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Yuan Y, Zhao J, Liu Q, Liu Y, Liu Y, Tian X, Qiao W, Zhao Y, Liu Y, Chen L. Human milk sphingomyelin: Function, metabolism, composition and mimicking. Food Chem 2024; 447:138991. [PMID: 38520905 DOI: 10.1016/j.foodchem.2024.138991] [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: 10/16/2023] [Revised: 02/28/2024] [Accepted: 03/08/2024] [Indexed: 03/25/2024]
Abstract
Human milk, which contains various nutrients, is the "gold standard" for infant nutrition. Healthy human milk meets all the nutritional needs of early infant development. Polar lipids mainly exist in the milk fat globule membrane, accounting for approximately 1-2% of human milk lipids; sphingomyelin (SM) accounts for approximately 21-24% of polar lipids. SM plays an important role in promoting the development of the brain and nervous system, regulating intestinal flora, and improving skin barriers. Though SM could be synthesized de novo, SM nutrition from dietary is also important for infants. The content and composition of SM in human milk has been reported, however, the molecular mechanisms of nutritional functions of SM for infants required further research. This review summarizes the functional mechanisms, metabolic pathways, and compositional, influencing factors, and mimicking of SM in human milk, and highlights the challenges of improving maternal and infant early/long-term nutrition.
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Affiliation(s)
- Yuying Yuan
- Key Laboratory of Dairy Science, Ministry of Education, Food Science College, Northeast Agricultural University, Harbin 150030, China; National Engineering Research Center of Dairy Health for Maternal and Child, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China; Beijing Engineering Research Center of Dairy, Beijing Technical Innovation Center of Human Milk Research, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China
| | - Junying Zhao
- National Engineering Research Center of Dairy Health for Maternal and Child, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China; Beijing Engineering Research Center of Dairy, Beijing Technical Innovation Center of Human Milk Research, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China
| | - Qian Liu
- Key Laboratory of Dairy Science, Ministry of Education, Food Science College, Northeast Agricultural University, Harbin 150030, China; National Engineering Research Center of Dairy Health for Maternal and Child, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China; Beijing Engineering Research Center of Dairy, Beijing Technical Innovation Center of Human Milk Research, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China
| | - Yan Liu
- National Engineering Research Center of Dairy Health for Maternal and Child, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China; Beijing Engineering Research Center of Dairy, Beijing Technical Innovation Center of Human Milk Research, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China
| | - Yan Liu
- National Engineering Research Center of Dairy Health for Maternal and Child, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China; Beijing Engineering Research Center of Dairy, Beijing Technical Innovation Center of Human Milk Research, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China
| | - Xiaoyan Tian
- Key Laboratory of Dairy Science, Ministry of Education, Food Science College, Northeast Agricultural University, Harbin 150030, China; National Engineering Research Center of Dairy Health for Maternal and Child, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China; Beijing Engineering Research Center of Dairy, Beijing Technical Innovation Center of Human Milk Research, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China
| | - Weicang Qiao
- National Engineering Research Center of Dairy Health for Maternal and Child, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China; Beijing Engineering Research Center of Dairy, Beijing Technical Innovation Center of Human Milk Research, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China
| | - Yanyan Zhao
- National Engineering Research Center of Dairy Health for Maternal and Child, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China; Beijing Engineering Research Center of Dairy, Beijing Technical Innovation Center of Human Milk Research, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China; Affiliated Hospital of Weifang Medical University, Weifang, Shandong 261031, China
| | - Yanpin Liu
- National Engineering Research Center of Dairy Health for Maternal and Child, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China; Beijing Engineering Research Center of Dairy, Beijing Technical Innovation Center of Human Milk Research, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China
| | - Lijun Chen
- Key Laboratory of Dairy Science, Ministry of Education, Food Science College, Northeast Agricultural University, Harbin 150030, China; National Engineering Research Center of Dairy Health for Maternal and Child, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China; Beijing Engineering Research Center of Dairy, Beijing Technical Innovation Center of Human Milk Research, Beijing Sanyuan Foods Co. Ltd., Beijing 100163, China.
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Ni X, Zhang Z, Deng Z, Li J. Optimizing ARA and DHA in infant formula: A systematic review of global trends, regional disparities, and considerations for precision nutrition. Food Res Int 2024; 182:114049. [PMID: 38519198 DOI: 10.1016/j.foodres.2024.114049] [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: 12/04/2023] [Revised: 01/18/2024] [Accepted: 01/24/2024] [Indexed: 03/24/2024]
Abstract
In the context of precision nutrition, the addition of ARA and DHA in infant formula needs to consider more factors. This study conducted a comprehensive literature review, including 112 relevant Chinese and English articles, to summarize and analyze the global levels of ARA, DHA, and the ARA/DHA ratio in breast milk. The data were correlated with local aquatic products intake and children's IQ. The results indicated that the average level of DHA in breast milk across regions is lower than that of ARA. Variations in DHA content were identified as a primary factor influencing ARA/DHA ratio fluctuations. Breast milk ARA and DHA levels decrease with prolonged lactation periods but increase over the past 22 years. Correlation analysis revealed a significant positive relationship between aquatic products intake and breast milk DHA levels (r = 0.64, p < 0.05). Breast milk DHA levels also showed a significant positive correlation with children's IQ (r = 0.67, p < 0.01). Stable breast milk ARA content did not exhibit significant correlations with aquatic products intake or children's IQ (r = 0, p > 0.05). Among 22 infant formula products available in China, only 5 had ARA levels within the range of breast milk. Most formula products had higher ARA levels than DHA, resulting in ARA/DHA ratios generally exceeding 1. The temporal and spatial variability in breast milk ARA and DHA levels may lead to diverse health outcomes in infants. Therefore, the addition of ARA and DHA in infant formula should consider this variability, including the molecular forms and positional isomerism of the added ARA and DHA. Additionally, considering the impact of different cognitive development tests and infant's gene expression on formula assessment results, there is a need to establish a more comprehensive infant health assessment system to guide the addition of ARA and DHA in formula.
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Affiliation(s)
- Xinggang Ni
- State Key Laboratory of Food Science and Resources, Nanchang University, Nanchang, Jiangxi, 330047, China
| | - Zhiyi Zhang
- State Key Laboratory of Food Science and Resources, Nanchang University, Nanchang, Jiangxi, 330047, China
| | - Zeyuan Deng
- State Key Laboratory of Food Science and Resources, Nanchang University, Nanchang, Jiangxi, 330047, China
| | - Jing Li
- State Key Laboratory of Food Science and Resources, Nanchang University, Nanchang, Jiangxi, 330047, China.
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Owolabi AJ, Ayede IA, Akinrinoye OO, Falade AG, Ajibola GB, Christopher OO, Arifalo GO, Abiona AO, Feskens EJM, Melse-Boonstra A, Schaafsma A. Growth and micronutrient status parameters of Nigerian preterm infants consuming preterm formula or breastmilk. Pediatr Res 2024:10.1038/s41390-023-02976-6. [PMID: 38195937 DOI: 10.1038/s41390-023-02976-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 11/26/2023] [Accepted: 12/04/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND Moderate-to-late preterm infants (32-34 weeks GA) have increased risk of neonatal morbidities compared to term infants, however dedicated nutritional guidelines are lacking. METHODS Moderate-to-late preterm infants received a preterm formula (n = 17) or breastmilk (n = 24) from age 2-10 weeks in a non-randomized, open-label observational study. Anthropometric measurements were assessed bi-weekly. Blood concentrations of hemoglobin, ferritin, serum retinol, and 25-hydroxy-vitamin D (25OHD) were analyzed at age 2 and 10 weeks. RESULT Average growth per day was 14.7 g/kg BW/day in formula-fed and 12.8 g/kg BW/day in breastmilk-fed infants but not different from each other. Length and head circumference in both groups were in line with the median reference values of the Fenton growth chart. At 10 weeks of age, hemoglobin tended to be higher in the formula-fed group (10.2 g/dL vs. 9.6 g/dL, p = 0.053). 25OHD increased in formula- and breastmilk-fed infants from 73.8 to 180.9 nmol/L and from 70.7 to 97.6 nmol/L, respectively. Serum retinol only increased in the formula-fed group (0.63 to 1.02 µmol/L, p < 0.001). CONCLUSION Breastfeeding resulted in adequate growth in moderate-late preterm infants but was limiting in some micronutrients. The preterm formula provided adequate micronutrients, but weight gain velocity was higher than the Fenton reference value. IMPACT STATEMENT Unfortified breastmilk resulted in adequate growth in weight, length and head circumference in Nigerian moderate to late preterm infants during an study period of 8 weeks, but status of vitamin D, vitamin A and iron needs to be monitored. The high-energy formula, developed for very preterm infants, resulted in higher growth in body weight in moderate to late preterm infants than the median of the Fenton preterm growth chart. This study supports the necessity of dedicated nutritional guidelines, and regular monitoring of growth and nutritional status of moderate to late preterm infants.
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Affiliation(s)
- Adedotun Joshua Owolabi
- Division of Human Nutrition and Health, Wageningen University and Research, P.O. Box 9101, 6700 HB, Wageningen, The Netherlands.
| | | | | | | | - Gboyega Bosun Ajibola
- Department of Obstetrics and Gynaecology, University College Hospital, Ibadan, Nigeria
| | | | | | | | - Edith J M Feskens
- Division of Human Nutrition and Health, Wageningen University and Research, P.O. Box 9101, 6700 HB, Wageningen, The Netherlands
| | - Alida Melse-Boonstra
- Division of Human Nutrition and Health, Wageningen University and Research, P.O. Box 9101, 6700 HB, Wageningen, The Netherlands
| | - Anne Schaafsma
- Expert Nutrition Team, FrieslandCampina, Stationsplein, Amersfoort, The Netherlands
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Marosvölgyi T, Dergez T, Szentpéteri JL, Szabó É, Decsi T. Higher Availability of Long-Chain Monounsaturated Fatty Acids in Preterm than in Full-Term Human Milk. Life (Basel) 2023; 13:life13051205. [PMID: 37240850 DOI: 10.3390/life13051205] [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: 02/27/2023] [Revised: 05/06/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023] Open
Abstract
While the role of n-3 and n-6 long-chain polyunsaturated fatty acids (LCPUFAs) in the maturation of the infantile nervous system is extensively studied and relatively well-characterized, data on the potential developmental importance of the n-9 long-chain monounsaturated fatty acid (LCMUFA), nervonic acid (NA, C24:1n-9) are scarce and ambiguous. Therefore, the aim of the present study was to reanalyze our available data on the contribution of NA and its LCMUFA precursors, gondoic acid (C20:1n-9) and erucic acid (EA, C22:1n-9) to the fatty acid composition of human milk (HM) during the first month of lactation in mothers of both preterm (PT) and full-term (FT) infants. HM samples were obtained daily during the first week of lactation, and then on the 14th, 21st, and 28th days. Values of the LCMUFAs, C20:1n-9, EA, and NA were significantly higher in colostrum than in transient and mature HM. Consequently, there were highly significant inverse associations between LCMUFA values and the duration of lactation. Moreover, C20:1n-9, EA, and NA values were monotonously, considerably, and at many timepoints significantly higher in PT than in FT HM samples. By the 28th day of lactation, summarized LCMUFA values in PT HM samples declined to the level measured in FT HM samples on the first day of lactation; however, EA and NA values were still significantly higher in PT than in FT HM on the 28th day. Significantly higher availability of LCMUFAs in PT than in FT HM underpins the potential biological role of this hitherto somewhat neglected group of fatty acids.
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Affiliation(s)
- Tamás Marosvölgyi
- Institute of Bioanalysis, Medical School, University of Pécs, 7624 Pécs, Hungary
- Department of Paediatrics, Medical School, University of Pécs, 7623 Pécs, Hungary
| | - Timea Dergez
- Institute of Bioanalysis, Medical School, University of Pécs, 7624 Pécs, Hungary
| | - József L Szentpéteri
- Institute of Transdisciplinary Discoveries, Medical School, University of Pécs, 7624 Pécs, Hungary
| | - Éva Szabó
- Department of Paediatrics, Medical School, University of Pécs, 7623 Pécs, Hungary
- Department of Biochemistry and Medical Chemistry, Medical School, University of Pécs, 7624 Pécs, Hungary
| | - Tamás Decsi
- Department of Paediatrics, Medical School, University of Pécs, 7623 Pécs, Hungary
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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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Agustina R, Rianda D, Lasepa W, Birahmatika FS, Stajic V, Mufida R. Nutrient intakes of pregnant and lactating women in Indonesia and Malaysia: Systematic review and meta-analysis. Front Nutr 2023; 10:1030343. [PMID: 37063336 PMCID: PMC10098007 DOI: 10.3389/fnut.2023.1030343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 01/02/2023] [Indexed: 04/03/2023] Open
Abstract
IntroductionOptimizing dietary intake during pregnancy and lactation is crucial to the growth and development of children and their lifelong health. We performed a systematic review and meta-analysis to describe the nutrient intakes of pregnant and lactating women in Indonesia and Malaysia, countries that are experiencing rapid nutrition transition in Southeast Asia.MethodsWe screened 2,258 studies published between January 1980 and March 2021. The nutrient intakes of pregnant and lactating women were quantitatively analyzed to calculate the percentage of adequacy using national recommended daily allowances or nutrient intakes (RDA/RNI) and estimated average requirements (EAR) for micronutrients. Standardized mean differences (SMD) between dietary intake and RDA/RNI were determined for selected nutrients.ResultsFifty-three studies were included and showed that energy and macronutrient intakes among pregnant and lactating women in both countries were below the RDA/RNI. In addition, most studies reported that women failed to meet the EAR for vitamin D (<70% EAR), vitamin E (<50% EAR), and water-soluble vitamins (<80% EAR) except for vitamin C and A among Malaysians. Moreover, calcium, potassium, and iron intakes of pregnant women were <60% EAR in Indonesia and <80% EAR in Malaysia. Phosphorus intake among pregnant women in both countries and sodium intake among Malaysian pregnant women exceeded 100% EAR. Indonesian lactating women had <60% EAR for calcium and potassium intakes, while Malaysian women had more than 100% EAR. For 21 studies reporting overall protein intakes, the standard mean difference (SMD) was −2.26 (95% CI; −2.98, −1.54) below the RDA/RNI for pregnant women and −0.67 SMD (95% CI −15.7, −11.5) for lactating women. When the four studies from Malaysia were analyzed separately, protein intakes of pregnant women were above the RNI. Moreover, low intakes of vitamin D, vitamin C, calcium, and iron, but sufficient intakes in vitamin A, zinc, and phosphorus were observed in pregnant women in both countries.ConclusionDietary intakes of energy, macronutrients, and micronutrients (vitamin D, vitamin E, water-soluble vitamins, calcium, and iron) of pregnant and lactating women in Indonesia and Malaysia were below the recommendations. Important heterogeneities were observed even between these two countries for specific essential nutrient intakes. Innovative research and targeted programs to address specific deficiencies should be prioritized.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021252204, identifier: CRD42021252204.
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Affiliation(s)
- Rina Agustina
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
- *Correspondence: Rina Agustina ;
| | - Davrina Rianda
- Human Nutrition Research Center, Indonesian Medical Education, and Research Center (HNRC-IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Wanda Lasepa
- Human Nutrition Research Center, Indonesian Medical Education, and Research Center (HNRC-IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Fitya S. Birahmatika
- Human Nutrition Research Center, Indonesian Medical Education, and Research Center (HNRC-IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Vladimir Stajic
- Blackmores Institute, Blackmores Limited, Sydney, NSW, Australia
| | - Rachmi Mufida
- Human Nutrition Research Center, Indonesian Medical Education, and Research Center (HNRC-IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
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The effectiveness of prenatal breastfeeding education on breastfeeding uptake postpartum: A systematic review. Midwifery 2023; 118:103579. [PMID: 36580847 DOI: 10.1016/j.midw.2022.103579] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 09/29/2022] [Accepted: 12/11/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The decision to breastfeed is influenced by physiological, psychological, and emotional factors. However, the importance of equipping mothers with the necessary knowledge for successful breastfeeding practice cannot be ruled out. Studies suggest that the decline in global breastfeeding rate can be linked to lack of adequate breastfeeding education during prenatal stage. Therefore, this review aims to determine the effectiveness of prenatal breastfeeding education on breastfeeding uptake postpartum. METHOD A systematic review of the studies identified by electronic database search (Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Psych INFO, and Sociological Abstracts and Applied Social Sciences Index and Abstracts (ASSIA) published between 2014 - 2021. RESULTS A total of 14 studies met the inclusion criteria. Results showed an increase in breastfeeding uptake, breastfeeding knowledge, increase in positive attitude to breastfeeding and an increase in maternal breastfeeding self-efficacy among mothers who participated in breastfeeding educational programs during prenatal care. CONCLUSION Prenatal breastfeeding education increases women's knowledge of breastfeeding. Mothers who are knowledgeable about breastfeeding and hold a positive approach towards breastfeeding have the tendency to initiate breastfeeding and continue for a lengthened period. Findings demonstrates a general correlation between prenatal breastfeeding education and increased breastfeeding uptake postpartum. The high level of positive breastfeeding outcome inherent in all the studies can be attributed to prenatal breastfeeding education.
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Ramiro-Cortijo D, Herranz Carrillo G, Gila-Diaz A, Ruvira S, Singh P, Braojos C, Martin CR, Arribas SM. Association between Adherence to the Healthy Food Pyramid and Breast Milk Fatty Acids in the First Month of Lactation. Nutrients 2022; 14:nu14245280. [PMID: 36558439 PMCID: PMC9780987 DOI: 10.3390/nu14245280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/13/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022] Open
Abstract
In lactating women, breast milk (BM) fatty acids may come from the diet or stored adipose tissue. Our objective was to evaluate the influence of the adherence to the healthy food pyramid (HFP), the dietary pattern in the Mediterranean region, and the maternal body composition on the BM fatty acids pattern. Fifty breastfeeding women answered a socioeconomic survey and the adherence to the HFP questionnaire (AP-Q). In addition, they provided a BM sample at 7 ± 1, 14 ± 1, and 28 ± 1 days postpartum. The body's composition was analyzed at days 7 and 28 by bioimpedance. The BM fatty acids were analyzed by gas chromatography-mass spectroscopy. We found a negative association between the consumption of olive oil and the BM palmitic acid levels (β = -3.19 ± 1.40; p = 0.030), and the intake of cereals and legumes was positively associated with the BM saturated fatty acids (β = 11.48 ± 3.87; p = 0.005). The intake of proteins and vegetables was positively associated with the omega-3 fatty acids and negatively with the omega-6:omega-3 ratio in BM. A negative association between the maternal age (β = -0.43 ± 0.11; p = 0.001) and the α-linolenic acid (ALA) levels was observed, being overall AP-Q positively associated with the ALA levels (β = 0.39 ± 0.15; p = 0.016). Physical activity reduced both the omega-3 and omega-6 fatty acids in BM. Diet had a larger influence than the maternal body's composition on BM fatty acids during the first month of lactation, demonstrating a better adherence to the HFP and positively impacting on the omega-3 content in BM, a fact that is modulated by one's maternal age.
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Affiliation(s)
- David Ramiro-Cortijo
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/ Arzobispo Morcillo 2, 28029 Madrid, Spain
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA
| | - Gloria Herranz Carrillo
- Division of Neonatology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), C/ del Profesor Martin Lagos, S/N, 28040 Madrid, Spain
| | - Andrea Gila-Diaz
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/ Arzobispo Morcillo 2, 28029 Madrid, Spain
| | - Santiago Ruvira
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/ Arzobispo Morcillo 2, 28029 Madrid, Spain
| | - Pratibha Singh
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA
| | - Cheyenne Braojos
- Department of Agricultural Chemistry and Food Science, Faculty of Science, Institute of Food Science Research (CIAL, UAM-CSIC), Universidad Autónoma de Madrid, C/ Nicolas Cabrera 9, 28049 Madrid, Spain
| | - Camilia R. Martin
- Department of Neonatology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA
| | - Silvia M. Arribas
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/ Arzobispo Morcillo 2, 28029 Madrid, Spain
- Correspondence:
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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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Zhang Z, Wang Y, Yang X, Cheng Y, Zhang H, Xu X, Zhou J, Chen H, Su M, Yang Y, Su Y. Human Milk Lipid Profiles around the World: A Systematic Review and Meta-Analysis. Adv Nutr 2022; 13:2519-2536. [PMID: 36083999 PMCID: PMC9776668 DOI: 10.1093/advances/nmac097] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 03/08/2022] [Accepted: 09/01/2022] [Indexed: 01/29/2023] Open
Abstract
Reported breast milk lipid concentrations may vary with geographical region, postnatal age, and year of sample collection. In this review, we summarized data on the concentrations of total fat, total phospholipids, cholesterol, and fatty acids in human milk worldwide and their variation according to lactation stage, study area, and sample collection year. A systematic literature search was performed using the PubMed, Embase, Web of Science, and Medline databases for English-language papers and Wanfang and China National Knowledge Infrastructure databases for Chinese-language papers. A total of 186 studies evaluating the human milk lipid profiles were included. According to random-effects models based on worldwide data, the summarized means (95% CIs) as percentages of total fat were 42.2% (41.1%, 43.3%) for SFAs, 36.6% (35.6%, 37.5%) for MUFAs, and 21.0% (19.3%, 22.7%) for PUFAs. However, the study heterogeneity was high for most types of fatty acids (I2 > 99%). Human milk from Western countries had higher concentrations of MUFAs and 18:1n-9 (ω-9), but lower concentrations of PUFAs, 18:2n-6, 20:4n-6, 18:3n-3, 20:5n-3, 22:6n-3, and total n-6 PUFA compared with those from non-Western countries (P < 0.001-0.011). Significant lactation stage differences were observed for total fat and some individual fatty acids. The concentrations of SFAs and 16:0 were significantly negatively correlated with sampling year (P < 0.001-0.028). In contrast, a significant positive correlation between the concentrations of 18:2n-6 and 18:3n-3 and sampling year was observed (P < 0.001-0.035). Our results suggest that the pooling of data on human milk lipid profiles in different studies should be done with caution due to the high between-study heterogeneity. The concentration of lipids, including total fat, cholesterol, and specific fatty acids, differs in human milk according to lactation stage, geographical region, and year of sample collection.
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Affiliation(s)
- Zheqing Zhang
- Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
| | - Yingyao Wang
- Chinese Nutrition Society, Beijing, China,CNS Academy of Nutrition and Health (Beijing Zhongyinghui Nutrition and Health Research Institute), Beijing, China
| | - Xiaoguang Yang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yiyong Cheng
- Institute of Health & Environmental Medicine, Tianjin, China
| | - Hong Zhang
- Wilmar (Shanghai) Biotechnology Research & Development Center Co., Ltd., Shanghai, China
| | - Xuebing Xu
- Wilmar (Shanghai) Biotechnology Research & Development Center Co., Ltd., Shanghai, China
| | - Jin Zhou
- CNS Academy of Nutrition and Health (Beijing Zhongyinghui Nutrition and Health Research Institute), Beijing, China
| | - Hengying Chen
- Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
| | - Mengyang Su
- Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
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11
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Li T, Samuel TM, Zhu Z, Howell B, Cho S, Baluyot K, Hazlett H, Elison JT, Wu D, Hauser J, Sprenger N, Zhu H, Lin W. Joint analyses of human milk fatty acids, phospholipids, and choline in association with cognition and temperament traits during the first 6 months of life. Front Nutr 2022; 9:919769. [PMID: 36091236 PMCID: PMC9449418 DOI: 10.3389/fnut.2022.919769] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 07/29/2022] [Indexed: 11/17/2022] Open
Abstract
Early dietary exposure via human milk nutrients offers a window of opportunity to support cognitive and temperament development. While several studies have focused on associations of few pre-selected human milk nutrients with cognition and temperament, it is highly plausible that human milk nutrients synergistically and jointly support cognitive and behavioral development in early life. We aimed to discern the combined associations of three major classes of human milk nutrients with cognition and temperament during the first 6 months of life when human milk is the primary source of an infant’s nutrition and explore whether there were persistent effects up to 18 months old. The Mullen Scales of Early Learning and Infant Behavior Questionnaires—Revised were used to assess cognition and temperament, respectively, of 54 exclusively/predominantly breastfed infants in the first 6 months of life, whose follow-ups were conducted at 6–9, 9–12, and 12–18 months old. Human milk samples were obtained from the mothers of the participants at less than 6 months of age and analyzed for fatty acids [total monounsaturated fatty acids, polyunsaturated fatty acid, total saturated fatty acid (TSFA), arachidonic acid (ARA), docosahexaenoic acid (DHA), ARA/DHA, omega-6/omega-3 polyunsaturated fatty acids ratio (n-6/n-3)], phospholipids [phosphatidylcholine, phosphatidylethanolamine (PE), phosphatidylinositol (PI), sphingomyelin], and choline [free choline, phosphocholine (PCho), glycerophosphocholine]. Feature selection was performed to select nutrients associated with cognition and temperament. The combined effects of selected nutrients were analyzed using multiple regression. A positive association between the arachidonic acid (ARA) and surgency was observed (p = 0.024). A significant effect of DHA, n-6/n-3, PE, and TSFA concentrations on receptive language (R2 = 0.39, p = 0.025) and the elevated ARA, PCho, and PI with increased surgency (R2 = 0.43, p = 0.003) was identified, suggesting that DHA and ARA may have distinct roles for temperament and language functions. Furthermore, the exploratory association analyses suggest that the effects of human milk nutrients on R.L. and surgency may persist beyond the first 6 months of life, particularly surgency at 12–18 months (p = 0.002). Our study highlighted that various human milk nutrients work together to support the development of cognition and temperament traits during early infancy.
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Affiliation(s)
- Tengfei Li
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Tinu M. Samuel
- Nestlé Product Technology Center-Nutrition, Société des Produits Nestlé S.A., Vevey, Switzerland
| | - Ziliang Zhu
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Brittany Howell
- Department of Human Development and Family Science, Fralin Biomedical Research Institute at Virginia Tech Carilion, Virginia Polytechnic Institute and State University, Roanoke, VA, United States
| | - Seoyoon Cho
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Kristine Baluyot
- Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Heather Hazlett
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Jed T. Elison
- Institute of Child Development, University of Minnesota, Minneapolis, MN, United States
| | - Di Wu
- Division of Oral and Craniofacial Health Science, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Jonas Hauser
- Nestlé Institute of Health Sciences, Société des Produits Nestlé SA, Lausanne, Switzerland
| | - Norbert Sprenger
- Nestlé Institute of Health Sciences, Société des Produits Nestlé SA, Lausanne, Switzerland
| | - Hongtu Zhu
- Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Weili Lin
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- *Correspondence: Weili Lin,
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12
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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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Castillo P, Kuda O, Kopecky J, Pomar CA, Palou A, Palou M, Picó C. Reverting to a healthy diet during lactation normalizes maternal milk lipid content of diet-induced obese rats and prevents early alterations in the plasma lipidome of the offspring. Mol Nutr Food Res 2022; 66:e2200204. [PMID: 35772018 PMCID: PMC9541142 DOI: 10.1002/mnfr.202200204] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/25/2022] [Indexed: 11/10/2022]
Abstract
Scope This study aims to assess in rats whether normalizing maternal diet during lactation prevents the harmful effects of western diet (WD) consumption during the whole perinatal period on the lipidomic profile in maternal milk and offspring plasma. Methods and Results Control dams (CON‐dams), fed with standard diet (SD); WD‐dams, fed with WD prior and during gestation and lactation; and reversion dams (REV‐dams), fed as WD‐dams but moved to SD during lactation are followed. Lipidomic analysis is performed in milk and plasma samples from pups. Milk of WD‐dams presents a different triacylglycerol composition and free fatty acid (FA) profile compared to CON‐dams, including an increased ratio of pro‐inflammatory to anti‐inflammatory long‐chain polyunsaturated FA. Such alterations, which are also present in the plasma of their offspring, are widely reversed in the milk of REV‐dams and the plasma of their pups. This is related with the recovery of control adiponectin expression levels in the mammary gland, and the presence of decreased expression of pro‐inflammatory factors. Conclusion Implementing a healthy diet during lactation prevents early alterations in the plasma lipidome of pups associated to the maternal intake of an obesogenic diet, which may be related to the normalization of milk lipid content and the inflammatory state in the mammary gland.
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Affiliation(s)
- Pedro Castillo
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Group of Nutrigenomics, Biomarkers and Risk Evaluation) of the University of the Balearic Islands, CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), and Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - Ondrej Kuda
- Institute of Physiology of the Czech Academy of Sciences, Videnska 1083, Prague, 14220, Czech Republic
| | - Jan Kopecky
- Institute of Physiology of the Czech Academy of Sciences, Videnska 1083, Prague, 14220, Czech Republic
| | - Catalina Amadora Pomar
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Group of Nutrigenomics, Biomarkers and Risk Evaluation) of the University of the Balearic Islands, CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), and Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - Andreu Palou
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Group of Nutrigenomics, Biomarkers and Risk Evaluation) of the University of the Balearic Islands, CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), and Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - Mariona Palou
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Group of Nutrigenomics, Biomarkers and Risk Evaluation) of the University of the Balearic Islands, CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), and Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - Catalina Picó
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Group of Nutrigenomics, Biomarkers and Risk Evaluation) of the University of the Balearic Islands, CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), and Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
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