Dietary Lipid Intake Influences the Alpha-tocopherol Levels in Human Milk

Vitamin E concentration in breast milk in different periods of lactation: Meta-analysis

Objective

This study systematized information about vitamin E concentration in healthy breast milk during different stages of lactation in order to support the strategies of protecting postpartum women and infants.

Methods

Studies published before April 30th, 2021, which detected vitamin E concentration in breast milk of healthy women by High Performance Liquid Chromatography (HPLC) or Ultra High Performance Liquid Chromatographic (UHPLC), were evaluated. The databases of CNKI (Chinese), WanFang Data (Chinese), VIP (Chinese), PubMed, Cochrane Library, Web of Science and Embase were searched. The random effect models were used to conduct meta-analysis by the statistical software package Stata 14.0.

Results

In all 4,791 searched publications, 53 with full text were selected, which included 46 descriptive studies, 1 case-control study, 1 non-randomized controlled trial, and 5 randomized controlled trials. The pooled mean of vitamin E concentration was 10.57 mg α-TE/L (95%CI 8.94–12.20) in colostrum, 4.03 mg α-TE/L (95%CI 3.29–4.77) in transitional milk and 3.29 mg α-TE/L (95%CI 2.95–3.64) in mature milk. Subgroup analysis showed that vitamin E concentration of colostrum in Asian countries was lower than that in Western countries in colostrum and transitional milk.

Conclusions

Vitamin E concentration in breast milk decreased during lactation until the mature milk was produced. The vitamin E concentration of colostrum in Asian countries was evidently lower than that in Western countries. The vitamin E concentration in mature milk is similar in different regions. The concentration of vitamin E in breast milk started to be stable from about 2 to 3 weeks postpartum until 4 or 6 months postpartum, but it needs additional evidence to support.

Dietary share of ultra-processed foods and its association with vitamin E biomarkers in Brazilian lactating women

Despite evidence showing that the intake of ultra-processed food has a negative impact on health, diet quality and dietary vitamin E, its impact on vitamin E nutritional status and breast milk remains unknown. This study aimed to assess the influence of the consumption of ultra-processed foods on vitamin E biomarkers of lactating women. A cross-sectional study was performed with 294 lactating women. Food consumption was obtained by 24-h dietary recall, and foods were grouped according to the NOVA classification. Levels of α-tocopherol were analysed by HPLC. Breast milk vitamin E (BMVE) adequacy was based on the quantity of the vitamin in the estimated intake volume. The Kruskal–Wallis test was used to compare the tertiles and linear regression to association between ultra-processed food consumption and biomarkers. Ultra-processed foods accounted for 16 % of energy intake and vitamin E intakes by all women were considered low. Serum α-tocopherol was 26·55 (sd 7·98) µmol/l, 5 % (n 11) showed inadequate vitamin E (< 12 µmol/l) and 78 % had an inadequate BMVE content (< 4 mg/780 ml). The regression showed that a higher dietary share of ultra-processed foods was associated with lower concentrations of serum α-tocopherol (β = –0·168, 95 % CI –0·047, 0·010, P = 0·003) and inadequate BMVE content (β = –0·144, 95 % CI = –0·505, 0·063, P = 0·012) (adjustment for income and maternal age). Thus, higher dietary shares of ultra-processed foods had an impact on vitamin E biomarkers, suggesting that inadequate dietary intake practices during lactation may reduce the supply of vitamin E to women and breast milk.