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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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Chilala P, Skalickova S, Horky P. Selenium Status of Southern Africa. Nutrients 2024; 16:975. [PMID: 38613007 PMCID: PMC11013911 DOI: 10.3390/nu16070975] [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: 03/11/2024] [Revised: 03/24/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024] Open
Abstract
Selenium is an essential trace element that exists in inorganic forms (selenite and selenates) and organic forms (selenoamino acids, seleno peptides, and selenoproteins). Selenium is known to aid in the function of the immune system for populations where human immunodeficiency virus (HIV) is endemic, as studies suggest that a lack of selenium is associated with a higher risk of mortality among those with HIV. In a recent study conducted in Zambia, adults had a median plasma selenium concentration of 0.27 μmol/L (IQR 0.14-0.43). Concentrations consistent with deficiency (<0.63 μmol/L) were found in 83% of adults. With these results, it can be clearly seen that selenium levels in Southern Africa should be investigated to ensure the good health of both livestock and humans. The recommended selenium dietary requirement of most domesticated livestock is 0.3 mg Se/kg, and in humans above 19 years, anRDA (recommended daily allowance) of 55 mcg Se/per dayisis recommended, but most of the research findings of Southern African countries have recorded low levels. With research findings showing alarming low levels of selenium in soils, humans, and raw feed materials in Southern Africa, further research will be vital in answering questions on how best to improve the selenium status of Southern African soils and plants for livestock and humans to attain sufficient quantities.
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Affiliation(s)
| | | | - Pavel Horky
- Department of Animal Nutrition and Forage Production, Faculty of AgriSciences, Mendel University in Brno, Zemedelska 3, 613 00 Brno, Czech Republic; (P.C.); (S.S.)
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Carretero-Krug A, Montero-Bravo A, Morais-Moreno C, Puga AM, Samaniego-Vaesken MDL, Partearroyo T, Varela-Moreiras G. Nutritional Status of Breastfeeding Mothers and Impact of Diet and Dietary Supplementation: A Narrative Review. Nutrients 2024; 16:301. [PMID: 38276540 PMCID: PMC10818638 DOI: 10.3390/nu16020301] [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: 11/27/2023] [Revised: 01/12/2024] [Accepted: 01/15/2024] [Indexed: 01/27/2024] Open
Abstract
Adequate nutrition during breastfeeding is crucial for ensuring the good health of mothers and babies. Despite the high energy and nutrient demands of breastfeeding, lactating women are often vulnerable from a nutritional perspective. The nutritional focus during breastfeeding tends to be on the newborn, often neglecting the mother's diet. Therefore, in the present narrative review, nutrient intakes were compared with the dietary reference values (DRVs) proposed by the European Food Safety Authority (EFSA) as well as by the World Health Organization/Food and Agriculture Organization (WHO/FAO). In the diets of lactating mothers, dietary inadequacies were observed in the intake of some vitamins, such as folic acid, vitamin B12, vitamin A, and vitamin D, and in the intake of certain minerals like calcium, iron, and iodine; polyunsaturated omega-3 fatty acid deficiencies, primarily in eicosapentaenoic acid and docosahexaenoic acid, were also observed. On the other hand, the debate on the necessity of supplementation during lactation continues; the need for nutritional supplementation during lactation depends on many factors, such us mothers' eating habits. There seems to be a positive association between nutritional supplementation of the lactating mother and the concentration of certain nutrients in human milk. The present narrative review provides an update on the nutritional status (fatty acids and micronutrients) of breastfeeding mothers and the impact of diet and dietary supplementation on human milk composition.
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Affiliation(s)
- Alejandra Carretero-Krug
- Grupo USP-CEU de Excelencia “Nutrición para la vida (Nutrition for Life)”, Ref: E02/0720, Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, 28660 Boadilla del Monte, Spain; (A.C.-K.); (A.M.-B.); (C.M.-M.); (A.M.P.); (M.d.L.S.-V.); (T.P.)
- Instituto CEU Alimentación y Sociedad, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, 28660 Boadilla del Monte, Spain
| | - Ana Montero-Bravo
- Grupo USP-CEU de Excelencia “Nutrición para la vida (Nutrition for Life)”, Ref: E02/0720, Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, 28660 Boadilla del Monte, Spain; (A.C.-K.); (A.M.-B.); (C.M.-M.); (A.M.P.); (M.d.L.S.-V.); (T.P.)
- Instituto CEU Alimentación y Sociedad, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, 28660 Boadilla del Monte, Spain
| | - Carmen Morais-Moreno
- Grupo USP-CEU de Excelencia “Nutrición para la vida (Nutrition for Life)”, Ref: E02/0720, Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, 28660 Boadilla del Monte, Spain; (A.C.-K.); (A.M.-B.); (C.M.-M.); (A.M.P.); (M.d.L.S.-V.); (T.P.)
| | - Ana M. Puga
- Grupo USP-CEU de Excelencia “Nutrición para la vida (Nutrition for Life)”, Ref: E02/0720, Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, 28660 Boadilla del Monte, Spain; (A.C.-K.); (A.M.-B.); (C.M.-M.); (A.M.P.); (M.d.L.S.-V.); (T.P.)
- Instituto CEU Alimentación y Sociedad, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, 28660 Boadilla del Monte, Spain
| | - Mª de Lourdes Samaniego-Vaesken
- Grupo USP-CEU de Excelencia “Nutrición para la vida (Nutrition for Life)”, Ref: E02/0720, Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, 28660 Boadilla del Monte, Spain; (A.C.-K.); (A.M.-B.); (C.M.-M.); (A.M.P.); (M.d.L.S.-V.); (T.P.)
- Instituto CEU Alimentación y Sociedad, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, 28660 Boadilla del Monte, Spain
| | - Teresa Partearroyo
- Grupo USP-CEU de Excelencia “Nutrición para la vida (Nutrition for Life)”, Ref: E02/0720, Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, 28660 Boadilla del Monte, Spain; (A.C.-K.); (A.M.-B.); (C.M.-M.); (A.M.P.); (M.d.L.S.-V.); (T.P.)
- Instituto CEU Alimentación y Sociedad, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, 28660 Boadilla del Monte, Spain
| | - Gregorio Varela-Moreiras
- Grupo USP-CEU de Excelencia “Nutrición para la vida (Nutrition for Life)”, Ref: E02/0720, Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, 28660 Boadilla del Monte, Spain; (A.C.-K.); (A.M.-B.); (C.M.-M.); (A.M.P.); (M.d.L.S.-V.); (T.P.)
- Instituto CEU Alimentación y Sociedad, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, 28660 Boadilla del Monte, Spain
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Dobrzyńska M, Kaczmarek K, Przysławski J, Drzymała-Czyż S. Selenium in Infants and Preschool Children Nutrition: A Literature Review. Nutrients 2023; 15:4668. [PMID: 37960322 PMCID: PMC10648445 DOI: 10.3390/nu15214668] [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: 09/29/2023] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/15/2023] Open
Abstract
Selenium (Se), an essential trace element, is fundamental to human health, playing an important role in the formation of thyroid hormones, DNA synthesis, the immune response, and fertility. There is a lack of comprehensive epidemiological research, particularly the serum Se concetration in healthy infants and preschool children compared to the estimated dietary Se intake. However, Se deficiencies and exceeding the UL have been observed in infants and preschool children. Despite the observed irregularities in Se intake, there is a lack of nutritional recommendations for infants and preschool children. Therefore, the main objective of this literature review was to summarize what is known to date about Se levels and the risk of deficiency related to regular consumption in infants and preschool children.
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Affiliation(s)
| | | | | | - Sławomira Drzymała-Czyż
- Department of Bromatology, Poznan University of Medical Science, Rokietnicka 3 Street, 60-806 Poznan, Poland; (M.D.); (K.K.); (J.P.)
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Mutonhodza B, Joy EJM, Bailey EH, Lark MR, Kangara MGM, Broadley MR, Matsungo TM, Chopera P. Linkages between soil, crop, livestock, and human selenium status in Sub-Saharan Africa: a scoping review. Int J Food Sci Technol 2022; 57:6336-6349. [PMID: 36605250 PMCID: PMC9804181 DOI: 10.1111/ijfs.15979] [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: 04/23/2022] [Accepted: 07/11/2022] [Indexed: 01/07/2023]
Abstract
Selenium (Se) is essential for human health, however, data on population Se status and agriculture-nutrition-health linkages are limited in sub-Saharan Africa (SSA). The scoping review aims to identify linkages between Se in soils/crops, dietary Se intakes, and livestock and human Se status in SSA. Online databases, organisational websites and grey literature were used to identify articles. Articles were screened at title, abstract and full text levels using eligibility criteria. The search yielded 166 articles from which 112 were excluded during abstract screening and 54 full text articles were assessed for eligibility. The scoping review included 34 primary studies published between 1984 and 2021. The studies covered Se concentrations in soils (n = 7), crops (n = 9), animal tissues (n = 2), livestock (n = 3), and human Se status (n = 15). The evidence showed that soil/crop Se concentrations affected Se concentration in dietary sources, dietary Se intake and biomarkers of Se status. Soil types are a primary driver of human Se status and crop Se concentration correlates positively with biomarkers of Se dietary status. Although data sets of Se concentrations exist across the food system in SSA, there is limited evidence on linkages across the agriculture-nutrition nexus. Extensive research on Se linkages across the food chain is warranted.
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Affiliation(s)
- Beaula Mutonhodza
- Department of Nutrition, Dietetics and Food SciencesUniversity of ZimbabweP.O. Box MP167, Mt PleasantHarareZimbabwe
| | - Edward J. M. Joy
- London School for Hygiene and Tropical MedicineKeppel StreetLondonWC1E 7HTUK,Rothamsted ResearchWest CommonHarpendenAL5 2JQUK
| | - Elizabeth H. Bailey
- School of BiosciencesUniversity of NottinghamSutton Bonington CampusLoughboroughLeicestershireLE12 5RDUK
| | - Murray R. Lark
- School of BiosciencesUniversity of NottinghamSutton Bonington CampusLoughboroughLeicestershireLE12 5RDUK
| | | | - Martin R. Broadley
- Rothamsted ResearchWest CommonHarpendenAL5 2JQUK,School of BiosciencesUniversity of NottinghamSutton Bonington CampusLoughboroughLeicestershireLE12 5RDUK
| | - Tonderayi M. Matsungo
- Department of Nutrition, Dietetics and Food SciencesUniversity of ZimbabweP.O. Box MP167, Mt PleasantHarareZimbabwe
| | - Prosper Chopera
- Department of Nutrition, Dietetics and Food SciencesUniversity of ZimbabweP.O. Box MP167, Mt PleasantHarareZimbabwe
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Haskell MJ, Maleta K, Arnold CD, Jorgensen JM, Fan YM, Ashorn U, Matchado A, Monangi NK, Zhang G, Xu H, Belling E, Landero J, Chappell J, Muglia LJ, Hallman M, Ashorn P, Dewey KG. Provision of Small-Quantity Lipid-Based Nutrient Supplements Increases Plasma Selenium Concentration in Pregnant Women in Malawi: A Secondary Outcome of a Randomized Controlled Trial. Curr Dev Nutr 2022; 6:nzac013. [PMID: 35317414 PMCID: PMC8929992 DOI: 10.1093/cdn/nzac013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 01/05/2022] [Accepted: 01/25/2022] [Indexed: 11/14/2022] Open
Abstract
Background Pregnant women in Malawi are at risk of selenium deficiency, which can have adverse effects on pregnancy outcomes. Interventions for improving selenium status are needed. Objectives To assess the effect of provision of small-quantity lipid-based nutrient supplements (SQ-LNSs) to Malawian women during pregnancy on their plasma selenium concentrations at 36 wk of gestation. Methods Pregnant women (≤20 wk of gestation) were randomly assigned to receive daily either: 1) iron and folic acid (IFA); 2) multiple micronutrients (MMN; 130 µg selenium per capsule); or 3) SQ-LNS (130 µg selenium/20 g). Plasma selenium concentrations were measured by inductively coupled plasma mass spectrometry at baseline and after ≥16 wk of intervention (at 36 wk of gestation) and compared by intervention group. Results At 36 wk of gestation, median (quartile 1, quartile 3) plasma selenium concentrations (micromoles per liter) were 0.96 (0.73, 1.23), 0.94 (0.78, 1.18), and 1.01 (0.85, 1.28) in the IFA, MMN, and SQ-LNS groups, respectively. Geometric mean (GM) plasma selenium concentration was 5.4% (95% CI: 1.8%, 9.0%) higher in the SQ-LNS group than in the MMN group and tended to be higher than in the IFA group (+4.2%; 95% CI: 1.0%, 7.8%). The prevalence of adjusted plasma selenium concentrations <1 µmol/L was 55.1%, 57.8%, and 47.3% in the IFA, MMN, and SQ-LNS groups, respectively; it was lower in the SQ-LNS group than in the MMN group, OR = 0.44 (95% CI: 0.24, 0.83), and tended to be lower than in the IFA group, OR = 0.54 (95% CI: 0.29, 1.03). There was a significant interaction between baseline plasma selenium concentration and intervention group (P = 0.003). In the lowest tertile of baseline selenium concentrations, GM plasma selenium concentration was higher, and the prevalence of low values was lower in the SQ-LNS group compared with the MMN and IFA groups at 36 wk of gestation (P ≤ 0.007). Conclusions Provision of SQ-LNS containing selenium to pregnant women can be an effective strategy for improving their selenium status.This trial was registered at clinicaltrials.gov (identifier: NCT01239693).
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Affiliation(s)
- Marjorie J Haskell
- Institute for Global Nutrition, University of California, Davis, Davis, CA, USA
- Department of Nutrition, University of California, Davis, Davis, CA, USA
| | - Kenneth Maleta
- Department of Public Health, School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Charles D Arnold
- Institute for Global Nutrition, University of California, Davis, Davis, CA, USA
- Department of Nutrition, University of California, Davis, Davis, CA, USA
| | - Josh M Jorgensen
- Institute for Global Nutrition, University of California, Davis, Davis, CA, USA
- Department of Nutrition, University of California, Davis, Davis, CA, USA
| | - Yue-Mei Fan
- Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Ulla Ashorn
- Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Andrew Matchado
- Institute for Global Nutrition, University of California, Davis, Davis, CA, USA
| | - Nagendra K Monangi
- Division of Neonatology, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Ge Zhang
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Center for Prevention of Preterm Birth, Perinatal Institute, Cincinnati Children's Hospital Medical Center and March of Dimes Prematurity Research Center Ohio Collaborative, Cincinnati, OH, USA
| | - Huan Xu
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Center for Prevention of Preterm Birth, Perinatal Institute, Cincinnati Children's Hospital Medical Center and March of Dimes Prematurity Research Center Ohio Collaborative, Cincinnati, OH, USA
| | - Elizabeth Belling
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Center for Prevention of Preterm Birth, Perinatal Institute, Cincinnati Children's Hospital Medical Center and March of Dimes Prematurity Research Center Ohio Collaborative, Cincinnati, OH, USA
| | - Julio Landero
- Department of Chemistry, University of Cincinnati, Cincinnati, OH, USA
| | - Joanne Chappell
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Center for Prevention of Preterm Birth, Perinatal Institute, Cincinnati Children's Hospital Medical Center and March of Dimes Prematurity Research Center Ohio Collaborative, Cincinnati, OH, USA
| | - Louis J Muglia
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Burroughs Wellcome Fund, Research Triangle Park, NC, USA
| | - Mikko Hallman
- Medical Research Centre Oulu, PEDEGO Research Unit, University of Oulu, Oulu, Pohjois-Pohjanmaa, Finland
| | - Per Ashorn
- Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Paediatrics, Tampere University Hospital, Tampere, Finland
| | - Kathryn G Dewey
- Institute for Global Nutrition, University of California, Davis, Davis, CA, USA
- Department of Nutrition, University of California, Davis, Davis, CA, USA
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Keikha M, Shayan-Moghadam R, Bahreynian M, Kelishadi R. Nutritional supplements and mother's milk composition: a systematic review of interventional studies. Int Breastfeed J 2021; 16:1. [PMID: 33397426 PMCID: PMC7780633 DOI: 10.1186/s13006-020-00354-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 12/14/2020] [Indexed: 12/31/2022] Open
Abstract
Background This study aims to systematically review the effects of maternal vitamin and/or mineral supplementation on the content of breast milk. Methods We systematically searched electronic databases including Medline via PubMed, Scopus and ISI Web of Science till May 24, 2018. The following terms were used systematically in all mentioned databases: (“human milk” OR “breast milk” OR “breast milk composition” OR “human breast milk composition” OR “composition breast milk” OR “mother milk” OR “human breast milk” OR “maternal milk”) AND (“vitamin a” OR “retinol” OR “retinal” OR “retinoic acid” OR “beta-carotene” OR “beta carotene” OR “ascorbic acid” OR “l-ascorbic acid” OR “l ascorbic acid” OR “vitamin c” OR “vitamin d” OR “cholecalciferol” OR “ergocalciferol” OR “calciferol” OR “vitamin e” OR “tocopherol” OR “tocotrienol” OR “alpha-tocopherol” OR “alpha tocopherol” OR “α-tocopherol” OR “α tocopherol” OR “vitamin k” OR “vitamin b” OR “vitamin b complex” OR “zinc” OR “iron” OR “copper” Or “selenium” OR “manganese” OR “magnesium”) and we searched Medline via Medical subject Headings (MeSH) terms. We searched Google Scholar for to increase the sensitivity of our search. The search was conducted on human studies, but it was not limited to the title and abstract. Methodological quality and risk of bias of included studies were evaluated by Jadad scale and Cochrane risk of bias tools, respectively. Results This review included papers on three minerals (zinc, iron, selenium) and 6 vitamins (vitamin A, B, D, C, E and K) in addition to multi-vitamin supplements. Although studies had different designs, e.g. not using random allocation and/or blinding, our findings suggest that maternal use of some dietary supplements, including vitamin A, D, vitamin B1, B2 and vitamin C might be reflected in human milk. Vitamin supplements had agreater effect on breast milk composition compared to minerals. Higher doses of supplements showed higher effects and they were reflected more in colostrum than in the mature milk. Conclusion Maternal dietary vitamin and/or mineral supplementation, particularly fat- soluble vitamins, vitamin B1, B2 and C might be reflected in the breast milk composition. No difference was found between mega dose and single dose administration of minerals.
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Affiliation(s)
- Mojtaba Keikha
- Department of Public Health, Sirjan School of Medical Sciences, Sirjan, Iran
| | - Ramin Shayan-Moghadam
- Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Bahreynian
- Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. .,Department of Nutrition, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Roya Kelishadi
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
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Selenium supplementation in HIV-infected individuals: A systematic review of randomized controlled trials. Clin Nutr ESPEN 2019; 34:1-7. [PMID: 31677697 DOI: 10.1016/j.clnesp.2019.09.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 08/02/2019] [Accepted: 09/06/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND & AIM HIV infection has been linked to selenium deficiency which, in turn, is thought to be associated with a high risk of tuberculosis and mortality in HIV-infected patients. Furthermore, several trials have reported the beneficial effects of selenium supplementation in patients with HIV. However, the evidence remains inconclusive. Our study aimed to investigate whether daily selenium supplementation in patients infected with HIV delays the progression of HIV infection. METHODS A systematic review was performed using EMBASE and Medline databases from January 2000 to June 2018. We included randomized clinical trials in adults comparing selenium with placebo and reporting outcomes including its effect on HIV viral load and cluster of differentiation 4 cell count (CD4). RESULTS Six out of the 507 retrieved articles that met the inclusion criteria were used in this review. Reviewed studies show that daily supplementation with 200 μg selenium may improve the rate of cluster of differentiation 4 (CD4) count. The length of selenium supplementation and follow-up varied from 9 to 24 months. Supplements were well tolerated in all reviewed studies. Whether daily selenium supplementation in HIV-infected persons suppresses HIV-infection requires further investigation as existing data are heterogeneous. CONCLUSIONS We found some clinical evidence that selenium supplementation can delay CD4 decline in HIV-infected patients, thus prolonging the onset of AIDS. However, we did not find quantifiable evidence that selenium supplementation suppresses or reduces HIV viral load.
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Ewing AC, Davis NL, Kayira D, Hosseinipour MC, van der Horst C, Jamieson DJ, Kourtis AP. Prescription of Antibacterial Drugs for HIV-Exposed, Uninfected Infants, Malawi, 2004-2010. Emerg Infect Dis 2018; 25. [PMID: 30561313 PMCID: PMC6302572 DOI: 10.3201/eid2501.180782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Antimicrobial drug resistance is a serious health hazard driven by overuse. Administration of antimicrobial drugs to HIV-exposed, uninfected infants, a population that is growing and at high risk for infection, is poorly studied. We therefore analyzed factors associated with antibacterial drug administration to HIV-exposed, uninfected infants during their first year of life. Our study population was 2,152 HIV-exposed, uninfected infants enrolled in the Breastfeeding, Antiretrovirals and Nutrition study in Lilongwe, Malawi, during 2004-2010. All infants were breastfed through 28 weeks of age. Antibacterial drugs were prescribed frequently (to 80% of infants), and most (67%) of the 5,329 prescriptions were for respiratory indications. Most commonly prescribed were penicillins (43%) and sulfonamides (23%). Factors associated with lower hazard for antibacterial drug prescription included receipt of cotrimoxazole preventive therapy, receipt of antiretroviral drugs, and increased age. Thus, cotrimoxazole preventive therapy may lead to fewer prescriptions for antibacterial drugs for these infants.
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Das JK, Hoodbhoy Z, Salam RA, Bhutta AZ, Valenzuela‐Rubio NG, Weise Prinzo Z, Bhutta ZA. Lipid-based nutrient supplements for maternal, birth, and infant developmental outcomes. Cochrane Database Syst Rev 2018; 8:CD012610. [PMID: 30168868 PMCID: PMC6513224 DOI: 10.1002/14651858.cd012610.pub2] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Ready-to-use lipid-based nutrient supplements (LNS) are a highly nutrient-dense supplement, which could be a good source of macro- and micronutrients for pregnant women who need to supplement their nutrient intake. OBJECTIVES To assess the effects of LNS for maternal, birth and infant outcomes in pregnant women. Secondary objectives were to explore the most appropriate composition, frequency and duration of LNS administration. SEARCH METHODS In May 2018, we searched CENTRAL, MEDLINE, Embase, 22 other databases and two trials registers for any published and ongoing studies. We also checked the reference lists of included studies and relevant reviews, and we contacted the authors of included studies and other experts in the field to identify any studies we may have missed, including any unpublished studies. SELECTION CRITERIA We included randomised controlled trials (RCTs) and quasi-RCTs that compared LNS given in pregnancy to no intervention, placebo, iron folic acid (IFA), multiple micronutrients (MMN) or nutritional counselling. DATA COLLECTION AND ANALYSIS We used standard Cochrane procedures. MAIN RESULTS We included four studies in 8018 pregnant women. All four studies took place in stable community settings in low- and middle-income countries: Bangladesh, Burkina Faso, Ghana and Malawi. None were in emergency settings. The oldest trial was published in 2009. Of the four included studies, one compared LNS to IFA, one compared LNS to MMN, and two compared LNS to both IFA and MMN.We considered the included studies to be of medium to high quality, and we rated the quality of the evidence as moderate using the GRADE approach.LNS versus IFAMaternal outcomes: there was no difference between the LNS and IFA groups as regards maternal gestational weight gain per week (standard mean difference (SMD) 0.46, 95% confidence interval (CI) -0.44 to 1.36; 2 studies, 3539 participants). One study (536 participants) showed a two-fold increase in the prevalence of maternal anaemia in the LNS group compared to the IFA group, but no difference between the groups as regards adverse effects. There was no difference between the two groups for maternal mortality (risk ratio (RR) 0.53, 95% CI 0.12 to 2.41; 3 studies, 5628 participants).Birth and infant outcomes: there was no difference between the LNS and IFA groups for low birth weight (LBW) (RR 0.87, 95% CI 0.72 to 1.05; 3 studies, 4826 participants), though newborns in the LNS group had a slightly higher mean birth weight (mean difference (MD) 53.28 g, 95% CI 28.22 to 78.33; 3 studies, 5077 participants) and birth length (cm) (MD 0.24 cm, 95% CI 0.11 to 0.36; 3 studies, 4986 participants). There was a reduction in the proportion of infants who were small for gestational age (SGA) (RR 0.94, 95% CI 0.89 to 0.99; 3 studies, 4823 participants) and had newborn stunting (RR 0.82, 95% CI 0.71 to 0.94; 2 studies, 4166 participants) in the LNS group, but no difference between the LNS and IFA groups for preterm delivery (RR 0.94, 95% CI 0.80 to 1.11; 4 studies, 4924 participants), stillbirth (RR 1.14; 95% CI 0.52 to 2.48; 3 studies, 5575 participants) or neonatal death (RR 0.96, 95% CI 0.14 to 6.51). The current evidence for child developmental outcomes is not sufficient to draw any firm conclusions.LNS versus MMNMaternal outcomes: one study (662 participants) showed no difference between the LNS and MMN groups as regards gestational weight gain per week or adverse effects. Another study (557 participants) showed an increased risk of maternal anaemia in the LNS group compared to the MMN group.Birth and infant outcomes: there was no difference between the LNS and MMN groups for LBW (RR 0.92, 95% CI 0.74 to 1.14; 3 studies, 2404 participants), birth weight (MD 23.67 g, 95% CI -10.53 to 57.86; 3 studies, 2573 participants), birth length (MD 0.20 cm, 95% CI -0.02 to 0.42; 3 studies, 2567 participants), SGA (RR 0.95, 95% CI 0.84 to 1.07; 3 studies, 2393 participants), preterm delivery (RR 1.15, 95% CI 0.93 to 1.42; 3 studies, 2630 participants), head circumference z score (MD 0.10, 95% CI -0.01 to 0.21; 2 studies, 1549 participants) or neonatal death (RR 0.88, 95% CI 0.36 to 2.15; 1 study, 1175 participants). AUTHORS' CONCLUSIONS Findings from this review suggest that LNS supplementation has a slight, positive effect on weight at birth, length at birth, SGA and newborn stunting compared to IFA. LNS and MMN were comparable for all maternal, birth and infant outcomes. Both IFA and MMN were better at reducing maternal anaemia when compared to LNS. We did not find any trials for LNS given to pregnant women in emergency settings.Readers should interpret the beneficial findings of the review with caution since the evidence comes from a small number of trials, with one-large scale study (conducted in community settings in Bangladesh) driving most of the impact. In addition, effect sizes are too small to propose any concrete recommendation for practice.
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Affiliation(s)
- Jai K Das
- Aga Khan University HospitalDivision of Women and Child HealthStadium RoadPO Box 3500KarachiSindPakistan
| | - Zahra Hoodbhoy
- Aga Khan University HospitalDivision of Women and Child HealthStadium RoadPO Box 3500KarachiSindPakistan
| | - Rehana A Salam
- Aga Khan University HospitalDivision of Women and Child HealthStadium RoadPO Box 3500KarachiSindPakistan
| | | | - Nancy G Valenzuela‐Rubio
- Autonomous University of SinaloaSchool of Nutrition and GastronomyPuerto Ensenada Ave. 1783Nuevo CuliacanCuliacanSinaloaMexico80170
- Mexican Association for Nutrition and Health ResearchCuliacanMexico
| | - Zita Weise Prinzo
- World Health OrganizationDepartment of Nutrition for Health and DevelopmentAvenue Appia 20GenevaGESwitzerland1211
| | - Zulfiqar A Bhutta
- The Hospital for Sick ChildrenCentre for Global Child HealthTorontoONCanadaM5G A04
- Aga Khan University HospitalCentre for Excellence in Women and Child HealthStadium RoadPO Box 3500KarachiPakistan74800
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11
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Allen LH, Donohue JA, Dror DK. Limitations of the Evidence Base Used to Set Recommended Nutrient Intakes for Infants and Lactating Women. Adv Nutr 2018; 9:295S-312S. [PMID: 29846528 PMCID: PMC6008957 DOI: 10.1093/advances/nmy019] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Reported values for concentrations of micronutrients in human milk form the basis of the majority of micronutrient intake recommendations for infants and the additional maternal requirements for lactation. The infant recommendations may also be extrapolated to provide estimates for young children. The purpose of this review is to evaluate the adequacy of the milk micronutrient concentration data used by the Institute of Medicine to set recommendations for the United States and Canada, by FAO/WHO, the United Kingdom, and the European Food Safety Authority. The concentrations accepted by each agency are presented for each micronutrient accompanied by the source of information and comments on the number, location, status, and stage of lactation of the sample population, where known. These summaries show the small number of participants from which samples were collected in most studies, the wide range of concentrations within studies, the lack of longitudinal data, and the variability in collection methods. These factors contribute to the variability in nutrient intake recommendations among committees, although this variability is reduced by some committees that accept milk-composition values proposed by others. Values are also summarized from milk collected in studies in which mothers or infants were known to be deficient on the basis of clinical symptoms, biomarkers of inadequacy, or both, to show the extent to which milk micronutrients can be reduced by poor maternal nutritional status. We conclude that a new, multicenter study is needed to establish reference values for milk constituents across lactation.
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Affiliation(s)
- Lindsay H Allen
- US Department of Agriculture, Agricultural Research Service, Western Human Nutrition Research Center, Davis, CA
| | - Juliana A Donohue
- US Department of Agriculture, Agricultural Research Service, Western Human Nutrition Research Center, Davis, CA
| | - Daphna K Dror
- US Department of Agriculture, Agricultural Research Service, Western Human Nutrition Research Center, Davis, CA
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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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13
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Abstract
Exclusive breastfeeding is recommended by the WHO for the first 6 mo of life because human milk protects against gastrointestinal infections and supplies balanced and adequate nutrient contents to the infant. However, reliable data on micronutrient concentrations in human milk are sparse, especially because some micronutrients are affected by maternal diet. Microbiological and competitive protein-binding assays, nuclear magnetic resonance or inductively coupled plasma spectroscopy, and chromatographic analyses are among the methods that have been applied to human-milk micronutrient analysis. However, the validation or evaluation of analytical methods in terms of their suitability for the complex human-milk matrix has been commonly ignored in reports, even though the human-milk matrix differs vastly from blood, plasma, or urine matrixes. Thus, information on the validity, accuracy, and sensitivity of the methods is essential for the estimation of infant and maternal intake requirements to support and maintain adequate milk micronutrient concentrations for healthy infant growth and development. In this review, we summarize current knowledge on methods used for analyzing water- and fat-soluble vitamins as well as iron, copper, zinc, iodine, and selenium in human milk and their different forms in milk; the tools available for quality control and assurance; and guidance for preanalytical considerations. Finally, we recommend preferred methodologic approaches for analysis of specific milk micronutrients.
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Affiliation(s)
- Daniela Hampel
- US Department of Agriculture, Agricultural Research Service,Western Human Nutrition Research Center, Davis, CA
- Department of Nutrition, University of California, Davis, Davis, CA
| | - Daphna K Dror
- US Department of Agriculture, Agricultural Research Service,Western Human Nutrition Research Center, Davis, CA
| | - Lindsay H Allen
- US Department of Agriculture, Agricultural Research Service,Western Human Nutrition Research Center, Davis, CA
- Department of Nutrition, University of California, Davis, Davis, CA
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Prentice S. They Are What You Eat: Can Nutritional Factors during Gestation and Early Infancy Modulate the Neonatal Immune Response? Front Immunol 2017; 8:1641. [PMID: 29234319 PMCID: PMC5712338 DOI: 10.3389/fimmu.2017.01641] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 11/09/2017] [Indexed: 12/17/2022] Open
Abstract
The ontogeny of the human immune system is sensitive to nutrition even in the very early embryo, with both deficiency and excess of macro- and micronutrients being potentially detrimental. Neonates are particularly vulnerable to infectious disease due to the immaturity of the immune system and modulation of nutritional immunity may play a role in this sensitivity. This review examines whether nutrition around the time of conception, throughout pregnancy, and in early neonatal life may impact on the developing infant immune system.
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Affiliation(s)
- Sarah Prentice
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom
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15
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Keikha M, Bahreynian M, Saleki M, Kelishadi R. Macro- and Micronutrients of Human Milk Composition: Are They Related to Maternal Diet? A Comprehensive Systematic Review. Breastfeed Med 2017; 12:517-527. [PMID: 28880568 DOI: 10.1089/bfm.2017.0048] [Citation(s) in RCA: 104] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND This study aims at systematically reviewing the observational and interventional studies on the association of maternal macro- and micronutrient intake with breast milk content. METHODS We systematically searched the Medline via PubMed, Scopus, and ISI Web of Knowledge till October 2016 with the following search strategy: ("human milk" OR "breast milk" OR "breast milk composition" OR "human breast milk composition" OR "composition breast milk" OR "mother milk" OR "human breast milk") AND ("maternal diet" OR "maternal nutrition"). We also searched Google scholar for increasing the sensitivity of our search. The search was not limited to title and abstract due to the possibility that the desired outcome might have been considered a secondary aim. We excluded conference papers, editorials, letters, commentary, short survey, and notes. The search was refined to English language, and we did not consider any time limitation. To increase the sensitivity and to select more studies, the reference list of the published studies was checked as well. RESULTS This review included 59 observational and 43 interventional studies on maternal diet related to breast milk composition. Different studies determined the associations and effects of some maternal dietary intake of micro and macronutrients and its reflection in human milk. CONCLUSION Maternal dietary intake, particularly fatty acids, and some micronutrients, including fat soluble vitamins, vitamin B1, and vitamin C, was related to their content in breast milk composition.
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Affiliation(s)
- Mojtaba Keikha
- 1 Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences , Shahroud, Iran
| | - Maryam Bahreynian
- 2 Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences , Isfahan, Iran
| | - Mohammad Saleki
- 3 Students' Research Center, Isfahan University of Medical Sciences , Isfahan, Iran
| | - Roya Kelishadi
- 2 Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences , Isfahan, Iran
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Ndounga Diakou LA, Ntoumi F, Ravaud P, Boutron I. Published randomized trials performed in Sub-Saharan Africa focus on high-burden diseases but are frequently funded and led by high-income countries. J Clin Epidemiol 2017; 82:29-36.e6. [DOI: 10.1016/j.jclinepi.2016.10.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 10/10/2016] [Accepted: 10/26/2016] [Indexed: 01/05/2023]
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17
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Ellwanger JH, Franke SIR, Bordin DL, Prá D, Henriques JAP. Biological functions of selenium and its potential influence on Parkinson's disease. AN ACAD BRAS CIENC 2016; 88:1655-1674. [PMID: 27556332 DOI: 10.1590/0001-3765201620150595] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 09/28/2015] [Indexed: 03/01/2023] Open
Abstract
Parkinson's disease is characterized by the death of dopaminergic neurons, mainly in the substantia nigra, and causes serious locomotor dysfunctions. It is likely that the oxidative damage to cellular biomolecules is among the leading causes of neurodegeneration that occurs in the disease. Selenium is an essential mineral for proper functioning of the brain, and mainly due to its antioxidant activity, it is possible to exert a special role in the prevention and in the nutritional management of Parkinson's disease. Currently, few researchers have investigated the effects of selenium on Parkinson´s disease. However, it is known that very high or very low body levels of selenium can (possibly) contribute to the pathogenesis of Parkinson's disease, because this imbalance results in increased levels of oxidative stress. Therefore, the aim of this work is to review and discuss studies that have addressed these topics and to finally associate the information obtained from them so that these data and associations serve as input to new research.
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Affiliation(s)
- Joel H Ellwanger
- Programa de Pós-Graduação em Biologia Celular e Molecular, Centro de Biotecnologia, Universidade Federal do Rio Grande do Sul/UFRGS, Campus do Vale, Prédio 43421, Av. Bento Gonçalves, 9500, 91501-970 Porto Alegre, RS, Brasil
| | - Silvia I R Franke
- Programa de Pós-Graduação em Promoção da Saúde, Universidade de Santa Cruz do Sul/UNISC, Bloco 42, sala 4206, Av. Independência, 2293, Universitário, 96815-900 Santa Cruz do Sul, RS, Brasil
| | - Diana L Bordin
- Programa de Pós-Graduação em Biologia Celular e Molecular, Centro de Biotecnologia, Universidade Federal do Rio Grande do Sul/UFRGS, Campus do Vale, Prédio 43421, Av. Bento Gonçalves, 9500, 91501-970 Porto Alegre, RS, Brasil
| | - Daniel Prá
- Programa de Pós-Graduação em Promoção da Saúde, Universidade de Santa Cruz do Sul/UNISC, Bloco 42, sala 4206, Av. Independência, 2293, Universitário, 96815-900 Santa Cruz do Sul, RS, Brasil.,Departamento de Biologia e Farmácia, Universidade de Santa Cruz do Sul/UNISC, Bloco 12, sala 1206, Av. Independência, 2293, Universitário, 96815-900 Santa Cruz do Sul, RS, Brasil
| | - João A P Henriques
- Programa de Pós-Graduação em Biologia Celular e Molecular, Centro de Biotecnologia, Universidade Federal do Rio Grande do Sul/UFRGS, Campus do Vale, Prédio 43421, Av. Bento Gonçalves, 9500, 91501-970 Porto Alegre, RS, Brasil.,Instituto de Biotecnologia, Universidade de Caxias do Sul/UCS, Rua Francisco Getúlio Vargas, 1130, 95070-560 Caxias do Sul, RS, Brasil
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