished and infectious environments. Recent technological advances have led to a rising movement towards advancing the science of human-milk biology. Herein, we describe the rationale and critical need for unveiling the multifunctionality of the various nutritional, nonnutritional, immune, and biological signaling pathways of the components in human milk that drive system development and maturation, growth, and development in the very early postnatal period of life. We provide a vision and conceptual framework for a research strategy and agenda to change the field of human-milk biology with implications for global policy, innovation, and interventions.
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Affiliation(s)
| | - Emily R Smith
- Milken Institute School of Public Health, The George Washington University, Departments of Global Health and Exercise and Nutrition Sciences, Washington, DC, USA
| | - Sun Eun Lee
- The Bill and Melinda Gates Foundation, Seattle, WA, USA
| | - Ashley J Vargas
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Andrew A Bremer
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Daniel J Raiten
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
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A Substantial Proportion of 6- to 12-Month-Old Infants Have Calculated Daily Absorbed Iron below Recommendations, Especially Those Who Are Breastfed. J Pediatr 2021; 231:36-42.e2. [PMID: 33144115 DOI: 10.1016/j.jpeds.2020.10.071] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/20/2020] [Accepted: 10/28/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To calculate the amount of bioavailable iron consumed among 6- to 12- month-old infants considering differences in iron bioavailability among dietary iron sources and to compare this with current recommended intakes. STUDY DESIGN We used the Feeding Infants and Toddlers Study database of dietary intakes from 2016 and the estimated bioavailability of dietary iron sources to evaluate the proportion of infants whose calculated total daily absorbed iron fell below physiologic requirements, that is, the recommended amount needed to fully support growth and erythropoiesis. RESULTS The calculated daily iron absorption was below the recommended amount in 54.3% of infants evaluated ranging from 19.5% of 448 exclusively formula-fed infants, to 95.8% of 296 exclusively breastfed infants and 72.2% of 102 mixed fed infants. The calculated mean iron absorption of 6- to 9- month-old breastfed infants was 0.27 mg/day, far less than the estimated physiologic requirement of 0.69 mg/day. The most highly bioavailable iron, heme iron, was <12% of the contributor to total iron absorbed in breastfed infants. CONCLUSIONS These data indicate a need for further education and public health policies to support increased iron intake in 6- to 12- month-old infants, emphasizing those receiving any breast milk. Exclusively formula-fed infants are at lower risk, but rates of low absorbed iron indicate that all infants may need monitoring for clinical evidence of low iron status. Consideration should be given to increasing the proportion of heme iron obtained from animal products in the diet where feasible.
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Hussain M, Li X, Wang L, Qayum A, Liu L, Zhang X, Hussain A, Koko M, Baigalmaa P. Recent Approaches and Methods for the Formulation of a Risk Free Infant Formula: Review. FOOD REVIEWS INTERNATIONAL 2021. [DOI: 10.1080/87559129.2021.1901113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Muhammad Hussain
- Department of Food Science, Food College, Northeast Agricultural University, Harbin, China
- Department of Food Science, Key Laboratory of Dairy Science, Ministry of Education, Northeast Agricultural University, Harbin, China
| | - Xiaodong Li
- Department of Food Science, Food College, Northeast Agricultural University, Harbin, China
- Department of Food Science, Key Laboratory of Dairy Science, Ministry of Education, Northeast Agricultural University, Harbin, China
| | - Lina Wang
- Department of Food Science, Food College, Northeast Agricultural University, Harbin, China
- Department of Food Science, Key Laboratory of Dairy Science, Ministry of Education, Northeast Agricultural University, Harbin, China
| | - Abdul Qayum
- Department of Food Science, Food College, Northeast Agricultural University, Harbin, China
- Department of Food Science, Key Laboratory of Dairy Science, Ministry of Education, Northeast Agricultural University, Harbin, China
| | - Lu Liu
- Department of Food Science, Food College, Northeast Agricultural University, Harbin, China
- Department of Food Science, Key Laboratory of Dairy Science, Ministry of Education, Northeast Agricultural University, Harbin, China
| | - Xiuxiu Zhang
- Department of Food Science, Food College, Northeast Agricultural University, Harbin, China
- Department of Food Science, Key Laboratory of Dairy Science, Ministry of Education, Northeast Agricultural University, Harbin, China
| | - Abid Hussain
- School of Food Science and Engineering, South China University of Technology, Guangzhou, PR China
| | - Marwa Koko
- Department of Food, Greases and Vegetable Protein Engineering, School of Food Sciences, Northeast Agriculture University Harbin, Harbin, China
| | - Purevsuren Baigalmaa
- Department of Food Science, Food College, Northeast Agricultural University, Harbin, China
- Department of Food Science, Key Laboratory of Dairy Science, Ministry of Education, Northeast Agricultural University, Harbin, China
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Nguyen MTT, Kim J, Seo N, Lee AH, Kim YK, Jung JA, Li D, To XHM, Huynh KTN, Van Le T, Israr B, Nazir A, Seo JA, Lee D, An HJ, Kim J. Comprehensive analysis of fatty acids in human milk of four Asian countries. J Dairy Sci 2021; 104:6496-6507. [PMID: 33685684 DOI: 10.3168/jds.2020-18184] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 11/18/2020] [Indexed: 01/25/2023]
Abstract
Human milk lipids provide not only energy but also indispensable bioactive components such as essential fatty acids. To establish the recommended daily intake value and guidelines for infant formula, a reference library of fatty acid composition has been generated from 4 Asian countries (South Korea, China, Vietnam, and Pakistan). Regardless of country, palmitic acid (C16:0), linoleic acid (C18:1), and linolenic acid (C18:2) were the 3 most abundant fatty acids in human milk and account for more than 75% of total fatty acids (total FA). However, there were several considerable differences between fatty acids, particularly n-3 and n-6 (omega-3 and omega-6) groups. Chinese mothers' milk had a high concentration of linoleic acid at 24.38 ± 10.02% of total FA, which may be due to maternal diet. Among the 4 countries, Pakistani mothers' milk contained a high amount of saturated fatty acid (56.83 ± 5.96% of total FA), and consequently, polyunsaturated fatty acids, including n-3 and n-6, were significantly lower than in other countries. It is noteworthy that docosahexaenoic acid (DHA) in Pakistani mothers' milk was 44.8 ± 33.3 mg/L, which is only 25 to 30% of the levels in the other 3 countries, suggesting the need for DHA supplementation for infants in Pakistan. Moreover, the ratio of n-6 to n-3 was also remarkably high in Pakistani mothers' milk (15.21 ± 4.96), being 1.4- to 1.7-fold higher than in other countries. The average DHA:ARA ratio in Asian human milk was 1.01 ± 0.79. Korean mothers' milk showed a high DHA:ARA ratio, with a value of 1.30 ± 0.98, but Pakistani mothers' milk had a significantly lower value (0.42 ± 0.12). The fatty acid compositions and anthropometric data of mother (body mass index, age) did not show any correlation. The obtained data might provide information about human milk compositions in the Asian region that could benefit from setting up recommended nutrient intake and infant formula for Asian babies.
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Affiliation(s)
- My Tuyen T Nguyen
- Department of Food and Nutrition, Chungnam National University, Daejeon 34134, Korea; College of Agriculture, Can Tho University, Can Tho, 900000, Vietnam
| | - Jieun Kim
- Department of Food and Nutrition, Chungnam National University, Daejeon 34134, Korea
| | - Nari Seo
- Graduate School of Analytical Science and Technology, Chungnam National University, Daejeon 34134, Korea
| | - A Hyun Lee
- Department of Food and Nutrition, Chungnam National University, Daejeon 34134, Korea
| | - Yong-Ki Kim
- Maeil Asia Human Milk Research Center, Maeil Dairies Co. Ltd., 63 Jinwiseo-ro, Jinwi-myeon, Pyeongtaek, Gyeonggi-do 17706, Korea
| | - Ji A Jung
- Maeil Asia Human Milk Research Center, Maeil Dairies Co. Ltd., 63 Jinwiseo-ro, Jinwi-myeon, Pyeongtaek, Gyeonggi-do 17706, Korea
| | - Dan Li
- College of Food Science and Engineering, Changchun University, Changchun 130022, China
| | - Xuan Hong M To
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam
| | - Khanh Trang N Huynh
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam
| | - Thanh Van Le
- Faculty of Nursing and Medical Technology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam
| | - Beenish Israr
- Faculty of Food, Nutrition, and Home Science, University of Agriculture, Faisalabad 38000, Pakistan
| | - Anum Nazir
- Faculty of Food, Nutrition, and Home Science, University of Agriculture, Faisalabad 38000, Pakistan
| | - Jung-A Seo
- Graduate School of Analytical Science and Technology, Chungnam National University, Daejeon 34134, Korea
| | - Daum Lee
- Graduate School of Analytical Science and Technology, Chungnam National University, Daejeon 34134, Korea
| | - Hyun Joo An
- Graduate School of Analytical Science and Technology, Chungnam National University, Daejeon 34134, Korea
| | - Jaehan Kim
- Department of Food and Nutrition, Chungnam National University, Daejeon 34134, Korea.
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Alemao CA, Budden KF, Gomez HM, Rehman SF, Marshall JE, Shukla SD, Donovan C, Forster SC, Yang IA, Keely S, Mann ER, El Omar EM, Belz GT, Hansbro PM. Impact of diet and the bacterial microbiome on the mucous barrier and immune disorders. Allergy 2021; 76:714-734. [PMID: 32762040 DOI: 10.1111/all.14548] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 07/10/2020] [Accepted: 07/30/2020] [Indexed: 12/11/2022]
Abstract
The prevalence of chronic immune and metabolic disorders is increasing rapidly. In particular, inflammatory bowel diseases, obesity, diabetes, asthma and chronic obstructive pulmonary disease have become major healthcare and economic burdens worldwide. Recent advances in microbiome research have led to significant discoveries of associative links between alterations in the microbiome and health, as well as these chronic supposedly noncommunicable, immune/metabolic disorders. Importantly, the interplay between diet, microbiome and the mucous barrier in these diseases has gained significant attention. Diet modulates the mucous barrier via alterations in gut microbiota, resulting in either disease onset/exacerbation due to a "poor" diet or protection against disease with a "healthy" diet. In addition, many mucosa-associated disorders possess a specific gut microbiome fingerprint associated with the composition of the mucous barrier, which is further influenced by host-microbiome and inter-microbial interactions, dietary choices, microbe immigration and antimicrobials. Our review focuses on the interactions of diet (macronutrients and micronutrients), gut microbiota and mucous barriers (gastrointestinal and respiratory tract) and their importance in the onset and/or progression of major immune/metabolic disorders. We also highlight the key mechanisms that could be targeted therapeutically to prevent and/or treat these disorders.
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Affiliation(s)
- Charlotte A. Alemao
- Priority Research Centre for Healthy Lungs Hunter Medical Research Institute New Lambton, Newcastle NSW Australia
- The University of Newcastle Newcastle NSW Australia
| | - Kurtis F. Budden
- Priority Research Centre for Healthy Lungs Hunter Medical Research Institute New Lambton, Newcastle NSW Australia
- The University of Newcastle Newcastle NSW Australia
| | - Henry M. Gomez
- Priority Research Centre for Healthy Lungs Hunter Medical Research Institute New Lambton, Newcastle NSW Australia
- The University of Newcastle Newcastle NSW Australia
| | - Saima F. Rehman
- Priority Research Centre for Healthy Lungs Hunter Medical Research Institute New Lambton, Newcastle NSW Australia
- The University of Newcastle Newcastle NSW Australia
| | - Jacqueline E. Marshall
- Faculty of Science Centre for Inflammation Centenary Institute University of Technology Sydney Sydney NSW Australia
| | - Shakti D. Shukla
- Priority Research Centre for Healthy Lungs Hunter Medical Research Institute New Lambton, Newcastle NSW Australia
- The University of Newcastle Newcastle NSW Australia
| | - Chantal Donovan
- Faculty of Science Centre for Inflammation Centenary Institute University of Technology Sydney Sydney NSW Australia
| | - Samuel C. Forster
- Department of Molecular and Translational Sciences Hudson Institute of Medical Research Centre for Innate Immunity and Infectious Diseases Monash University Clayton VIC Australia
| | - Ian A. Yang
- Thoracic Program The Prince Charles Hospital Metro North Hospital and Health Service Brisbane QLD Australia
- Faculty of Medicine UQ Thoracic Research Centre The University of Queensland Brisbane QLD Australia
| | - Simon Keely
- Hunter Medical Research Institute Priority Research Centre for Digestive Health and Neurogastroenterology University of Newcastle New Lambton Heights NSW Australia
| | - Elizabeth R. Mann
- Lydia Becker Institute of Immunology and Inflammation University of Manchester Manchester UK
- Faculty of Biology Medicine and Health Manchester Collaborative Centre for Inflammation Research Manchester Academic Health Science Centre University of Manchester Manchester UK
| | - Emad M. El Omar
- St George & Sutherland Clinical School Microbiome Research Centre University of New South Wales Sydney NSW Australia
| | - Gabrielle T. Belz
- Diamantina Institute University of Queensland Woolloongabba QLD Australia
- Department of Medical Biology Walter and Eliza Hall Institute of Medical Research University of Melbourne Parkville VIC Australia
| | - Philip M. Hansbro
- Priority Research Centre for Healthy Lungs Hunter Medical Research Institute New Lambton, Newcastle NSW Australia
- The University of Newcastle Newcastle NSW Australia
- Faculty of Science Centre for Inflammation Centenary Institute University of Technology Sydney Sydney NSW Australia
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Maples JM, McCarley C, Blankenship MM, Yoho K, Johnson KP, Fortner KB, Tinius RA. Metabolic Flexibility and Weight Status May Contribute to Inter-Individual Changes in Breastmilk Lipid Content in Response to an Acute Bout of Exercise: Preliminary Findings from a Pilot Study. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2020; 13:1756-1769. [PMID: 33414866 PMCID: PMC7745905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
Abstract
The purposes of this pilot study were to describe changes in breastmilk lipid content in response to an acute bout of moderate intensity exercise and to explore maternal metabolic health factors, including metabolic flexibility, which may impact this change. A cross-sectional, observational, pilot study design was performed in 14 women between 4 and 6 months postpartum. Whole body fasting lipid oxidation was assessed, a standardized high-fat breakfast was consumed, and lipid oxidation was again measured 120-minutes post-meal. Metabolic flexibility was determined by comparing the change in lipid oxidation before and after the meal. Women completed 30-minutes of moderate intensity treadmill walking 150-minutes post-meal. Breastmilk was expressed and analyzed for lipid content before and after exercise. Overall, there was no significant difference between pre- and post-exercise breastmilk lipid content (pre-exercise 59.4±36.1 g/L vs. post-exercise 52.5±20.7 g/L, p=0.26). However, five (36%) women had an increase in breastmilk lipid content in response to the exercise bout, compared to nine (64%) that had a decrease in breastmilk lipid content suggesting inter-individual variability. The change in breastmilk lipid content from pre- to post-exercise was positively correlated to metabolic flexibility (r=0.595, p=0.03). Additionally, post-exercise lipid content was positively correlated with body mass index (BMI), body composition, and postpartum weight retention. Preliminary findings from this pilot study suggest that metabolic flexibility and maternal weight status may help explain the inter-individual changes in breastmilk lipid content in response to an acute bout of moderate intensity exercise.
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Affiliation(s)
- Jill M Maples
- Department of Obstetrics and Gynecology, The University of Tennessee Graduate School of Medicine, Knoxville, TN, USA
| | - Charlotte McCarley
- Department of Obstetrics and Gynecology, The University of Tennessee Graduate School of Medicine, Knoxville, TN, USA
| | - Maire M Blankenship
- School of Nursing and Allied Health, Western Kentucky University, Bowling Green, KY, USA
| | - Kristin Yoho
- School of Kinesiology, Recreation, and Sport, Western Kentucky University, Bowling Green, KY, USA
| | - K Paige Johnson
- Department of Obstetrics and Gynecology, The University of Tennessee Graduate School of Medicine, Knoxville, TN, USA
| | - Kimberly B Fortner
- Department of Obstetrics and Gynecology, The University of Tennessee Graduate School of Medicine, Knoxville, TN, USA
| | - Rachel A Tinius
- School of Kinesiology, Recreation, and Sport, Western Kentucky University, Bowling Green, KY, USA
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Divedi P, Maheshwari P, Seth S, Mishra A. Analysis of Transitional Milk of Post-Natal Cases in Non-Anaemic Mothers and Its Comparison With Anaemic Mothers in Rural Western Uttar Pradesh. Cureus 2020; 12:e11818. [PMID: 33409063 PMCID: PMC7781501 DOI: 10.7759/cureus.11818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2020] [Indexed: 11/23/2022] Open
Abstract
AIM Present study is aimed at determining the analysis of transitional milk of post-natal non-anaemic mothers and its comparison with anaemic mothers in rural Uttar Pradesh. METHODS Totally, 132 post-natal cases were enrolled for the study. After taking ethical committee approval, breast milk samples were collected from day 4 to 11. We measured the following important parameters in breast milk (fat, density, carbohydrates, solid not fat [SNF], protein and added water). Data were analysed by using SPSS-24 software (IBM Corp., Armonk, NY). Tests used in our study were the analysis of variance (ANOVA) test, Chi-square test and independent T-test. RESULT In our study, it was found that severe anaemia causes significant changes in fat, lactose and protein content of breast milk. We found that there are no significant changes in breast milk composition with age. Our study shows statistically no association between residence and breast milk content. CONCLUSION As the severity of anaemia increases, protein and fat content in breast milk decreases, lactose content on the contrary follows a reverse relationship with maternal haemoglobin. Maternal anaemia not only affects the macronutrients in breast milk but also decreases the density of breast milk.
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Affiliation(s)
- Pragati Divedi
- Obstetrics and Gynaecology, Santosh Medical College and Hospital, Ghaziabad, IND
| | - Parul Maheshwari
- Obstetrics and Gynaecology, Uttar Pradesh University of Medical Sciences, Saifai, IND
| | - Shikha Seth
- Obstetrics and Gynaecology, Government Institute of Medical Sciences, Greater Noida, IND
| | - Archana Mishra
- Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND
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Fabrizio V, Trzaski JM, Brownell EA, Esposito P, Lainwala S, Lussier MM, Hagadorn JI. Individualized versus standard diet fortification for growth and development in preterm infants receiving human milk. Cochrane Database Syst Rev 2020; 11:CD013465. [PMID: 33226632 PMCID: PMC8094236 DOI: 10.1002/14651858.cd013465.pub2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Human milk as compared to formula reduces morbidity in preterm infants but requires fortification to meet their nutritional needs and to reduce the risk of extrauterine growth failure. Standard fortification methods are not individualized to the infant and assume that breast milk is uniform in nutritional content. Strategies for individualizing fortification are available; however it is not known whether these are safe, or if they improve outcomes in preterm infants. OBJECTIVES To determine whether individualizing fortification of breast milk feeds in response to infant blood urea nitrogen (adjustable fortification) or to breast milk macronutrient content as measured with a milk analyzer (targeted fortification) reduces mortality and morbidity and promotes growth and development compared to standard, non-individualized fortification for preterm infants receiving human milk at < 37 weeks' gestation or at birth weight < 2500 grams. SEARCH METHODS We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2019, Issue 9), in the Cochrane Library; Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Daily and Versions(R); and the Cumulative Index to Nursing and Allied Health Literature (CINAHL), on September 20, 2019. We also searched clinical trials databases and the reference lists of retrieved articles for pertinent randomized controlled trials (RCTs) and quasi-randomized trials. SELECTION CRITERIA We considered randomized, quasi-randomized, and cluster-randomized controlled trials of preterm infants fed exclusively breast milk that compared a standard non-individualized fortification strategy to individualized fortification using a targeted or adjustable strategy. We considered studies that examined any use of fortification in eligible infants for a minimum duration of two weeks, initiated at any time during enteral feeding, and providing any regimen of human milk feeding. DATA COLLECTION AND ANALYSIS Data were collected using the standard methods of Cochrane Neonatal. Two review authors evaluated the quality of the studies and extracted data. We reported analyses of continuous data using mean differences (MDs), and dichotomous data using risk ratios (RRs). We used the GRADE approach to assess the certainty of evidence. MAIN RESULTS Data were extracted from seven RCTs, resulting in eight publications (521 total participants were enrolled among these studies), with duration of study interventions ranging from two to seven weeks. As compared to standard non-individualized fortification, individualized (targeted or adjustable) fortification of enteral feeds probably increased weight gain during the intervention (typical mean difference [MD] 1.88 g/kg/d, 95% confidence interval [CI] 1.26 to 2.50; 6 studies, 345 participants), may have increased length gain during the intervention (typical MD 0.43 mm/d, 95% CI 0.32 to 0.53; 5 studies, 242 participants), and may have increased head circumference gain during the intervention (typical MD 0.14 mm/d, 95% CI 0.06 to 0.23; 5 studies, 242 participants). Compared to standard non-individualized fortification, targeted fortification probably increased weight gain during the intervention (typical MD 1.87 g/kg/d, 95% CI 1.15 to 2.58; 4 studies, 269 participants) and may have increased length gain during the intervention (typical MD 0.45 mm/d, 95% CI 0.32 to 0.57; 3 studies, 166 participants). Adjustable fortification probably increased weight gain during the intervention (typical MD 2.86 g/kg/d, 95% CI 1.69 to 4.03; 3 studies, 96 participants), probably increased gain in length during the intervention (typical MD 0.54 mm/d, 95% CI 0.38 to 0.7; 3 studies, 96 participants), and increased gain in head circumference during the intervention (typical MD 0.36 mm/d, 95% CI 0.21 to 0.5; 3 studies, 96 participants). We are uncertain whether there are differences between individualized versus standard fortification strategies in the incidence of in-hospital mortality, bronchopulmonary dysplasia, necrotizing enterocolitis, culture-proven late-onset bacterial sepsis, retinopathy of prematurity, osteopenia, length of hospital stay, or post-hospital discharge growth. No study reported severe neurodevelopmental disability as an outcome. One study that was published after our literature search was completed is awaiting classification. AUTHORS' CONCLUSIONS We found moderate- to low-certainty evidence suggesting that individualized (either targeted or adjustable) fortification of enteral feeds in very low birth weight infants increases growth velocity of weight, length, and head circumference during the intervention compared with standard non-individualized fortification. Evidence showing important in-hospital and post-discharge clinical outcomes was sparse and of very low certainty, precluding inferences regarding safety or clinical benefits beyond short-term growth.
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Affiliation(s)
- Veronica Fabrizio
- Division of Neonatology, Connecticut Children's, Hartford, CT, USA
- Department of Pediatrics, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Jennifer M Trzaski
- Division of Neonatology, Connecticut Children's, Hartford, CT, USA
- Department of Pediatrics, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Elizabeth A Brownell
- School of Nursing, University of Texas Health Science Center, San Antonio, TX, USA
- Department of Pediatrics, University of Texas Health Science Center, San Antonio, Texas, USA
| | | | - Shabnam Lainwala
- Division of Neonatology, Connecticut Children's, Hartford, CT, USA
- Department of Pediatrics, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Mary M Lussier
- Division of Neonatology, Connecticut Children's, Hartford, CT, USA
| | - James I Hagadorn
- Division of Neonatology, Connecticut Children's, Hartford, CT, USA
- Department of Pediatrics, University of Connecticut School of Medicine, Farmington, CT, USA
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Saben JL, Sims CR, Piccolo BD, Andres A. Maternal adiposity alters the human milk metabolome: associations between nonglucose monosaccharides and infant adiposity. Am J Clin Nutr 2020; 112:1228-1239. [PMID: 32844207 DOI: 10.1093/ajcn/nqaa216] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 07/09/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Human milk composition is altered by maternal obesity. The association between milk metabolites and infant outcomes has not been thoroughly investigated. OBJECTIVES This study aimed to quantify maternal adiposity-related differences in the human milk metabolome and to identify metabolites associated with infant adiposity during the first 6 mo postpartum using untargeted metabolomics. METHOD Maternal anthropometrics were assessed ≤14 weeks of gestation. Human milk samples were collected at 0.5 mo (n = 159), 2 mo (n = 131), and 6 mo (n = 94) postpartum from normal weight (NW, BMI = 18.5-24.9 kg/m2) and obese (OB, BMI >30 kg/m2) mothers. GC-time-of-flight-MS was used to identify metabolic signatures that discriminate NW and OB women. Partial least squared (PLS)-discriminant analysis, and PLS-regression models were assessed to examine relations between metabolites and maternal BMI and fat mass. Metabolites altered by maternal obesity were used in linear mixed effect models to predict infant adiposity. RESULTS Multivariate modeling identified 23, 17, and 10 metabolites that described maternal adiposity indices at 0.5 mo, 2 mo, and 6 mo postpartum, respectively. Monosaccharides and sugar alcohols were the most representative annotated metabolite classes that were increased in milk from OB women and included: mannose, ribose, lyxose, lyxitol (0.5 mo); mannose, ribitol, glycerol, isothreonic acid, lyxitol (2 mo); lyxitol and isothreonic acid (6 mo). Other discriminant metabolites included: 1-monostearin, xylonolactone, shikimic acid, pseudo uridine, and dodecanol (0.5 mo); N-acetyl-D-hexosamine and fumaric acid (2 mo); uric acid and tyrosine (6 mo). Mannose, lyxitol, and shikimic acid predicted higher infant adiposity over the first 6 mo of life. CONCLUSIONS This study reports on 1 of the largest cohorts to date examining the metabolic profiles in human milk comparing NW and OB women. Maternal adiposity was associated with increased amounts of milk nonglucose monosaccharides. Human milk metabolomics may be useful in predicting infant adiposity. These trials were registered at www.clinicaltrials.gov as NCT01131117 and NCT02125149.
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Affiliation(s)
- Jessica L Saben
- Arkansas Children's Nutrition Center, Little Rock, AR, USA.,J.L.S. Scientific Consulting, L.L.C., Thornton, CO, USA
| | - Clark R Sims
- Arkansas Children's Nutrition Center, Little Rock, AR, USA
| | - Brian D Piccolo
- Arkansas Children's Nutrition Center, Little Rock, AR, USA.,University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Aline Andres
- Arkansas Children's Nutrition Center, Little Rock, AR, USA.,University of Arkansas for Medical Sciences, Little Rock, AR, USA
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A comparison of macronutrient-based methods for deriving energy values in human milk. J Perinatol 2020; 40:1688-1693. [PMID: 32665689 DOI: 10.1038/s41372-020-0731-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/21/2020] [Accepted: 07/07/2020] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Energy values for human milk are increasingly available clinically, though there are no standards for deriving these values. We compared published calorie methods using a common set of samples. STUDY DESIGN Ten human milk samples were measured for gross and digestible macronutrients using laboratory methods. Four calorie conversion factors were used: Atwater general (ATW-GEN); Atwater milk specific (ATW-MILK), human milk specific (HUM-MILK), and combustible conversions (COMBUST). Differences in derived calories were assessed using ANOVA. RESULTS There was a significant difference (P < 0.001) in calorie values between methods. Gross macronutrients with COMBUST conversion factors produced the highest calorie values (19.4 ± 1.4 kcal/ounce) whereas digestible macronutrients with HUM-MILK conversion factors produced the lowest calorie values (16.3 ± 1.3 kcal/ounce). Mean difference between these values was 3.1 kcal/ounce (95% CI 2.5, 3.7). CONCLUSION Mean calorie difference of 3.1 kcal/ounce is clinically important for preterm infants, suggesting the need for standardization.
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