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Dicklin MR, Anthony JC, Winters BL, Maki KC. ω-3 Polyunsaturated Fatty Acid Status Testing in Humans: A Narrative Review of Commercially Available Options. J Nutr 2024; 154:1487-1504. [PMID: 38522783 DOI: 10.1016/j.tjnut.2024.03.015] [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: 01/08/2024] [Revised: 03/13/2024] [Accepted: 03/18/2024] [Indexed: 03/26/2024] Open
Abstract
There is an increasing body of evidence supporting a link between low intakes of ω-3 long-chain polyunsaturated fatty acids (LCPUFA) and numerous diseases and health conditions. However, few people are achieving the levels of fish/seafood or eicosapentaenoic acid and docosahexaenoic acid intake recommended in national and international guidelines. Knowledge of a person's ω-3 LCPUFA status will benefit the interpretation of research results and could be expected to lead to an increased effort to increase intake. Dietary intake survey methods are often used as a surrogate for measuring ω-3 PUFA tissue status and its impact on health and functional outcomes. However, because individuals vary widely in their ability to digest and absorb ω-3 PUFA, analytical testing of biological samples is desirable to accurately evaluate ω-3 PUFA status. Adipose tissue is the reference biospecimen for measuring tissue fatty acids, but less-invasive methods, such as measurements in whole blood or its components (e.g., plasma, serum, red blood cell membranes) or breast milk are often used. Numerous commercial laboratories provide fatty acid testing of blood and breast milk samples by different methods and present their results in a variety of reports such as a full fatty acid profile, ω-3 and ω-6 fatty acid profiles, fatty acid ratios, as well as the Omega-3 Index, the Holman Omega-3 Test, OmegaScore, and OmegaCheck, among others. This narrative review provides information about the different ways to measure ω-3 LCPUFA status (including both dietary assessments and selected commercially available analytical tests of blood and breast milk samples) and discusses evidence linking increased ω-3 LCPUFA intake or status to improved health, focusing on cardiovascular, neurological, pregnancy, and eye health, in support of recommendations to increase ω-3 LCPUFA intake and testing.
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Affiliation(s)
| | | | | | - Kevin C Maki
- Midwest Biomedical Research, Addison, IL, United States; Indiana University School of Public Health, Bloomington, IN, United States.
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Cetin I, Carlson SE, Burden C, da Fonseca EB, di Renzo GC, Hadjipanayis A, Harris WS, Kumar KR, Olsen SF, Mader S, McAuliffe FM, Muhlhausler B, Oken E, Poon LC, Poston L, Ramakrishnan U, Roehr CC, Savona-Ventura C, Smuts CM, Sotiriadis A, Su KP, Tribe RM, Vannice G, Koletzko B. Omega-3 fatty acid supply in pregnancy for risk reduction of preterm and early preterm birth. Am J Obstet Gynecol MFM 2024; 6:101251. [PMID: 38070679 DOI: 10.1016/j.ajogmf.2023.101251] [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: 10/13/2023] [Revised: 12/03/2023] [Accepted: 12/04/2023] [Indexed: 01/14/2024]
Abstract
This clinical practice guideline on the supply of the omega-3 docosahexaenoic acid and eicosapentaenoic acid in pregnant women for risk reduction of preterm birth and early preterm birth was developed with support from several medical-scientific organizations, and is based on a review of the available strong evidence from randomized clinical trials and a formal consensus process. We concluded the following. Women of childbearing age should obtain a supply of at least 250 mg/d of docosahexaenoic+eicosapentaenoic acid from diet or supplements, and in pregnancy an additional intake of ≥100 to 200 mg/d of docosahexaenoic acid. Pregnant women with a low docosahexaenoic acid intake and/or low docosahexaenoic acid blood levels have an increased risk of preterm birth and early preterm birth. Thus, they should receive a supply of approximately 600 to 1000 mg/d of docosahexaenoic+eicosapentaenoic acid, or docosahexaenoic acid alone, given that this dosage showed significant reduction of preterm birth and early preterm birth in randomized controlled trials. This additional supply should preferably begin in the second trimester of pregnancy (not later than approximately 20 weeks' gestation) and continue until approximately 37 weeks' gestation or until childbirth if before 37 weeks' gestation. Identification of women with inadequate omega-3 supply is achievable by a set of standardized questions on intake. Docosahexaenoic acid measurement from blood is another option to identify women with low status, but further standardization of laboratory methods and appropriate cutoff values is needed. Information on how to achieve an appropriate intake of docosahexaenoic acid or docosahexaenoic+eicosapentaenoic acid for women of childbearing age and pregnant women should be provided to women and their partners.
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Affiliation(s)
- Irene Cetin
- Fondazione IRCCS, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy (Dr Cetin)
| | - Susan E Carlson
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, KS (Dr Carlson)
| | - Christy Burden
- Academic Women's Health Unit, Bristol Medical School: Translational Health Sciences, University of Bristol, Bristol, United Kingdom (Dr Burden)
| | - Eduardo B da Fonseca
- Department of Obstetrics and Gynaecology, Federal University of Paraíba, João Pessoa, Brazil (Dr da Fonseca)
| | - Gian Carlo di Renzo
- Centre of Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy (Dr di Renzo); PREIS School, Florence, Italy (Dr di Renzo)
| | - Adamos Hadjipanayis
- School of Medicine, European University Cyprus, Nicosia, Cyprus (Dr Hadjipanayis); European Academy of Paediatrics, Brussels, Belgium (Dr Hadjipanayis)
| | - William S Harris
- Fatty Acid Research Institute, Sioux Falls, SD (Dr Harris); Department of Internal Medicine, Sanford School of Medicine, University of South Dakota, Sioux Falls, SD (Dr Harris)
| | - Kishore R Kumar
- Cloudnine Hospitals, Bangalore, India (Dr Kumar); University of Notre Dame Australia, Perth, Australia (Dr Kumar)
| | - Sjurdur Frodi Olsen
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (Dr Olsen); Department of Public Health, University of Copenhagen, Copenhagen, Denmark (Dr Olsen); Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (Dr Olsen)
| | - Silke Mader
- European Foundation for the Care of Newborn Infants, Munich, Germany (Ms Mader)
| | - Fionnuala M McAuliffe
- UCD Perinatal Research Centre, National Maternity Hospital, University College Dublin, Dublin, Ireland (Dr McAuliffe)
| | - Beverly Muhlhausler
- Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Canberra, Australia (Dr Muhlhausler); School of Agriculture, Food and Wine, University of Adelaide, Adelaide, Australia (Dr Muhlhausler); South Australian Health and Medical Research Institute, Adelaide, Australia (Dr Muhlhausler)
| | - Emily Oken
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA (Dr Oken)
| | - Liona C Poon
- Maternal Medicine, Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong, China (Dr Poon); Department of Women and Children's Health, King's College London, London, United Kingdom (Dr Poon)
| | - Lucilla Poston
- School of Life Course and Population Sciences, King's College London, London, United Kingdom (Dr Poston); International Society for Developmental Origins of Health and Disease (Dr Poston)
| | - Usha Ramakrishnan
- Hubert Department of Global Health, Emory University, Atlanta, GA (Dr Ramakrishnan); Doctoral Program in Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta, GA (Dr Ramakrishnan)
| | - Charles C Roehr
- National Perinatal Epidemiology Unit, Clinical Trials Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom (Dr Roehr); Faculty of Health Sciences, University of Bristol, Bristol, United Kingdom (Dr Roehr); Newborn Care, Women and Children's Division, Southmead Hospital, Bristol, United Kingdom (Dr Roehr); European Society for Paediatric Research, Satigny, Switzerland (Dr Roehr)
| | - Charles Savona-Ventura
- Department of Obstetrics & Gynaecology, Mater Dei Hospital, University of Malta Medical School, Msida, Malta (Dr Savona-Ventura); Centre for Traditional Chinese Medicine & Culture, University of Malta, Msida, Malta (Dr Savona-Ventura)
| | - Cornelius M Smuts
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa (Dr Smuts)
| | - Alexandros Sotiriadis
- Second Department of Obstetrics and Gynecology, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece (Dr Sotiriadis)
| | - Kuan-Pin Su
- Mind-Body Interface Research Center (MBI-Lab), China Medical University Hospital, Taichung, Taiwan (Dr Su); An-Nan Hospital, China Medical University, Tainan, Taiwan (Dr Su); College of Medicine, China Medical University, Taichung, Taiwan (Dr Su)
| | - Rachel M Tribe
- Department of Women and Children's Health, School of Life Course and Population Sciences, King's College London, St Thomas' Hospital, London, United Kingdom (Dr Tribe)
| | | | - Berthold Koletzko
- Dr. von Hauner Children's Hospital, Ludwig Maximilian University of Munich Hospital, Munich, Germany (Dr Koletzko); Child Health Foundation (Stiftung Kindergesundheit), Munich, Germany (Dr Koletzko); European Academy of Paediatrics, Brussels, Belgium (Dr Koletzko).
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Association of Fatty Acid Desaturase 1 rs174547 Polymorphism with the Composition of Long-Chain Polyunsaturated Fatty Acids in Serum Glycerophospholipids during Pregnancy. Nutrients 2023; 15:nu15030722. [PMID: 36771429 PMCID: PMC9919170 DOI: 10.3390/nu15030722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 01/25/2023] [Accepted: 01/28/2023] [Indexed: 02/05/2023] Open
Abstract
The increase in fetal requirements of long-chain polyunsaturated fatty acids (LCPUFAs) during pregnancy alters maternal fatty acid metabolism, and therefore, fatty acid desaturase (FADS) gene polymorphisms may change blood fatty acid composition or concentration differently during pregnancy. We investigated the relationship between a FADS1 single-nucleotide polymorphism (SNP) and maternal serum LCPUFA levels in Japanese pregnant women during the first and third trimesters and at delivery. Two hundred and fifty-three pregnant women were included, and fatty acid compositions of glycerophospholipids in serum (weight %) and the FADS1 SNP rs174547 (T/C) were analyzed. LCPUFAs, including arachidonic acid (ARA) and docosahexaenoic acid (DHA), significantly decreased from the first to the third trimester of pregnancy. Furthermore, DHA significantly decreased from the third trimester of pregnancy to delivery. At all gestational stages, linoleic acid (LA) and α-linolenic acid were significantly higher with the number of minor FADS1 SNP alleles, whereas γ-linolenic acid and ARA and the ARA/LA ratio were significantly lower. DHA was significantly lower with the number of minor FADS1 SNP alleles only in the third trimester and at delivery, suggesting that genotype effects become more obvious as pregnancy progresses.
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Huang Q, Zhou X, Zhang C, Huang L, Wang Q, Chen Q, Tang H, Luo J, Wang Z, Yuan C, Zheng Y. Relative Validity and Reproducibility of Dietary Measurements Assessed by a Semiquantitative Food Frequency Questionnaire among Chinese Healthy Adults. Nutrients 2023; 15:nu15030545. [PMID: 36771253 PMCID: PMC9920913 DOI: 10.3390/nu15030545] [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: 12/21/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 01/24/2023] Open
Abstract
This study aimed to evaluate the relative validity and reproducibility of a semiquantitative food frequency questionnaire (SFFQ) in adult populations in China. Among the 49 recruited healthy participants (age range: 20-60 years), the relative validity of a 79-item SFFQ was assessed in two ways: (1) by comparing its dietary intake estimates with those from the average measurements of three inconsecutive 24 h dietary records (24-HDRs); and (2) by comparing its estimates of dietary fatty acids with the measured plasma levels of fatty acids. The reproducibility of the SFFQ was evaluated by a comparison of two SFFQ measurements from the same participants collected one year apart. In the relative validity study, the average Spearman correlation coefficient (r) was 0.27 among 18 prespecified food group intakes estimated from the SFFQ and the 24-HDRs; nevertheless, that of five food group intakes (e.g., red meat and seafood) was higher (all rs > 0.40, p < 0.05). In addition, a moderate correlation between the SFFQ estimate of polyunsaturated fatty acid intakes (energy-adjusted percentage of total fatty acids) and its plasma level was observed (r = 0.42, p < 0.05). Regarding the one-year reproducibility of the SFFQ-assessed intakes, the average rank intraclass correlation coefficient (ICC) was 0.35 for the 18 food group estimates. In particular, moderately reproducible estimates of seven food group intakes (e.g., refined grains and red meat, all ICCs ≥ 0.40, p < 0.05) were observed. In conclusion, the SFFQ provides valid and reproducible estimates of dietary intakes for various food groups in general and performs well as a potential tool for estimating habitual dietary intakes of some unsaturated fatty acids.
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Affiliation(s)
- Qiumin Huang
- Human Phenome Institute, School of Life Sciences, Fudan University, Shanghai 200433, China
| | - Xiaofeng Zhou
- Human Phenome Institute, School of Life Sciences, Fudan University, Shanghai 200433, China
| | - Chuqi Zhang
- Human Phenome Institute, School of Life Sciences, Fudan University, Shanghai 200433, China
| | - Liyan Huang
- School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Qi Wang
- Human Phenome Institute, School of Life Sciences, Fudan University, Shanghai 200433, China
| | - Qinsheng Chen
- Human Phenome Institute, School of Life Sciences, Fudan University, Shanghai 200433, China
| | - Huiru Tang
- Human Phenome Institute, School of Life Sciences, Fudan University, Shanghai 200433, China
| | - Jingchun Luo
- Human Phenome Institute, School of Life Sciences, Fudan University, Shanghai 200433, China
| | - Zhengyuan Wang
- Department of Nutrition Hygiene, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
| | - Changzheng Yuan
- School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, China
- Correspondence: (C.Y.); (Y.Z.)
| | - Yan Zheng
- Human Phenome Institute, School of Life Sciences, Fudan University, Shanghai 200433, China
- Correspondence: (C.Y.); (Y.Z.)
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Geographic variations and determinants of EPA plus DHA and EPA alone in pregnant and lactating women from China. Br J Nutr 2022; 128:733-743. [PMID: 34526160 DOI: 10.1017/s0007114521003731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
EPA and DHA are essential for maternal and fetal health, but epidemiological data are sparse in China. We examined the trends of EPA alone and a combination of EPA plus DHA in pregnant and lactating women in three distinct geographic regions in China and explored their potential influencing factors. A total of 1015 healthy women during mid-pregnancy, late pregnancy or lactation were recruited from Weihai (coastland), Yueyang (lakeland) and Baotou (inland) cities of China between May and July of 2014. Maternal EPA and DHA concentrations (percentage of total fatty acids) in plasma and erythrocytes were measured by capillary GC. Adjusted EPA plus DHA concentrations in both plasma and erythrocytes significantly declined from mid-pregnancy (2·92 %, 6·95 %) to late pregnancy (2·20 %, 6·42 %) and lactation (2·40 %, 6·29 %) (Ptrend < 0·001); and both concentrations were highest in coastland, followed by lakeland, and lowest in inland (P < 0·001). Regarding EPA alone, the concentrations were higher in women during lactation or late pregnancy and in women in coastland and inland areas. Moreover, concentrations of EPA or EPA plus DHA were higher in women with older age, higher education, higher annual family income per capita and higher dietary intake of marine aquatic product and mutton. In lactating women, erythrocyte EPA concentration was higher in those having breast-feeding partially v. exclusively. In conclusion, maternal plasma and erythrocyte concentrations of EPA plus DHA or EPA alone differed with geographic regions, physiological periods and maternal characteristics, indicating a need of population-specific health strategies to improve fatty acids status in pregnant and lactating women.
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Docosahexaenoic Acid as the Bidirectional Biomarker of Dietary and Metabolic Risk Patterns in Chinese Children: A Comparison with Plasma and Erythrocyte. Nutrients 2022; 14:nu14153095. [PMID: 35956271 PMCID: PMC9370652 DOI: 10.3390/nu14153095] [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: 07/05/2022] [Revised: 07/20/2022] [Accepted: 07/26/2022] [Indexed: 11/29/2022] Open
Abstract
Objective: The present study aims to measure docosahexaenoic acid (DHA) in both the plasma and erythrocyte of a child population and compares them with respect to their associations with dietary and metabolic risk patterns. Methods: A cross-sectional study was conducted, and a total of 435 children ages 5−7 years old were recruited. Diet information was collected using a food frequency questionnaire (FFQ). The physical indicators, blood pressure, and glycolipid metabolic indicators were determined. The plasma and erythrocyte DHA were analyzed using a gas chromatography mass spectrometer. Principal component analysis was used to identify dietary and metabolic risk patterns. Multivariate regression analyses were used to investigate the associations of DHA status with dietary and metabolic risk patterns. Results: A significant correlation between plasma and the erythrocyte DHA concentration was found (r = 0.232, p < 0.001). A diversified dietary pattern characterized that a high intake of diversified foods had a positive association with the plasma DHA level (β = 0.145, 95% CI: 0.045~0.244, p = 0.004). Children of obesity risk patterns with a high weight, pelvis breadth, BMI, upper arm circumference, and chest circumference had lower plasma DHA concentrations (OR = 0.873, 95% CI: 0.786~0.969, p = 0.011). Children with higher plasma and erythrocyte DHA concentrations were adhered to blood lipid risk patterns with high CHOL and LDL-C levels. The plasma DHA (OR = 1.271, 95% CI: 1.142~1.415, p < 0.001) had a stronger association with a blood lipid risk pattern than erythrocyte (OR = 1.043, 95% CI: 1.002~1.086, p = 0.040). Conclusions: The diversified dietary pattern had a higher plasma DHA concentration. Lower levels of plasma DHA were positively associated with obesity in children. DHA in plasma appears to be more strongly associated with blood lipid metabolism than erythrocyte. Plasma DHA may be a more sensitive bidirectional biomarker to evaluate the recently comprehensive diet intake and metabolic risk of children.
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Yu HT, Xu WH, Chen YR, Ji Y, Tang YW, Li YT, Gong JY, Chen YF, Liu GL, Xie L. Association of Prepregnancy Obesity and Remodeled Maternal-Fetal Plasma Fatty Acid Profiles. Front Nutr 2022; 9:897059. [PMID: 35651505 PMCID: PMC9149296 DOI: 10.3389/fnut.2022.897059] [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: 03/15/2022] [Accepted: 04/06/2022] [Indexed: 11/13/2022] Open
Abstract
Background Fatty acids, especially polyunsaturated fatty acid (PUFA), are found abundantly in the brain and are fundamental for a fetus's growth. The fatty acid profiles of mothers and fetuses may be affected by maternal prepregnancy body mass index (pre-BMI), thus affecting fetal growth and development. Methods A total of 103 mother-fetus pairs were divided into overweight/obese (OW, n = 26), normal weight (NW, n = 60), and underweight (UW, n = 17) groups according to pre-BMI. Fatty acid profiles in maternal and umbilical cord plasma were analyzed by gas chromatography. Results The infant birth BMI z-score of the OW group was higher than that of the NW and UW groups (p < 0.05). The OW mothers had significantly higher plasma n-6 PUFA and n-6/n-3, but lower docosahexaenoic acid (DHA) and n-3 PUFA (p < 0.05). In cord plasma, the proportions of DHA and n-3 PUFA were lower in the OW group (p < 0.05), whereas the n-6/n-3 ratio was higher in the OW group (p < 0.05). The pre-BMI was negatively correlated with cord plasma DHA in all subjects (r = −0.303, p = 0.002), and the same negative correlation can be observed in the OW group (r = −0.561, p = 0.004), but not in the NW and UW groups (p > 0.05). The pre-BMI was positively correlated with cord plasma n-6/n-3 in all subjects (r = 0.325, p = 0.001), and the same positive correlation can be found in the OW group (r = 0.558, p = 0.004), but not in NW and UW groups (p > 0.05). Conclusions Maternal pre-BMI was associated with the maternal-fetal plasma fatty acid profiles, whereas the adverse fatty acid profiles are more noticeable in the prepregnancy OW mothers.
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Affiliation(s)
- Hai-Tao Yu
- Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, Changchun, China
| | - Wen-Hui Xu
- Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, Changchun, China
| | - Yi-Ru Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, Changchun, China
| | - Ye Ji
- Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, Changchun, China
| | - Yi-Wei Tang
- Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, Changchun, China
| | - Yue-Ting Li
- Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, Changchun, China
| | - Jia-Yu Gong
- Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, Changchun, China
| | - Yi-Fei Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, Changchun, China
| | - Guo-Liang Liu
- Experimental Teaching Center for Preventive Medicine, School of Public Health, Jilin University, Changchun, China
| | - Lin Xie
- Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, Changchun, China
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Zhou Y, Si K, Li H, Li X, Tanumihardjo SA, Liu J. Geographic and socio-demographic determinants of plasma retinol concentrations in Chinese pregnant and lactating women. Eur J Nutr 2021; 61:1561-1570. [PMID: 34860270 DOI: 10.1007/s00394-021-02759-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 11/25/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To examine plasma retinol status and its determinants in Chinese pregnant or lactating women. METHODS A cross-sectional study involving 1211 healthy women in mid-pregnancy, late pregnancy, or lactation was conducted in northern, central, and southern China. Plasma retinol concentration was determined by high-performance liquid chromatography. Multivariate quantile regression or modified Poisson regression was used to estimate adjusted medians, or to examine the associations of suboptimal retinol concentration (< 1.05 µmol/L) with various factors. RESULTS The overall median (interquartile range) retinol concentration was 1.25 (1.06-1.46) µmol/L. The adjusted concentration was higher in women at lactation (1.39 [1.20-1.63] µmol/L) and mid-pregnancy (1.26 [1.10-1.44] µmol/L) than late pregnancy (1.07 [0.92-1.28] µmol/L), and higher in women in the central area (1.34 [1.18-1.49] µmol/L) and the north (1.26 [1.10-1.43] µmol/L) than the south (1.19 [1.07-1.31] µmol/L). The retinol concentration was more likely to be low in women with lower pre-pregnancy BMI, younger age, less education, and in lactating women who had a caesarean birth or were breastfeeding exclusively. A total of 290 (24.0%) women had a suboptimal retinol concentration, and the prevalence was higher in women at late pregnancy, residing in the south, with younger age, and having underweight pre-pregnancy. CONCLUSION About one-fourth of pregnant or lactating women in China had suboptimal retinol concentrations that varied with phases of pregnancy and lactation, region of residence, and socio-demographic characteristics, indicating a need for population-specific public health strategies to optimize vitamin A status.
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Affiliation(s)
- Yubo Zhou
- Institute of Reproductive and Child Health/ National Health Commission Key Laboratory of Reproductive Health, Peking University Health Science Center, No. 38 Xueyuan Rd, Haidian District, Beijing, 100191, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Keyi Si
- Institute of Reproductive and Child Health/ National Health Commission Key Laboratory of Reproductive Health, Peking University Health Science Center, No. 38 Xueyuan Rd, Haidian District, Beijing, 100191, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Hongtian Li
- Institute of Reproductive and Child Health/ National Health Commission Key Laboratory of Reproductive Health, Peking University Health Science Center, No. 38 Xueyuan Rd, Haidian District, Beijing, 100191, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Xiucui Li
- Institute of Reproductive and Child Health/ National Health Commission Key Laboratory of Reproductive Health, Peking University Health Science Center, No. 38 Xueyuan Rd, Haidian District, Beijing, 100191, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Sherry A Tanumihardjo
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Jianmeng Liu
- Institute of Reproductive and Child Health/ National Health Commission Key Laboratory of Reproductive Health, Peking University Health Science Center, No. 38 Xueyuan Rd, Haidian District, Beijing, 100191, China. .,Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China.
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Trends and influencing factors of plasma folate levels in Chinese women at mid-pregnancy, late pregnancy and lactation periods. Br J Nutr 2021; 126:885-891. [PMID: 33256875 DOI: 10.1017/s0007114520004821] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Folate status for women during early pregnancy has been investigated, but data for women during mid-pregnancy, late pregnancy or lactation are sparse or lacking. Between May and July 2014, we conducted a cross-sectional study in 1211 pregnant and lactating women from three representative regions in China. Approximately 135 women were enrolled in each stratum by physiological periods (mid-pregnancy, late pregnancy or lactation) and regions (south, central or north). Plasma folate concentrations were measured by microbiological assay. The adjusted medians of folate concentration decreased from 28·8 (interquartile range (IQR) 19·9, 38·2) nmol/l in mid-pregnancy to 18·6 (IQR 13·2, 26·4) nmol/l in late pregnancy, and to 17·0 (IQR 12·3, 22·5) nmol/l in lactation (Pfor trend < 0·001). Overall, lower folate concentrations were more likely to be observed in women residing in the northern region, with younger age, higher pre-pregnancy BMI, lower education or multiparity, and in lactating women who had undergone a Caesarean delivery or who were breastfeeding exclusively. In total, 380 (31·4 %) women had a suboptimal folate status (folate concentration <13·5 nmol/l). Women in late pregnancy and lactating, residing in the northern region, having multiparity and low education level had a higher risk of suboptimal folate status, while those with older age had a lower risk. In conclusion, maternal plasma folate concentrations decreased as pregnancy progressed, and were influenced by geographic region and maternal socio-demographic characteristics. Future studies are warranted to assess the necessity of folic acid supplementation during later pregnancy and lactation especially for women at a higher risk of folate depletion.
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Parasannanavar D, Gaddam I, Bukya T, Ibrahim S A, Reddy K S, Banjara SK, Salvadi BPP, Kumar B N, Rao SF, Geddam JJB, Rajkumar H. Omega-3 polyunsaturated fatty acid intake and plasma fatty acids of school going Indian children - a cross-sectional study. Prostaglandins Leukot Essent Fatty Acids 2021; 170:102294. [PMID: 34052598 DOI: 10.1016/j.plefa.2021.102294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 03/25/2021] [Accepted: 05/06/2021] [Indexed: 12/18/2022]
Abstract
Long-chain omega-3 polyunsaturated fatty acids (PUFA) such as docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) play an essential role in cognitive and behavioural changes among school going children. This study delineates the dietary omega-3 PUFA [alpha-Linolenic acid (ALA), DHA, and EPA] intake and plasma fatty acids levels among school-going children. This is a cross-sectional study purely observational in nature, wherein 625 apparently healthy boys and girls aged between 7 and 13 years were selected from five different schools of Hyderabad. Dietary information on omega-3 PUFA (ALA, DHA, and EPA) intake was collected using a food frequency questionnaire. Plasma fatty acid concentrations were measured in 34% of sub-sample using standard gas chromatography. The study revealed that the average dietary intakes of omega-3 PUFA, ALA, DHA, and EPA were 55.46, 15.82, 35.59, 4.06 mg/day, respectively. There was a significant difference in mean DHA intake among gender and age group [girls (38.64±1.45 mg/day), boys (31.80±1.38 mg/day) p < 0.001] and [7-10 years (31.75±1.38 mg/day), 11-13 years (38.07±1.40 mg/day) p < 0.01]. The mean plasma DHA and DPA levels of overall subjects were 0.98 nmol% and 0.18nmol% respectively which was comparable among different gender, age and BMI-for age groups. There was a positive correlation between dietary DHA intake and plasma DHA level [ρ=0.376 (p < 0.001)]. The current study demonstrated that the omega-3 PUFA intake in school going children was less and reinforces the importance of increasing the omega-3 PUFA intake through diet and supplements.
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Affiliation(s)
- Devaraj Parasannanavar
- Division of Clinical Epidemiology, ICMR-National Institute of Nutrition, Hyderabad, Telangana, India-500 007. 8074928620.
| | - Indraja Gaddam
- ICMR-National Institute of Nutrition, Hyderabad, Telangana, India-500 007.
| | - Tulja Bukya
- Division of Clinical Epidemiology, ICMR-National Institute of Nutrition, Hyderabad, Telangana, India-500 007. 8074928620.
| | - Ahamed Ibrahim S
- Lipid Chemistry Department, ICMR-National Institute of Nutrition, Hyderabad, Telangana, India-500 007.
| | - Suryam Reddy K
- Lipid Chemistry Department, ICMR-National Institute of Nutrition, Hyderabad, Telangana, India-500 007.
| | - Santosh Kumar Banjara
- Clinical Division, ICMR-National Institute of Nutrition, Hyderabad, Telangana, India-500 007.
| | - Blessy P Priyanka Salvadi
- Division of Clinical Epidemiology, ICMR-National Institute of Nutrition, Hyderabad, Telangana, India-500 007. 8074928620.
| | - Naveen Kumar B
- Division of Clinical Epidemiology, ICMR-National Institute of Nutrition, Hyderabad, Telangana, India-500 007. 8074928620.
| | - Sylvia Fernandez Rao
- Behavioral Science Unit, Extension & Training Division, (ICMR)-National Institute of Nutrition, Hyderabad, Telangana, India-500 007.
| | - J J Babu Geddam
- Division of Clinical Epidemiology, ICMR-National Institute of Nutrition, Hyderabad, Telangana, India-500 007. 8074928620.
| | - Hemalatha Rajkumar
- Scientist 'G' and The Director, ICMR-National Institute of Nutrition, Jamai-Osmania, Tarnaka, Hyderabad, Telangana-500007.
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Zhou Y, Yan L, Li H, Li X, Liu Y, Liu J. Patterns and Determinants of Essential and Toxic Elements in Chinese Women at Mid-Pregnancy, Late Pregnancy, and Lactation. Nutrients 2021; 13:nu13020668. [PMID: 33669610 PMCID: PMC7922563 DOI: 10.3390/nu13020668] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/06/2021] [Accepted: 02/12/2021] [Indexed: 12/13/2022] Open
Abstract
Maternal status of essential and toxic elements affects the health of the mother, developing fetus, or breastfeeding infant. However, few studies have examined the patterns of these elements and their determinants in pregnant or lactating women. Plasma samples of 1211 healthy mid-pregnant, late pregnant, and lactating women enrolled in coastland, lakeland, and inland areas of China from May–July 2014, were analyzed for concentrations of 15 elements, using inductively coupled plasma mass spectrometry. The adjusted median concentrations of elements varied by physiologic stage and region. Lactating versus pregnant women showed higher concentrations of Zn, Cr, Mo, Ni, Sb, Cd and Pb, but lower concentrations of Cu, I, Al and Hg. In pregnant women, the concentrations of Fe, Zn, I, Mo, Ni, Al, Hg and Cd were higher in mid- versus late-pregnancy. Overall, the highest concentrations were observed in Zn, I, Mn, Al, and Pb in coastland, in Hg in lakeland, and in Fe in inland area. Element concentrations varied by maternal age, pre-pregnancy BMI, education, parity, delivery mode, feeding practice, and intakes of aquatic products and mutton. In conclusion, essential and toxic elements coexisted in pregnant and lactating women, and their concentrations varied by physiologic stages, regions, maternal socio-demographic characteristics and dietary factors.
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Affiliation(s)
- Yubo Zhou
- Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health, Peking University, Beijing 100191, China; (Y.Z.); (H.L.); (X.L.)
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Lailai Yan
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing 100191, China; (L.Y.); (Y.L.)
- Medical and Health Analysis Center, School of Public Health, Peking University, Beijing 100191, China
- Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China
| | - Hongtian Li
- Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health, Peking University, Beijing 100191, China; (Y.Z.); (H.L.); (X.L.)
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Xiucui Li
- Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health, Peking University, Beijing 100191, China; (Y.Z.); (H.L.); (X.L.)
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Yaqiong Liu
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing 100191, China; (L.Y.); (Y.L.)
- Medical and Health Analysis Center, School of Public Health, Peking University, Beijing 100191, China
- Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China
| | - Jianmeng Liu
- Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health, Peking University, Beijing 100191, China; (Y.Z.); (H.L.); (X.L.)
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
- Correspondence: ; Tel.: +86-10-82801136
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Marine n-3 fatty acid consumption in a Norwegian renal transplant cohort: Comparison of a food frequency questionnaire with plasma phospholipid marine n-3 levels. PLoS One 2020; 15:e0244089. [PMID: 33332416 PMCID: PMC7746258 DOI: 10.1371/journal.pone.0244089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 12/02/2020] [Indexed: 11/19/2022] Open
Abstract
Background High levels of plasma marine n-3 fatty acids (n-3FAs) are associated with improved patient and graft survival in renal transplant recipients (RTRs). The aim of this study was to evaluate the utility of a new food frequency questionnaire (FFQ) to estimate marine n-3FA consumption in future epidemiological research. Methods We developed an FFQ with a simple design of 10 questions to assess intake of marine sources of n-3FAs. RTRs included in the recent ORENTRA trial (n = 132) completed the study FFQ at the baseline visit eight weeks after engraftment and at the end of study visit one year post-transplant. We measured the reference biomarker plasma phospholipid (PL) marine n-3FA levels by gas chromatography at the same time points to evaluate association and degree of agreement between FFQ based marine n-3FA consumption estimates and the biomarker. Results The median plasma PL marine n-3FA level was 6.0 weight percentage (wt)% (interquartile range [IQR] 4.7 to 7.3) at baseline and 6.3 wt% (IQR 4.8 to 7.4) at end of study. Median FFQ based marine n-3FA consumption estimates were 22.8 g/month (IQR 13.0 to 34.0) at baseline and 20.3 g/month (IQR 14.5 to 32.3) at end of study. FFQ based marine n-3FA consumption estimates showed a moderate correlation with plasma PL marine n-3FA levels at baseline (Spearman’s correlation coefficient rs = 0.43, p<0.001) and a stronger correlation at end of study (rs = 0.62, p<0.001). Bland Altman plots showed a reasonable degree of agreement between the two methods at both time points. Conclusions Marine n-3FA consumption estimates based on the FFQ showed a moderate correlation with the reference biomarker plasma PL marine n-3FA levels. The FFQ might be useful in epidemiological studies where resources are limited.
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