Retinol Levels and Severity of Patients with COVID-19.

The new coronavirus infection represents a serious threat to global health and economies. In this sense, it is paramount to know the nutritional factors that may be related to the prognosis of the disease. Evidence shows that vitamin A may play an important preventive and therapeutic role in supporting respiratory infections as in COVID-19. The aim of our study was to evaluate the association of vitamin A (retinol) status with the prognosis of the disease. A case-control study from a cohort study was conducted in Brazil between May and October 2020. The study population was chosen by convenience, consisting of participants diagnosed with COVID-19. Recruitment was carried out using different approaches, including through dissemination on social media and in four hospitals in the city of Natal/RN, Brazil, recruiting participants from the COVID-19 ward and hospitalized participants who tested positive for the disease. The participants were allocated into two groups according to severity, with a group of mild (n = 88) or critical (n = 106) patients and compared to a control group (selected before the pandemic, n = 46). The extraction of retinol serum was performed and analyzed using the high-performance liquid chromatography method (HPLC). The retinol level was calculated in mmol/L, and levels below 0.7 µmol/L (20 µg/dL) were considered to be a vitamin A deficiency. Our findings suggest that the participants with mild and critical COVID-19 had lower retinol levels compared to the healthy controls (p = 0.03). In addition, milder cases of COVID-19 were associated with increased symptoms and prolonged symptoms after 90 days since the beginning of infection. However, the survival analysis showed no association with higher cases of death among participants with vitamin A deficiency (p = 0.509). More studies are needed to understand how nutritional status, including vitamin A levels, can influence prognosis and is a risk factor for the development of long COVID syndrome.

Nutritional adequacy of commercial food products targeted at 0-36-month-old children: a study in Brazil and Portugal.

In the context of the global childhood obesity, it is essential to monitor the nutrition value of commercial foods. A cross-sectional study (November 2018 to April 2019) aimed to evaluate the nutritional adequacy of processed/ultra-processed food products targeted at 0-36-month-old children in Portugal and in Brazil. The nutrient profiling model developed by the Pan American Health Organization was used. A total of food 171 products were assessed (123 in Portugal and forty eight in Brazil). From the fifteen available meat- or fish-based meals in Brazil, 60 % exceeded the amount of Na and 100 % exceeded the target for total fat. Given the lack of specification of sugars within carbohydrates in the label of the foods in Brazil, it was not possible to calculate free sugars. In Portugal, from the seventeen fruit and vegetable purees and the six juice/smoothie/tea/drinks available, 82 % and 67 %, respectively, surpassed the level of free sugar, while total and saturated fat was excessive in all yogurt and yogurt-related products (n 21), 40 % of biscuit/wafer/crisps (two out of five) and 13 % meat- or fish-based meals (two out of sixteen). These findings demonstrate the relevance of improving the nutritional profile of some food products targeted to young children.

Vitamin E Levels in Preterm and Full-Term Infants: A Systematic Review.

Vitamin E deficiency (VED) is associated with clinical repercussions in preterm newborns (PTN), but low levels are also found in full-term newborns (TN). As this inadequacy can compromise neurogenesis in childhood, studies are needed to assess whether there is a difference in vitamin E status among newborns according to gestational age to provide support for neonatal monitoring protocols. This systematic review presents a synthesis of the available information on the vitamin E status among PTN and TN. The review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Observational studies that evaluated alpha-tocopherol levels were searched in the databases reported in the protocol registered in PROSPERO (CRD42021165152). The Newcastle-Ottawa Scale was used to assess the methodological quality. Overall, 1809 articles were retrieved; 10 were included in the systematic review. In the PTN, the alpha-tocopherol levels ranged from 3.9 to 8.5 mmol/L, while in TN, they were 4.9 to 14.9 mmol/L, and VED ranged from 19% to 100% in newborns. Despite substantial heterogeneity in research methodology and VED classification, the results suggest that the alpha-tocopherol levels among preterm and full-term newborns is below the recommended levels. Our findings demonstrate that further investigations are needed to standardize this classification and to monitor vitamin E status in birth and postnatal with adequate bias control.

Impacts of Consumption of Ultra-Processed Foods on the Maternal-Child Health: A Systematic Review.

Background and Aims: Changes in eating patterns have been leading to an increase in the consumption of ultra-processed foods (UPF), negatively impacting the quality of the diet and generating risk of harm to the health of the adult population, however, there is no systematized evidence of the impact of UPF in maternal-child health. Thus, in this study we aimed to evaluated the association between UPF consumption and health outcomes in the maternal-child population. Methods: Systematic review registered on the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42021236633), conducted according to the PRISMA diagram in the following databases: PubMed, Medline, Scopus, Web of Science, Scielo, and CAPES thesis and dissertation directory. We included original cross-sectional, case-control and cohort studies in any language. Eligibility criteria were (a) food consumption assessment by the NOVA classification, (b) health outcome (nutritional or diseases), and (c) maternal-child population (pregnant, lactating women and infants/children). All data were analyzed and extracted to a spreadsheet structured by two independent reviewers. We evaluated the methodological quality of the studies included using the Newcastle-Otawa Scale and RoB 2. Results: Searches retrieved 7,801 studies and 15 contemplated the eligibility criteria. Most studies included were cohort studies (n = 8, 53%), had children as their population (n = 9, 60%) and only one study evaluated UPF consumption in infants and lactating women. Panoramically, we observed that a higher participation of UPF in children's diet has been associated with different maternal-child outcomes, such as increase of weight gain, adiposity measures, overweight, early weaning, lower diet quality, metabolic alterations, diseases, and consumption of plastic originated from packaging. Only one of the studies included did not present high methodological quality. Conclusion: Despite the limited literature on UPF consumption and health outcomes in the maternal-child population, the highest UPF consumption negatively impacted nutrition and disease development indicators in pregnant, lactating women and children. Considering the expressive participation of these foods in the diet, other studies should be conducted to further investigate the impact of UPF consumption on different health indicators, especially in the lactation phase for this was the one to present the most important knowledge gap. Systematic Review Registration: [https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021236633], identifier [CRD42021236633].

Intrauterine growth and the vitamin e status of full-term and preterm newborns / Crescimento intrauterino e status de vitamina e de recém-nascidos a termo e pré-termo

ABSTRACT Objective: To determine the concentration of alpha-tocopherol in umbilical cord serum of full-term and preterm newborns, in order to assess the nutritional status of both groups in relation to the vitamin and its possible correlation with intrauterine growth. Methods: A cross-sectional observational study conducted with 140 newborns, of which 64 were preterm and 76 were full-term. They did not have any malformations, they came from healthy mothers, who were nonsmokers, and delivered a single baby. Intrauterine growth was evaluated by weight-to-gestational age at birth, using Intergrowth-21st. Thealpha-tocopherol levels of umbilical cord serum were analyzed by High Performance Liquid Chromatography. Results: The mean concentration of alpha-tocopherol in umbilical cord serum for preterm and full-term infants was 263.3±129.5 and 247.0±147.6 µg/dL (p=0.494). In the preterm group, 23% were small for gestational age, whereas in the full-term group, this percentage was only 7% (p=0.017). Low levels of vitamin E were found in 95.3% of preterm infants and 92.1% of full-term infants. There was no correlation between alpha-tocopherol levels and weight to gestational age Z score (p=0.951). Conclusions: No association was found between alpha-tocopherol levels and weight to gestational age at birth. Intrauterine growth restriction was more frequent in preterm infants and most infants had low levels of vitamin E at the time of delivery.

RESUMO Objetivo: Determinar a concentração de alfatocoferol em soro de cordão umbilical de recém-nascidos a termo e pré-termo, a fim de avaliar o estado nutricional de ambos os grupos com relação a essa vitamina e sua possível correlação sobre o crescimento intrauterino. Métodos: Estudo observacional de caráter transversal realizado com 140 recém-nascidos, 64 pré-termo e 76 a termo, sem malformações, oriundos de mães saudáveis, não fumantes e com parto de concepto único. O crescimento intrauterino foi avaliado pelo índice peso por idade gestacional ao nascer, utilizando a Intergrowth-21st. Os níveis de alfatocoferol do soro do cordão umbilical foram analisados por cromatografia líquida de alta eficiência. Resultados: A concentração média de alfatocoferol no soro do cordão umbilical para recém-nascidos pré-termo e a termo foi de, respectivamente, 263,3±129,5 e 247,0±147,6 µg/dL (p=0,494). Baixos níveis de vitamina E foram encontrados em 95,3% dos prematuros e em 92,1% dos neonatos a termo. Nogrupo pré-termo, 23% eram pequenos para a idade gestacional, enquanto no grupo a termo esse percentual foi de apenas 7% (p=0,017). Não houve correlação entre os níveis de alfatocoferol e o escore Z de peso para idade gestacional (p=0,951). Conclusões: Não foi encontrada associação entre os níveis de alfatocoferol e a adequação do peso à idade gestacional ao nascer. A restrição do crescimento intrauterino foi mais frequente nos nascidos pré-termo, e a maioria dos recém-nascidos apresentou níveis baixos de vitamina E no momento do parto.

INTRAUTERINE GROWTH AND THE VITAMIN E STATUS OF FULL-TERM AND PRETERM NEWBORNS.

OBJECTIVE: To determine the concentration of alpha-tocopherol in umbilical cord serum of full-term and preterm newborns, in order to assess the nutritional status of both groups in relation to the vitamin and its possible correlation with intrauterine growth. METHODS: A cross-sectional observational study conducted with 140 newborns, of which 64 were preterm and 76 were full-term. They did not have any malformations, they came from healthy mothers, who were nonsmokers, and delivered a single baby. Intrauterine growth was evaluated by weight-to-gestational age at birth, using Intergrowth-21st. Thealpha-tocopherol levels of umbilical cord serum were analyzed by High Performance Liquid Chromatography. RESULTS: The mean concentration of alpha-tocopherol in umbilical cord serum for preterm and full-term infants was 263.3±129.5 and 247.0±147.6 µg/dL (p=0.494). In the preterm group, 23% were small for gestational age, whereas in the full-term group, this percentage was only 7% (p=0.017). Low levels of vitamin E were found in 95.3% of preterm infants and 92.1% of full-term infants. There was no correlation between alpha-tocopherol levels and weight to gestational age Z score (p=0.951). CONCLUSIONS: No association was found between alpha-tocopherol levels and weight to gestational age at birth. Intrauterine growth restriction was more frequent in preterm infants and most infants had low levels of vitamin E at the time of delivery.

Relationship between the dietary intake, serum, and breast milk concentrations of vitamin A and vitamin E in a cohort of women over the course of lactation.

This study evaluated the nutritional status of lactating women with regard to vitamins A and E and the relationship between dietary intake and concentrations in serum and milk. A longitudinal study was conducted with 43 women at a hospital in northeastern Brazil. Blood and milk samples and food intake recalls were obtained at three moments during the breastfeeding period. Retinol and alpha-tocopherol were analysed by high-performance liquid chromatography. Dietary inadequacy was analysed according to the estimated average requirement, with intrapersonal variation adjusted by the multiple source method. Food intake was classified by quartiles of consumption. Serum retinol was 1.65 µmol/L, with 5% of low concentrations (<0.7 µmol/L) at the first collection. Serum alpha-tocopherol decreased from 30.18 to 25.49 µmol/L at the third collection (P = 0.008), with an increase in the percentage frequency of deficiency (<12 µmol/L). Both vitamins maintained stable concentrations in milk at the different collection times, and the overall dietary inadequacy of vitamins A and E was 58% and 100%, respectively. There was a correlation only between vitamin A intake and serum retinol (r = 0.403, P = 0.007), and higher retinol concentrations were found in women classified in the highest consumption quartile (P = 0.031). Over the course of lactation, there was a high degree of inadequacy in vitamin intake and a reduction in serum alpha-tocopherol, whereas its concentrations in milk remained unchanged. Dietary intake of vitamin A has been shown to influence serum retinol, which underscores the importance of adequate nutrition and monitoring of vitamin deficiency during lactation.

Association of Serum Alpha-Tocopherol and Retinol with the Extent of Coronary Lesions in Coronary Artery Disease.

Background and aims: Fat-soluble vitamins play an important role in the pathogenesis of cardiovascular disease and progression of atherosclerosis. This study aimed at investigating the relationship of the serum levels of alpha-tocopherol and retinol with the extent of coronary lesions in patients with coronary artery disease. Methods. Patients with coronary artery disease (n=177) aged 30-74 years, who underwent their first coronary angiography, were enrolled. The extent of coronary lesions was assessed using the Friesinger index (FI). Accordingly, patients were grouped as follows: FI = 0-4 (n=90), FI = 5-9 (n=50), and FI = 10-15 (n=37). Serum levels of vitamins were ‬determined via high-performance liquid chromatography and serum biochemical analysis. Results. Assessment of FI-based groups revealed that 50.8% patients had a coronary artery lesion to a low extent (FI 0-4). Individuals in this group were younger and had lower glucose and serum alpha-tocopherol levels than the other groups (p < 0.05). Low levels of alpha-tocopherol were more frequent in the FI 0-4 group than that in the other groups (p=0.03). No difference was observed between the mean serum retinol levels among the FI-based groups (n=0.492), and the low frequency of retinol was consistent among the FI groups (n=0.348). Conclusions. The low level of alpha-tocopherol together with the presence of dyslipidemia is probably associated with the initial events in atherosclerosis. Increased alpha-tocopherol levels in patients with more extensive coronary artery lesions may have resulted from altered vitamin E metabolism with increased oxidative stress.

VITAMIN E IN HUMAN MILK AND ITS RELATION TO THE NUTRITIONAL REQUIREMENT OF THE TERM NEWBORN. / VITAMINA E NO LEITE HUMANO E SUA RELAÇÃO COM O REQUERIMENTO NUTRICIONAL DO RECÉM-NASCIDO A TERMO.

OBJECTIVES: To determine the alpha-tocopherol concentration in breast milk at different periods of lactation and to estimate the possible supply of vitamin E to the infant. METHODS: A longitudinal observational study was carried out with 100 mothers at University Hospital Ana Bezerra (HUAB), at Universidade Federal do Rio Grande do Norte, in Santa Cruz (RN), Northeast Brazil. Samples of colostrum (n=100), transitional milk (n=77), and mature milk (n=63) were collected. Alpha-tocopherol was analyzed by high-performance liquid chromatography. Vitamin supply to the newborn was estimated by comparing the nutritional requirement of vitamin E (4 mg/day) with the potential daily intake of milk. RESULTS: The mean alpha-tocopherol concentration found in colostrum, transitional, and mature milk was 40.5±15.0 µmol/L, 13.9±5.2 µmol/L, and 8.0±3.8 µmol/L, respectively (p<0.001). The possible effect of these milks offered to the infant 6.2 mg/day of vitamin E in colostrum, 4.7 mg/day in transitional milk, and 2.7 mg/day in mature milk (p<0.0001), shows that only the mature milk did not guarantee the recommended quantity of this vitamin. CONCLUSIONS: Alpha-tocopherol levels in human milk decrease through the progression of lactation, and the possible intake of colostrum and transitional milk met the nutritional requirement of the infant. Mature milk may provide smaller amounts of vitamin E. Thus, it is important to study the factors that are associated with such low levels.

OBJETIVOS: Determinar a concentração de alfa-tocoferol no leite materno em diferentes períodos de lactação e estimar o provável fornecimento de vitamina E ao lactente. MÉTODOS: Estudo longitudinal observacional realizado com 100 puérperas atendidas para o parto no Hospital Universitário Ana Bezerra (HUAB) da Universidade Federal do Rio Grande do Norte (UFRN), em Santa Cruz (RN). Foram coletados leite colostro (n=100), leite de transição (n=77) e leite maduro (n=63) no seguimento da lactação. O alfa-tocoferol foi analisado por cromatografia líquida de alta eficiência. O fornecimento de vitamina E para o neonato foi estimado comparando-se o requerimento nutricional de vitamina E (4 mg/dia) com a ingestão diária de leite. RESULTADOS: A concentração média de alfa-tocoferol encontrada nos leites colostro, de transição e maduro foi 40,5±15,0 µmol/L, 13,9±5,2 µmol/L e 8,0±3,8 µmol/L, respectivamente (p<0,001). A possível ingestão desses leites pelo lactente forneceu 6,2 mg/dia de vitamina E no colostro, 4,7 mg/dia no de transição e 2,7 mg/dia no maduro (p<0,0001), evidenciando que apenas o último não garantiu a quantidade recomendada dessa vitamina. CONCLUSÕES: Os níveis de alfa-tocoferol no leite diminuíram com a progressão da lactação, e a provável ingestão dos leites colostro e de transição conseguiu atender ao requerimento nutricional do lactente. O leite maduro pode fornecer menores quantidades da vitamina E, o que torna importante o estudo dos fatores que se associam a esses baixos níveis.

Vitamina e no leite humano e sua relação com o requerimento nutricional do recém-nascido a termo / Vitamin e in human milk and its relation to the nutritional requirement of the term newborn

RESUMO Objetivos: Determinar a concentração de alfa-tocoferol no leite materno em diferentes períodos de lactação e estimar o provável fornecimento de vitamina E ao lactente. Métodos: Estudo longitudinal observacional realizado com 100 puérperas atendidas para o parto no Hospital Universitário Ana Bezerra (HUAB) da Universidade Federal do Rio Grande do Norte (UFRN), em Santa Cruz (RN). Foram coletados leite colostro (n=100), leite de transição (n=77) e leite maduro (n=63) no seguimento da lactação. O alfa-tocoferol foi analisado por cromatografia líquida de alta eficiência. O fornecimento de vitamina E para o neonato foi estimado comparando-se o requerimento nutricional de vitamina E (4 mg/dia) com a ingestão diária de leite. Resultados: A concentração média de alfa-tocoferol encontrada nos leites colostro, de transição e maduro foi 40,5±15,0 µmol/L, 13,9±5,2 µmol/L e 8,0±3,8 µmol/L, respectivamente (p<0,001). A possível ingestão desses leites pelo lactente forneceu 6,2 mg/dia de vitamina E no colostro, 4,7 mg/dia no de transição e 2,7 mg/dia no maduro (p<0,0001), evidenciando que apenas o último não garantiu a quantidade recomendada dessa vitamina. Conclusões: Os níveis de alfa-tocoferol no leite diminuíram com a progressão da lactação, e a provável ingestão dos leites colostro e de transição conseguiu atender ao requerimento nutricional do lactente. O leite maduro pode fornecer menores quantidades da vitamina E, o que torna importante o estudo dos fatores que se associam a esses baixos níveis.

ABSTRACT Objectives: To determine the alpha-tocopherol concentration in breast milk at different periods of lactation and to estimate the possible supply of vitamin E to the infant. Methods: A longitudinal observational study was carried out with 100 mothers at University Hospital Ana Bezerra (HUAB), at Universidade Federal do Rio Grande do Norte, in Santa Cruz (RN), Northeast Brazil. Samples of colostrum (n=100), transitional milk (n=77), and mature milk (n=63) were collected. Alpha-tocopherol was analyzed by high-performance liquid chromatography. Vitamin supply to the newborn was estimated by comparing the nutritional requirement of vitamin E (4 mg/day) with the potential daily intake of milk. Results: The mean alpha-tocopherol concentration found in colostrum, transitional, and mature milk was 40.5±15.0 µmol/L, 13.9±5.2 µmol/L, and 8.0±3.8 µmol/L, respectively (p<0.001). The possible effect of these milks offered to the infant 6.2 mg/day of vitamin E in colostrum, 4.7 mg/day in transitional milk, and 2.7 mg/day in mature milk (p<0.0001), shows that only the mature milk did not guarantee the recommended quantity of this vitamin. Conclusions: Alpha-tocopherol levels in human milk decrease through the progression of lactation, and the possible intake of colostrum and transitional milk met the nutritional requirement of the infant. Mature milk may provide smaller amounts of vitamin E. Thus, it is important to study the factors that are associated with such low levels.

α-Tocopherol in breast milk of women with preterm delivery after a single postpartum oral dose of vitamin E.

We evaluated the effect of maternal vitamin E supplementation on the α-tocopherol concentrations of colostrum, transitional milk and mature milk of women who had given birth prematurely. This longitudinal randomised-controlled trial divided eighty-nine women into two groups: a control group and a supplemented group. Blood and breast milk were collected from all the participants after delivery. Next, each woman in the supplemented group received 400 IU of RRR-α-tocopheryl acetate. Further breast milk samples were collected 24 h after the first collection, as well as 7 and 30 d after delivery. α-Tocopherol concentrations were determined by HPLC. The baseline α-tocopherol concentrations in the maternal serum of the two groups were similar: 1159·8 (sd 292·4) µg/dl (27·0 (SD 6·8) µmol/l) for the control group and 1128·3 (sd 407·2) µg/dl (26·2 (SD 9·5) µmol/l) for the supplemented group. None of the women was vitamin E deficient. Breast milk α-tocopherol concentrations increased by 60 % 24 h after supplementation in the intervention group and did not increase at all in the control group. α-Tocopherol concentration of the transitional milk in the supplemented group was 35 % higher compared with the control group. α-Tocopherol concentrations of the mature milk in both groups were similar. Maternal supplementation with 400 IU of RRR-α-tocopherol increased the vitamin E concentrations of the colostrum and transitional milk, but not of the mature milk. This study presents relevant information for the design of strategies to prevent and combat vitamin E deficiency in the risk group of preterm infants.

Influência do tipo de descongelamento sobre o nível de retinol do leite materno / Influence of the type of thawing on the retinol level of human milk

O presente trabalho enfatiza que o Banco de Leite Humano (BLH) da Maternidade Escola Januário Cicco, da Universidade Federal do Rio Grande do Norte, coleta, processa e controla a qualidade do leite materno doado. No entanto, este processamento pode interferir na composição de nutrientes, como a vitamina A, que pode ser facilmente destruída pela exposição à luz e ao oxigênio. Sendo esta vitamina um micronutriente essencial para a saúde, por desempenhar papel importante em diversos processos vitais, foi avaliado o efeito do descongelamento por banho-maria e forno micro-ondas sobre os níveis de retinol do leite materno.

Níveis de alfa-tocoferol no soro e leite materno de puérperas atendidas em maternidade pública de Natal, Rio Grande do Norte / Levels of alpha-tocopherol in the serum and breast-milk of child-bearing women attending a public maternity hospital in the city of Natal, in the Brazilian State of Rio Grande do Norte

OBJETIVOS: avaliar os níveis de alfa-tocoferol no soro e leite materno em diferentes estágios de lactação de puérperas e verificar a adequação nutri cional de vitamina E do leite oferecido ao lactente. MÉTODOS: participaram do estudo 32 parturientes adultas com idade média de 25 anos. Foram coletados 5 mL de sangue e 2 mL de colostro, em condição de jejum, para análise dos níveis de alfa tocoferol. Entre 10 e 15 dias pós-parto foram coletados mais 2 mL de leite. As amostras foram analisadas por Cromatografia Líquida de Alta Eficiência. A adequação nutricional do leite para a vitamina E foi calculada pelo produto do volume estimado de ingestão de leite com a concentração de α-tocoferol no leite e por comparação direta desse produto com o valor de referência para ingestão do nutriente (4 mg/dia). RESULTADOS: os níveis de alfa-tocoferol no sangue foram 29 ± 0,9 µmol/L (Média ± Erro padrão) e no colostro e leite de transição foram 28,7 ± 4,7 µmol/L e 7,8 ± 1,0 µmol/L, respectivamente. O consumo estimado de colostro forneceu 241 por cento da recomendação dietética e o de leite de transição atingiu 66 por cento. CONCLUSÕES: o grupo de mulheres estudadas apresentou um estado nutricional satisfatório de vitamina E, refletido no leite materno, principalmente no colostro, cujos valores foram capazes de suprir mais do que o dobro do requerimento nutricional do lactente.

OBJECTIVES: to evaluate levels of alpha-tocopherol in the serum and breast-milk of women at various stages in lactation and to confirm whether nutritio nally appropriate levels of vitamin E are present in the milk given to the babies. METHODS: thirty-two child-bearing women with an average age of 25 years took part in the study. 5 mL of blood and 2 mL of colostrum were collected, under fasting conditions, for the purposes of analyzing the levels of alpha-tocopherol. Between 10 to 15 days after childbirth, a further 2 mL of breast-milk was collected. The samples were analyzed using High-Efficiency Liquid Chromatography. The nutritional adequacy of the breast-milk in terms of vitamin E content was calculated by multiplying the estimated volume of milk ingested by the infant by the concen tration of α-tocopherol in the breast-milk and comparing this directly with the gold standard for intake of this nutrient (4 mg/day). RESULTS: alfa-tocopherol in the blood were 29 ± 0.9 µmol/L (mean ± standard error) and in the colostrum and transition milk were 28.7 ± 4,7 µmol/L and 7.8 ± 1.0 µmol/L, respectively. The estimated consumption of colostrum provided 241 percent the recommended dietary intake and the transition milk provided 66 percent. CONCLUSIONS: the group of women under study had nutritionally adequate levels of vitamin E, and these levels are reflected in their breast-milk, especially in the colostrum, which contained more than double the nutritional requirement of the infant.

[The effect of vitamin A supplementation upon retinol concentration in the colostrum of women in a public maternity hospital]. / Efeito da suplementação com vitamina A sobre a concentração de retinol no colostro de mulheres atendidas em uma maternidade pública.

OBJECTIVE: The aim was to evaluate the effect of supplementary vitamin A upon the colostrum retinol levels in puerperal women cared for at a public maternity hospital in Natal, RN, Brazil. Analysis was conducted on the influence of the colostrum retinol and the maternal nutritional condition as response to supplementation. METHODS: For analysis of serum retinol 5 ml of fasting blood and two samples of milk were collected before and 24 hours after supplementation. A questionnaire was used to define the frequency of previous vitamin A intake. High Efficiency Liquid Chromatography was used to analyze the retinol. RESULTS: Vitamin A intake was 1492.4 +/- 1264 microg RAE/day and 23% probably had an inadequate intake. At the beginning of supplementation, 0 hour, and at 24 hours, the control and supplemented groups presented serum retinol concentrations of 1.3 +/- 0.4 and 1.4 +/- 0.4 micromol/L (7% deficiency) and 3.5 +/- 1.7 micromol/L and 3.3 +/- 1.8 micromol/L (p>0.05) at 0 hour colostrum, respectively. Retinol in the 24 hours milk of the supplemented group increased from of 3.6 +/- 1.9 and 6.8 +/- 2.6 micromol/L (p<0.0001), respectively. Women with deficient levels of retinol in the colostrum at 0 hour(<2.04 mol/L) transferred more retinol to the colostrum at 24 hours milk than those with adequate levels (an increase of 326.1% and 86.5%, respectively). CONCLUSION: The megadose of vitamin A was efficient in the first 24 hours after supplementation. The supplementation response was influenced by the basal levels of retinol in the colostrum. Parturient women with low initial levels of retinol transferred more retinol to the milk, after the megadose, than nursing women with sufficient levels. This possibly confirms the action of the Vitamin A transfer mechanisms proposed by the mammary gland.

Efeito da suplementação com vitamina A sobre a concentração de retinol no colostro de mulheres atendidas em uma maternidade pública / The effect of vitamin A supplementation upon retinol concentration in the colostrum of women in a public maternity hospital

OBJETIVOS: Avaliar o efeito da suplementação com vitamina A sobre os níveis de retinol no colostro de puérperas atendidas em maternidade pública de Natal-RN, analisando a influência do estado nutricional materno e retinol no colostro na resposta a esta suplementação. MÉTODOS: Foram coletados 5 ml de sangue em jejum para análise do retinol sérico, e duas amostras de leite, antes e 24h após suplementação. O consumo de vitamina A foi obtido pelo questionário de frequência de consumo. O retinol foi analisado por cromatografia líquida de alta eficiência. RESULTADOS: O consumo de vitamina A foi 1492,4 ± 1264 µgRAE/dia e 23 por cento tinha consumo provavelmente inadequado. No início (0h) e após 24h da suplementação, os grupos comparativo e suplementado apresentaram concentrações séricas de retinol de 1,3 ± 0,4 e 1,4 ± 0,4 µmol/L (7 por cento de deficiência) e 3,5 ± 1,7 µmol/L e 3,3 ± 1,8 µmol/L (p>0,05) no colostro 0h, respectivamente. No grupo suplementado o retinol aumentou no colostro 24h, com valores de 3,6 ± 1,9 e 6,8 ± 2,6 µmol/L (p<0,0001), respectivamente. Mulheres com níveis deficientes de retinol no colostro 0h (<2,04 µmol/L) transferiram mais retinol ao colostro 24h do que as com níveis adequados (326,1 por cento e 86,5 por cento de aumento, respectivamente). CONCLUSÃO: A megadose foi eficaz nas primeiras 24h após a suplementação. Os níveis basais de retinol no colostro influenciaram a resposta à suplementação. As parturientes que apresentaram valores baixos de retinol transferiram mais retinol oriundo da megadose ao leite do que as lactantes com níveis suficientes, possivelmente ressaltando a atuação dos mecanismos de transferência de vitamina A propostos na glândula mamária.

OBJECTIVE: The aim was to evaluate the effect of supplementary vitamin A upon the colostrum retinol levels in puerperal women cared for at a public maternity hospital in Natal, RN, Brazil. Analysis was conducted on the influence of the colostrum retinol and the maternal nutritional condition as response to supplementation. METHODS: For analysis of serum retinol 5ml of fasting blood and two samples of milk were collected before and 24 hours after supplementation. A questionnaire was used to define the frequency of previous vitamin A intake. High Efficiency Liquid Chromatography was used to analyze the retinol. RESULTS: Vitamin A intake was 1492.4 ± 1264 µgRAE/day and 23 percent probably had an inadequate intale. At the beginning of supplementation, 0 hour, and at 24 hours, the control and supplemented groups presented serum retinol concentrations of 1.3 ± 0.4 and 1.4 ± 0.4 µmol/L (7 percent deficiency) and 3.5 ± 1.7 µmol/L and 3.3 ± 1.8 µmol/L (p>0.05) at 0 hour colostrum, respectively. Retinol in the 24 hours milk of the supplemented group increased from of 3.6 ± 1.9 and 6.8 ± 2.6 µmol/L (p<0.0001), respectively. Women with deficient levels of retinol in the colostrum at 0 hour(<2.04 mol/L) transferred more retinol to the colostrum at24 hours milk than those with adequate levels (an increase of 326.1 percent and 86.5 percent, respectively). CONCLUSION: The megadose of vitamin A was efficient in the first 24 hours after supplementation. The supplementation response was influenced by the basal levels of retinol in the colostrum. Parturient women with low initial levels of retinol transferred more retinol to the milk, after the megadose, than nursing women with sufficient levels. This possibly confirms the action of the Vitamin A transfer mechanisms proposed by the mammary gland.

Avaliação da concentração de retinol em requeijões cremosos comercializados em Natal, RN/Brasil / Retinol concentrations in the cream cheeses sold in Natal, RN/Brazil

Os lipídeos são componentes de diferentes alimentos da dieta humana. Sua concentração afeta os teores de vitaminas lipossolúveis, como a vitamina A, que apresenta ação relevante nos processos biológicos como reprodução, ciclo visual e diferenciação celular. O requeijão, que constitui um queijo fundido derivado do leite, é considerado fonte desse micronutriente. As concentrações de retinol foram avaliadas em duas marcas de requeijão (A e B) nas versões integral e desnatada, comercializadas na cidade de Natal/RN. Três unidades de cada versão das duas marcas foram adquiridas em supermercado da cidade. Após a extração, a concentração de retinol foi determinada por cromatografia líquida de alta eficiência. As médias das concentrações de retinol em cada marca foram 40,5 ± 0,7 e 14,3 ± 4,5g/100g respectivamente para requeijão integral e desnatado da marca A (p<0,05), e de 75,7 ± 3,51 e 26,3 ± 2,52g/100g respectivamente para integral e desnatado da marca B (p<0,05). Os resultados demonstraram que a versão integral possui concentração de retinol superior à versão desnatada; entretanto, os níveis de retinol encontrados estão abaixo dos valores relatados por outros autores. Essa variação possivelmente ocorre em virtude da ausência de padronização na fabricação do requeijão.

Análise do retinol sérico em puérperas atendidas em uma maternidade pública de Natal/RN / Analysis of serum retinol in puerperal women at a public maternity in Natal, RN

A vitamina A é um micronutriente essencial para a saúde e está envolvida em processos biológicos, tais como a visão, o crescimento e a diferenciação celular. A hipovitaminose A pode causar repercussões sistêmicas que afetam estruturas epiteliais de diferentesórgãos, além dos olhos. A identificação precoce dos indivíduos em risco de desenvolver a deficiência de vitamina A deve ser uma preocupação dos profissionais de saúde, na tentativa de direcionamento dos programas governamentais de intervenção voltadospara os grupos mais vulneráveis. O objetivo deste trabalho foi verificar o nível de retinol no soro de nutrizes atendidas na MEJC, Natal/RN. O sangue foi extraído segundo Nierenberg e Nann (1992) e analisados por CLAE. Dentre as nutrizes estudadas, a média daconcentração de retinol no sangue foi de 38,4±11,0μg/dL, sendo que 7,5% corresponderam a uma concentração considerada marginal (10 – 20μg/dL), 82,5% satisfatório (20 – 50μg/dL), e 10% excessivo (50 – 100μg/dL). A WHO (1994) considera um quadro de indicativo de deficiência uma prevalência maior ou igual a 15% de concentração sérica de retinol menor que 20μg/dL, portanto as concentraçõesencontradas por este trabalho podem ser consideradas adequadas demonstrando uma aparente normalidade da média de retinol do soro.

[Impact on colostrum retinol levels of immediate postpartum supplementation with retinyl palmitate]. / Impacto da suplementação com retinil palmitato no pós-parto imediato sobre os níveis de retinol do colostro.

OBJECTIVE: To assess the effect of retinyl palmitate supplementation on colostrum retinol levels, investigating the influence of maternal variables (age, type of delivery, and biochemical nutritional status) on these levels. METHOD: The study included 33 mothers receiving care at the Januário Cicco Maternity School, in the city of Natal, Rio Grande do Norte, Brazil. In the first hours after delivery, blood and colostrum samples were collected. Another colostrum sample was collected six hours after maternal supplementation with 200,000 IU of retinyl palmitate. Serum and colostrum retinol levels were determined by high-performance liquid chromatography. RESULTS: The mean retinol level in colostrum before the supplementation was 110.8 +/- 82.3 microg/dL, and after supplementation it was 164.4 +/- 106.5 microg/dL (P < 0.025). Of the 33 mothers, 12 of them either did not respond to supplementation or had an increase of less than 10% in colostrum retinol levels; serum retinol in these women was significantly lower as compared to the responders (P = 0.024). In comparison to women with a normal delivery, the mothers who underwent cesarean delivery (64%) had lower serum retinol levels, but not lower colostrum retinol levels (P = 0.036). Maternal age did not influence retinol levels in either serum or colostrum. CONCLUSION: The increase in colostrum retinol levels following vitamin A supplementation was sufficient to guarantee double the retinol requirements of a newborn infant.

Impacto da suplementação com retinil palmitato no pós-parto imediato sobre os níveis de retinol do colostro / Impact on colostrum retinol levels of immediate postpartum supplementation with retinyl palmitate

OBJETIVO: Avaliar o efeito da suplementação com retinil palmitato sobre os níveis de retinol no colostro, investigando a influência de variáveis maternas (idade, tipo de parto e estado nutricional bioquímico) sobre esses níveis. MÉTODO:Participaram do estudo 33 nutrizes atendidas na Maternidade Escola Januário Cicco, Estado do Rio Grande do Norte, Brasil. Foram coletadas, nas primeiras horas após o parto, uma amostra de sangue e uma de colostro. Uma nova amostra de colostro foi coletada 6 horas após suplementação materna com 200 000 UI de retinil palmitato. O retinol no sangue e colostro foi determinado por cromatografia líquida de alta eficiência. RESULTADOS: Os níveis médios de retinol no colostro antes da suplementação foram de 110,8 ± 82,3 mug/dL, tendo atingido 164,4 ± 106,5 mug/dL após a suplementação (P < 0,025). Doze puérperas não responderam à suplementação ou tiveram um aumento inferior a 10 por cento nos níveis de retinol no colostro; o nível de retinol sérico dessas mulheres foi significativamente mais baixo do que o daquelas que responderam à suplementação (P = 0,024). Puérperas com parto cesáreo (64 por cento) tiveram níveis menores de retinol no soro (P = 0,036), mas não no leite, em comparação a mulheres com parto normal. A idade não influenciou os níveis de retinol, nem no soro nem no leite. CONCLUSÕES: A suplementação com retinil palmitato foi eficaz na elevação dos níveis de retinol no colostro, garantindo o fornecimento de quantidade suficiente de vitamina A para satisfazer o dobro das necessidades de retinol do recém-nascido.

OBJECTIVE: To assess the effect of retinyl palmitate supplementation on colostrum retinol levels, investigating the influence of maternal variables (age, type of delivery, and biochemical nutritional status) on these levels. METHOD: The study included 33 mothers receiving care at the Januário Cicco Maternity School, in the city of Natal, Rio Grande do Norte, Brazil. In the first hours after delivery, blood and colostrum samples were collected. Another colostrum sample was collected six hours after maternal supplementation with 200 000 IU of retinyl palmitate. Serum and colostrum retinol levels were determined by high-performance liquid chromatography. RESULTS: The mean retinol level in colostrum before the supplementation was 110.8 ± 82.3 mug/dL, and after supplementation it was 164.4 ± 106.5 mug/dL (P < 0.025). Of the 33 mothers, 12 of them either did not respond to supplementation or had an increase of less than 10 percent in colostrum retinol levels; serum retinol in these women was significantly lower as compared to the responders (P = 0.024). In comparison to women with a normal delivery, the mothers who underwent cesarean delivery (64 percent) had lower serum retinol levels, but not lower colostrum retinol levels (P = 0.036). Maternal age did not influence retinol levels in either serum or colostrum. CONCLUSIONS: The increase in colostrum retinol levels following vitamin A supplementation was sufficient to guarantee double the retinol requirements of a newborn infant.

Avaliação dos níveis de retinol no colostro humano e a sua relação com o estado nutricional materno em vitamina A / Evaluation of retinol levels in the human colostrum and its relation with maternal vitamin A nourishing state

A vitamina A é um composto essencial devido à sua atuação nos processos de diferenciação celular, desenvolvimento e manutenção tissular e resposta imune. O leite materno é a única fonte de vitamina A do recém-nascido alimentado exclusivamente ao seio. Entretanto, alguns autores afirmam que o consumo alimentar e o estado nutricional materno adequado podem favorecer a transferência de vitamina A para o leite, enquanto outros estudos revelam que a concentração de vitamina A no leite não é influenciada pela dieta materna. O objetivo do presente estudo foi identificar os níveis de retinol no colostro humano e a sua relação com o estado nutricional materno em vitamina A. Participaram deste estudo 53 mulheres atendidas na Maternidade Escola da UFRN. Foram coletadas amostras de colostro e sangue e ambas analisadas por Cromatografia Líquida de Alta Eficiência. Os níveis médios de retinol no colostro e soro materno corresponderam a 87,8 ± 55,6 mg/100 mL e 24,2 ± 9,5 mg /100 mL. Como média de consumo de vitamina A detectou-se uma quantidade adequada (1737,6 ± 1785,1 mg RAE/dia), porém houve elevado percentual de inadequação quando realizada a avaliação individual. Observou-se que o nível de retinol no colostro não apresentou associação com níveis de retinol no soro ou com consumo dietético do grupo total, entretanto, em situações de consumo elevado foi observada a influência da ingestão dietética. Os resultados sugerem que o colostro não é um bom indicador do estado nutricional materno em vitamina A em populações com níveis marginais de retinol sérico ou com deficiência de retinol subclínica.