Vitamin A status during the third trimester of pregnancy in Spanish women: influence on concentrations of vitamin A in breast milk

AbstractDetermining the predictors of serum retinol at mid-pregnancy is relevant for planning interventions aimed at improving vitamin A status of pregnant women and their offspring. This prospective study assessed predictors of serum retinol at the beginning of the third trimester of pregnancy. We enrolled 442 pregnant women living in the urban area of Cruzeiro do Sul, Western Brazilian Amazon. Demographic, socio-economic, environmental and clinical characteristics as well as obstetric history, anthropometric, dietary and biochemical data, including serum retinol, were gathered between 16 and 20 gestational weeks. Serum retinol also measured at the beginning of the third trimester of pregnancy (approximately 28 gestational weeks) was the outcome of interest. Multiple linear regression models were used to evaluate associations with the outcome. Overall, the following variables explained serum retinol at the beginning of the third trimester of pregnancy in the adjusted model (R2 = 11·1 %): seasonality (winter season – November to April; β=0·134; 95 % CI 0·063, 0·206), weekly consumption of Amazonian fruits (β=0·087; 95 % CI 0·012, 0·162) and retinol concentrations between 16 and 20 gestational weeks (β=0·045; 95 % CI 0·016, 0·074) were positively associated, whereas having a smoker in the house was negatively associated (β=–0·087; 95 % CI: –0·166, –0·009). Consumption of pro-vitamin A-rich fruits by pregnant women should be encouraged. Passive smoking may play a role in decreasing vitamin A status as a proxy of smoking exposure during pregnancy.

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Thiamin status during the third trimester of pregnancy and its influence on thiamin concentrations in transition and mature breast milk

British Journal Of Nutrition ◽

10.1079/bjn20041153 ◽

2004 ◽

Vol 92 (1) ◽

pp. 129-135 ◽

Cited By ~ 25

Author(s):

Rosa M. Ortega ◽

Rosa M. Martínez ◽

Pedro Andrés ◽

Lilliam Marín-Arias ◽

Ana M. López-Sobaler

Keyword(s):

Breast Milk ◽

Public Health Problem ◽

Third Trimester ◽

Mature Milk ◽

Important Public Health Problem ◽

Thiamin Deficiency ◽

The Third ◽

Vitamin Intake ◽

Severe Deficiency ◽

Spanish Women

AbstractThiamin deficiency remains an important public health problem in some populations. The aim of the present investigation was to study thiamin status during the third trimester of pregnancy and its influence on the concentration of this vitamin in transition (days 13–14 of lactation) and mature breast milk (day 40 of lactation) in a group of Spanish women. The pregnancies and lactation periods of fifty-one healthy women 18–35 (mean 26·7 (sd 3·7)) years old were monitored. Vitamin intake during the third trimester was determined by recording the consumption of foods over 5 d and of the quantities provided by dietary supplements. Thiamin status during this stage of pregnancy was determined by measuring the activation coefficient of erythrocyte transketolase (α-ETK). Milk thiamin content was estimated (in 41% of the subjects) by oxidizing thiamin to thiocrome and measuring fluorescence. Subjects with thiamin intakes above that recommended (group H) had more satisfactory serum α-ETK coefficients (1·01 (sd 0·19)) than did those with lower intakes (group L) (1·21 (sd 0·30); P>0·05). Mature milk thiamin concentrations were significantly higher in group H subjects (0·59 (sd 0·44) μmol/l) than group L subjects (0·25 (sd 0·07) μmol/l). Subjects with α-ETK coefficients >1·25 in the third trimester had significantly lower mature milk thiamin concentration (0·31 (sd 0·10) μmol/l) than did subjects with more satisfactory α-ETK levels at this time (0·55 (sd 0·42) μmol/l; P>0·05). The thiamin status of women can be improved since 25·5% of subjects took less than that recommended and 13·7% showed signs of severe deficiency (α-ETK >1·25). The influence of maternal thiamin intake on α-ETK coefficients and on mature breast milk thiamin concentration is confirmed.

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Impact of Maternal Daily Oral Low-Dose Vitamin A Supplementation on the Mother–Infant Pair: A Randomised Placebo-Controlled Trial in China

Nutrients ◽

10.3390/nu13072370 ◽

2021 ◽

Vol 13 (7) ◽

pp. 2370

Author(s):

Ye Ding ◽

Ping Hu ◽

Yue Yang ◽

Fangping Xu ◽

Fang Li ◽

...

Keyword(s):

Health Status ◽

Breast Milk ◽

Vitamin A ◽

Low Dose ◽

Maternal Serum ◽

Control Group ◽

Vitamin A Supplementation ◽

Maternal Vitamin ◽

Vitamin A Status ◽

Lactating Mothers

Background: The nutritional status of vitamin A in lactating mothers and infants is still not optimistic. Due to the dietary habits and dietary restrictions of postpartum customs in China, vitamin A supplementation has been advocated as a potential strategy to improve vitamin A status of lactating mothers with inadequate dietary vitamin A intake. Existing clinical trials are limited to single or double high-dose maternal administrations. However, in China, vitamin A supplements are readily available in the form of daily oral low-dose supplements, and the effect of these is unknown. This study aimed to evaluate the effects of daily oral low-dose vitamin A supplementation on the retinol levels in the serum and breast milk of lactating mothers and the health status of infants in China. Methods: Lactating mothers who met the inclusion criteria and planned to continue exclusive breastfeeding were randomly assigned to receive either daily oral vitamin A and D drops (one soft capsule of 1800 IU vitamin A and 600 IU vitamin D2), or a matching placebo for 2 months. Before and after the intervention, dietary intake was investigated by instant photography, and the retinol concentration in maternal serum and breast milk was determined by ultra-high performance liquid chromatography-tandem mass spectrometry. During the trial, the health status of infants was diagnosed by a paediatrician or reported by lactating mothers. A total of 245 participants completed the study, with 117 in the supplementation group and 128 in the control group. Results: After the 2-month intervention, maternal serum retinol concentrations increased in the supplementation group with no change in the control group. Although breast milk retinol concentrations decreased significantly in both groups, the decrease in the supplementation group was significantly lower than that in the control group. However, maternal vitamin A supplementation was not associated with a lower risk of infant febrile illness, respiratory tract infection, diarrhoea, and eczema. Conclusions: Daily oral low-dose vitamin A supplementation is helpful in improving maternal vitamin A status, despite having no effect on infant health status through breast milk.

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The effects of daily consumption of β-cryptoxanthin–rich tangerines and β-carotene–rich sweet potatoes on vitamin A and carotenoid concentrations in plasma and breast milk of Bangladeshi women with low vitamin A status in a randomized controlled trial

American Journal of Clinical Nutrition ◽

10.3945/ajcn.113.058180 ◽

2013 ◽

Vol 98 (5) ◽

pp. 1200-1208 ◽

Cited By ~ 21

Author(s):

Tami Turner ◽

Betty J Burri ◽

Kazi M Jamil ◽

Maleka Jamil

Keyword(s):

Randomized Controlled Trial ◽

Breast Milk ◽

Vitamin A ◽

Controlled Trial ◽

Sweet Potatoes ◽

Daily Consumption ◽

Randomized Controlled ◽

Vitamin A Status ◽

Β Carotene

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Serum retinol, the acute phase response, and the apparent misclassification of vitamin A status in the third National Health and Nutrition Examination Survey

American Journal of Clinical Nutrition ◽

10.1093/ajcn/72.5.1170 ◽

2000 ◽

Vol 72 (5) ◽

pp. 1170-1178 ◽

Cited By ~ 121

Author(s):

Charles B Stephensen ◽

Ginny Gildengorin

Keyword(s):

Vitamin A ◽

Acute Phase ◽

National Health ◽

Acute Phase Response ◽

Phase Response ◽

Nutrition Examination Survey ◽

Serum Retinol ◽

The Third ◽

Health And Nutrition ◽

Vitamin A Status

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Vitamin A and Breast-Feeding: A Comparison of Data from Developed and Developing Countries

Food and Nutrition Bulletin ◽

10.1177/156482659401500201 ◽

1994 ◽

Vol 15 (2) ◽

pp. 1-16 ◽

Cited By ~ 22

Author(s):

Vicky Newman

Keyword(s):

Developing Countries ◽

Breast Milk ◽

Vitamin A ◽

Human Milk ◽

Breast Feeding ◽

Developed Countries ◽

Lactating Women ◽

Vitamin A Status ◽

Sufficient Vitamin ◽

Liver Storage

The vitamin A status of lactating women, its effect on the vitamin A content of human milk, and the adequacy of human milk as a source of vitamin A for the infant were assessed, comparing data from developing countries with those from developed countries. The vitamin A concentration in breast milk during the first two weeks of lactation is nearly double that at one month. It is even higher in preterm milk than in term milk during the first several months. Human milk alone provides sufficient vitamin A to prevent clinical deficiency throughout the first 12 months of life, even in presumably more poorly nourished populations in developing countries. However, it is not sufficient to allow liver storage after about six months of lactation.

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Plasma and Breast Milk Vitamin A as Indicators of Vitamin A Status in Pregnant Women

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831.70.6.271 ◽

2000 ◽

Vol 70 (6) ◽

pp. 271-277 ◽

Cited By ~ 24

Author(s):

Richard Semba ◽

Newton Kumwenda ◽

Taha Taha ◽

Laban Mtimavalye ◽

Robin Broadhead ◽

...

Keyword(s):

Breast Milk ◽

Vitamin A ◽

Pregnant Women ◽

Acute Phase ◽

Acute Phase Proteins ◽

Post Partum ◽

Controlled Trial ◽

Geometric Mean ◽

Vitamin A Status ◽

Plasma Retinol

Breast milk vitamin A is not well characterized as an indicator of vitamin A status in women with infections. A controlled trial of vitamin A, 3 mg retinol equivalent/day, was conducted among 697 pregnant women with human immunodeficiency virus (HIV) infection in Malawi which allowed comparison of plasma versus breast milk vitamin A as indicators of vitamin A status. Retinol concentrations were measured in plasma at baseline (18–28 weeks) and 38 weeks gestation and breast milk at 6 weeks post-partum. Plasam a1-acid glycoprotein (AGP) and C-reactive protein (CRP) were measured at baseline. Plasma retinol (geometric mean, SD) at 38 weeks was 0.72 (0.44, 1.18) and 0.61 (0,38, 0.98) mmol/L (P < 0.0002) and breast milk retinol was 1.32 (0.71, 2.43) and 0.95 (0.49, 1.82) mmol/L (P < 0.0001) in vitamin A and placebo groups, respectively. Women with elevated acute phase protein (AGP > 1 gm/L and/or CRP > 5 mg/L) at baseline who received vitamin A had significantly higher plasma and breast milk vitamin A at follow-up compared with placebo, Elevated acute phase proteins did not distinguish women with low body stores of vitamin A. Breast rnilk retinol appears to be a better indicator of vitamin A status than plasma retinol in women with infections.

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