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Ren Q, Li K, Li J, Pan J, Liu Y, Chen Y, Xu Y, Xie Q. Longitudinal Changes in Human Milk Minerals and Vitamins in the Chinese Population: A Scoping Review. Nutrients 2024; 16:1710. [PMID: 38892644 PMCID: PMC11174910 DOI: 10.3390/nu16111710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 05/24/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024] Open
Abstract
This scoping review aims to investigate longitudinal changes in minerals and vitamins concentrations in human milk among the Chinese population. Following the PRISMA-ScR guidelines, a comprehensive and systematic literature search was conducted using both English and Chinese databases. Data were extracted and categorized into six defined lactation stages. We found that the concentration of most minerals decreased throughout the lactation period, although calcium (Ca) and magnesium (Mg) fluctuated slightly across lactation periods. Fat-soluble vitamins also showed a decline throughout the lactation period, while water-soluble vitamins exhibited an increasing trend. However, folic acid, biotin, and pantothenic acid demonstrated a downward trend. Overall, this review has identified the longitudinal changes in minerals and vitamins concentrations in human milk among the Chinese population. In order to conduct a more in-depth examination of maternal characteristics and nutritional factors of the composition of human milk, it is recommended to utilize standardized protocols for the collection and analysis of human milk samples.
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Affiliation(s)
- Qiqi Ren
- Heilongjiang Feihe Dairy Co., Ltd., C-16, 10A Jiuxianqiao Rd., Chaoyang, Beijing 100015, China; (Q.R.); (K.L.); (J.L.); (J.P.)
- PKUHSC—China Feihe Joint Research Institute of Nutrition and Healthy Lifespan Development, Xueyuan Road 38, Haidian, Beijing 100083, China
| | - Kaifeng Li
- Heilongjiang Feihe Dairy Co., Ltd., C-16, 10A Jiuxianqiao Rd., Chaoyang, Beijing 100015, China; (Q.R.); (K.L.); (J.L.); (J.P.)
- PKUHSC—China Feihe Joint Research Institute of Nutrition and Healthy Lifespan Development, Xueyuan Road 38, Haidian, Beijing 100083, China
| | - Jufang Li
- Heilongjiang Feihe Dairy Co., Ltd., C-16, 10A Jiuxianqiao Rd., Chaoyang, Beijing 100015, China; (Q.R.); (K.L.); (J.L.); (J.P.)
- PKUHSC—China Feihe Joint Research Institute of Nutrition and Healthy Lifespan Development, Xueyuan Road 38, Haidian, Beijing 100083, China
| | - Jiancun Pan
- Heilongjiang Feihe Dairy Co., Ltd., C-16, 10A Jiuxianqiao Rd., Chaoyang, Beijing 100015, China; (Q.R.); (K.L.); (J.L.); (J.P.)
- PKUHSC—China Feihe Joint Research Institute of Nutrition and Healthy Lifespan Development, Xueyuan Road 38, Haidian, Beijing 100083, China
| | - Yang Liu
- Heilongjiang Feihe Dairy Co., Ltd., C-16, 10A Jiuxianqiao Rd., Chaoyang, Beijing 100015, China; (Q.R.); (K.L.); (J.L.); (J.P.)
- PKUHSC—China Feihe Joint Research Institute of Nutrition and Healthy Lifespan Development, Xueyuan Road 38, Haidian, Beijing 100083, China
| | - Yong Chen
- Heilongjiang Feihe Dairy Co., Ltd., C-16, 10A Jiuxianqiao Rd., Chaoyang, Beijing 100015, China; (Q.R.); (K.L.); (J.L.); (J.P.)
- PKUHSC—China Feihe Joint Research Institute of Nutrition and Healthy Lifespan Development, Xueyuan Road 38, Haidian, Beijing 100083, China
| | - Yajun Xu
- PKUHSC—China Feihe Joint Research Institute of Nutrition and Healthy Lifespan Development, Xueyuan Road 38, Haidian, Beijing 100083, China
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Xueyuan Road 38, Haidian, Beijing 100083, China
- Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, Xueyuan Road 38, Haidian, Beijing 100083, China
| | - Qinggang Xie
- Heilongjiang Feihe Dairy Co., Ltd., C-16, 10A Jiuxianqiao Rd., Chaoyang, Beijing 100015, China; (Q.R.); (K.L.); (J.L.); (J.P.)
- PKUHSC—China Feihe Joint Research Institute of Nutrition and Healthy Lifespan Development, Xueyuan Road 38, Haidian, Beijing 100083, China
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Zhang H, Ren X, Yang Z, Lai J. Vitamin A Concentration in Human Milk: A Meta-Analysis. Nutrients 2022; 14:nu14224844. [PMID: 36432530 PMCID: PMC9699574 DOI: 10.3390/nu14224844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 11/09/2022] [Accepted: 11/11/2022] [Indexed: 11/18/2022] Open
Abstract
Humans require vitamin A (VA). However, pooled VA data in human milk is uncommon internationally and offers little support for dietary reference intake (DRIs) revision of infants under 6 months. As a result, we conducted a literature review and a meta-analysis to study VA concentration in breast milk throughout lactation across seven databases by August 2021. Observational or intervention studies involving nursing mothers between the ages of 18 and 45, with no recognized health concerns and who had full-term infants under 48 months were included. Studies in which retinol concentration was expressed as a mass concentration on a volume basis and determined using high-, ultra-, or ultra-fast performance liquid chromatography (HPLC, UPLC, or UFLC) were chosen. Finally, 76 papers involving 9171 samples published between 1985 and 2021 qualified for quantitative synthesis. Results from the random-effects model showed that the VA concentration of healthy term human milk decreased significantly as lactation progressed. VA (µg/L) with 95% CI at the colostrum, transitional, early mature and late mature stages being 920.7 (744.5, 1095.8), 523.7 (313.7, 733.6), 402.4 (342.5, 462.3) and 254.7 (223.7, 285.7), respectively (X2 = 71.36, p < 0.01). Subgroup analysis revealed no significant differences identified in VA concentration (µg/L) between Chinese and non-Chinese samples at each stage, being 1039.1 vs. 895.8 (p = 0.64), 505.7 vs. 542.2(p = 0.88), 408.4 vs. 401.2 (p = 0.92), 240.0 vs. 259.3 (p = 0.41). The findings have significant implications for the revision of DRIs for infants under six months.
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Affiliation(s)
- Huanmei Zhang
- Department of Maternal and Child Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
- China-DRIs Expert Committee on Human Milk Composition, Chinese Nutrition Society, Beijing 100050, China
| | - Xiangnan Ren
- Department of Maternal and Child Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
- China-DRIs Expert Committee on Human Milk Composition, Chinese Nutrition Society, Beijing 100050, China
| | - Zhenyu Yang
- Department of Maternal and Child Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
- China-DRIs Expert Committee on Human Milk Composition, Chinese Nutrition Society, Beijing 100050, China
| | - Jianqiang Lai
- China-DRIs Expert Committee on Human Milk Composition, Chinese Nutrition Society, Beijing 100050, China
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
- Correspondence:
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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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Yang C, Zhao A, Ren Z, Zhang J, Wang P, Zhang Y. Vitamin A Nutritional Status of Urban Lactating Chinese Women and Its Associated Factors. Nutrients 2022; 14:nu14153184. [PMID: 35956361 PMCID: PMC9370282 DOI: 10.3390/nu14153184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/28/2022] [Accepted: 08/02/2022] [Indexed: 01/09/2023] Open
Abstract
We aimed to investigate dietary vitamin A (DVA) intake, serum vitamin A (SVA) concentrations, and breast milk vitamin A (BMVA) concentrations of urban lactating Chinese women and explore the associated factors. We recruited 326 lactating women from ten cities in China and collected their dietary information, blood samples, and breast milk samples. SVA and BMVA were assessed with high-performance liquid chromatography. Mann–Whitney U tests, Kruskal–Wallis H tests, Chi-square tests, Spearman correlation tests, and multiple regression analyses were conducted. The median (25th, 75th) of DVA, SVA and BMVA were 372.36 (209.12, 619.78) μg RAE/day, 1.99 (1.71, 2.35) μmol/L, and 1.67 (1.13, 2.15) μmol/L, respectively. Only 3.1% of lactating women met the recommended nutrient intake of Vitamin A (VA), and 20.6% had a BMVA level below 1.05 μmol/L. Compared to underweight or normal weight women, overweight or obese lactating women had lower DVA and BMVA but higher SVA (p = 0.022; p = 0.030; p = 0.003). Multiparous women had a higher risk of inadequate BMVA (p = 0.023) than primiparous women. SVA and BMVA were positively associated with DVA, especially for lactating women not using VA supplements (β = 0.174, 95%CI = 0.025, 0.324, p = 0.022; β = 0.501, 95%CI = 0.208, 0.795, p = 0.001). There was no association between SVA and BMVA (β = 0.165, 95%CI = −0.037, 0.366, p = 0.109). In conclusion, VA nutritional status among Chinese urban lactating women needs more attention, especially for those who are obese, overweight, or higher parity. Increased DVA may contribute to increased BMVA.
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Affiliation(s)
- Chenlu Yang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China; (C.Y.); (Z.R.); (J.Z.)
- Children’s Health Care Center, Beijing Children’s Hospital of Capital Medical University, National Center for Children’s Health, Beijing 100045, China
| | - Ai Zhao
- Vanke School of Public Health, Tsinghua University, Beijing 100091, China;
| | - Zhongxia Ren
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China; (C.Y.); (Z.R.); (J.Z.)
| | - Jian Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China; (C.Y.); (Z.R.); (J.Z.)
| | - Peiyu Wang
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing 100191, China;
- Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, School of Public Health, Peking University, Beijing 100191, China
| | - Yumei Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China; (C.Y.); (Z.R.); (J.Z.)
- Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, School of Public Health, Peking University, Beijing 100191, China
- Correspondence:
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Abstract
In evaluating vitamin E (VE) nutritional status of preterm infants, it is essential that any data should be compared with those of healthy term infants, and never with those of adults. Moreover, it should be evaluated in terms of gestational age (GA), not birth weight (BW), because placental transfer of most nutrients from mother to fetus is dependent on GA, not BW. Judging from the limited data during the last 75 years, there was no significant correlation between GA and VE concentrations in circulation or in the red blood cells (RBCs), leukocytes, and buccal mucosal cells. In addition, the oxidizability of polyunsaturated fatty acids (PUFAs) in plasma or RBCs, as targets for protection by VE chain-breaking ability, was lower in preterm infants. However, because of the minimal information available about hepatic VE levels, which is considered a key determinant of whole body VE status, the decision on whether VE status of preterm infants is comparable with that of term infants should be postponed. Clinical trials of VE supplementation in preterm infants were repeatedly undertaken to investigate whether VE reduces severity or inhibits development of several diseases specific to preterm infants, namely retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD), and germinal matrix hemorrhage - intraventricular hemorrhage (GMH-IVH). Most of these trials resulted in a misfire, with a few exceptions for IVH prevention. However, almost all these studies were performed from 1980s to early 1990s, in the pre-surfactant era, and the study populations were composed of mid-preterm infants with GAs of approximately 30 weeks (wks). There is considerable difference in 'preterm infants' between the pre- and post-surfactant eras; modern neonatal medicine mainly treats preterm infants of 28 wks GA or less. Therefore, these results are difficult to apply in modern neonatal care. Before considering new trials of VE supplementation, we should fully understand modern neonatal medicine, especially the recent method of oxygen supplementation. Additionally, a deeper understanding of recent progress in pathophysiology and therapies for possible target diseases is necessary to decide whether VE administration is still worth re-challenging in modern neonatal intensive care units (NICUs). In this review, we present recent concepts and therapeutic trends in ROP, BPD, and GMH-IVH for those unfamiliar with neonatal medicine. Numerous studies have reported the possible involvement of reactive oxygen species (ROS)-induced damage in relation to supplemental oxygen use, inflammation, and immature antioxidant defense in the development of both BPD and ROP. Various antioxidants effectively prevented the exacerbation of BPD and ROP in animal models. In the future, VE should be re-attempted as a complementary factor in combination with various therapies for BPD, ROP, and GMH-IVH. Because VE is a natural and safe supplement, we are certain that it will attract attention again in preterm medicine.
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Affiliation(s)
- Tohru Ogihara
- Division of Neonatology, Department of Pediatrics, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan.
| | - Makoto Mino
- Division of Neonatology, Department of Pediatrics, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
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Buffet-Bataillon S, Bellanger A, Boudry G, Gangneux JP, Yverneau M, Beuchée A, Blat S, Le Huërou-Luron I. New Insights Into Microbiota Modulation-Based Nutritional Interventions for Neurodevelopmental Outcomes in Preterm Infants. Front Microbiol 2021; 12:676622. [PMID: 34177860 PMCID: PMC8232935 DOI: 10.3389/fmicb.2021.676622] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 05/12/2021] [Indexed: 12/19/2022] Open
Abstract
Gut microbiota and the central nervous system have parallel developmental windows during pre and post-natal life. Increasing evidences suggest that intestinal dysbiosis in preterm infants predisposes the neonate to adverse neurological outcomes later in life. Understanding the link between gut microbiota colonization and brain development to tailor therapies aimed at optimizing initial colonization and microbiota development are promising strategies to warrant adequate brain development and enhance neurological outcomes in preterm infants. Breast-feeding has been associated with both adequate cognitive development and healthy microbiota in preterms. Infant formula are industrially produced substitutes for infant nutrition that do not completely recapitulate breast-feeding benefices and could be largely improved by the understanding of the role of breast milk components upon gut microbiota. In this review, we will first discuss the nutritional and bioactive component information on breast milk composition and its contribution to the assembly of the neonatal gut microbiota in preterms. We will then discuss the emerging pathways connecting the gut microbiota and brain development. Finally, we will discuss the promising microbiota modulation-based nutritional interventions (including probiotic and prebiotic supplementation of infant formula and maternal nutrition) for improving neurodevelopmental outcomes.
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Affiliation(s)
- Sylvie Buffet-Bataillon
- Institut NuMeCan, INRAE, INSERM, Univ Rennes, Saint-Gilles, France
- Department of Clinical Microbiology, CHU Rennes, Rennes, France
| | - Amandine Bellanger
- Institut NuMeCan, INRAE, INSERM, Univ Rennes, Saint-Gilles, France
- Department of Pediatrics-Neonatology, CHU Rennes, Rennes, France
| | - Gaelle Boudry
- Institut NuMeCan, INRAE, INSERM, Univ Rennes, Saint-Gilles, France
| | | | | | - Alain Beuchée
- Department of Pediatrics-Neonatology, Univ Rennes, CHU Rennes, LTSI-UMR 1099, Rennes, France
| | - Sophie Blat
- Institut NuMeCan, INRAE, INSERM, Univ Rennes, Saint-Gilles, France
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Redeuil K, Lévêques A, Oberson JM, Bénet S, Tissot E, Longet K, de Castro A, Romagny C, Beauport L, Fischer Fumeaux CJ, Tolsa JF, Affolter M, Giménez EC, Garcia-Rodenas CL, Thakkar SK. Vitamins and carotenoids in human milk delivering preterm and term infants: Implications for preterm nutrient requirements and human milk fortification strategies. Clin Nutr 2021; 40:222-228. [DOI: 10.1016/j.clnu.2020.05.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 05/04/2020] [Accepted: 05/10/2020] [Indexed: 01/22/2023]
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Zhang Y, Crowe-White KM, Kong L, Tan L. Vitamin A Status and Deposition in Neonatal and Weanling Rats Reared by Mothers Consuming Normal and High-Fat Diets with Adequate or Supplemented Vitamin A. Nutrients 2020; 12:nu12051460. [PMID: 32443575 PMCID: PMC7284941 DOI: 10.3390/nu12051460] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/14/2020] [Accepted: 05/15/2020] [Indexed: 12/13/2022] Open
Abstract
The circulating level of vitamin A (VA; retinol) was reported to be lower in obese adults. It is unknown if maternal obesity influences the VA status of offspring. The objective of the study was to determine the VA status and deposition of neonatal and weanling rats reared by mothers consuming a normal or high-fat diet (NFD or HFD) with or without supplemented VA. Pregnant Sprague-Dawley rats were randomized to an NFD or HFD with 2.6 mg/kg VA. Upon delivery, half of the rat mothers in the NFD or HFD cohort were switched to an NFD or HFD with supplemented VA at 129 mg/kg (NFD+VA and HFD+VA group). The other half remained on their original diet (NFD and HFD group). At postnatal day 14 (P14), P25, and P35, pups (n = 4 or 3/group/time) were euthanized. The total retinol concentration in the serum, liver, visceral white adipose tissue (WAT), and brown adipose tissue (BAT) was measured. At P14, the HFD+VA group showed a significantly lower serum VA than the NFD+VA group. At P25, both the VA concentration and total mass in the liver, WAT, and BAT were significantly higher in the HFD+VA than the NFD+VA group. At P35, the HFD group exhibited a significantly higher VA concentration and mass in the liver and BAT compared with the NFD group. In conclusion, maternal HFD consumption resulted in more VA accumulation in storage organs in neonatal and/or weanling rats, which potentially compromised the availability of VA in circulation, especially under the VA-supplemented condition.
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Bezerra DS, Ribeiro KDS, Lima MSR, Pires Medeiros JF, da Silva AGCL, Dimenstein R, Osório MM. Retinol status and associated factors in mother-newborn pairs. J Hum Nutr Diet 2019; 33:222-231. [PMID: 31602713 DOI: 10.1111/jhn.12707] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Vitamin A deficiency is still considered to be a nutritional problem during pregnancy, lactation and early childhood. The present study aimed to assess the vitamin A status of women and their newborns in the Brazilian Northeast and to determine the association between retinol in the maternal serum, umbilical cord blood and colostrum. METHODS Vitamin A status in 65 pairs of women and newborns was assessed from samples of the mother's serum, umbilical cord serum and colostrum using high-performance liquid chromatography. The inadequacy of the vitamin A status of mothers and infants was identified if the retinol values were <0.7 µmol L- 1 in maternal serum or umbilical cord blood or <1.05 µmol L-1 in colostrum. RESULTS The prevalence of inadequate maternal vitamin A status was 21.5% (95% CI: 11.5%-31.5%) and 13.8% [95% confidence interval (CI) = 5.4%-22.2%] based on maternal serum and colostrum, respectively. Among newborns, 41.5% (95% CI = 29.3%-53.5%) presented a low status of vitamin A based on cord serum. Multiple linear regression analysis identified that maternal serum retinol is a predictor of umbilical cord retinol (P = 0.005). Retinol in maternal serum was lower in mothers who were less educated (P = 0.04) and colostrum retinol was higher in older (P = 0.04) and multiparous (P = 0.002) mothers. CONCLUSIONS Vitamin A deficiency is a common problem among mothers attended in public hospitals in Northeast Brazil and maternal retinol concentrations are associated with retinol status in newborns. Maternal age, parity and educational level were related to the maternal vitamin A status.
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Affiliation(s)
- D S Bezerra
- Department of Nutrition, School of Health Sciences of Trairi - Federal University of Rio Grande do Norte, Santa Cruz, Rio Grande do Norte, Brazil
| | - K D S Ribeiro
- Department of Nutrition - Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - M S R Lima
- Department of Biochemistry, Bioscience Centre - Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - J F Pires Medeiros
- Department of Biochemistry, Bioscience Centre - Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - A G C L da Silva
- Department of Nutrition - Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - R Dimenstein
- Department of Biochemistry, Bioscience Centre - Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - M M Osório
- Program in Nutrition - Federal University of Pernambuco, Recife, Pernambuco, Brazil
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Casavale KO, Ahuja JKC, Wu X, Li Y, Quam J, Olson R, Pehrsson P, Allen L, Balentine D, Hanspal M, Hayward D, Hines EP, McClung JP, Perrine CG, Belfort MB, Dallas D, German B, Kim J, McGuire M, McGuire M, Morrow AL, Neville M, Nommsen-Rivers L, Rasmussen KM, Zempleni J, Lynch CJ. NIH workshop on human milk composition: summary and visions. Am J Clin Nutr 2019; 110:769-779. [PMID: 31274142 PMCID: PMC6895543 DOI: 10.1093/ajcn/nqz123] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 05/27/2019] [Indexed: 12/19/2022] Open
Abstract
Nationally representative data from mother-child dyads that capture human milk composition (HMC) and associated health outcomes are important for advancing the evidence to inform federal nutrition and related health programs, policies, and consumer information across the governments in the United States and Canada as well as in nongovernment sectors. In response to identified gaps in knowledge, the National Institute of Diabetes and Digestive and Kidney Diseases of the NIH sponsored the "Workshop on Human Milk Composition-Biological, Environmental, Nutritional, and Methodological Considerations" held 16-17 November 2017 in Bethesda, Maryland. Through presentations and discussions, the workshop aimed to 1) share knowledge on the scientific need for data on HMC; 2) explore the current understanding of factors affecting HMC; 3) identify methodological challenges in human milk (HM) collection, storage, and analysis; and 4) develop a vision for a research program to develop an HMC data repository and database. The 4 workshop sessions included 1) perspectives from both federal agencies and nonfederal academic experts, articulating scientific needs for data on HMC that could lead to new research findings and programmatic advances to support public health; 2) information about the factors that influence lactation and/or HMC; 3) considerations for data quality, including addressing sampling strategies and the complexities in standardizing collection, storage, and analyses of HM; and 4) insights on how existing research programs and databases can inform potential visions for HMC initiatives. The general consensus from the workshop is that the limited scope of HM research initiatives has led to a lack of robust estimates of the composition and volume of HM consumed and, consequently, missed opportunities to improve maternal and infant health.
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Affiliation(s)
- Kellie O Casavale
- Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD, USA,Address correspondence to KOC (e-mail: ). Present address for KOC: US Food and Drug Administration, Center for Food Safety and Applied Nutrition, College Park, MD, USA
| | - Jaspreet K C Ahuja
- Nutrient Data Laboratory, Beltsville Human Nutrition Research Center, Agricultural Research Service, US Department of Agriculture, Beltsville, MD, USA
| | - Xianli Wu
- Nutrient Data Laboratory, Beltsville Human Nutrition Research Center, Agricultural Research Service, US Department of Agriculture, Beltsville, MD, USA
| | - Ying Li
- Nutrient Data Laboratory, Beltsville Human Nutrition Research Center, Agricultural Research Service, US Department of Agriculture, Beltsville, MD, USA
| | - Julia Quam
- Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD, USA
| | - Richard Olson
- Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD, USA
| | - Pamela Pehrsson
- Nutrient Data Laboratory, Beltsville Human Nutrition Research Center, Agricultural Research Service, US Department of Agriculture, Beltsville, MD, USA
| | - Lindsay Allen
- Western Human Nutrition Research Center, Agricultural Research Service, US Department of Agriculture, Davis, CA, USA
| | - Douglas Balentine
- Center for Food Safety and Applied Nutrition, US Food and Drug Administration, US Department of Health and Human Services, College Park, MD, USA
| | - Manjit Hanspal
- Environmental influences on Child Health Outcomes (ECHO) program, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA
| | - Deborah Hayward
- Bureau of Nutritional Sciences, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Erin Pias Hines
- National Center for Environmental Assessment, US Environmental Protection Agency, Research Triangle Park, NC, USA
| | - James P McClung
- US Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - Cria G Perrine
- Centers for Disease Control and Prevention; US Department of Health and Human Services, Atlanta, GA, USA
| | | | - David Dallas
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Bruce German
- Department of Food Science and Technology, University of California, Davis, Davis, CA, USA
| | - Jae Kim
- Divisions of Neonatology and Pediatric Gastroenterology, University of California, San Diego, San Diego, CA, USA
| | - Mark McGuire
- College of Agricultural and Life Sciences, University of Idaho, Moscow, ID, USA
| | - Michelle McGuire
- School of Biological Sciences, Washington State University, Pullman, WA, USA,Present address for Michelle McGuire: University of Idaho, Moscow, ID, USA
| | - Ardythe L Morrow
- Center for Interdisciplinary Research in Human Milk and Lactation, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Margaret Neville
- Department of Physiology and Biophysics, University of Colorado, Denver, Denver, CO, USA
| | | | | | - Janos Zempleni
- Nebraska Center for the Prevention of Obesity Diseases, University of Nebraska–Lincoln, Lincoln, NE, USA
| | - Christopher J Lynch
- Office of Nutrition Research, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA
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11
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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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