The Relationship between Dietary Vitamin A Intake and the Levels of Sialic Acid in the Breast Milk of Lactating Women

Abstract: There is no available data on the secretion and concentration of ketamine and its metabolites in breastmilk. There are statements in the literature made as to the safety of the use of ketamine in lactating women, though these are unsupported. This information is pertinent for the treatment of breastfeeding women who may have depression, PTSD, postpartum depression, and other emotional difficulties and would benefit from ketamine treatment. The objective of this study was to measure the presence and concentration of ketamine in breastmilk and three of its metabolites. We have provided a longitudinal pharmacokinetic analysis of the presence of ketamine and several of its major metabolites (norketamne, dehydronorketamine and hydronorketamine) in 4 women receiving 2 different intramuscular doses of ketamine—0.5mg/kg and 1.0mg/kg. Our results demonstrate the insignificance of ketamine’s presence In breast milk after a 12-hour period of suspension. Given ketamine’s proven record of effectiveness for the treatment of depression, and its intermittent use for this purpose, our data support the safety of its administration for the treatment of postpartum depression (PPD)and other emotional disorders during a woman’s chosen period to provide breast milk to her child without significant interruption or exposure. This provides the necessary data for the study of ketamine assisted psychotherapy as a potential treatment of postpartum emotional disorders without the loss of the relationship between mother and child which breast feeding so vitally provides. We review conventional pharmacologic treatments involved in the treatment of PPD.

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The relationships between leptin and vitamin A levels in plasma of fattening cattle supplemented with vitamin A

Animal Science ◽

10.1017/s1357729800058409 ◽

2001 ◽

Vol 73 (3) ◽

pp. 433-441 ◽

Cited By ~ 3

Author(s):

T. Tokuda ◽

S. Kono ◽

T. Fujihara

Keyword(s):

Vitamin A ◽

Insulin Concentration ◽

Dietary Vitamin ◽

Plasma Vitamin ◽

Plasma Samples ◽

High Vitamin ◽

Fattening Period ◽

Plasma Leptin ◽

The Relationship

AbstractThe objective of this study was to examine the effect of dietary vitamin A (retinol) on leptin in cattle. The relationship between plasma leptin and insulin was also examined. The experiment studies 16 9-month-old steers over the following 20-month fattening period. Four treatment diets were given to four steers in each of four groups. Cattle in treatment A were given a diet high in vitamin A (9000 to 10500 µg/day) throughout the experiment. Cattle in treatment B were given a diet low in vitamin A (300 to 4500 µg/day) for 0 to 10 months, after that they were given the high vitamin A diet during the period 10 to 20 months. Cattle in treatment C were given the low vitamin A diet for 0 to 14 months, after that they were given the high vitamin A diet for the period 14 to 20 months. Cattle in treatment D were given the low vitamin A diet throughout the experiment. Plasma samples were collected at 2-month intervals during the experiment to determine the plasma leptin, insulin and vitamin A concentrations. Plasma leptin concentration significantly increased over the fattening period (P< 0·001) but did not differ between the treatments (P> 0·05). Plasma leptin concentration was positively correlated with insulin concentration (r = 0·44,P< 0·001), although it was not correlated with plasma vitamin A concentration (r = –0·01,P> 0·05). It was concluded that dietary vitamin A in cattle does not affect plasma leptin concentration.

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Carcinoma of the Colon — Association with Low Dietary Vitamin A in Females: Preliminary Communication

Journal of the Royal Society of Medicine ◽

10.1177/014107688607900810 ◽

1986 ◽

Vol 79 (8) ◽

pp. 462-464

Author(s):

G H Tomkin ◽

Louise Scott ◽

C Ogbuah ◽

Margaret O'Shaughnessy

Keyword(s):

Vitamin A ◽

Cancer Patients ◽

Cholesterol Metabolism ◽

Plasma Lipid ◽

Metastatic Carcinoma ◽

Dietary Vitamin ◽

Carcinoma Of The Colon ◽

Preliminary Communication ◽

Relationship Of ◽

The Relationship

Seventeen patients with non-metastatic carcinoma of the colon (9 male, 8 female) were compared with age- and sex-matched controls in a study examining the relationship of diet and altered cholesterol metabolism with carcinoma of the colon. Bile acid excretion in the faeces was significantly less in cancer patients ( P > 0.001), and a significantly lower intake of retinol ( P > 0.01) and vitamin A ( P > 0.05) was demonstrated in female cancer patients. There was no difference between patients and controls in hepatic cholesterol enzyme activity or in fasting plasma lipid levels.

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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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Adequacy of vitamin A and fat in the breast milk of lactating women in south Sri Lanka

Public Health Nutrition ◽

10.1017/s1368980008001857 ◽

2008 ◽

Vol 11 (7) ◽

pp. 747-750 ◽

Cited By ~ 4

Author(s):

Chandrani Liyanage ◽

Manjula Hettiarachchi ◽

Prabhath Mangalajeewa ◽

Sarath Malawipathirana

Keyword(s):

Breast Milk ◽

Vitamin A ◽

Milk Fat ◽

Pearson Correlation ◽

Fat Content ◽

Lactating Women ◽

Milk Samples ◽

Significant Difference ◽

Urban Rural ◽

The Right

AbstractObjectiveTo determine vitamin A (retinol) and fat concentrations in breast milk during early lactation.MethodsHealthy lactating women (n 88) aged between 18 and 35 years were randomly selected for the study from urban, semi-urban, rural and estate (plantation) sectors of Galle District. Their anthropometry was recorded; breast milk samples were collected from the right breast one hour after the last feed. Breast milk retinol was determined by HPLC and fat content by the crematocrit method.ResultsSubjects were in the 2nd to 9th month of lactation. Retinol concentrations of the breast milk samples ranged from 0·10 to 2·46 μmol/l, with a mean of 0·50 μmol/l, and correlated positively with parity (Pearson correlation coefficient, r = 0·307; P = 0·01) and negatively with period of lactation (r = −0·209; P = 0·05). The fat content of breast milk ranged between 5·09 and 56·46 g/l with a mean of 26·95 g/l. A significant difference in either breast milk fat or retinol content and mean birth weight of the babies was not seen between the groups. The ratio of retinol to fat in breast milk was positively correlated with weight (r = 0·274; P = 0·01) and height (r = 0·328; P < 0·001) of the mothers.ConclusionsIn this primary investigation on breast milk quality the fat content was found to be marginal; the majority of lactating mothers (92·0 %) were not providing the minimum daily requirement (1·05 μmol/l) of retinol to their babies.

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Vitamin E and stress

British Journal Of Nutrition ◽

10.1079/bjn19670086 ◽

1967 ◽

Vol 21 (4) ◽

pp. 845-864 ◽

Cited By ~ 12

Author(s):

J. Green ◽

I. R. Muthy ◽

A. T. Diplock ◽

J. Bunyan ◽

M. A. Cawthorne ◽

...

Keyword(s):

Vitamin E ◽

Vitamin A ◽

Dietary Vitamin ◽

Dietary Pufa ◽

Weanling Rats ◽

Depletion Rate ◽

Gastro Intestinal Tract ◽

The Relationship ◽

Liver Vitamin

1. The nature of the relationship between vitamins A and E has been studied in the rat and the chick.2. Stress induced by diets rich in polyunsaturated fatty acids (PUFA) was found to have no effect on the liver vitamin A reserves of vitamin E-deficient rats given dietary vitamin A or repeated small oral doses of vitamin A.3. Dietary PUFA did not affect the liver vitamin A reserves of young rats given necrogenic diets deficient in vitamin E and selenium, nor were these reserves affected by the onset of liver necrosis or its prevention by Se.4. The effect of dietary PUFA on the rate of depletion of liver vitamin A reserves in weanling rats or rats depleted initially of vitamins A and E and then given a single large dose of vitamin A was studied over periods from 2 to 12½ weeks. In three experiments the dietary PUFA did not significantly accelerate vitamin A depletion. In one experiment the depletion rate was increased, but this was not reversed by dietary vitamin E and thus could not be attributed to an enhancement of peroxidation in vivo but rather to a toxic effect. The effect of vitamin E in these experiments was not consistent but, in general, it slightly decreased the rate of depletion.5. Large doses of vitamin A did not affect the metabolism of small amounts of [14C]D-α-tocopherol in the vitamin E-deficient rat or chick, when interaction of the two vitamins in the gastro-intestinal tract was avoided.6. Large doses of vitamin A (40000 i.u. in total) given to vitamin E-deficient chicks receiving a diet containing 1% linoleic acid (as maize oil esters) did not accelerate the onset of encephalomalacia and therefore failed to exert a pro-oxidative effect on tissue tocopherol.7. The conclusion drawn from these experiments was that any relationship that may exist in vivo between vitamins A and E is not concerned with an effect of vitamin E in preventing oxidation of vitamin A. A critical review of the literature on the nature of the relationship in general supports this view.

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Weekly Vitamin A and Iron Supplementation during Pregnancy Increases Vitamin A Concentration of Breast Milk but Not Iron Status in Indonesian Lactating Women

Journal of Nutrition ◽

10.1093/jn/131.10.2664 ◽

2001 ◽

Vol 131 (10) ◽

pp. 2664-2669 ◽

Cited By ~ 33

Author(s):

Siti Muslimatun ◽

Marjanka K. Schmidt ◽

Clive E. West ◽

Werner Schultink ◽

Joseph G. A. J. Hautvast ◽

...

Keyword(s):

Breast Milk ◽

Vitamin A ◽

Iron Supplementation ◽

Iron Status ◽

Lactating Women

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Breast Milk–Derived Retinol Is a Potential Surrogate for Serum in the 13C-Retinol Isotope Dilution Test in Zambian Lactating Women with Vitamin A Deficient and Adequate Status

Journal of Nutrition ◽

10.1093/jn/nxaa320 ◽

2020 ◽

Vol 151 (1) ◽

pp. 255-263

Author(s):

Chisela Kaliwile ◽

Charles Michelo ◽

Jesse Sheftel ◽

Christopher R Davis ◽

Michael Grahn ◽

...

Keyword(s):

Breast Milk ◽

Vitamin A ◽

Isotope Dilution ◽

Policy Development ◽

Demographic Data ◽

Reproductive Age ◽

Serum Retinol ◽

Women Of Reproductive Age ◽

Retinyl Acetate ◽

Lactating Women

ABSTRACT Background Vitamin A (VA) deficiency (VAD) affects ∼19 million pregnant women worldwide. The extent of VAD in Zambian women of reproductive age is unknown owing to lack of survey inclusion or the use of static serum retinol concentrations, a low-sensitivity biomarker. Objectives This cross-sectional study employed isotopic techniques to determine VA status with serum and milk among women aged 18–49 y (n = 197) either lactating with infants aged 0–24 mo or nonlactating with or without infants. Methods Assistants were trained and piloted data collection. Demographic data, anthropometry, and relevant histories were obtained including malaria and anemia. For retinol isotope dilution (RID), baseline fasting blood and casual breast milk samples were collected before administration of 2.0 μmol 13C2-retinyl acetate and 24-h dietary recalls. On day 14, blood (n = 144) and milk (n = 66) were collected. Prevalence of total liver VA reserves (TLR) ≤0.10 μmol/g was defined as VAD with comparison to the DRI assumption of 0.07 μmol/g as minimally acceptable for North Americans. Results When a 20% adjustment for dose lost to milk was made in the RID equation for lactation, mean total body VA stores (TBS) for lactating women were 25% lower than for nonlactating women (P < 0.01), which was not the case without adjustment (P = 0.3). Mean ± SD TLR for all women were 0.15 ± 0.11 μmol/g liver. Using retinol purified from breast milk instead of serum for RID analysis yielded similar TBS and TLR, which were highly correlated between methods (P < 0.0001). Serum retinol ≤0.70 μmol/L had 0% sensitivity using either VAD liver cutoff and milk retinol ≤1.0 μmol/L had 42% sensitivity for VAD at 0.10 μmol/g. Conclusions Determining accurate VA status among women of reproductive age, especially lactating women, forms a basis for extrapolation to the general population and informing policy development and program implementation.

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The influence of dietary vitamin A on triiodothyronine, retinoic acid, and glucocorticoid receptors in liver of hypothyroid rats

British Journal Of Nutrition ◽

10.1079/bjn19960033 ◽

1996 ◽

Vol 76 (2) ◽

pp. 295-306 ◽

Cited By ~ 15

Author(s):

M. Coustaut ◽

V. Pallet ◽

H. Garcin ◽

P. Higueret

Keyword(s):

Retinoic Acid ◽

Vitamin A ◽

Nuclear Receptors ◽

Glucocorticoid Receptors ◽

Hormone Receptors ◽

Binding Capacity ◽

Dietary Vitamin ◽

Glucocorticoid Hormone ◽

Maximum Binding Capacity ◽

The Relationship

The properties of nuclear receptors belonging to the superfamily of receptors acting as transcription factors are modulated by nutritional and hormonal conditions. We showed recently that retinoic acid (RA) restored to normal the expression of receptors attenuated by hypothyroidism. The present study was designed to find out whether dietary vitamin A (as retinol) had the same effect. Propylthiouracil in drinking water induced both hypothyroidism and a vitamin A-deficient status in rats. The maximum binding capacity (Cmax) of triiodothyronine nuclear receptors (TR) was unchanged, while that of nuclear RA receptors (RAR) and nuclear glucocorticoid hormone receptors (GRn) was reduced in the liver of these hypothyroid rats. The reduced Cmax of RAR stemmed from a lower level of RAR mRNA, while the reduced Cmax of GRn was assumed to be due to reduced translocation of the receptor from the cytosol to the nucleus. Feeding the hypothyroid rats with a vitamin A-rich diet did not restore the Cmax of either RAR or GRn to normal. The lack of effect of dietary retinol on RAR expression may be attributed to either genomic (unoccupied TR block the expression of RAR genes) and/or extragenomic (hypothyroidism decreases the availability of retinol and/or its metabolism to RA) mechanisms. Triiodothyronine is thought to favour the translocation of glucocorticoid hormone receptors from cytosol to nucleus. These findings provide more information on the relationship between vitamin A and hormonal status, showing that a vitamin A-rich diet is without apparent effect on the expression of nuclear receptors in hypothyroid rats.

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Simulated Impact of Vitamin A Fortified Sugar on Dietary Adequacy and Association of Usual Sugar Intake With Plasma and Breast Milk Retinol Among Lactating Women in Rural Zambia

Current Developments in Nutrition ◽

10.1093/cdn/nzab053_097 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 1104-1104

Author(s):

Demewoz Woldegebreal ◽

Reina Engle-Stone ◽

Bess Caswell ◽

Hanqi Luo ◽

Kevin Dodd ◽

...

Keyword(s):

Breast Milk ◽

Vitamin A ◽

Lactating Women ◽

Legal Requirement ◽

Dietary Adequacy ◽

Sugar Intake ◽

Nutrition Research ◽

Usual Intake ◽

Rural Zambia ◽

The Impact

Abstract Objectives Zambia introduced mandatory sugar fortification with vitamin A (VA) in 1998; however, regulatory monitoring and evaluation have been limited. We studied the contribution of VA-fortified sugar intake to dietary adequacy, and examined associations between usual sugar and VA intakes with plasma and breast milk retinol concentrations in lactating women in rural Zambia. Methods We conducted three 24-h dietary recalls among each of 255 lactating women enrolled in a randomized trial, at the time of baseline venous blood and breast milk collection. We measured retinol in biospecimens using high-performance liquid chromatography. We simulated VA intake under various sugar fortification scenarios: 3.1 and 8.8 mg/kg (measured median fortification levels of VA in sugar from previous studies), 10 mg/kg (minimum legal requirement) and 15 mg/kg (minimum legal requirement at factory level). Usual intake distributions, prevalence of inadequate VA intake (< Estimated Average Requirement of 900 μg RAE/d) and prevalence of retinol intake above the tolerable upper intake level (UL, >3000 μg/d) for each scenario were estimated using the National Cancer Institute (NCI) method. We applied the NCI's “bivariate model” as a regression calibration tool to examine associations of usual intake of sugar and dietary VA with plasma and breast milk retinol concentrations. Results In the absence of sugar fortification, the prevalence of VA inadequacy was predicted to be 83% (SE: 6). Fortification of sugar with VA at 3.1 mg/kg, 8.8 mg/kg, 10 mg/kg and 15 mg/kg would reduce the prevalence of VA inadequacy by 7 (SE:6), 24 (SE:14), 30 (SE:15) and 47 (SE:18) percentage points, respectively, without increasing the risk of retinol intake above the UL. Usual sugar intake and usual VA intake were not associated with plasma retinol or breastmilk retinol concentrations. Conclusions The sugar fortification program has the potential to reduce dietary VA inadequacy, but the impact is likely to be limited if actual fortification levels are lower than mandated levels. Even if target fortification levels are achieved (10 mg/kg), sugar fortification alone is unlikely to eliminate dietary VA inadequacy among lactating women in rural Zambia. Funding Sources HarvestPlus and the Sight and Life Global Nutrition Research Institute at Johns Hopkins University.

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