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Jhamb I, Freeman A, Lotfi MR, VanOrmer M, Hanson C, Anderson-Berry A, Thoene M. Evaluation of Vitamin E Isoforms in Placental Tissue and Their Relationship with Maternal Dietary Intake and Plasma Concentrations in Mother-Infant Dyads. Antioxidants (Basel) 2023; 12:1797. [PMID: 37891877 PMCID: PMC10604073 DOI: 10.3390/antiox12101797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/19/2023] [Accepted: 09/22/2023] [Indexed: 10/29/2023] Open
Abstract
α-tocopherol is a vitamin E isoform with potent antioxidant activity, while the γ-tocopherol isoform of vitamin E exerts more pro-inflammatory effects. In maternal-fetal environments, increased plasma α-tocopherol concentrations are associated with positive birth outcomes, while higher γ-tocopherol concentrations are linked with negative pregnancy outcomes. However, little is known about tocopherol concentrations in placental tissue and their role in modulating placental oxidative stress, a process that is implicated in many complications of pregnancy. The objectives of this research are to evaluate the concentrations of α- and γ-tocopherol in placental tissue and assess relationships with maternal and umbilical cord plasma concentrations. A total of 82 mother-infant dyads were enrolled at the time of delivery, and maternal and umbilical cord blood samples and placenta samples were collected. α- and γ-tocopherol concentrations in these samples were analyzed by high-performance liquid chromatography (HPLC). γ-tocopherol concentrations demonstrated significant, positive correlations among all sample types (p-values < 0.001). Placental tissue had a significantly lower ratio of α:γ-tocopherol concentrations when compared to maternal plasma and umbilical cord plasma (2.9 vs. 9.9 vs. 13.2, respectively; p < 0.001). Additional research should explore possible mechanisms for tocopherol storage and transfer in placental tissue and assess relationships between placental tocopherol concentrations and measures of maternal-fetal oxidative stress and clinical outcomes of pregnancy.
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Affiliation(s)
- Ishani Jhamb
- Department of Pediatrics, Division of Neonatology, University of California San Diego, San Diego, CA 92037, USA
| | - Alyssa Freeman
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Michelle R. Lotfi
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Matthew VanOrmer
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Corrine Hanson
- College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Ann Anderson-Berry
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Melissa Thoene
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE 68198, USA
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2
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Xi Y, Wang X, Liu K, Zhang H, Ren X, Zhao A, Yang Y, Lai J, Xiao R. Vitamin E concentration in breast milk in different periods of lactation: Meta-analysis. Front Nutr 2022; 9:1050011. [PMID: 36438759 PMCID: PMC9691403 DOI: 10.3389/fnut.2022.1050011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 10/26/2022] [Indexed: 11/11/2022] Open
Abstract
ObjectiveThis 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.MethodsStudies 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.ResultsIn 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.ConclusionsVitamin 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.
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Affiliation(s)
- Yuandi Xi
- Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, Beijing, China
- China-DRIs Research Group on Human Milk Composition, Beijing, China
| | - Xianyun Wang
- Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, Beijing, China
| | - Kuo Liu
- Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, Beijing, China
| | - Huanmei Zhang
- China-DRIs Research Group on Human Milk Composition, Beijing, China
- National Institute for Nutrition and Health, Chinese Center for Disease Control, Beijing, China
- Key Laboratory of Human Milk Science, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiangnan Ren
- China-DRIs Research Group on Human Milk Composition, Beijing, China
- National Institute for Nutrition and Health, Chinese Center for Disease Control, Beijing, China
- Key Laboratory of Human Milk Science, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ai Zhao
- China-DRIs Research Group on Human Milk Composition, Beijing, China
- Wanke School of Public Health, Tsinghua University, Beijing, China
| | - Yuexin Yang
- China-DRIs Research Group on Human Milk Composition, Beijing, China
- National Institute for Nutrition and Health, Chinese Center for Disease Control, Beijing, China
| | - Jianqiang Lai
- China-DRIs Research Group on Human Milk Composition, Beijing, China
- National Institute for Nutrition and Health, Chinese Center for Disease Control, Beijing, China
- Key Laboratory of Human Milk Science, Chinese Center for Disease Control and Prevention, Beijing, China
- *Correspondence: Jianqiang Lai
| | - Rong Xiao
- Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, Beijing, China
- Rong Xiao
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Kolnik S, Wood TR. Role of Vitamin E in Neonatal Neuroprotection: A Comprehensive Narrative Review. Life (Basel) 2022; 12:1083. [PMID: 35888171 PMCID: PMC9316652 DOI: 10.3390/life12071083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/15/2022] [Accepted: 07/18/2022] [Indexed: 11/16/2022] Open
Abstract
Vitamin E (Vit E) is an essential lipophilic antioxidant and anti-inflammatory agent that has potential as a neuroprotectant in newborn infants with brain injury. Vit E has shown promise in many in vitro studies, but success in translation to in vivo animal studies and the clinical setting has been mixed, with concern of adverse effects at high intravenous doses in preterm infants. However, a recent rise in knowledge of the beneficial effects of fat emulsions containing higher levels of Vit E, along with associated improved outcomes in some neonatal co-morbidities, has led many to reconsider Vit E administration as a potential therapeutic modality to improve neurological outcomes in the setting of neonatal brain injury. This narrative review discusses Vit E's structure, mechanism(s) of action, evidence in animal models, and association with health outcomes in neonates, including both dietary and supplemental Vit E and their bioavailability and pharmacokinetics as it relates to the brain. Lastly, long-term neurodevelopmental outcomes along with gaps in current knowledge are critiqued, which to date suggests that additional translational studies in larger animal models and assessment of safety profiles of different routes and doses of administration should be explored prior to large clinical trials. Importantly, a greater understanding of the brain region(s) and cell type(s) affected by Vit E may help to target the use of Vit E as a beneficial neuroprotective agent to specific populations or types of injury seen in newborns.
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Affiliation(s)
- Sarah Kolnik
- Division of Neonatology, Department of Pediatrics, University of Washington, Seattle, WA 98195, USA;
| | - Thomas R. Wood
- Division of Neonatology, Department of Pediatrics, University of Washington, Seattle, WA 98195, USA;
- Center on Human Development and Disability, University of Washington, Seattle, WA 98195, USA
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4
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Yang X, Jiang S, Deng X, Luo Z, Chen A, Yu R. Effects of Antioxidants in Human Milk on Bronchopulmonary Dysplasia Prevention and Treatment: A Review. Front Nutr 2022; 9:924036. [PMID: 35923207 PMCID: PMC9340220 DOI: 10.3389/fnut.2022.924036] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 06/21/2022] [Indexed: 12/20/2022] Open
Abstract
Bronchopulmonary dysplasia (BPD) is a severe chronic lung illness that affects neonates, particularly premature infants. It has far-reaching consequences for infant health and their families due to intractable short- and long-term repercussions. Premature infant survival and long-term quality of life are severely harmed by BPD, which is characterized by alveolarization arrest and hypoplasia of pulmonary microvascular cells. BPD can be caused by various factors, with oxidative stress (OS) being the most common. Premature infants frequently require breathing support, which results in a hyperoxic environment in the developing lung and obstructs lung growth. OS can damage the lungs of infants by inducing cell death, inhibiting alveolarization, inducing inflammation, and impairing pulmonary angiogenesis. Therefore, antioxidant therapy for BPD relieves OS and lung injury in preterm newborns. Many antioxidants have been found in human milk, including superoxide dismutase, glutathione peroxidase, glutathione, vitamins, melatonin, short-chain fatty acids, and phytochemicals. Human milk oligosaccharides, milk fat globule membrane, and lactoferrin, all unique to human milk, also have antioxidant properties. Hence, human milk may help prevent OS injury and improve BPD prognosis in premature infants. In this review, we explored the role of OS in the pathophysiology of BPD and related signaling pathways. Furthermore, we examined antioxidants in human milk and how they could play a role in BPD to understand whether human milk could prevent and treat BPD.
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Affiliation(s)
- Xianpeng Yang
- Department of Neonatology, Wuxi Maternity and Child Health Care Hospital, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Shanyu Jiang
- Department of Neonatology, Wuxi Maternity and Child Health Care Hospital, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Xianhui Deng
- Department of Neonatology, Wuxi Maternity and Child Health Care Hospital, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Zichen Luo
- Department of Neonatology, Wuxi Maternity and Child Health Care Hospital, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Ailing Chen
- Translational Medicine Laboratory, Research Institute for Reproductive Health and Genetic Diseases, The Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University, Wuxi, China
- *Correspondence: Ailing Chen
| | - Renqiang Yu
- Department of Neonatology, Wuxi Maternity and Child Health Care Hospital, Wuxi School of Medicine, Jiangnan University, Wuxi, China
- Renqiang Yu
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Rumore S, McGrath K, Scott A, Sexton E, Wong T. Fat soluble vitamin status in children on home parenteral nutrition in a tertiary paediatric intestinal rehabilitation unit. Clin Nutr ESPEN 2021; 46:240-245. [PMID: 34857203 DOI: 10.1016/j.clnesp.2021.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 09/20/2021] [Accepted: 10/04/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUNDS & AIMS Children with intestinal failure on home parenteral nutrition are at risk of fat malabsorption and fat soluble vitamin deficiency. Fish oil containing mixed lipid emulsions (SMOFlipid®) with higher vitamin E content, have a theoretical risk of exceeding current recommendations for vitamin E dosing and, may influence other fat soluble vitamin status in these children. The aim of this study was to assess for fat soluble vitamin status in children on long-term home parental nutrition receiving a mixed lipid emulsion (SMOFlipid®) compared with those receiving traditional soy or soy/olive oil based (non- SMOFlipid®) lipid emulsions and whether this is influenced by the underlying cause of intestinal failure. METHODS Retrospective longitudinal study in a tertiary referral paediatric hospital of children on home parental nutrition during the period January 2000 to June 2019. Data was retrieved using medical and pharmacy records, laboratory database, and summarised using inferential statistics. RESULTS 111 patients (n = 58 female) received home parental nutrition in 121 discrete episodes (range 45-5329 days). N = 61 (55%) were diagnosed with anatomical short bowel syndrome, of which necrotising enterocolitis was the most common cause (n = 14). SMOFlipid® was used exclusively in n = 79 patients, non-SMOFlipid® exclusively in n = 19, and n = 13 changed from non-SMOFlipid® to SMOFlipid® during the study period. The median vitamin E level and vitamin E:lipid ratio were significantly higher for patients on SMOFlipid® compared to non-SMOFlipid® (27.9 vs 18.3 μmol/L respectively, p < 0.001; 7.10 vs 4.00 μmol/mmol; p < 0.001). Median vitamin A level was comparable (1.19 vs 1.12 μmol/L, p = 0.241), while median vitamin D level was significantly lower in the non-SMOFlipid® group consistent with mild deficiency (63.7 vs 43.0 nmol/L, p < 0.001). CONCLUSION The use of SMOFlipid® correlated with higher Vitamin E level in paediatric home parental nutrition patients. Lower vitamin D level appears to correlate with the use of non-SMOFlipid®. A larger prospective cohort is required to delineate any clinical significance from these findings.
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Affiliation(s)
- Sarah Rumore
- Department of Gastroenterology and Nutrition, Nutritional Support and Intestinal Failure Team, Birmingham Women's and Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK.
| | - Kathleen McGrath
- Department of Gastroenterology and Nutrition, Nutritional Support and Intestinal Failure Team, Birmingham Women's and Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK
| | - Amanda Scott
- Nutritional Support and Intestinal Failure Team, Birmingham Women's and Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK
| | - Elaine Sexton
- Birmingham Women's and Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK
| | - Theodoric Wong
- Department of Gastroenterology and Nutrition, Nutritional Support and Intestinal Failure Team, Birmingham Women's and Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK
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No Evidence for Sex-specificity in Vitamins C, E, and Fatty Acid Content of Human Milk from Healthy Polish Mothers. J Pediatr Gastroenterol Nutr 2021; 73:e20-e25. [PMID: 33783401 DOI: 10.1097/mpg.0000000000003136] [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] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Human milk (HM) is a complex fluid that meets the nutritional needs of infants. Its composition is associated with environmental, maternal, and fetal variables. It provides nutrients and bioactive substances, including cytokines, immunoglobulins, and constituents with antioxidative properties. Boys are reportedly more susceptible to oxidative stress. This study aimed to determine the relationship between infant sex and the antioxidants vitamins C and E, and the fatty acid (FA) profile of HM. Results of this investigation may infer sex differences for the composition of infant formulas. METHODS Thirty days after delivery, a sample of HM was collected from 152 healthy, non-smoking mothers of full-term new-borns (77 males) born in good clinical condition. After FAs were extracted from the fat component, they were converted into methyl esters and separated using high-performance gas chromatography. Tocopherol content was determined using a method described in a previous study. Vitamin C content was determined using reversed-phase high-performance liquid chromatography with ultraviolet detection, as described in the same study. RESULTS The study groups (male vs female offspring) did not differ in terms of vitamin and FA content in HM. The only difference found was in gondoic acid 20:1 (n-9), with a higher concentration in the HM of mothers with female offspring (mean 0.63 ± 0.18 vs 0.59 ± 0.15 g/100 g FA; P < 0.047). CONCLUSIONS Despite the acknowledged differences in the composition of HM associated with infant sex and the increased oxidative stress in males, antioxidant content did not appear to differ according to infant sex. These results suggest that there is no need for the antioxidant content of infant formulas to be sex-specific.
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7
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Lorenzetti S, Plösch T, Teller IC. Antioxidative Molecules in Human Milk and Environmental Contaminants. Antioxidants (Basel) 2021; 10:550. [PMID: 33916168 PMCID: PMC8065843 DOI: 10.3390/antiox10040550] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/23/2021] [Accepted: 03/26/2021] [Indexed: 12/21/2022] Open
Abstract
Breastfeeding provides overall beneficial health to the mother-child dyad and is universally recognized as the preferred feeding mode for infants up to 6-months and beyond. Human milk provides immuno-protection and supplies nutrients and bioactive compounds whose concentrations vary with lactation stage. Environmental and dietary factors potentially lead to excessive chemical exposure in critical windows of development such as neonatal life, including lactation. This review discusses current knowledge on these environmental and dietary contaminants and summarizes the known effects of these chemicals in human milk, taking into account the protective presence of antioxidative molecules. Particular attention is given to short- and long-term effects of these contaminants, considering their role as endocrine disruptors and potential epigenetic modulators. Finally, we identify knowledge gaps and indicate potential future research directions.
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Affiliation(s)
- Stefano Lorenzetti
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità (ISS), 00161 Rome, Italy;
| | - Torsten Plösch
- Perinatal Neurobiology, Department of Human Medicine, School of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, 26129 Oldenburg, Germany;
- Department of Obstetrics and Gynaecology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
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8
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Kilvington A, Barnaba C, Rajasekaran S, Laurens Leimanis ML, Medina-Meza IG. Lipid profiling and dietary assessment of infant formulas reveal high intakes of major cholesterol oxidative product (7-ketocholesterol). Food Chem 2021; 354:129529. [PMID: 33761334 DOI: 10.1016/j.foodchem.2021.129529] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 02/03/2021] [Accepted: 03/02/2021] [Indexed: 12/17/2022]
Abstract
Approximately two-thirds of US infants receive infant formula (IF) as a primary or sole nutritional source during the first six months of life. IF is available in a variety of commercial presentations; from a manufacturing standpoint, they can be categorized as powder- (PIF) or liquid- (LIF) based formulations. Thirty commercial IFs were analyzed in their oxidative and non-oxidative lipid profiles. We identified 7-ketocholesterol - a major end-product of cholesterol oxidation - as a potential biomarker of IF manufacturing. The statistical analysis allowed a re-classification of IF based on their metabolomic fingerprint, resulting in three groups assigned with low-to-high oxidative status. Finally, we modeled the dietary intake of cholesterol, sterols, and 7-ketocholesterol in the first year of life. The database provided in this study will be instrumental for scientists interested in infant nutrition, to establish bases for epidemiological studies aimed to find connections between nutrition and diet-associated diseases, such as sitosterolemia.
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Affiliation(s)
- Alice Kilvington
- Department of Chemical Engineering and Materials Science, Michigan State University, East Lansing, MI, USA.
| | - Carlo Barnaba
- Institute of Quantitative Health Science and Engineering, Michigan State University, East Lansing, MI, USA.
| | - Surender Rajasekaran
- Pediatric Intensive Care Unit, Helen DeVos Children's Hospital, 100 Michigan Street NE, Grand Rapids, MI, USA; Department of Pediatric and Human Development, College of Human Medicine, Michigan State University, East Lansing, MI, USA.
| | - Mara L Laurens Leimanis
- Pediatric Intensive Care Unit, Helen DeVos Children's Hospital, 100 Michigan Street NE, Grand Rapids, MI, USA; Department of Pediatric and Human Development, College of Human Medicine, Michigan State University, East Lansing, MI, USA.
| | - Ilce G Medina-Meza
- Department of Chemical Engineering and Materials Science, Michigan State University, East Lansing, MI, USA; Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, MI, USA.
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Martini M, Altomonte I, Licitra R, Bartaloni FV, Salari F. A preliminary investigation into the unsaponifiable fraction of donkey milk: Sterols of animal origin, phytosterols, and tocopherols. J Dairy Sci 2020; 104:1378-1383. [PMID: 33189282 DOI: 10.3168/jds.2020-19268] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 08/29/2020] [Indexed: 12/26/2022]
Abstract
We investigated the main sterols, phytosterols, and the α- and γ-tocopherol content in donkey milk during the first 2 mo of lactation. Cholesterol was the main sterol in milk (mean ± standard deviation = 0.97 ± 0.443 g/100 g of fat). Lanosterol was the main minor sterol of animal origin, followed by desmosterol (0.003 ± 0.001 and 0.001 ± 0.001 g/100 g of fat, respectively). Of the phytosterols, β-sitosterol was the main sterol of vegetal origin in donkey milk (0.005 ± 0.002 g/100 g of fat), but lower levels of campesterol, brassicasterol, and stigmasterol were also recorded. Mean levels of α- and γ-tocopherol were 0.01 ± 0.007 and 0.003 ± 0.001 g/100 g of fat, respectively. We observed no significant changes in sterol or tocopherol content during the first 2 mo of lactation. The presence of lanosterol in donkey milk is of particular interest, because lanosterol is a potential drug and has important physiological effects. The presence of phytosterols, which are considered nutraceutical molecules, enhances the nutritional quality of donkey milk fat for consumers.
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Affiliation(s)
- M Martini
- Department of Veterinary Science, University of Pisa, Pisa 56124, Italy; Interdepartmental Research Center Nutrafood "Nutraceuticals and Food for Health," University of Pisa, Pisa 56124, Italy
| | - I Altomonte
- Interdepartmental Center for Agricultural and Environmental Research "E. Avanzi," University of Pisa, San Piero a Gardo (PI) 56122, Italy.
| | - R Licitra
- Department of Veterinary Science, University of Pisa, Pisa 56124, Italy
| | - F V Bartaloni
- Department of Veterinary Science, University of Pisa, Pisa 56124, Italy
| | - F Salari
- Department of Veterinary Science, University of Pisa, Pisa 56124, Italy
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10
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Nguyen MTT, Kim J, Lee H, Won S, Kim Y, Jung JA, Li D, To XHM, Huynh KTN, Le TV, Israr B, An HJ, Kim J. A Comparison of Vitamin and Lutein Concentrations in Breast Milk from Four Asian Countries. Nutrients 2020; 12:E1794. [PMID: 32560305 PMCID: PMC7353211 DOI: 10.3390/nu12061794] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/04/2020] [Accepted: 06/15/2020] [Indexed: 01/12/2023] Open
Abstract
Vitamins are the essential elements for human life and, particularly, for infant health. Human milk is the best source of nutrients for newborns, however, the information of vitamins in Asian maternal milk is still limited. In this study, we have collected 580 Asian maternal milk samples from Korea (n = 254), China (n = 137), Pakistan (n = 92), and Vietnam (n = 97). The vitamin concentrations, including vitamin B-groups (8 vitamins), fat-soluble vitamin (retinol, D, E, K) and lutein in the breast milk of were investigated. The concentration of thiamin (B1), biotin (B7), and folic acid (B9) in mother's milk of four countries were not considerably different, while riboflavin (B2), pantothenic acid (B5), and pyridoxine (B6) level in Vietnam samples were significantly lower than those in other countries. In contrast, retinol (A) and tocopherol (E) were found to be higher levels in Vietnamese maternal milk. Korean and Chinese maternal milk had low concentrations of retinol that may cause vitamin A deficiency in children. However, Chinese mother's milk was distinguished with a high concentration of lutein. Pakistani mother's milk was observed as having a significant problem of folic acid (B9) deficiency. Regardless of the country, vitamin B12, K, and D did not seem to be provided sufficiently through maternal milk. The moderate positive correlations were found between vitamin concentrations in each country and the pooled sample. The data obtained in this study were able to provide vital information to assess the nutritional status of breast milk in Asian countries and contributed to the efforts of ensuring the best nutrition for Asian children.
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Affiliation(s)
- My Tuyen Thi Nguyen
- Department of Food and Nutrition, Chungnam National University, Daejeon 34134, Korea; (M.T.T.N.); (J.K.); (H.L.); (S.W.)
- College of Agriculture, Can Tho University, Can Tho City 900000, Vietnam
| | - Jieun Kim
- Department of Food and Nutrition, Chungnam National University, Daejeon 34134, Korea; (M.T.T.N.); (J.K.); (H.L.); (S.W.)
| | - Hyunjun Lee
- Department of Food and Nutrition, Chungnam National University, Daejeon 34134, Korea; (M.T.T.N.); (J.K.); (H.L.); (S.W.)
| | - Soyoon Won
- Department of Food and Nutrition, Chungnam National University, Daejeon 34134, Korea; (M.T.T.N.); (J.K.); (H.L.); (S.W.)
| | - Yongki Kim
- Central Research Laboratory, Maeil Co., Ltd., 63 Jinwiseo-ro, Jinwi-myeon Pyeongtaek, Gyeonggi-do 17706, Korea; (Y.K.); (J.A.J.)
| | - Ji A. Jung
- Central Research Laboratory, Maeil Co., Ltd., 63 Jinwiseo-ro, Jinwi-myeon Pyeongtaek, Gyeonggi-do 17706, Korea; (Y.K.); (J.A.J.)
| | - Dan Li
- College of Food Science and Engineering, Changchun University, Changchun 130022, China;
| | - Xuan Hong Mai To
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam; (X.H.M.T.); (K.T.N.H.)
| | - Khanh Trang Nguyen Huynh
- Department of Obstetrics and Gynecology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam; (X.H.M.T.); (K.T.N.H.)
| | - 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;
| | - 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; (M.T.T.N.); (J.K.); (H.L.); (S.W.)
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Abstract
OBJECTIVE Dietary lipid intake is associated with serum alpha-tocopherol levels; however, its impact on human milk is unknown. The objective of this study was to evaluate the relationship between maternal intake of vitamin E, lipids, and fatty acids and the concentration of alpha-tocopherol in human milk. METHODS We conducted a longitudinal observational study, including 143 lactating women on 7, 30, and 90 days postpartum. Dietary intake was collected using 24-hour recall. On day 90, a human milk sample was collected and analyzed for alpha-tocopherol concentration. The prevalence of inadequate vitamin E intake was determined by the Estimated Average Requirement (16 mg/day), and the alpha-tocopherol concentration was analyzed by high-performance liquid chromatography. RESULTS Dietary intake of vitamin E was associated with the intake of lipids (r = 0.237, P = 0.004) and fatty acids (P < 0.05), and 100% of the participants had inadequate vitamin intake. Mean alpha-tocopherol concentration in the human milk samples was 7.11 (standard deviation 3.95) μmol/L and was correlated with lipid (r = 0.201, P = 0.042) and polyunsaturated fatty acid intake (r = 0.235, P = 0.017). Higher vitamin E levels were found in participants with the highest quartile of polyunsaturated fatty acid intake. CONCLUSIONS Alpha-tocopherol concentration was associated with the dietary intake of lipids and fatty acids, demonstrating that its bioavailability is associated with fats in the mammary gland. These results suggest development of appropriate strategies to increase the levels of vitamin E in breast milk that may help to prevent and treat vitamin E deficiency.
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da Silva AGCL, de Sousa Rebouças A, Mendonça BMA, Silva DCNE, Dimenstein R, Ribeiro KDDS. Relationship between the dietary intake, serum, and breast milk concentrations of vitamin A and vitamin E in a cohort of women over the course of lactation. MATERNAL & CHILD NUTRITION 2019; 15:e12772. [PMID: 30578660 PMCID: PMC7198973 DOI: 10.1111/mcn.12772] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 11/12/2018] [Accepted: 12/13/2018] [Indexed: 12/16/2022]
Abstract
This study evaluated the nutritional status of lactating women with regard to vitamins A and E and the relationship between dietary intake and concentrations in serum and milk. A longitudinal study was conducted with 43 women at a hospital in northeastern Brazil. Blood and milk samples and food intake recalls were obtained at three moments during the breastfeeding period. Retinol and alpha-tocopherol were analysed by high-performance liquid chromatography. Dietary inadequacy was analysed according to the estimated average requirement, with intrapersonal variation adjusted by the multiple source method. Food intake was classified by quartiles of consumption. Serum retinol was 1.65 μmol/L, with 5% of low concentrations (<0.7 μmol/L) at the first collection. Serum alpha-tocopherol decreased from 30.18 to 25.49 μmol/L at the third collection (P = 0.008), with an increase in the percentage frequency of deficiency (<12 μmol/L). Both vitamins maintained stable concentrations in milk at the different collection times, and the overall dietary inadequacy of vitamins A and E was 58% and 100%, respectively. There was a correlation only between vitamin A intake and serum retinol (r = 0.403, P = 0.007), and higher retinol concentrations were found in women classified in the highest consumption quartile (P = 0.031). Over the course of lactation, there was a high degree of inadequacy in vitamin intake and a reduction in serum alpha-tocopherol, whereas its concentrations in milk remained unchanged. Dietary intake of vitamin A has been shown to influence serum retinol, which underscores the importance of adequate nutrition and monitoring of vitamin deficiency during lactation.
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Affiliation(s)
| | - Amanda de Sousa Rebouças
- Department of BiochemistryFederal University of Rio Grande do NorteNatalRio Grande do NorteBrazil
| | | | | | - Roberto Dimenstein
- Department of BiochemistryFederal University of Rio Grande do NorteNatalRio Grande do NorteBrazil
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de Sousa Rebouças A, Costa Lemos da Silva AG, Freitas de Oliveira A, Thalia Pereira da Silva L, de Freitas Felgueiras V, Cruz MS, Silbiger VN, da Silva Ribeiro KD, Dimenstein R. Factors Associated with Increased Alpha-Tocopherol Content in Milk in Response to Maternal Supplementation with 800 IU of Vitamin E. Nutrients 2019; 11:nu11040900. [PMID: 31013594 PMCID: PMC6520676 DOI: 10.3390/nu11040900] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 04/05/2019] [Accepted: 04/09/2019] [Indexed: 11/16/2022] Open
Abstract
Background: Vitamin E supplementation might represent an efficient strategy to increase the vitamin E content in milk. The present study aimed to evaluate the impact of supplementation with 800 IU RRR-alpha-tocopherol on the alpha-tocopherol content of milk and the factors associated with the increase in vitamin E. Methods: Randomized clinical trial with 79 lactating women from Brazil, who were assigned to the control group, or to the supplemented group (800 IU of RRR-alpha-tocopherol). Milk and serum were collected between 30 and 90 days after delivery (collection 1), and on the next day (collection 2). Alpha-tocopherol was analyzed using high-performance liquid chromatography. Results: In the supplemented group, the alpha-tocopherol content in serum and milk increased after supplementation (p < 0.001). In the multivariate analysis, only alpha-tocopherol in milk (collection 1) was associated with the level of this vitamin in milk after supplementation (β = 0.927, p < 0.001), and binary logistic regression showed that the dietary intake was the only determinant for the greater effect of supplementation in milk. Conclusion: The pre-existing vitamin level in milk and diet are determinants for the efficacy of supplementation in milk, suggesting that in populations with vitamin E deficiency, high-dose supplementation can be used to restore its level in milk.
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Affiliation(s)
- Amanda de Sousa Rebouças
- Department of Biochemistry, Federal University of Rio Grande do Norte, 59078-970 Natal-RN, Brazil.
| | | | | | | | | | - Marina Sampaio Cruz
- Department of Pharmacy, Federal University of Rio Grande do Norte, 59012-570 Natal-RN, Brazil.
| | | | | | - Roberto Dimenstein
- Department of Biochemistry, Federal University of Rio Grande do Norte, 59078-970 Natal-RN, Brazil.
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Wei W, Yang J, Xia Y, Chang C, Sun C, Yu R, Zhou Q, Qi C, Jin Q, Wang X. Tocopherols in human milk: Change during lactation, stability during frozen storage, and impact of maternal diet. Int Dairy J 2018. [DOI: 10.1016/j.idairyj.2018.03.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Kuchan MJ, Moulton CJ, Dyer RA, Jensen SK, Schimpf KJ, Innis SM. RRR-α-Tocopherol Is the Predominant Stereoisomer of α-Tocopherol in Human Milk. Curr Dev Nutr 2018; 2:nzy055. [PMID: 30140787 PMCID: PMC6101621 DOI: 10.1093/cdn/nzy055] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 04/26/2018] [Accepted: 06/12/2018] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The naturally occurring α-tocopherol (α-T) stereoisomer, RRR-α-tocopherol (RRR-α-T), is known to be more bioactive than all-rac-α-tocopherol (all-rac-α-T), a synthetic racemic mixture of 8 stereoisomers. There is widespread use of all-rac-α-T in maternal supplements. OBJECTIVE The aim of the study was to thoroughly describe the α-T stereoisomer profile of human milk. METHODS We measured the α-T stereoisomer profile in milk from 2 cohorts of women: a cohort of 121 women who provided milk on days 30 and 60 of lactation (study 1) and a separate cohort of 51 women who provided milk on days 10, 21, 71, and 120 of lactation (study 2). RESULTS RRR-α-T was the predominant stereoisomer (P < 0.0001) in all samples in both studies despite a large intrasubject range in total α-T (0.7-22 μg/mL). On average, RRR-α-T comprised 73-76% of total α-T, but average values for the synthetic stereoisomers were RRS, 8-14%; RSR, 6-8%; RSS, 5-6%; and the sum of 2S stereoisomers (Σ2S), 3-5%. Despite the predominance of RRR-α-T, the sum of the synthetic stereoisomers comprised as much as 48% of total α-T. We calculated the ratio of RRR to the sum of the synthetic 2R (RRS + RSR + RSS) stereoisomers (s2R) to assess the degree to which RRR is favored in milk. Consistent with discrimination among 2R stereoisomers in mammary tissue, RRR/s2R values ranged from 2.8 to 3.6, as opposed to the expected ratio of 0.33 if there was no discrimination. However, the RRR to s2R ratio did not correlate with milk α-T concentration, but both components of the ratio did. CONCLUSIONS RRR-α-T is the predominant stereoisomer in human milk, concentrations of synthetic 2R stereoisomers were notable, and the relation between milk total α-T and stereoisomer profile is complex. Due to the wide range found in milk α-T stereoisomer profile, investigation into its impact on α-T status and functional outcomes in breastfed infants is warranted.
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Affiliation(s)
- Matthew J Kuchan
- Discovery Research and Development, Abbott Nutrition, Columbus, OH
| | | | - Roger A Dyer
- BC Children's Hospital Research Institute, Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Soren K Jensen
- Department of Animal Science, Aarhus University, Tjele, Denmark
| | - Karen J Schimpf
- Analytical Research and Development, Abbott Nutrition, Columbus, OH
| | - Sheila M Innis
- BC Children's Hospital Research Institute, Department of Pediatrics, University of British Columbia, Vancouver, Canada
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Silva ALCD, Ribeiro KDDS, Melo LRMD, Bezerra DF, Queiroz JLCD, Lima MSR, Pires JF, Bezerra DS, Osório MM, Dimenstein R. VITAMIN E IN HUMAN MILK AND ITS RELATION TO THE NUTRITIONAL REQUIREMENT OF THE TERM NEWBORN. REVISTA PAULISTA DE PEDIATRIA 2018; 35:158-164. [PMID: 28977333 PMCID: PMC5496727 DOI: 10.1590/1984-0462/;2017;35;2;00015] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 10/11/2016] [Indexed: 11/29/2022]
Abstract
Objectives: To determine the alpha-tocopherol concentration in breast milk at different periods of lactation and to estimate the possible supply of vitamin E to the infant. Methods: A longitudinal observational study was carried out with 100 mothers at University Hospital Ana Bezerra (HUAB), at Universidade Federal do Rio Grande do Norte, in Santa Cruz (RN), Northeast Brazil. Samples of colostrum (n=100), transitional milk (n=77), and mature milk (n=63) were collected. Alpha-tocopherol was analyzed by high-performance liquid chromatography. Vitamin supply to the newborn was estimated by comparing the nutritional requirement of vitamin E (4 mg/day) with the potential daily intake of milk. Results: The mean alpha-tocopherol concentration found in colostrum, transitional, and mature milk was 40.5±15.0 µmol/L, 13.9±5.2 µmol/L, and 8.0±3.8 µmol/L, respectively (p<0.001). The possible effect of these milks offered to the infant 6.2 mg/day of vitamin E in colostrum, 4.7 mg/day in transitional milk, and 2.7 mg/day in mature milk (p<0.0001), shows that only the mature milk did not guarantee the recommended quantity of this vitamin. Conclusions: Alpha-tocopherol levels in human milk decrease through the progression of lactation, and the possible intake of colostrum and transitional milk met the nutritional requirement of the infant. Mature milk may provide smaller amounts of vitamin E. Thus, it is important to study the factors that are associated with such low levels.
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Abstract
The WHO recommends exclusive breastfeeding for the first 6 mo of life to promote optimal infant health and development. Understanding the micro- and macronutrient concentrations of human milk and how each nutrient fluctuates with lactational stage, maternal factors, and supplementation is imperative for supporting good breastfeeding practices. Where maternal undernutrition compromises human milk quality, a thorough awareness of the effectiveness of interventions can direct efforts to achieve both maternal and infant nutrient sufficiency. This review of current knowledge covers trends in nutrient concentrations over the course of lactation and describes the influence of maternal intake, status, supplementation, and other factors on human milk concentrations of each nutrient.
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Affiliation(s)
- Daphna K Dror
- US Department of Agriculture, Agricultural Research Service, Western Human Nutrition Research Center, Davis, CA
| | - Lindsay H Allen
- US Department of Agriculture, Agricultural Research Service, Western Human Nutrition Research Center, Davis, CA
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18
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Abstract
Exclusive breastfeeding is recommended by the WHO for the first 6 mo of life because human milk protects against gastrointestinal infections and supplies balanced and adequate nutrient contents to the infant. However, reliable data on micronutrient concentrations in human milk are sparse, especially because some micronutrients are affected by maternal diet. Microbiological and competitive protein-binding assays, nuclear magnetic resonance or inductively coupled plasma spectroscopy, and chromatographic analyses are among the methods that have been applied to human-milk micronutrient analysis. However, the validation or evaluation of analytical methods in terms of their suitability for the complex human-milk matrix has been commonly ignored in reports, even though the human-milk matrix differs vastly from blood, plasma, or urine matrixes. Thus, information on the validity, accuracy, and sensitivity of the methods is essential for the estimation of infant and maternal intake requirements to support and maintain adequate milk micronutrient concentrations for healthy infant growth and development. In this review, we summarize current knowledge on methods used for analyzing water- and fat-soluble vitamins as well as iron, copper, zinc, iodine, and selenium in human milk and their different forms in milk; the tools available for quality control and assurance; and guidance for preanalytical considerations. Finally, we recommend preferred methodologic approaches for analysis of specific milk micronutrients.
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Affiliation(s)
- Daniela Hampel
- US Department of Agriculture, Agricultural Research Service,Western Human Nutrition Research Center, Davis, CA
- Department of Nutrition, University of California, Davis, Davis, CA
| | - Daphna K Dror
- US Department of Agriculture, Agricultural Research Service,Western Human Nutrition Research Center, Davis, CA
| | - Lindsay H Allen
- US Department of Agriculture, Agricultural Research Service,Western Human Nutrition Research Center, Davis, CA
- Department of Nutrition, University of California, Davis, Davis, CA
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Xue Y, Campos-Giménez E, Redeuil KM, Lévèques A, Actis-Goretta L, Vinyes-Pares G, Zhang Y, Wang P, Thakkar SK. Concentrations of Carotenoids and Tocopherols in Breast Milk from Urban Chinese Mothers and Their Associations with Maternal Characteristics: A Cross-Sectional Study. Nutrients 2017; 9:nu9111229. [PMID: 29120377 PMCID: PMC5707701 DOI: 10.3390/nu9111229] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 11/07/2017] [Accepted: 11/07/2017] [Indexed: 01/09/2023] Open
Abstract
Milk composition remains the best estimate of infant requirements. The aims of this study were to quantify carotenoids and tocopherols in human milk from healthy Chinese mothers, and to explore their associations with lactation stage, region, socio-economic and obstetric characteristics, and dietary intake. Human milk was obtained from 509 healthy mothers, and concentrations of carotenoids and tocopherols were analyzed by Ultra High Performance Liquid Chromatography. The mothers’ socio-economic and obstetric characteristics and dietary intake through a single 24-h dietary recall were evaluated. The median concentrations (μg/100 mL) of each component of 0–4 days, 5–11 days, 12–30 days, 31–60 days, 61–120 days, and 121–240 days postpartum were respectively as follows: β-carotene 8.0, 2.8, 2.1, 1.7, 1.9, 1.8; β-cryptoxanthin 6.2, 3.4, 2.4, 1.7, 1.8, 2.1; lutein 5.7, 7.0, 2.2, 2.9, 2.8, 3.7; lycopene 6.3, 2.5, 1.8, 1.4, 1.4, 1.5; zeaxanthin 1.0, 1.4, 0.8, 0.8, 1.0, 1.1; α-tocopherol 645, 382, 239, 206, 212, 211; γ-tocopherol 68, 63, 70, 73, 68, 88. The levels of those components varied significantly among different lactation stages and presented regional differences. Associations of carotenoid contents with maternal education, delivery mode, and present body mass index were found in multivariate analyses. These results suggested that lactation stage, region, and socio-economic and obstetric factors were associated with human milk concentrations of carotenoids and tocopherols in healthy Chinese mothers.
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Affiliation(s)
- Yong Xue
- Department of Nutrition & Food Hygiene, School of Public Health, Peking University Health Science Center, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China.
| | - Esther Campos-Giménez
- Nestlé Research Center, Nestec, Vers-chez-les-blanc, CH-1000 Lausanne 26, Switzerland.
| | | | - Antoine Lévèques
- Nestlé Research Center, Nestec, Vers-chez-les-blanc, CH-1000 Lausanne 26, Switzerland.
| | - Lucas Actis-Goretta
- Nestlé Research Center, Nestec, Vers-chez-les-blanc, CH-1000 Lausanne 26, Switzerland.
| | - Gerard Vinyes-Pares
- Nestlé Research Center Beijing, Building E-F, No. 5 Dijin Road, Haidian District, Beijing 100095, China.
| | - Yumei Zhang
- Department of Nutrition & Food Hygiene, School of Public Health, Peking University Health Science Center, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China.
| | - Peiyu Wang
- Department of Nutrition & Food Hygiene, School of Public Health, Peking University Health Science Center, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China.
| | - Sagar K Thakkar
- Nestlé Research Center, Nestec, Vers-chez-les-blanc, CH-1000 Lausanne 26, Switzerland.
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Keikha M, Bahreynian M, Saleki M, Kelishadi R. Macro- and Micronutrients of Human Milk Composition: Are They Related to Maternal Diet? A Comprehensive Systematic Review. Breastfeed Med 2017; 12:517-527. [PMID: 28880568 DOI: 10.1089/bfm.2017.0048] [Citation(s) in RCA: 111] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND This study aims at systematically reviewing the observational and interventional studies on the association of maternal macro- and micronutrient intake with breast milk content. METHODS We systematically searched the Medline via PubMed, Scopus, and ISI Web of Knowledge till October 2016 with the following search strategy: ("human milk" OR "breast milk" OR "breast milk composition" OR "human breast milk composition" OR "composition breast milk" OR "mother milk" OR "human breast milk") AND ("maternal diet" OR "maternal nutrition"). We also searched Google scholar for increasing the sensitivity of our search. The search was not limited to title and abstract due to the possibility that the desired outcome might have been considered a secondary aim. We excluded conference papers, editorials, letters, commentary, short survey, and notes. The search was refined to English language, and we did not consider any time limitation. To increase the sensitivity and to select more studies, the reference list of the published studies was checked as well. RESULTS This review included 59 observational and 43 interventional studies on maternal diet related to breast milk composition. Different studies determined the associations and effects of some maternal dietary intake of micro and macronutrients and its reflection in human milk. CONCLUSION Maternal dietary intake, particularly fatty acids, and some micronutrients, including fat soluble vitamins, vitamin B1, and vitamin C, was related to their content in breast milk composition.
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Affiliation(s)
- Mojtaba Keikha
- 1 Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences , Shahroud, Iran
| | - Maryam Bahreynian
- 2 Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences , Isfahan, Iran
| | - Mohammad Saleki
- 3 Students' Research Center, Isfahan University of Medical Sciences , Isfahan, Iran
| | - Roya Kelishadi
- 2 Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences , Isfahan, Iran
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Melo LRMD, Clemente HA, Bezerra DF, Dantas RCS, Ramalho HMM, Dimenstein R. Effect of maternal supplementation with vitamin E on the concentration of α‐tocopherol in colostrum. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2017. [DOI: 10.1016/j.jpedp.2016.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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22
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Sámano R, Martínez-Rojano H, Hernández RM, Ramírez C, Flores Quijano ME, Espíndola-Polis JM, Veruete D. Retinol and α-Tocopherol in the Breast Milk of Women after a High-Risk Pregnancy. Nutrients 2017; 9:E14. [PMID: 28045436 PMCID: PMC5295058 DOI: 10.3390/nu9010014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 11/20/2016] [Accepted: 12/21/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND There is scant information about whether, after a high-risk pregnancy, breast milk provides enough vitamins for assuring satisfactory bodily reserves in newborns. OBJECTIVE To comparatively evaluate, in women with high-risk and normal pregnancy, the concentration of retinol and α-tocopherol in breast milk. METHODS This cross-sectional, analytical study was evaluated with reverse-phase high-performance liquid chromatography (HPLC). Informed consent was signed by 95 mothers with a high-risk pregnancy and 32 mothers with a normal pregnancy. From the mothers with a high-risk pregnancy were obtained: 23 samples of colostrum, 24 of transitional milk, and 48 of mature milk. From the normal pregnancy group, 32 mature milk samples were collected. Pregestational Body Mass Index (BMI) and the gestational weight gain were noted. Models of logistic regression were constructed to identify the variables related to a low concentration of either retinol or α-tocopherol in breast milk. RESULTS The concentration of retinol and α-tocopherol in mature milk was 60 (interquartile range (IQR), 41-90) and 276 (103-450) μg/dL, respectively, for the high-risk pregnancy group, and 76 (65-91) and 673 (454-866) µg/dL, respectively, for the normal pregnancy group (p = 0.001). The concentration of retinol and α-tocopherol was similar in the subgroups of mothers with different disorders during gestation. A clear correlation was found between a greater pregestational weight and a lower concentration of retinol (Rho = -0.280, p = 0.006), and between α-tocopherol and retinol in all cases (Rho = 0.463, p = 0.001). Among women having a high-risk pregnancy, those delivering prematurely rather than carrying their pregnancy to term had a reduced concentration of retinol (54 (37-78) vs. 70 (49-106) µg/dL; p = 0.002) and a tendency to a lower concentration of α-tocopherol in breast milk (185 (75-410) vs. 339 (160-500) µg/dL; p = 0.053). Compared to mothers with a normal pregnancy, those with a high-risk pregnancy (whether carried to term or ending in preterm delivery) exhibited a reduced concentration of retinol in mature milk (p = 0.003), as well as a tendency to a lower concentration of α-tocopherol (p = 0.054). CONCLUSION Even though the women in the high-risk pregnancy group showed a deficiency of vitamins A and E in their breast milk, the unique biological benefits of this milk justify the promotion of breast feeding as the optimal method of nourishing neonates and infants. In these cases, it should be recommended that the woman increase her consumption of certain nutrients during pregnancy. Additionally, after childbirth mothers should consider the use of supplements to produce milk of adequate quality and thus meet the needs of the baby and prevent any deficiency in micronutrients.
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Affiliation(s)
- Reyna Sámano
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Secretaría de Salud Montes Urales 800, Miguel Hidalgo, Lomas Virreyes, Ciudad de México CP. 11000, Mexico.
| | - Hugo Martínez-Rojano
- Departamento de Posgrado e Investigación, Escuela Superior de Medicina del Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón s/n, Colonia Casco de Santo Tomas, Delegación Miguel Hidalgo, Ciudad de México CP. 11340, Mexico.
- Coordinación de Medicina Laboral, Instituto de Diagnóstico y Referencia Epidemiológicos (InDRE) "Dr. Manuel Martínez Báez", Secretaría de Salud Francisco de P. Miranda 177, Lomas de Plateros, Ciudad de México CP. 01480, Mexico.
| | - Rosa M Hernández
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Secretaría de Salud Montes Urales 800, Miguel Hidalgo, Lomas Virreyes, Ciudad de México CP. 11000, Mexico.
| | - Cristina Ramírez
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Secretaría de Salud Montes Urales 800, Miguel Hidalgo, Lomas Virreyes, Ciudad de México CP. 11000, Mexico.
| | - María E Flores Quijano
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Secretaría de Salud Montes Urales 800, Miguel Hidalgo, Lomas Virreyes, Ciudad de México CP. 11000, Mexico.
| | - José M Espíndola-Polis
- Departamento de Nutrición Humana, Universidad del Altiplano, Mirasol 1, Tlacomulco, Tlaxcala de Xicohténcatl CP. 90102, Mexico.
| | - Daniela Veruete
- Universidad del Valle de México, campus Chapultepec Av. Constituyentes No. 151, Miguel Hidalgo, San Miguel Chapultepec I Secc, Ciudad de México CP. 11850, Mexico.
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Effect of maternal supplementation with vitamin E on the concentration of α-tocopherol in colostrum. J Pediatr (Rio J) 2017; 93:40-46. [PMID: 27327566 DOI: 10.1016/j.jped.2016.03.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 03/11/2016] [Accepted: 03/23/2016] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE To evaluate the effect of maternal supplementation with vitamin E on the concentration of α-tocopherol in colostrum and its supply to the newborn. METHOD This randomized clinical trial enrolled 99 healthy adult pregnant women; of these, 39 were assigned to the control group and 60 to the supplemented group. After an overnight fast, 5mL of blood and 2mL of colostrum were collected. After the first sampling (0h milk), the supplemented group received 400IU of supplementary vitamin E. Another 2mL milk aliquot was collected in both groups 24h after supplementation (24h milk). The samples were analyzed by high-performance liquid chromatography. The α-tocopherol content provided by colostrum was calculated by considering a daily intake of 396mL of milk and comparing the resulting value to the recommended daily intake for infants aged 0-6 months (4mg/day). RESULTS The initial mean concentration of α-tocopherol in colostrum was 1509.3±793.7μg/dL in the control group and 1452.9±808.6μg/dL in the supplemented group. After 24h, the mean α-tocopherol concentration was 1650.6±968.7μg/dL in the control group (p>0.05) and 2346.9±1203.2μg/dL in the supplemented group (p<0.001), increasing the vitamin E supply to the newborn to 9.3mg/day. Initially, 18 women in the supplemented group provided colostrum α-tocopherol contents below 4mg/day; after supplementation only six continued to provide less than the recommended amount. CONCLUSION Maternal vitamin E supplementation increases the supply of the vitamin to the infant by providing more than twice the Recommended Daily Intake.
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Hanson C, Lyden E, Furtado J, Van Ormer M, Anderson-Berry A. A Comparison of Nutritional Antioxidant Content in Breast Milk, Donor Milk, and Infant Formulas. Nutrients 2016; 8:nu8110681. [PMID: 27801820 PMCID: PMC5133069 DOI: 10.3390/nu8110681] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 10/17/2016] [Accepted: 10/24/2016] [Indexed: 02/06/2023] Open
Abstract
Human milk is the optimal food for human infants, including infants born prematurely. In the event that a mother of a hospitalized infant cannot provide breast milk, donor milk is considered an acceptable alternative. It is known that the macronutrient composition of donor milk is different than human milk, with variable fat content and protein content. However, much less is known about the micronutrient content of donor milk, including nutritional antioxidants. Samples of breast milk from 12 mothers of infants hospitalized in the Newborn Intensive Care Unit until were collected and analyzed for concentrations of nutritional antioxidants, including α-carotene, β-carotene, β-cryptoxanthin, lycopene, lutein + zeaxanthin, retinol, and α-tocopherol. Additionally, a homogenized sample of donor milk available from a commercial milk bank and samples of infant formulas were also analyzed. Concentrations of nutritional antioxidants were measured using high-performance liquid chromatography. Compared to breast milk collected from mothers of hospitalized infants, commercially available donor milk had 18%–53% of the nutritional antioxidant content of maternal breast milk. As donor milk is becoming a common nutritional intervention for the high risk preterm infant, the nutritional antioxidant status of donor milk–fed premature infants and outcomes related to oxidative stress may merit further investigation.
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Affiliation(s)
- Corrine Hanson
- College of Allied Health Professions, University of Nebraska Medical Center, Medical Nutrition Education, 984045 Nebraska Medical Center, Omaha, NE 68198-4045, USA.
| | - Elizabeth Lyden
- College of Public Health, University of Nebraska Medical Center, 984375 Nebraska Medical Center, Omaha, NE 68198-4375, USA.
| | - Jeremy Furtado
- Department of Nutrition, Harvard School of Public Health, 655 Huntington Avenue, Boston, MA 02215, USA.
| | - Matthew Van Ormer
- Pediatrics, University of Nebraska Medical Center, 981205 Nebraska Medical Center, Omaha, NE 68198-1205, USA.
| | - Ann Anderson-Berry
- Pediatrics, University of Nebraska Medical Center, 981205 Nebraska Medical Center, Omaha, NE 68198-1205, USA.
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Kschonsek J, Stimming M, Libuda L, Kersting M, Böhm V. Food-based modification of LC-PUFA concentration in complementary food did not affect plasma vitamin E concentration in infants. NFS JOURNAL 2016. [DOI: 10.1016/j.nfs.2016.02.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Retinol and Alpha-tocopherol in the Colostrum of Lactating Tunisian Women Delivering Prematurely: Associations with Maternal Characteristics. Pediatr Neonatol 2016; 57:120-6. [PMID: 26293321 DOI: 10.1016/j.pedneo.2015.06.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 05/12/2015] [Accepted: 06/15/2015] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND This study aims to assess vitamin A and E concentrations in the premature colostrum of lactating Tunisian women and to identify maternal characteristics that may affect these concentrations. METHODS Human colostrum was obtained from 105 mothers who gave birth prematurely in the Centre for Maternity and Neonatology of Tunis (Tunisia). Retinol and alpha-tocopherol were analyzed in the colostrum and in plasma by high-performance liquid chromatography. RESULTS Retinol and alpha-tocopherol concentrations were 57.5 ± 50.1 μg/dL and 1222 ± 772 μg/dL in the colostrum, respectively, and 51.7 ± 20.0 μg/dL and 1351 ± 772 μg/dL in plasma, respectively. Concentrations of each vitamin in the colostrum were positively correlated with their respective concentrations in plasma (r = 0.415, p = 0.001 for retinol and r = 0.392, p = 0.003 for alpha-tocopherol). In multivariate analysis, colostrum vitamin A was associated with plasma vitamin A and preeclampsia, while colostrum vitamin E was associated with plasma vitamin E, gestational age, and preeclampsia. CONCLUSION In Tunisian women, colostrum vitamin A and E levels are close to the average values reported in the literature. The levels are too low to cover the needs of very low birth weight (VLBW) infants, particularly in women with plasma vitamin deficiencies, preeclampsia, or very premature delivery. Given the undeniable beneficial effects of human colostrum, whenever feasible, VLBW infants should be fed colostrum. Infant vitamin A and E requirements should be met by milk fortification or supplementation.
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Jiang J, Xiao H, Wu K, Yu Z, Ren Y, Zhao Y, Li K, Li J, Li D. Retinol and α-tocopherol in human milk and their relationship with dietary intake during lactation. Food Funct 2016; 7:1985-91. [DOI: 10.1039/c5fo01293g] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Human milk is considered as an optimal nutrition source for neonates, and vitamins A and E improve oxidative stress in offspring through breast milk.
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Affiliation(s)
- Jiajing Jiang
- Department of Food Science and Nutrition
- Zhejiang University
- Hangzhou
- China
- APCNS Centre of Nutrition and Food Safety
| | - Hailong Xiao
- Department of Food Science and Nutrition
- Zhejiang University
- Hangzhou
- China
- Department of Hangzhou Food and Drug Inspection
| | - Kejian Wu
- Department of Food Science and Nutrition
- Zhejiang University
- Hangzhou
- China
- APCNS Centre of Nutrition and Food Safety
| | - Zuxun Yu
- Department of Fine Chemical
- Zhejiang University
- Hangzhou
- China
| | - Yiping Ren
- Zhejiang Provincial Center for Disease Prevention and Control
- Hangzhou
- China
| | - Yiming Zhao
- Department of Food Science and Nutrition
- Zhejiang University
- Hangzhou
- China
- APCNS Centre of Nutrition and Food Safety
| | - Kelei Li
- Department of Food Science and Nutrition
- Zhejiang University
- Hangzhou
- China
- APCNS Centre of Nutrition and Food Safety
| | - Jiaomei Li
- Department of Food Science and Nutrition
- Zhejiang University
- Hangzhou
- China
- APCNS Centre of Nutrition and Food Safety
| | - Duo Li
- Department of Food Science and Nutrition
- Zhejiang University
- Hangzhou
- China
- APCNS Centre of Nutrition and Food Safety
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Stimming M, Mesch CM, Kersting M, Kalhoff H, Demmelmair H, Koletzko B, Schmidt A, Böhm V, Libuda L. Vitamin E content and estimated need in German infant and follow-on formulas with and without long-chain polyunsaturated fatty acids (LC-PUFA) enrichment. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2014; 62:10153-10161. [PMID: 25220561 DOI: 10.1021/jf502469b] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Many formulas (FM) for infants are nowadays supplemented with LC-PUFA. Due to the susceptibility of LC-PUFA to peroxidation, a potential risk of oxidative stress must be considered. We analyzed the concentration of unsaturated fatty acids to calculate an estimated vitamin E need and the concentration of vitamin E as an important lipophilic antioxidant in LC-PUFA enriched (FM(+), n = 31) and not enriched (FM(-), n = 29) formulas as well as in breast milk (BM, n = 118). No differences were observed in the ratios of vitamin E content to estimated vitamin E need between FM(+) and FM(-). Ratios were consistently above the minimum value according to European law. FM showed similar or higher ratios than BM, except in a worst-case scenario where BM showed higher ratios than FM(+). Our results indicate adequate vitamin E content relative to unsaturated fatty acid content in present-day commercial formulas. Given that breast milk tends to contain higher ratios of vitamin E content to estimated vitamin E need than LC-PUFA enriched formulas (at least in a worst-case scenario), the potential effects of increasing vitamin E content in LC-PUFA enriched formulas should be explored.
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Affiliation(s)
- Madlen Stimming
- Research Institute of Child Nutrition (FKE) Dortmund, Rheinische Friedrich-Wilhelms University Bonn , Heinstueck 11, 44225 Dortmund, Germany
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Fares S, Feki M, Khouaja-Mokrani C, Sethom MM, Jebnoun S, Kaabachi N. Nutritional practice effectiveness to achieve adequate plasma vitamin A, E and D during the early postnatal life in Tunisian very low birth weight infants. J Matern Fetal Neonatal Med 2014; 28:1324-1328. [DOI: 10.3109/14767058.2014.953922] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Samira Fares
- Faculty of Medicine of Tunis, Department of Biochemistry, El Manar University, Rabta Hospital, Tunis, Tunisia and
| | - Moncef Feki
- Faculty of Medicine of Tunis, Department of Biochemistry, El Manar University, Rabta Hospital, Tunis, Tunisia and
| | - Chahnez Khouaja-Mokrani
- Faculty of Medicine of Tunis, Service of Neonatology, Centre of Maternity and Neonatology of Tunis, El Manar University, Tunis, Tunisia
| | - Mohamed Marouane Sethom
- Faculty of Medicine of Tunis, Department of Biochemistry, El Manar University, Rabta Hospital, Tunis, Tunisia and
| | - Sami Jebnoun
- Faculty of Medicine of Tunis, Service of Neonatology, Centre of Maternity and Neonatology of Tunis, El Manar University, Tunis, Tunisia
| | - Naziha Kaabachi
- Faculty of Medicine of Tunis, Department of Biochemistry, El Manar University, Rabta Hospital, Tunis, Tunisia and
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Lima MSR, Dimenstein R, Ribeiro KDS. Vitamin E concentration in human milk and associated factors: a literature review. J Pediatr (Rio J) 2014; 90:440-8. [PMID: 24953721 DOI: 10.1016/j.jped.2014.04.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 04/04/2014] [Accepted: 04/15/2014] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To systematize information about vitamin E concentration in human milk and the variables associated with this composition in order to find possible causes of deficiency, supporting strategies to prevent it in postpartum women and infants. SOURCE Studies published between 2004 and 2014 that assayed alpha-tocopherol in human milk of healthy women by high performance liquid chromatography were evaluated. The keywords used were "vitamin E", "alpha-tocopherol", "milk, human", "lactation", and equivalents in Portuguese, in the BIREME, CAPES, PubMed, SciELO, ISI Web of Knowledge, HighWire Press, Ingenta, and Brazilian Digital Library of Theses and Dissertations databases. SUMMARY OF THE FINDINGS Of the 41 publications found on the subject, 25 whose full text was available and met the inclusion criteria were selected. The alpha-tocopherol concentrations found in milk were similar in most populations studied. The variable phase of lactation was shown to influence vitamin E content in milk, which is reduced until the mature milk appears. Maternal variables parity, anthropometric nutritional status, socioeconomic status, and habitual dietary intake did not appear to affect the alpha-tocopherol levels in milk. However, the influence of the variables maternal age, gestational age, biochemical nutritional status in alpha-tocopherol, and maternal supplementation with vitamin E had conflicting results in the literature. CONCLUSION Alpha-tocopherol concentration in milk decreases during lactation, until the mature milk appears. To confirm the influence of some maternal and child variables on milk vitamin E content, further studies with adequate design are needed.
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Affiliation(s)
- Mayara S R Lima
- Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil.
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Lima MS, Dimenstein R, Ribeiro KD. Vitamin E concentration in human milk and associated factors: a literature review. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2014. [DOI: 10.1016/j.jpedp.2014.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Bell EF, Hansen NI, Brion LP, Ehrenkranz RA, Kennedy KA, Walsh MC, Shankaran S, Acarregui MJ, Johnson KJ, Hale EC, Messina LA, Crawford MM, Laptook AR, Goldberg RN, Van Meurs KP, Carlo WA, Poindexter BB, Faix RG, Carlton DP, Watterberg KL, Ellsbury DL, Das A, Higgins RD. Serum tocopherol levels in very preterm infants after a single dose of vitamin E at birth. Pediatrics 2013; 132:e1626-33. [PMID: 24218460 PMCID: PMC3838534 DOI: 10.1542/peds.2013-1684] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/16/2013] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Our aim was to examine the impact of a single enteral dose of vitamin E on serum tocopherol levels. The study was undertaken to see whether a single dose of vitamin E soon after birth can rapidly increase the low α-tocopherol levels seen in very preterm infants. If so, this intervention could be tested as a means of reducing the risk of intracranial hemorrhage. METHODS Ninety-three infants <27 weeks' gestation and <1000 g were randomly assigned to receive a single dose of vitamin E or placebo by gastric tube within 4 hours of birth. The vitamin E group received 50 IU/kg of vitamin E as dl-α-tocopheryl acetate (Aquasol E). The placebo group received sterile water. Blood samples were taken for measurement of serum tocopherol levels by high-performance liquid chromatography before dosing and 24 hours and 7 days after dosing. RESULTS Eighty-eight infants received the study drug and were included in the analyses. The α-tocopherol levels were similar between the groups at baseline but higher in the vitamin E group at 24 hours (median 0.63 mg/dL vs. 0.42 mg/dL, P = .003) and 7 days (2.21 mg/dL vs 1.86 mg/dL, P = .04). There were no differences between groups in γ-tocopherol levels. At 24 hours, 30% of vitamin E infants and 62% of placebo infants had α-tocopherol levels <0.5 mg/dL. CONCLUSIONS A 50-IU/kg dose of vitamin E raised serum α-tocopherol levels, but to consistently achieve α-tocopherol levels >0.5 mg/dL, a higher dose or several doses of vitamin E may be needed.
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Affiliation(s)
- Edward F Bell
- Department of Pediatrics, University of Iowa, 200 Hawkins Dr, Iowa City, IA 52242.
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