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Liu W, Zeng T, Mueed A, Zhang B, Wei T, Deng Z, Xi Q. Dynamic changes at high-protein dietary pattern of major fatty acids in healthy lactating women: A systematic review and meta-analysis. Nutrition 2024; 121:112362. [PMID: 38354680 DOI: 10.1016/j.nut.2024.112362] [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: 11/12/2023] [Revised: 01/14/2024] [Accepted: 01/17/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND Fatty acids (FAs) in human milk are important nutrients for infants. They play important roles in energy supply, nervous system development, and metabolic function maintenance. However, how the composition of major milk FAs change with lactation stages remains controversial. OBJECTIVES To systematically review the concentration range of major FAs in human milk at various lactation stages. METHODS A total of 12 papers involving 50 sets of data with 3507 participants were reviewed according to the PRISMA checklist and flow diagram. The inclusion criteria was the literatures had the FAs contents in breast milk of healthy lactation mothers at three lactation stages and the dietary patterns could be calculated. The exclusion criteria were: the studies were duplicates, were unrelated to dietary patterns or breast milk composition, and/or the study populations were unhealthy. We searched PubMed, the China National Knowledge Infrastructure, WanFang, and Web of science. Agency for Health Care Research and Quality (AHRQ) was used to assess the bias of studies. The mean values of polyunsaturated fatty acids (PUFAs) including docosahexaenoic acid (DHA), arachidonic acid (AA), eicosapentaenoic acid (EPA), α-linolenic acid (ALA), linoleic acid (LA), monounsaturated fatty acids (MUFAs), and saturated fatty acids (SFAs, including lauric acid and palmitic acid), in human milk at three lactation stages (colostrum 1-7 d, transitional milk 8-14 d, mature milk 15 d-3 mo) of healthy lactating women were investigated in terms of the high protein dietary pattern. Publication biases were evaluated by Egger's test. RESULTS According to the percentage in total fat of colostrum, transitional milk, and mature milk (% wt/wt), respectively, the results showed that PUFA (25.72%, 24.92%, and 22.69%), AA (0.85%, 0.76%, and 0.59%), DHA (0.53%, 0.47%, and 0.39%), EPA (0.15%, 0.10%, and 0.10%), and MUFA (37.39%, 37.21%, and 36.14%) contents in breast milk decreased with lactation, while another two PUFA forms, LA (17.47%, 17.82%, and 17.48%), and ALA (1.09%, 1.39%, and 1.24%) arrived at a peak in the transitional milk and then decreased in the mature milk, SFA (37.46%, 38.64%, and 40.52%), and lauric acid contents (2.78%, 4.91%, and 4.97%) increased with the lactation stages. CONCLUSION These findings could shed light on the dynamic change progress of major FA metabolism, potentially enhancing the knowledge of lactation biology, and improving infant feeding practices to meet their needs.
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Affiliation(s)
- Weixin Liu
- Jiangxi Provincial Key Laboratory of Preventive Medicine, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Tianyuan Zeng
- Jiuting Town Community Health Service Center, Shanghai, China
| | - Abdul Mueed
- Key Laboratory of Food Science and Resources, Nanchang University, Nanchang, China
| | - Baojun Zhang
- Jiangxi Provincial Key Laboratory of Preventive Medicine, Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Teng Wei
- Key Laboratory of Food Science and Resources, Nanchang University, Nanchang, China
| | - Zeyuan Deng
- Key Laboratory of Food Science and Resources, Nanchang University, Nanchang, China
| | - Qinghua Xi
- Jiangxi Provincial Key Laboratory of Preventive Medicine, Jiangxi Medical College, Nanchang University, Nanchang, China; Key Laboratory of Food Science and Resources, Nanchang University, Nanchang, China.
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Fan L, Wang X, Szeto IMY, Liu B, Sinclair AJ, Li D. Dietary intake of different ratios of ARA/DHA in early stages and its impact on infant development. Food Funct 2024; 15:3259-3273. [PMID: 38469864 DOI: 10.1039/d3fo04629j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
Long-chain polyunsaturated fatty acids (LC-PUFAs), arachidonic acid (ARA, 20:4n-6) and docosahexaenoic acid (DHA, 22:6n-3) are essential in the development of infants. ARA and DHA from breast milk or infant formula are the main sources of access for infants to meet their physiological and metabolic needs. The ratio of ARA to DHA in breast milk varies among regions and different lactation stages. Different ratios of ARA and DHA mainly from algal oil, animal fat, fish oil, and microbial oil, are added to infant formula in different regions and infant age ranges. Supplementing with appropriate ratios of ARA and DHA during infancy promotes brain, neural, visual, and other development aspects. In this review, we first introduced the current intake status of ARA and DHA in different locations, lactation stages, and age ranges in breast milk and infant formula. Finally, we discussed the effect of different ratios of ARA and DHA on infant development. This review provided a comprehensive research basis for the nutritional research of infants who consume different ratios of ARA and DHA.
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Affiliation(s)
- Lijiao Fan
- Institute of Nutrition & Health, School of Public Health, Qingdao University, Qingdao 266071, China.
| | - Xincen Wang
- Institute of Nutrition & Health, School of Public Health, Qingdao University, Qingdao 266071, China.
| | | | - Biao Liu
- National Center of Technology Innovation for Dairy, Hohhot 010110, China
| | - Andrew J Sinclair
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Notting Hill, VIC 3168, Australia
- Faculty of Health, Deakin University, Burwood, VIC 3152, Australia
| | - Duo Li
- Institute of Nutrition & Health, School of Public Health, Qingdao University, Qingdao 266071, China.
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Notting Hill, VIC 3168, Australia
- Department of Food Science and Nutrition, Zhejiang University, Hangzhou 310058, China
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Petersohn I, Hellinga AH, van Lee L, Keukens N, Bont L, Hettinga KA, Feskens EJM, Brouwer-Brolsma EM. Maternal diet and human milk composition: an updated systematic review. Front Nutr 2024; 10:1320560. [PMID: 38352250 PMCID: PMC10862141 DOI: 10.3389/fnut.2023.1320560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/28/2023] [Indexed: 02/16/2024] Open
Abstract
Context Exclusive breastfeeding for 6 months after birth provides infants with the best start for life. A review by Bravi et al. summarized the importance of maternal diet as a determinant of human milk composition based on data up to 2015, but evidence on nutrient intake level was limited. Objective We updated the review by Bravi et al., critically assessed differences in study designs and sampling methods, and graphically visualized trends and associations. Data sources PubMed was systematically searched for articles published between January 2015 and March 2021. Data extraction Article screening, selection, and data extraction was done by two independent researchers, including a risk of bias assessment based on 11 criteria. Articles were eligible when including: quantitative information, commonly used effect estimates, healthy mother-infant dyads. Results Twenty seven observational and five intervention studies were identified (n = 7,138) and combined with results of Bravi et al. Fatty acids were still the most studied human milk components in relation to maternal diet (n = 17 studies) with maternal fish intake being predominantly positively associated with milk ALA (r = 0.28-0.42), DHA (r = 0.24-0.46), and EPA (r = 0.25-0.28) content. PUFAs from diet were generally positively correlated with their concentrations in milk, while SFA intake was negatively associated with several fatty acids in milk. Studies on associations with maternal diet and milk carbohydrates, proteins, vitamins and minerals were limited in number and varied in methods and results. Conclusion This updated review shows that evidence on the association between maternal diet and human milk fatty acids is rapidly increasing, but still diversified in methodology and results. Further studies, preferably intervention studies, assessing diet and milk carbohydrates, proteins, vitamins and minerals are needed to be able draw conclusions on the importance of maternal diet for human milk composition as a whole.
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Affiliation(s)
- Inga Petersohn
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
- Ausnutria BV, Zwolle, Netherlands
| | - Anneke H. Hellinga
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht, Netherlands
| | | | - Nicole Keukens
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Louis Bont
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht, Netherlands
- Department of Paediatric Immunology and Infectious Diseases, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, Netherlands
- ReSViNET Foundation, Zeist, Netherlands
| | - Kasper A. Hettinga
- Division of Food Quality and Design, Wageningen University and Research, Wageningen, Netherlands
| | - Edith J. M. Feskens
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Elske M. Brouwer-Brolsma
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
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Einerhand AWC, Mi W, Haandrikman A, Sheng XY, Calder PC. The Impact of Linoleic Acid on Infant Health in the Absence or Presence of DHA in Infant Formulas. Nutrients 2023; 15:2187. [PMID: 37432333 DOI: 10.3390/nu15092187] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 04/27/2023] [Accepted: 05/01/2023] [Indexed: 07/12/2023] Open
Abstract
Both linoleic acid (LA) and α-linolenic acid (ALA) are essential dietary fatty acids, and a balanced dietary supply of these is of the utmost importance for health. In many countries across the globe, the LA level and LA/ALA ratio in breast milk (BM) are high. For infant formula (IF), the maximum LA level set by authorities (e.g., Codex or China) is 1400 mg LA/100 kcal ≈ 28% of total fatty acid (FA) ≈ 12.6% of energy. The aims of this study are: (1) to provide an overview of polyunsaturated fatty acid (PUFA) levels in BM across the world, and (2) to determine the health impact of different LA levels and LA/ALA ratios in IF by reviewing the published literature in the context of the current regulatory framework. The lipid composition of BM from mothers living in 31 different countries was determined based on a literature review. This review also includes data from infant studies (intervention/cohort) on nutritional needs regarding LA and ALA, safety, and biological effects. The impact of various LA/ALA ratios in IF on DHA status was assessed within the context of the current worldwide regulatory framework including China and the EU. Country averages of LA and ALA in BM range from 8.5-26.9% FA and 0.3-2.65% FA, respectively. The average BM LA level across the world, including mainland China, is below the maximum 28% FA, and no toxicological or long-term safety data are available on LA levels > 28% FA. Although recommended IF LA/ALA ratios range from 5:1 to 15:1, ratios closer to 5:1 seem to promote a higher endogenous synthesis of DHA. However, even those infants fed IF with more optimal LA/ALA ratios do not reach the DHA levels observed in breastfed infants, and the levels of DHA present are not sufficient to have positive effects on vision. Current evidence suggests that there is no benefit to going beyond the maximum LA level of 28% FA in IF. To achieve the DHA levels found in BM, the addition of DHA to IF is necessary, which is in line with regulations in China and the EU. Virtually all intervention studies investigating LA levels and safety were conducted in Western countries in the absence of added DHA. Therefore, well-designed intervention trials in infants across the globe are required to obtain clarity about optimal and safe levels of LA and LA/ALA ratios in IF.
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Affiliation(s)
| | - Wiola Mi
- Bunge Loders Croklaan Nutrition, Shanghai 200051, China
| | | | - Xiao-Yang Sheng
- Department of Developmental Behavioral Pediatric & Children Healthcare, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200051, China
| | - Philip C Calder
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton SO16 6YD, UK
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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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6
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MilkyBase, a database of human milk composition as a function of maternal-, infant- and measurement conditions. Sci Data 2022; 9:557. [PMID: 36085296 PMCID: PMC9463137 DOI: 10.1038/s41597-022-01663-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/24/2022] [Indexed: 01/15/2023] Open
Abstract
This study describes the development of a database, called MilkyBase, of the biochemical composition of human milk. The data were selected, digitized and curated partly by machine-learning, partly manually from publications. The database can be used to find patterns in the milk composition as a function of maternal-, infant- and measurement conditions and as a platform for users to put their own data in the format shown here. The database is an Excel workbook of linked sheets, making it easy to input data by non-computationally minded nutritionists. The hierarchical organisation of the fields makes sure that statistical inference methods can be programmed to analyse the data. Uncertainty quantification and recording dynamic (time-dependent) compositions offer predictive potentials. Measurement(s) | Concentration of biochemical compounds in human milk or/and derived quantities, like their sums or ratios. | Technology Type(s) | Data mining, by means of Machine Learning and targeted manual literature search within available scientific publications in the internet. | Factor Type(s) | Georgaphical region • Cohort size • Measurement Method • Various characteristics (including history) of mother, child, breast milk and measurement | Sample Characteristic - Organism | Human milk | Sample Characteristic - Environment | Standard birth environment | Sample Characteristic - Location | Various regions of the world |
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Ni M, Wang Y, Yang Z, Xu X, Zhang H, Yang Y, Zhang L, Chen J. Profiles of total and sn-2 fatty acid of human mature milk and their correlated factors: A cross-sectional study in China. Front Nutr 2022; 9:926429. [PMID: 36071934 PMCID: PMC9441907 DOI: 10.3389/fnut.2022.926429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 07/22/2022] [Indexed: 11/15/2022] Open
Abstract
Fatty acid (FA) in breast milk is beneficial to the growth and neurodevelopment of infants. However, the structure profiles of breast milk FAs and the influencing factors which are crucial for normal function have not been fully elucidated. This study aimed to characterize the profiles of total and sn-2 FAs in human mature milk based on two representative urban areas in China and explore potential sociodemographic determinants. Mothers (n = 70) at 40–100 d postpartum from Beijing and Danyang were recruited according to unified inclusion and exclusion criteria. Total and sn-2 FA compositions were examined by gas chromatography and quantified. Using the Spearman correlation and multiple regression model, we found that the location and maternal education level were the most conspicuous correlated factor. The milk of mothers from Beijing had higher levels of the n-6 series of long-chain polyunsaturated fatty acids (LCPUFA) (C20:2, C20:3n-6, C20:4n-6, n-6PUFA/n-3PUFA, LA/ALA, and ARA/DHA) than that of Danyang, while the opposite was observed in the n-3 series of LCPUFA (C18:3n-3 and Total n-3PUFA). Compared to the milk of mothers with a high school degree or below, those with a bachelor's degree or above had lower SFAs (C10:0, C12:0, C14:0, and Total SFA), n-3 series of LCPUFA (C18:3n-3 and Total n-3PUFA), C18:1n-9t, and higher n-6 series of LCPUFA (C18:2n-6c, C20:2, C20:4n-6, Total n-6PUFA, and n-6PUFA/n-3PUFA). Maternal age, infant gender, pre-conception body mass index (BMI), parity, delivery mode, and gestational weight gain were also associated with total FAs. However, fewer associations were found between the above factors and sn-2 FAs. This study will promote an understanding of human breast milk's lipid profile and help develop a formula more suitable for infants.
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Affiliation(s)
- Mengmei Ni
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yingyao Wang
- Chinese Nutrition Society, Beijing, China
- CNS Academy of Nutrition and Health (Beijing Zhongyinghui Nutrition and Health Research Institute) Beijing Zhongyinghui Nutrition and Health Research Institute, Beijing, China
| | - Zhirui Yang
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xuebing Xu
- Wilmar (Shanghai) Biotechnology Research & Development Center Co., Ltd., Shanghai, China
| | - Hong Zhang
- Wilmar (Shanghai) Biotechnology Research & Development Center Co., Ltd., Shanghai, China
| | - Yuexin Yang
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
- *Correspondence: Yuexin Yang
| | - Lishi Zhang
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Lishi Zhang
| | - Jinyao Chen
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Jinyao Chen
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Simon Sarkadi L, Zhang M, Muránszky G, Vass RA, Matsyura O, Benes E, Vari SG. Fatty Acid Composition of Milk from Mothers with Normal Weight, Obesity, or Gestational Diabetes. Life (Basel) 2022; 12:life12071093. [PMID: 35888181 PMCID: PMC9323340 DOI: 10.3390/life12071093] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/15/2022] [Accepted: 07/19/2022] [Indexed: 05/31/2023] Open
Abstract
Gestation and the neonatal period are crucial periods in infant development. Many components of breast milk, including fatty acids, play an important role in strengthening the immune system. The aim of our research was to evaluate the fatty acid profiles of milk from 69 mothers, including subjects having a normal weight, obesity, or gestational diabetes. For the analyses, we used gas chromatography (GC) with flame ionization detection (FID) and GC coupled with mass spectrometry (GC/MS). The main fatty acids found in breast milk were palmitic acid (C16:0; 26-28%), linoleic acid (C18:2; 23-28%), and α-linolenic acid linoleic acid (C18:3; 15-17%), followed by myristic acid (C14:0; 5-8%), lauric acid (C12:0; 4-6%) and stearic acid (C18:0; 4-5%). The average breakdown of fatty acids was 50% saturated, 44% polyunsaturated, and 6% monounsaturated. Breast milk samples were classified using principal component analysis and linear discriminant analysis. Results showed that milk from the two major groups of obese and normal body mass index (BMI) could be distinguished with an accuracy of 89.66%. Breast milk samples of Hungarian and Ukrainian mothers showed significant differences based on the fatty acid composition, which variations are attributable to the mothers' dietary habits.
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Affiliation(s)
- Livia Simon Sarkadi
- Department of Nutrition, Hungarian University of Agriculture and Life Sciences, 1118 Budapest, Hungary; (M.Z.); (G.M.)
| | - Miaomiao Zhang
- Department of Nutrition, Hungarian University of Agriculture and Life Sciences, 1118 Budapest, Hungary; (M.Z.); (G.M.)
| | - Géza Muránszky
- Department of Nutrition, Hungarian University of Agriculture and Life Sciences, 1118 Budapest, Hungary; (M.Z.); (G.M.)
| | - Réka Anna Vass
- Department of Obstetrics and Gynecology, University of Pécs Medical School, 7624 Pecs, Hungary;
- National Laboratory for Human Reproduction, University of Pécs, 7624 Pecs, Hungary
| | - Oksana Matsyura
- Department of Pediatrics No. 2, Danylo Halytsky Lviv National Medical University, 79010 Lviv, Ukraine;
| | - Eszter Benes
- Department of Food and Analytical Chemistry, Hungarian University of Agriculture and Life Sciences, 1118 Budapest, Hungary;
| | - Sandor G. Vari
- International Research and Innovation in Medicine Program, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA;
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Furangseroj T, Suteerojntrakool O, Hongvisitagul P, Chatchatee P, Suratannon N, Sapwarobol S, Techasukthavorn V, Dahlan W, Chomtho S. Effects of Maternal Exclusion Diet for Infants Suspected Food Allergy on Fatty Acid Composition in Breast Milk. Breastfeed Med 2022; 17:611-617. [PMID: 35544150 DOI: 10.1089/bfm.2021.0352] [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: 11/12/2022]
Abstract
Background: Levels of fatty acid (FA) in breast milk (BM) may vary depending on the maternal diet. This study aimed to explore FA composition in BM of lactating women following dietary restrictions due to infant allergic conditions. Materials and Methods: Thai lactating mothers of term infants who were on exclusion diets were recruited. Mature BM was collected before and after a period (at least 2 weeks) of dietary restriction. FA in BM was analyzed by gas chromatography-mass spectrometry. Results: Fifty lactating women 33.7 ± 3.6 years of age were enrolled. Thirty-three percent of the lactating mothers restricted more than eight food items. Most common dietary restriction were cow's milk (88%) and eggs (74%). After the period of dietary exclusion, total polyunsaturated FA showed no significant change, while saturated FA (SFA) declined, and monounsaturated FA (MUFA) increased. A decrease in fat intake was associated with an increase in arachidonic acid (ARA) and docosahexaenoic acid (DHA) content in BM (r = -0.37, r = -0.36; p < 0.05). However, a rise in ARA, eicosapentaenoic acid (EPA), and DHA intake was associated with an increase in linoleic acid and EPA in BM, respectively (r = 0.38, r = 0.55 and r = 0.41; p < 0.05). Infant weight-for-age z-score did not significantly change after the period of maternal dietary exclusion. Conclusion: Maternal exclusion diet resulted in lower SFA and higher MUFA composition in BM. Further study should explore the long-term outcomes of maternal dietary restriction on infant and child health.
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Affiliation(s)
- Thipaporn Furangseroj
- Division of Nutrition, Department of Pediatrics, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
| | - Orapa Suteerojntrakool
- King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand.,Pediatric Nutrition Research Unit, Division of Nutrition, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Prawpan Hongvisitagul
- Division of Nutrition, Department of Pediatrics, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
| | - Pantipa Chatchatee
- King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand.,Pediatric Allergy & Clinical Immunology Research Unit, Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Narissara Suratannon
- King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand.,Pediatric Allergy & Clinical Immunology Research Unit, Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Suwimol Sapwarobol
- The Medical Food Research Group, Department of Nutrition and Dietetics, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Varanya Techasukthavorn
- The Medical Food Research Group, Department of Nutrition and Dietetics, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Winai Dahlan
- The Halal Science Center, Chulalongkorn University, Bangkok, Thailand
| | - Sirinuch Chomtho
- King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand.,Pediatric Nutrition Research Unit, Division of Nutrition, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Ward E, Yang N, Muhlhausler BS, Leghi GE, Netting MJ, Elmes MJ, Langley-Evans SC. Acute changes to breast milk composition following consumption of high-fat and high-sugar meals. MATERNAL AND CHILD NUTRITION 2021; 17:e13168. [PMID: 33660402 PMCID: PMC8189213 DOI: 10.1111/mcn.13168] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 01/25/2021] [Accepted: 02/09/2021] [Indexed: 12/14/2022]
Abstract
Breast milk composition is influenced by habitual diet, yet little is known about the short-term effects of changes in maternal diet on breast milk macronutrient concentrations. Our aim was to determine the acute effect of increased consumption of sugar/fat on breast milk protein, lactose and lipids. Exclusively breastfeeding women (n = 9) were provided with a control, higher fat (+28 g fat) and higher sugar (+66 g sugar) diet over three separate days at least 1 week apart. Hourly breast milk samples were collected concurrently for the analysis of triglycerides, cholesterol, protein, and lactose concentrations. Breast milk triglycerides increased significantly following both the higher fat and sugar diet with a greater response to the higher sugar compared to control diet (mean differences of 3.05 g/dL ± 0.39 and 13.8 g/dL ± 0.39 in higher fat and sugar diets, respectively [P < 0.001]). Breast milk cholesterol concentrations increased most in response to the higher sugar diet (0.07 g/dL ± 0.005) compared to the control (0.04 g/dL) and the higher fat diet (0.05 g/dL) P < 0.005. Breast milk triglyceride and lactose concentrations increased (P < 0.001, P = 0.006), whereas protein decreased (p = 0.05) in response to the higher fat diet compared to the control. Independent of diet, there were significant variations in breast milk composition over the day; triglycerides and cholesterol concentrations were higher at end of day (P < 0.001), whereas protein and lactose concentrations peaked at Hour 10 (of 12) (P < 0.001). In conclusion, controlled short-term feeding to increase daily sugar/fat consumption altered breast milk triglycerides, cholesterol, protein and lactose. The variations observed in breast milk protein and lactose across the 12 h period is suggestive of a circadian rhythm.
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Affiliation(s)
- Ellen Ward
- School of Biosciences, University of Nottingham, Sutton Bonington, Loughborough, UK
| | - Ni Yang
- School of Biosciences, University of Nottingham, Sutton Bonington, Loughborough, UK
| | - Beverly S Muhlhausler
- Commonwealth Scientific and Industrial Research Organisation (CSIRO), Adelaide, South Australia, Australia.,School of Agriculture, Food and Wine, University of Adelaide, Adelaide, South Australia, Australia
| | - Gabriela E Leghi
- School of Agriculture, Food and Wine, University of Adelaide, Adelaide, South Australia, Australia
| | - Merryn J Netting
- Women and Kids Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia.,Discipline of Paediatrics, University of Adelaide, Adelaide, South Australia, Australia
| | - Matthew J Elmes
- School of Biosciences, University of Nottingham, Sutton Bonington, Loughborough, UK
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Variability of Lipids in Human Milk. Metabolites 2021; 11:metabo11020104. [PMID: 33670205 PMCID: PMC7916976 DOI: 10.3390/metabo11020104] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/02/2021] [Accepted: 02/09/2021] [Indexed: 12/20/2022] Open
Abstract
Lipids in breastmilk play a critical role in infant growth and development. However, few studies have investigated sources of variability of both high- and low-abundant milk lipids. The objective of our study was to investigate individual and morning-evening differences in the human milk lipidome. In this study, a modified two-phase method (MTBE: Methanol 7:2) was validated for the extraction of lipids from human breastmilk. This method was then applied to samples from a group of 20 healthy women to measure inter- and intra-individual (morning versus evening) variability of the breastmilk lipidome. We report here the levels of 237 lipid species from 13 sub-classes using reversed-phase liquid chromatography mass spectrometry (RP-LCMS) and direct-infusion mass spectrometry (DI-MS). About 85% of lipid species showed stable inter-individual differences across time points. Half of lipid species showed higher concentrations in the evening compared with the morning, with phosphatidylethanolamines (PEs) and triacylglycerols (TAGs) exhibiting the largest changes. In morning and evening samples, the biological variation was greater for diacylglycerols (DAGs) and TAGs compared with phospholipids and sphingolipids, and the variation in DAGs and TAGs was greater in evening samples compared with morning samples. These results demonstrate that variation in the milk lipidome is strongly influenced by individual differences and time of day.
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12
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Ding Y, Indayati W, Basnet TB, Li F, Luo H, Pan H, Wang Z. Dietary intake in lactating mothers in China 2018: report of a survey. Nutr J 2020; 19:72. [PMID: 32664937 PMCID: PMC7362564 DOI: 10.1186/s12937-020-00589-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 07/09/2020] [Indexed: 01/01/2023] Open
Abstract
Background The nutritional status of lactating mothers (LMs) is related to their own health and significantly impacts the secretion of breast-milk, and subsequently the growth and development of infants. Due to the influence of regional economy, traditional habits, and lack of nutrition knowledge, the problem of poor dietary nutrition among Chinese LMs is prominent. We aimed to evaluate and compare the dietary and nutrient intakes in LMs from urban and rural areas in China to provide baseline data for the implementation of relevant health guidance and strategies. Methods A multi-stage sampling method was used to recruit urban and rural LMs from 13 provinces and municipalities in China. An online dietary record using food photographs was employed to keep track of what the LMs had eaten in 2 days in the form of face-to-face interview. A total of 954 participants were included in the final analysis. Data expressed as quartiles P50 (P25; P75) were compared using the Mann-Whitney U-test (level of significance: p < 0.05). Results The consumption of staple food was higher in the rural (283.37 g/d) than in the urban areas (263.21 g/d). The consumption of vegetables, fruits, fish, shrimp, and shellfish, milk and dairy products was lower than the recommended amounts in both areas, and the insufficient intake of these food types was more serious in rural areas. While the energy intake of 83.8% of all LMs was lower than the estimated energy reference, it was comparable in the urban and rural areas. The intake of macronutrients (carbohydrates, protein, and fats) in rural areas was lower than in urban areas. The intake of some vitamins (VA, VB1, VB2, VB9 and VC) and minerals (calcium, magnesium, iodine and copper) was not ideal for LMs in both rural and urban areas. Conclusions Overall, the dietary intake in LMs was lower than the recommended levels. Many essential nutrients failed to meet the recommended doses, both in the urban and rural areas. The deficiencies in micronutrients were more prevalent in rural compared to urban areas. Educating LMs about women’s health and appropriate dietary intake is, therefore, essential.
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Affiliation(s)
- Ye Ding
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, 211166, People's Republic of China
| | - Wiwik Indayati
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, 211166, People's Republic of China
| | - Til Bahadur Basnet
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, 211166, People's Republic of China
| | - Fang Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, 211166, People's Republic of China
| | - Hongliang Luo
- Danone Open Science Research Center for Life-transforming Nutrition, Shanghai, 201204, People's Republic of China
| | - Han Pan
- Danone Open Science Research Center for Life-transforming Nutrition, Shanghai, 201204, People's Republic of China
| | - Zhixu Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, 211166, People's Republic of China.
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Dietary patterns and their association with breast milk macronutrient composition among lactating women. Int Breastfeed J 2020; 15:52. [PMID: 32503555 PMCID: PMC7273657 DOI: 10.1186/s13006-020-00293-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 05/18/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUD Breast milk is the optimal food for infant growth and development. The purpose of this study was to evaluate the association between breast milk macronutrient composition with dietary pattern among lactating women. METHODS A total of 220 lactating women from 2011 to 2012 in Changsha, a city of south-central China, was recruited using a multi-stage sampling method. Breast milk was collected, and the protein, fat, lactose, total dry matter, and energy contents of breast milk were measured. A 24 h recall method on three consecutive days was used to collect the dietary information of lactating women and an exploratory factor analysis was performed was to identify dietary patterns. The association between the concentration of a breast milk component and dietary pattern was assessed using a multivariable linear regression model. RESULTS Three major dietary patterns were classified. Lactating women with dietary pattern 1 mainly ate fresh vegetables and fresh legumes. Those with dietary pattern 2 mainly ate red meat, cereals and eggs, and those with dietary pattern 3 mainly ate fungi and algae, dries legumes and soy milk. Pattern 2 was positively associated with the concentration of protein (B = 0.07, 95% CI 0.00, 0.15), total dry matter (B = 0.20, 95% CI 0.02, 0.38) and energy (B = 1.66, 95% CI 0.03, 3.30) in breast milk. Morever, lactation period was negatively associated with the protein and total dry matter concentrations and positively associated with lactose. CONCLUSIONS The results show the lactation period was an important factor affecting milk composition and a dietary pattern with high intake of red meat, cereals, and eggs was associated with higher protein, total dry matter, and energy contents in breast milk. These findings show that the dietary patterns of lactating women can affect breast milk macronutrient composition and provide a foundation for improving child health.
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