Polyphenol analysis in human milk by a rapid, cost-effective, and accurate micromethod: translational development.

OBJECTIVE: To develop a rapid method for analysing polyphenols, which are potentially active antioxidants against neonatal oxidative stress, from small human milk (HM) volumes. METHODS: Acid and alkaline extractions were compared using two dyes: Folin-Ciocalteu and Fast Blue BB. Linearity, sensitivity, recovery percentage, polyphenol content, precision, and stability were assessed in 14 HM samples and compared using the Kruskal-Wallis H test (p<0.05). The best technique was applied to 284 HM samples to determine their polyphenolic content and its association with maternal diet by multifactorial linear regression. RESULTS: Acidic extraction successfully recovered the gallic acid reference standard, whereas alkaline extraction overestimated it. Calibration curves for all methods were linear (R2>0.96) up to 500 mg/L. All bicarbonate-based Folin-Ciocalteu methods assayed were stable and repeatable, whereas Fast Blue BB-based variants were not. HM polyphenols (mean=94.68 mg/L) positively correlated to the dietary intake of hydroxycinnamic acids, the most consumed polyphenolic family in this population. CONCLUSIONS: A bicarbonate-based Folin-Ciocalteu micromethod allowed the accurate determination of polyphenols in HM, which might be useful for translational research settings and HM banks.

Polyphenol analysis in human milk by a rapid, cost-effective, and accurate micromethod: translational development / Análise de polifenóis no leite humano por meio de um micrométodo rápido, econômico e preciso: desenvolvimento translacional

ABSTRACT Objective: To develop a rapid method for analysing polyphenols, which are potentially active antioxidants against neonatal oxidative stress, from small human milk (HM) volumes. Methods: Acid and alkaline extractions were compared using two dyes: Folin-Ciocalteu and Fast Blue BB. Linearity, sensitivity, recovery percentage, polyphenol content, precision, and stability were assessed in 14 HM samples and compared using the Kruskal-Wallis H test (p<0.05). The best technique was applied to 284 HM samples to determine their polyphenolic content and its association with maternal diet by multifactorial linear regression. Results: Acidic extraction successfully recovered the gallic acid reference standard, whereas alkaline extraction overestimated it. Calibration curves for all methods were linear (R2>0.96) up to 500 mg/L. All bicarbonate-based Folin-Ciocalteu methods assayed were stable and repeatable, whereas Fast Blue BB-based variants were not. HM polyphenols (mean=94.68 mg/L) positively correlated to the dietary intake of hydroxycinnamic acids, the most consumed polyphenolic family in this population. Conclusions: A bicarbonate-based Folin-Ciocalteu micromethod allowed the accurate determination of polyphenols in HM, which might be useful for translational research settings and HM banks.

RESUMO Objetivo: Desenvolver um método rápido para analisar polifenóis, que são antioxidantes potencialmente ativos contra o estresse oxidativo neonatal, em pequenos volumes de leite humano (LH). Métodos: Foram comparadas extrações ácidas e alcalinas usando dois corantes: Folin-Ciocalteu e Fast Blue BB. Foram avaliadas variáveis como linearidade, sensibilidade, percentagem de recuperação, teor de polifenóis, precisão e estabilidade em 14 amostras de LH, comparadas usando o teste de Kruskal-Wallis H (p<0,05). A melhor técnica foi aplicada a 284 amostras de LH para determinar seu teor polifenólico e sua associação com a dieta materna por regressão linear multifatorial. Resultados: A extração ácida recuperou com sucesso o padrão de referência do ácido gálico, enquanto a extração alcalina o superestimou. As curvas de calibração para todos os métodos foram lineares (R2>0,96) até os 500 mg/L. Todos os métodos testados baseados em Folin-Ciocalteu com bicarbonato foram estáveis e repetíveis, enquanto as variantes baseadas em Fast Blue BB não. Os polifenóis do HM (média=94,68 mg/L) correlacionaram-se positivamente com a ingestão dietética de ácidos hidroxicinâmicos, a família de polifenóis mais consumida nesta população. Conclusões: Um micrométodo baseado em bicarbonato de Folin-Ciocalteu permitiu a determinação precisa de polifenóis no HM, o que pode ser útil para configurações de pesquisa translacional e bancos de HM.

Aplicación de la dinámica de sistemas en el análisis de la evolución de la hipoacusia y la evaluación del impacto de estrategias sanitarias

Objetivos: Aplicar la dinámica de sistemas para estimar la evolución de la incidencia y la prevalencia de hipoacusia en personas mayores en países de bajos, medios y altos ingresos, así como el acceso al tratamiento, y evaluar la influencia de la implementación de estrategias sanitarias sobre estos indicadores. Metodología: Los análisis se realizaron mediante simulación con dinámica de sistemas según parámetros globales. Para ello, se desarrolló un diagrama de bucles causal, integrando la incidencia, la prevalencia y el tratamiento de hipoacusia con el nivel de desigualdad, factores de riesgo, uso de dispositivos de ayuda auditiva, fuerza laboral de audiólogos y otorrinolaringólogos según el nivel de ingresos del país. Luego, se construyó un diagrama de flujo para ejecutar las simulaciones durante un período de 100 años. Además, se ejecutaron cuatro simulaciones con estrategias sanitarias (reducción de factores de riesgo, mejora en el uso dispositivos de ayuda auditiva, aumento del número de audiólogos y otorrinolaringólogos) y se estimó el porcentaje de cambio respecto al modelo basal. Resultados: Los países de bajos ingresos mostraron una mayor incidencia y prevalencia de hipoacusia, menor acceso a tratamiento adecuado y una mayor prevalencia de hipoacusia sin tratar o con tratamiento inadecuado. La reducción de factores de riesgo creció en un 15 y 33 % la población con audición normal en los próximos 50 y 100 años, respectivamente. Además, la mejora en el uso de dispositivos de ayuda auditiva logró una reducción del 60 % de la población con tratamientos inadecuados o sin tratamiento, y el aumento de audiólogos y otorrinolaringólogos incrementó un 250 % el acceso a un tratamiento adecuado. Conclusiones: La evolución de la salud auditiva está condicionada por factores económicos, donde los entornos más desfavorecidos muestran peores indicadores. Además, la implementación de estrategias combinadas favorecería la salud auditiva en el futuro.

Objectives: To estimate the evolution of the incidence and prevalence of hearing loss in the elderly in low-, middle- and high-income countries by means of system dynamics simulation according to global parameters and to analyze the influence of the implementation of health strategies. Methodology: A causal loop diagram was developed to relate the incidence, prevalence and treatment of hearing loss to the level of inequality, risk factors (RF), use of hearing aids (HA), audiologist and otolaryngologist (ENT) workforce by country income level. A flow chart was then constructed to run the simulations over a 100-year period. In addition, four simulations were run with health strategies (reduction of RF, improvement in HA use, increase in the number of audiologists and ENT specialists) and the percentage change from the baseline model was estimated. Results: Low-income countries showed a higher incidence and prevalence of hearing loss, less access to adequate treatment, and a higher prevalence of untreated or inadequately treated hearing loss. The reduction of RF increased the population with normal hearing by 15% and 33% over the next 50 and 100 years, respectively. In addition, the improvement in the use of ha achieved a 60% reduction in the population with inadequate or untreated treatment, and the increase in audiologists and ENT specialists improved the access to adequate treatment by 250%. Conclusions: The evolution of hearing health is conditioned by economic factors, where the most disadvantaged environments show worse indicators. In addition, the implementation of combined strategies would favor hearing health in the future. System dynamics is a very useful methodology for health managers because it enables to understand how a disease evolves and define what are the best health interventions considering different scenarios.

Objetivos: Aplicar a dinâmica do sistema para estimar a evolução da incidência e prevalência da perda auditiva em pessoas idosas em países de baixo, médio e alto rendimento, bem como o acesso ao tratamento, e avaliar a influência da implementação de estratégias de saúde sobre estes indicadores. Metodologia: As análises foram conduzidas utilizando simulação da dinâmica do sistema com base em parâmetros globais. Para tal, foi desenvolvido um diagrama do laço causal, integrando a incidência, prevalência e tratamento da perda auditiva com o nível de desigualdade, fatores de risco, utilização de aparelhos auditivos, mão-de-obra de audiologistas e otorrinolaringologistas por nível de rendimento nacional. Foi então construído um fluxograma para executar as simulações ao longo de um período de 100 anos. Além disso, foram realizadas quatro simulações com estratégias de saúde (reduzindo os fatores de risco, melhorando a utilização de aparelhos auditivos, aumentando o número de audiologistas e otorrinolaringologistas) e foi estimada a mudança percentual em relação ao modelo de base. Resultados: Os países de baixos rendimentos mostraram maior incidência e prevalência de perda auditiva, menor acesso a tratamento apropriado e maior prevalência de perda auditiva não tratada ou tratada de forma inadequada. A redução dos fatores de risco aumentou a população com audição normal em 15 e 33% durante os próximos 50 e 100 anos, respectivamente. Além disso, uma melhor utilização de aparelhos auditivos permitiu uma redução de 60% na população mal tratada ou não tratada, e o aumento do número de audiologistas e especialistas em ORL aumentou em 250% o acesso ao tratamento adequado. Conclusões: A evolução da saúde auditiva é condicionada por fatores económicos, com os ambientes mais desfavorecidos a apresentarem indicadores piores. Além disso, a implementação de estratégias combinadas favoreceria a saúde auditiva no futuro.

[Yerba mate as a safe polyphenolic source during human lactation]. / La yerba mate como fuente segura de polifenoles durante la lactancia humana.

Background: Yerba mate intake is conditioned by assumptions about its benefits and risks for breastfeeding, with a lack of solid evidence. Objective: To evaluate the safety of yerba mate teas during human lactation. Material and methods: Cross-sectional study with 279 adult lactating women from Argentina (years 2013-2020), during the first six months postpartum, without current pregnancy or active pathologies. Social, reproductive, and food data were compiled. Body mass index and percentage of body fat were also established. The adherence to dietary patterns, intake of yerba mate and its phytochemicals were estimated. Milk biochemistry included nutritional, oxidative and tissue markers. Intake means were compared using the Wilcoxon's test depending on the data recorded, while the multiple nonparametric Kernel regression was used to evaluate the effects on body and milk. Results: It was found a wide range of intake, and tube-sipped tea was the main way of consumption. Concerning its constraints, in-cup tea was more used by women without a partner, whereas tube-sipped tea was consumed mainly by employed women, during late postpartum, and with 12 or more years of formal education. Additionally, these teas were an important source of 18 hydroxycinnamic acids and flavonoids. Moreover, yerba mate provided more than 35% of dietary polyphenols. No anthropometric effects or changes in milk nutrients and biomarkers were found. Conclusions: Yerba mate was a safe source of polyphenols, as it did not compromise lactation and maternal nutritional status.

Introducción: el consumo de yerba mate está condicionado por supuestos sobre sus beneficios y riesgos para la lactancia materna, los cuales carecen de evidencia sólida. Objetivo: evaluar la seguridad de las infusiones de yerba mate durante la lactancia. Material y métodos: estudio transversal con 279 mujeres lactantes adultas de Argentina (años 2013-2020), en los primeros seis meses postparto, sin embarazo ni patologías activas. Se recopilaron datos sociales, reproductivos y alimentarios, índice de masa corporal y porcentaje de grasa corporal. Se estimó adherencia a patrones alimentarios, consumo de mate y sus fitoquímicos. Se analizaron marcadores nutricionales, oxidativos y tisulares en leche. Por la prueba de Wilcoxon, se compararon las medias de consumo según las variables recopiladas y por regresión no paramétrica de Kernel múltiple se evaluaron los efectos corporales y lácteos. Resultados: se encontró un amplio rango en la ingesta de infusiones y el mate cebado fue la principal forma consumida. Respecto a sus condicionantes, el mate cocido fue más bebido por mujeres sin pareja, mientras que el mate cebado fue más consumido por puérperas tardías, con empleo y nivel educativo ≥ 12 años. Además, estas infusiones constituyeron una fuente relevante de 18 ácidos hidroxicinámicos y flavonoides, que proveyeron diariamente más del 35% de los polifenoles dietarios. No se encontraron efectos corporales ni cambios en los niveles de los nutrientes y en los biomarcadores lácteos. Conclusiones: la yerba mate fue una fuente polifenólica segura que no comprometió la lactancia ni el estado nutricional materno.

Dietary Intake of Polyphenols Enhances Executive/Attentional Functioning and Memory with an Improvement of the Milk Lipid Profile of Postpartum Women from Argentina.

Puerperium may lead to memory and executive/attentional complaints that interfere with women's daily life. This might be prevented by dietary compounds, such as neuroprotective polyphenols. Their bioactivity depends on their effects on lipid metabolism in different tissues, such as the brain, fat, and breast. Thus, a polyphenol-related cognitive improvement may be associated with changes of lipids in human milk, which are key for infant neurodevelopment. A cross-sectional study was conducted on 75 postpartum women from Córdoba (Argentina), involving several neuropsychological tests. Diet was registered to identify polyphenol intake and food pattern adherence, with sociodemographic and other psychological variables (insomnia, stress, subjective cognitive complaints) being also studied. Triacylglycerols, cholesterol, and their oxidative forms were analyzed as milk biomarkers. Multivariate statistical methods were applied. Results confirmed that women who consumed polyphenols presented better executive/attentional performance (i.e., higher correct responses, conceptual level responses, complete categories, verbal fluency; lower attentional interferences, and perseverative errors) and word retention with lower interference. Polyphenols were positively associated with milk lipids, which were higher in women with better cognition. Furthermore, they had lower oxidized triacylglycerols. In conclusion, polyphenolic intake during postpartum may improve executive/attentional functioning, memory, and milk lipid profile.

Association of Dietary Intake of Polyphenols with an Adequate Nutritional Profile in Postpartum Women from Argentina.

HJ-Biplot analysis is a multivariate graphic representation that collects data covariation structure between variables and individuals to represent them in a low-dimensional space with the highest quality in the same reference system. Consequently, it is a promising technique for evaluating dietary exposure to polyphenols and accurately characterizing female nutrition. Herein, we hypothesized that polyphenol intake defines specific clusters with dietary impacts, which can be assessed using HJ-Biplot, based on a cross-sectional study in Argentina. The study included 275 healthy postpartum women who provided information about their food frequency intake and other conditions, which were then used to evaluate polyphenolic intake using the Phenol-Explorer database. Outcomes were established using HJ-Biplot for clustering and ANOVA to compare their impact on diet quality indicators. Two HJ-Biplot models were run (for intakes >20 mg/d and 5∼20 mg/d, respectively) to identify three clusters per model with excellent statistical fitness to explain the data. Thus, specific polyphenolic clusters with potentially bioactive and safe compounds were defined despite significant interindividual variability. In fact, women with the lowest polyphenolic intake exhibited worse dietary quality, body fat, and physical activity. As a result, HJ-Biplot proved to be an effective technique for clustering women based on their dietary intake of these compounds. Furthermore, cluster membership improved the intake of antioxidants, water, fiber, and healthy fats. Additionally, women with formal jobs and a higher educational level showed a better diet. Dietary polyphenols are critical during postpartum because they exert beneficial effects on women and breastfed infants.

Variaciones del estado cognitivo en el puerperio y sus determinantes: una revisión narrativa / Variations of the cognitive status in the puerperium and their determinants: a narrative review

Resumen Las modificaciones neurobiológicas que experimenta la mujer durante el puerperio, junto con los consecuentes cambios psicosociales, determinan variaciones en el funcionamiento cognitivo. Con el objetivo de describir las variaciones cognitivas que ocurren durante el postparto y sus factores determinantes, se desarrolló una revisión narrativa a partir de la búsqueda bibliográfica en PubMed y Google Scholar. Se evidenció un constante crecimiento del número de publicaciones a lo largo de los años (PubMed= 186; Google Scholar= 26730). El análisis de los artículos permitió: a) Caracterizar las funciones cognitivas durante el puerperio; b) Analizar los efectos neuropsicológicos producidos por los cambios endocrinológicos y anatomofisiológicos; c) Analizar el efecto de la calidad del sueño sobre la cognición; d) Analizar las funciones cognitivas en función de las experiencias obstétricas. En conclusión, la mujer puérpera se caracteriza por presentar variaciones en sus funciones cognitivas, las cuales están determinadas por cambios estructurales, funcionales, psicológicos y sociales. Es necesario fomentar investigaciones neuropsicológicas en esta población, ya que la atención del posparto todavía se centra en el cuidado del recién nacido, sin abordar a la mujer puérpera de manera integral.

Abstract The neurobiological modifications that women experience during the puerperium, together with the consequent psychosocial changes, lead to variations in cognitive functions. In order to describe the cognitive variations that occur during postpartum and the determining factors, a narrative review was conducted by means of a bibliographic search in PubMed and Google Scholar. A steady increase in the number of published works was located (PubMed = 186; Google Scholar = 26,730). The analysis of the articles made it possible to: a) characterize the cognitive functions during the puerperium; b) analyze the neuropsychological effects produced by the endocrinological and anatomophysiological changes; c) analyze the effect of the quality of sleep on cognition; d) analyze cognitive functions according to obstetric experiences. In conclusion, puerperal women are characterized by variations in their cognitive functions, which are determined by structural, functional, psychological and social changes. It is necessary to conduct neuropsychological research in this population, since postpartum care still focuses on the care of the newborn, without addressing the puerperal woman in a comprehensive manner.

Positive correlation between proteasome activity and polyphenols in the telencephalon of adult female mice.

INTRODUCTION: Proteasome regulates proteostasis, and can be compromised in neurodegenerative diseases. Thus, our aim was to correlate the activity of proteasome to the level of polyphenols in telencephalon during murine adulthood. METHODS: Proteasome activity, polyphenols and other variables (glucose and hydroperoxides) were analysed in Balb/c female telencephala (n = 20, age = 4-12 months), using multivariate methods. RESULTS: The following values were found: proteasome activity = 3.1 ± 0.6 FI/µg of tissue proteins, glucose = 0.1 ± 0.0 µg/µg, hydroperoxides = 363.4 ± 96.6 OD/µg, and polyphenols = 0.1 ± 0.0 ng/µg. Polyphenols reduced during aging showed a direct correlation with proteasome (Pearson's coefficient = 0.43, p = 0.0590, and a multivariate linear regressive coefficient = 17.85, p = 0.0216), with glucose and hydroperoxides being not involved (p>0.1). This correlation was confirmed by partial least square regression (beta = 0.67). CONCLUSION: Proteasome activity can be affected during ageing, and promoted by telencephalic polyphenol levels. Thus, these diet compounds might exert benefits in adult brain.

[Regional oxidative stress in encephalon of female mice with polyphenolic exposure from tea extracts in oral overweight plant-based treatment].

Polyphenols provide by diet may act as antioxidant in the Central Nervous System and exert a protective effect on metabolic diseases. The aim of this study was to establish tea extract effects on oxidative status and murine overweight in accordance with polyphenolic availability in different encephalic regions. METHODS: Balb/c mice (female, n>3) with overweight received for 15 days 100 mg/Kg/d of extract from Lantana grisebachii, Aspidosperma quebracho-blanco, or Ilex paraguariensis extracts and control group (received water without extract). Body weight gain was recorded regularly. Polyphenols, hydroperoxides (HP), lipid peroxides (LP), and superoxide anion (SO) were measured in brain (telencephalon and diencephalon), midbrain, brainstem and cerebellum. Results were compared by ANOVA followed by the Tukey test (P<0.05). RESULTS: A. quebracho-blanco-based treatment decreased weight gain and increased polyphenols in brainstem (p<0.02), although it concomitantly increased SO and LP in this region (p=0.0029 and p=0.0280, respectively). L. grisebachii-based treatment reduced oxidative markers differentially in each region (p<0.05). I. paraguariensis-based treatment oxidized midbrain and cerebellum, although it was antioxidant in the brainstem (p<0.05). All treatments were antioxidant in telencephalon (p=0.0029). CONCLUSIONS: The A. quebracho-blanco extract was active on overweight and increased polyphenols in brainstem, with safe functional derivatives being required to avoid oxidative stress. Other extracts affected oxidative status in a region-dependent manner.