Breast Milk Retinol Levels after Vitamin A Supplementation at Different Postpartum Amounts and Intervals.

Maternal vitamin A (VA) supplementation in risk areas for Vitamin A deficiency (VAD) was launched to improve the level of this nutrient in nursing mothers and in their breast milk. This longitudinal and randomized study aimed to evaluate the levels of retinol in breast milk after supplementation with VA in varying amounts (200,000 IU or 400,000 IU) and different postpartum intervals. Women were distributed into four intervention groups and given a single 200,000 IU postnatal dosage of VA at time 0 h (postnatal morning) (G200 0H); a single 200,000 IU dosage of VA in week four (G200 4W); 200,000 IU of VA at time 0 h + 200,000 IU of VA 24 h after the first supplementation (G400 24H); and 200,000 IU of VA at time 0 h + 200,000 IU of VA one week after the first supplementation (G400 1W). Breast milk samples were collected over a 12-week period (0 h, 24 h and 1, 4, 12 weeks post-natal). Retinol levels were determined by high-performance liquid chromatography. The Generalized Estimated Equation (GEE) assessed the different retinol levels. The G200 (0H), G400 (24H), and G400 (1W) groups presented higher retinol levels at 24 h than the G200 (4W) group (p < 0.001). The retinol levels of all groups were similar at times 1, 4 and 12 weeks after delivery (p > 0.05). Maternal VA supplementation increased retinol levels in the colostrum. Different supplementation dosages or postpartum administration times did not result in added benefit to retinol levels in mature breast milk.

Factors Associated with Increased Alpha-Tocopherol Content in Milk in Response to Maternal Supplementation with 800 IU of Vitamin E.

BACKGROUND: Vitamin E supplementation might represent an efficient strategy to increase the vitamin E content in milk. The present study aimed to evaluate the impact of supplementation with 800 IU RRR-alpha-tocopherol on the alpha-tocopherol content of milk and the factors associated with the increase in vitamin E. METHODS: Randomized clinical trial with 79 lactating women from Brazil, who were assigned to the control group, or to the supplemented group (800 IU of RRR-alpha-tocopherol). Milk and serum were collected between 30 and 90 days after delivery (collection 1), and on the next day (collection 2). Alpha-tocopherol was analyzed using high-performance liquid chromatography. RESULTS: In the supplemented group, the alpha-tocopherol content in serum and milk increased after supplementation (p < 0.001). In the multivariate analysis, only alpha-tocopherol in milk (collection 1) was associated with the level of this vitamin in milk after supplementation (ß = 0.927, p < 0.001), and binary logistic regression showed that the dietary intake was the only determinant for the greater effect of supplementation in milk. CONCLUSION: The pre-existing vitamin level in milk and diet are determinants for the efficacy of supplementation in milk, suggesting that in populations with vitamin E deficiency, high-dose supplementation can be used to restore its level in milk.

Vitamin A nutritional status in high- and low-income postpartum women and its effect on colostrum and the requirements of the term newborn / Estado nutricional de vitamina A de puérperas de alta e baixa renda e seu efeito sobre o colostro e a necessidade do recém-nascido a termo

Abstract Objective To evaluate the vitamin A status in serum and colostrum of postpartum women with different socioeconomic status, comparing the colostrum retinol supply with the vitamin A requirement of the newborn. Methods Cross-sectional study conducted with 424 postpartum women. Vitamin A maternal dietary intake was estimated using a food frequency questionnaire. Colostrum and serum retinol levels were measured by high performance liquid chromatography (HPLC). Serum retinol concentrations <20 µg/dL were indicative of vitamin A deficiency (VAD). Vitamin A levels provided by colostrum <400 µgRAE/day were considered as insufficient for term newborns. Results The mean maternal vitamin A intake during pregnancy was 872.2 ± 639.2 µgRAE/day in low-income women and 1169.2 ± 695.2 µgRAE/day for high-income women (p < 0.005). The prevalence of vitamin A deficiency was 6.9% (n = 18) in the low-income group and 3.7% (n = 6) in the high-income group. The estimated mean retinol intake by infants of the high- and low-income mothers were 343.3 µgRAE/day (85.8% AI) and 427.2 µgRAE/day (106.8% AI), respectively. Conclusions Serum vitamin A deficiency was considered a mild public health problem in both populations; however, newborns of low-income women were more likely to receive lower retinol levels through colostrum when compared with newborns of high-income mothers.

Resumo Objetivo Avaliar o estado nutricional de vitamina A no soro e colostro de puérperas com diferentes condições de renda, comparando os níveis de retinol fornecido através do colostro coma necessidade de vitamina A do recém-nascido. Métodos Estudo transversal com 424 mulheres pós-parto. A ingestão de vitamina A dietética pelas mães foi estimada através de um questionário de frequência do consumo alimentar. Os níveis retinol no soro e colostro foram quantificados por cromatografia líquida de alta eficiência (CLAE). Concentrações de retinol <20 µg/dL no soro foram indicativas de vitamin A deficiency. Os níveis de vitamina A fornecidas pelo colostro < 400 µg/RAE/dia foram considerados insuficientespara os recém-nascidos a termo. Resultados A ingestão média de vitamina A das mães durante a gravidez foi de 872,2 ± 639,2 µgRAE/dia em mulheres de baixa renda e 1169,2 ± 695,2 µgRAE/dia em mulheresde alta renda (p < 0,005). A prevalência de vitamin A deficiency foi de 6,9% (n = 18) no grupo de baixa renda e de 3,7% (n = 6) no grupo de alta renda. A estimativa dos valores médios de ingestão de retinol por lactentes de mães de baixa e alta renda foi de 343,3 µg/RAE/dia (85,8%AI) e 427,2 µg/RAE/dia (106,8% AI), respectivamente. Conclusões A vitamin A deficiency no soro foi prevalente em ambas as populações, entretanto, recém-nascidos de mães de baixa renda foram mais propensos a receberem níveis inferiores de retinol no colostro em comparação com recém-nascidos de mães de alta renda.

Vitamin A nutritional status in high- and low-income postpartum women and its effect on colostrum and the requirements of the term newborn.

OBJECTIVE: To evaluate the vitamin A status in serum and colostrum of postpartum women with different socioeconomic status, comparing the colostrum retinol supply with the vitamin A requirement of the newborn. METHODS: Cross-sectional study conducted with 424 postpartum women. Vitamin A maternal dietary intake was estimated using a food frequency questionnaire. Colostrum and serum retinol levels were measured by high performance liquid chromatography (HPLC). Serum retinol concentrations <20µg/dL were indicative of vitamin A deficiency (VAD). Vitamin A levels provided by colostrum <400µgRAE/day were considered as insufficient for term newborns. RESULTS: The mean maternal vitamin A intake during pregnancy was 872.2±639.2µgRAE/day in low-income women and 1169.2±695.2µgRAE/day for high-income women (p<0.005). The prevalence of vitamin A deficiency was 6.9% (n=18) in the low-income group and 3.7% (n=6) in the high-income group. The estimated mean retinol intake by infants of the high- and low-income mothers were 343.3µgRAE/day (85.8% AI) and 427.2µgRAE/day (106.8% AI), respectively. CONCLUSIONS: Serum vitamin A deficiency was considered a mild public health problem in both populations; however, newborns of low-income women were more likely to receive lower retinol levels through colostrum when compared with newborns of high-income mothers.

Retinol and Betacarotene Status in Mother-Infant Dyads and Associations between Them.

BACKGROUND/AIMS: Assessing the diet and biochemical indicators of vitamin A deficiency (VAD) in high-risk populations is crucial in cases where this deficiency is mainly caused by chronically inadequate intake. This study aimed to determine the retinol and betacarotene status in mother-infant dyads, and to evaluate the associations between them. METHODS: Umbilical cord serum, maternal serum, and colostrum were collected from 134 healthy mothers living in a risk region for VAD. Vitamin A and betacarotene were quantified by liquid chromatography, and dietary information was collected using a food frequency questionnaire. RESULTS: Although the overall mean intakes of vitamin A and betacarotene were considered adequate, 16% of the women had insufficient intake. Mean retinol levels were also adequate, yet low levels were diagnosed in about 8% of the mothers, based on maternal serum and colostrum, and in 16% of the cord serum samples. Retinol and betacarotene were positively associated in cord serum (p = 0.004), maternal serum (p = 0.041), and colostrum (p < 0.001) but was not associated with dietary intake. CONCLUSIONS: A diagnosis of adequacy based on mean biochemical and dietary data of this population in fact masks the marginal vitamin A status presented by mothers and children.

Breast milk retinol concentration in mothers of preterm newborns.

BACKGROUND: Preterm newborns have low vitamin A reserves at birth, which increases their risk of morbidity and mortality. In the absence of supplementation, breast milk is the only source of this nutrient for exclusively breastfed infants. AIMS: To assess retinol concentration in preterm milk and the relationship between this retinol concentration and lactation phase, degree of prematurity, and maternal serum retinol level. STUDY DESIGN: Longitudinal study. SUBJECTS: Fifty-eight preterm mothers. OUTCOME MEASURES: Colostrum (1-3d), transitional (7-15d), and mature human milk (30-55d) samples were collected. Maternal blood was collected once at postpartum. Retinol level was measured using high-performance liquid chromatography. RESULTS: Milk retinol concentration was statistically different between lactation phases (p<0.001): 2.84±1.05µmol/L in colostrum (58), 3.47±1.28µmol/L in transitional (58), and 2.03±0.61µmol/L in mature milk (30). No difference was found in milk retinol levels between groups with different degrees of prematurity (p>0.05). Maternal serum retinol (1.82±0.50µmol/L) did not correlate with milk levels (p>0.05). CONCLUSIONS: Retinol level in preterm milk seems to be independent of the degree of prematurity and maternal serum status. A significant increase in micronutrient levels in transitional milk was observed, which is likely to contribute to reserves in the premature liver.

Effect of maternal supplementation with vitamin E on the concentration of α-tocopherol in colostrum / Efeito da suplementação materna com vitamina E sobre a concentração de α-tocopherolol no colostro

Abstract: Objective: To evaluate the effect of maternal supplementation with vitamin E on the concentration of α-tocopherol in colostrum and its supply to the newborn. Method: This randomized clinical trial enrolled 99 healthy adult pregnant women; of these, 39 were assigned to the control group and 60 to the supplemented group. After an overnight fast, 5 mL of blood and 2 mL of colostrum were collected. After the first sampling (0 h milk), the supplemented group received 400 IU of supplementary vitamin E. Another 2 mL milk aliquot was collected in both groups 24 h after supplementation (24 h milk). The samples were analyzed by high-performance liquid chromatography. The α-tocopherol content provided by colostrum was calculated by considering a daily intake of 396 mL of milk and comparing the resulting value to the recommended daily intake for infants aged 0-6 months (4 mg/day). Results: The initial mean concentration of α-tocopherol in colostrum was 1509.3 ± 793.7 µg/dL in the control group and 1452.9 ± 808.6 µg/dL in the supplemented group. After 24 h, the mean α-tocopherol concentration was 1650.6 ± 968.7 µg/dL in the control group (p > 0.05) and 2346.9 ± 1203.2 µg/dL in the supplemented group (p < 0.001), increasing the vitamin E supply to the newborn to 9.3 mg/day. Initially, 18 women in the supplemented group provided colostrum α-tocopherol contents below 4 mg/day; after supplementation only six continued to provide less than the recommended amount. Conclusion: Maternal vitamin E supplementation increases the supply of the vitamin to the infant by providing more than twice the Recommended Daily Intake.

Resumo: Objetivo: Avaliar o efeito da suplementação materna com vitamina E sobre a concentração de α-tocoferol no colostro e o fornecimento dessa para o recém-nascido. Método: O estudo clínico randomizado foi feito com 99 parturientes adultas e saudáveis, 39 alocadas no grupo controle e 60 no grupo suplementado. Após jejum noturno, foram coletados 5 mL de sangue e 2 mL de colostro das parturientes. Após a primeira coleta (leite 0 h), o grupo suplementado recebeu suplementação com 400 UI de vitamina E. Foi feita nova coleta de 2 mL de colostro, em ambos os grupos, 24 h após a suplementação (leite 24 h). As amostras foram analisadas por cromatografia líquida de alta eficiência. A quantidade de α-tocoferol fornecida pelo colostro foi considerada para uma ingestão diária de 396 mL de leite e comparada com a ingestão diária recomendada para crianças de 0 a 6 meses (4 mg/dia). Resultados: A concentração média inicial de α-tocoferol no colostro foi de 1.509,3 ± 793,7 µg/dL no grupo controle e 1.452,9 ± 808,6 µg/dL no grupo suplementado. Após 24 horas a concentração média de α-tocoferol no grupo controle foi de 1.650,6 ± 968,7 µg/dL (p > 0,05) e de 2.346,9 ± 1203,2 µg/dL (p < 0,001) no grupo suplementado. Aumentou-se assim a oferta de vitamina E para o recém-nascido para 9,3 mg/dia. Inicialmente 18 mulheres do grupo suplementado forneciam valores inferiores a 4 mg/dia de α-tocoferol em seu colostro, após suplementação apenas seis continuaram a fornecer quantidade inferior ao recomendado. Conclusão: A suplementação materna com vitamina E promove o aumento do fornecimento da vitamina para o recém-nascido e fornece mais do que o dobro da ingestão diária recomendada.

Effect of maternal supplementation with vitamin E on the concentration of α-tocopherol in colostrum.

OBJECTIVE: To evaluate the effect of maternal supplementation with vitamin E on the concentration of α-tocopherol in colostrum and its supply to the newborn. METHOD: This randomized clinical trial enrolled 99 healthy adult pregnant women; of these, 39 were assigned to the control group and 60 to the supplemented group. After an overnight fast, 5mL of blood and 2mL of colostrum were collected. After the first sampling (0h milk), the supplemented group received 400IU of supplementary vitamin E. Another 2mL milk aliquot was collected in both groups 24h after supplementation (24h milk). The samples were analyzed by high-performance liquid chromatography. The α-tocopherol content provided by colostrum was calculated by considering a daily intake of 396mL of milk and comparing the resulting value to the recommended daily intake for infants aged 0-6 months (4mg/day). RESULTS: The initial mean concentration of α-tocopherol in colostrum was 1509.3±793.7µg/dL in the control group and 1452.9±808.6µg/dL in the supplemented group. After 24h, the mean α-tocopherol concentration was 1650.6±968.7µg/dL in the control group (p>0.05) and 2346.9±1203.2µg/dL in the supplemented group (p<0.001), increasing the vitamin E supply to the newborn to 9.3mg/day. Initially, 18 women in the supplemented group provided colostrum α-tocopherol contents below 4mg/day; after supplementation only six continued to provide less than the recommended amount. CONCLUSION: Maternal vitamin E supplementation increases the supply of the vitamin to the infant by providing more than twice the Recommended Daily Intake.

Effect of routine prenatal supplementation on vitamin concentrations in maternal serum and breast milk.

OBJECTIVE: The aim of the present study was to assess the effect of multivitamin supplements and their different vitamin A sources on retinol concentrations in serum and colostrum milk of postpartum women. METHODS: This was a retrospective cross-sectional study composed of healthy postpartum women attending two Brazilian private maternity wards (N = 100). According to the type of multivitamin taken during pregnancy, the women were assigned to one of four groups: control group (CG; n = 25), formulation 1 (F1; n = 25), formulation 2 (F2; n = 25), and formulation 3 (F3; n = 25). Blood and colostrum samples were collected under fasting conditions and retinol was analyzed by high-performance liquid chromatography. Dietary vitamin A was assessed using a food frequency questionnaire. Retinol concentrations <20 µg/dL (<0.70 µmol/L) in serum and <60 µg/dL (2.10 µmol/L) in colostrum were considered indicative of vitamin A deficiency. RESULTS: Of women in the control group, 12% (n = 3) presented serum retinol levels below the cut-off value for adequacy; this was not observed in the supplemented groups. Evaluating the retinol content in breast milk, supplemented groups F1 and F3 presented 4% (n = 1) of inadequacy cases, whereas F2 presented 40% (n = 10). The concentrations found in the F2 and F3 groups were statistically different (P < 0.05). CONCLUSIONS: The use of multivitamin supplements containing vitamin A during pregnancy prevents vitamin A deficiency regardless of the source administered. In breast milk, supplementation with ß-carotene provided a lower concentration of vitamin A compared with retinol.

Estado nutricional em vitamina A de puérperas adolescentes e adultas assistidas em maternidade pública / Vitamin A status of puerperal adolescents and adults attending public maternity hospitals

RESUMO Objetivo Avaliar o estado nutricional em vitamina A de puérperas adolescentes e adultas em relação à ingestão alimentar, retinol no soro e colostro e o suprimento desta vitamina para o recém-nascido. Métodos Estudo transversal, incluindo 136 puérperas, sendo 68 adolescentes e 68 adultas, atendidas em uma maternidade pública. A ingestão dietética de vitamina A foi estimada por um questionário de frequência do consumo alimentar. Foram coletados sangue e colostro em condição de jejum para análise dos níveis de retinol. As amostras foram analisadas por cromatografia líquida de alta eficiência. A estimativa da ingestão de vitamina A pelo recém-nascido foi calculada pelo volume ingerido de leite e a média da concentração de retinol no colostro materno. Resultados A estimativa de consumo foi 681,2±535 µgRAE/dia, para as adolescentes, e 891,8±831,5 µgRAE/dia, para as adultas (p>0,05). As médias de retinol sérico foram 40,6±9,7 µg/dL, no grupo das adolescentes, e 44,9±10,9 µg/dL, no das adultas (p<0,05). No colostro, as adolescentes apresentaram concentração de retinol de 83,1±26,5 µg/dL e as adultas de 81,8±29,8 µg/dL (p>0,05). O volume médio ingerido pelos lactentes provenientes de puérperas adolescentes foi de 435,1+140,7 µgRAE/dia e de 409,7+150,8 µgRAE/dia pelos recém-nascidos das adultas. Na análise individual, 42,6% (n=29) das adolescentes e 52,9% (n=36) das mães adultas não supriram adequadamente a recomendação diária do lactente. Conclusão As adolescentes apresentaram ingestão inadequada de vitamina A. Ambos os grupos apresentaram percentuais de inadequação no soro e colostro e, consequentemente, no fornecimento da vitamina A aos recém-nascidos.

ABSTRACT Objective To assess the vitamin A status of puerperal adolescents and adults in relation to food intake, serum and colostrum retinol, and the supply of this vitamin to the newborn. Methods Dietary vitamin A intake was investigated by a food frequency questionnaire. Fasting blood and colostrum samples were collected for retinol quantification by high-performance liquid chromatography. Newborn vitamin A intake was given by multiplying milk intake by the mean colostrum retinol level. Results This cross-sectional study included 136 puerperal women (68 adolescents and 68 adults) seen at a public maternity hospital. The estimated dietary intake was 681.2±535 µgRAE/day for adolescents and 891.8±831.5 µgRAE/day for adults (p>0.05). The mean serum retinol levels were 40.6±9.7 µg/dL in adolescents and 44.9±10.9 µg/dL in adults (p<0.05). The mean colostrum retinol levels in adolescents and adults were 83.1±26.5 µg/dL and 81.8±29.8 µg/dL, respectively (p>0.05). The adolescents' newborns had a mean retinol intake of 435.1±140.7 µgRAE/day, and the adults' newborns had a mean retinol intake of 409.7 ± 150.8 µgRAE/day. Twenty-nine (42.6%) adolescents and thirty-six (52.9%) adults did not supply enough vitamin A per day to their newborns. Conclusion Adolescents had inadequate vitamin A intake. Adolescents and adults had similar prevalences of inadequate serum retinol. Some adolescents and adults had inadequate colostrum retinol levels, resulting in low retinol intake by their newborns.

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.

Association between maternal vitamin E status and alpha-tocopherol levels in the newborn and colostrum.

Vitamin E is important because of its antioxidant activity in situations of oxidative stress, especially postnatally. Hence, the objective was to verify whether maternal alpha-tocopherol level is associated with the alpha-tocopherol levels of the newborn and colostrum. This is a cross-sectional study of 58 women and their term newborns from a public hospital. Blood and colostrum were collected to measure alpha-tocopherol levels by high-performance liquid chromatography. Mothers with serum alpha-tocopherol levels <16.2 mmol L(-1) and newborns <11.6 mmol L(-1) were indicative of deficiency or low levels. Mothers were divided into two groups: <16.2 mmol L(-1) and those with levels ≥16.2 mmol L(-1) . The mean (95% confidence interval) serum alpha-tocopherol levels of mothers, umbilical cords and colostrum were 28 (24-32), 6 (5-8) and 39 mmol L(-1) (32-45), respectively (P < 0.001); 19% of the women and 90% of the newborns had low alpha-tocopherol levels. Maternal alpha-tocopherol level was associated with that of the umbilical cord. Newborns from mothers at risk of deficiency had low alpha-tocopherol levels (P < 0.001). Colostrum levels of vitamin E were not influenced by maternal serum. Maternal deficiency influenced the vitamin E level of the umbilical cord but does not in the colostrum, evidencing distinct transfer mechanisms via the mammary gland.

Alpha-Tocopherol Concentration in Colostrum and Serum of Women With Premature Labor.

OBJECTIVE: The aim of the study was to evaluate and compare the levels of alpha-tocopherol in colostrum milk and serum of mothers with premature birth, classified as severe prematurity and moderate prematurity. METHODS: Cross-sectional study with 65 women, 18 births classified as severe prematurity (<32 weeks of gestation) and 47 as moderate prematurity (≥32 weeks of gestation). The study only included mothers without any conditions associated with pregnancy and who had a single conception without any malformation. Samples of serum and colostrum were collected during fasting in the immediate postpartum, and alpha-tocopherol was analyzed by high-performance liquid chromatography. To determine the biochemical nutritional status of vitamin E, a serum cutoff (11.6 µmol/L) was adopted. The Student t test for independent variables compared the average concentrations of alpha-tocopherol in serum and colostrum among prematurity groups. Differences were considered significant when P < 0.05. RESULTS: The alpha-tocopherol concentrations in colostrum were similar in both groups, being 34.5 ±â€Š20.2 µmol/L for women with severe prematurity and 35.1 ±â€Š16.3 µmol/L for moderate prematurity. For the serum of puerperal women with severe prematurity, alpha-tocopherol concentration was, however, lower than in women with moderate prematurity, 22.2 ±â€Š4.4 µmol/L versus 27.1 ±â€Š8.6 µmol/L (P < 0.05). The serum levels of alpha-tocopherol indicated nutritional risk at 5.6% (n = 1) of women with severe prematurity and 4.3% (n = 2) for those with moderate prematurity. CONCLUSIONS: Severe prematurity affected the levels of alpha-tocopherol in maternal serum; however, the level of prematurity did not change the concentration of vitamin E in colostrum.

Influência do tempo de armazenamento sobre a concentração de alfa-tocoferol e gama-tocoferol em óleos vegetais / Influence of the storage time on the concentration of alpha-tocopherol and gamma-tocopherol in vegetable oils

O alfa- e o gama-tocoferol estão entre os homólogos da vitamina E, que possui importante papel como antioxidante. As fontes dietéticas mais ricas em vitamina E são os óleos vegetais. Este trabalho avaliou os níveis de alfa- e gama-tocoferol nos óleos de canola, girassol, milho e soja, e averiguou sua variação com o tempo de armazenamento. Os óleos vegetais foram adquiridos nos supermercados da cidade de Natal/RN, e mantidos sob temperatura ambiente e ao abrigo da luz. As análises foram realizadas em diferentes momentos durante o armazenamento (tempo 0 e após 30, 60 e 90 dias). Cromatografia líquida de alta eficiência (CLAE) foi usada para determinar as concentrações dos analitos. A análise estatística foi realizada utilizando-se o teste de variância (ANOVA) e as diferenças foram consideradas estatisticamente significativas quando p < 0,05. Ao final do tempo de armazenamento (90 dias) foi verificada diminuição significativa nos níveis de alfa- e gama-tocoferolde 38,7 % e 36,0 %, no óleo de canola; 42,2 % e 22,2 %, no óleo de soja; 28,3 % e 29,2 %, no óleo de girassol;39,0 % e 17,9 %, no óleo de milho, respectivamente. As concentrações de alfa- e gama-tocoferol nos óleos vegetais reduziram significativamente após armazenamento, sob as condições empregadas no estudo.

The alpha- and gamma-tocopherol are among the homologues of vitamin E which plays a key role as anantioxidant. The richest dietary sources of vitamin E are vegetable oils. This study aimed at evaluating thealpha- and gamma-tocopherol contents in oils from canola, sunflower, corn and soybeans, and to verify their variations after storage time. The vegetable oils were purchased at supermarkets in Natal / RN, and they were keptat room temperature and protected from light. The tests was made at different times during storage (time 0 and after 30, 60 and 90 days). The high performance liquid chromatography (HPLC) was used to determinetheir concentrations. The statistical analysis was performed using analysis of variance (ANOVA) test and thedifferences were considered statistically significant when p < 0.05. By the end of the storage time (90 days), thealpha- and gamma-tocopherol contents showed a significant decrease of 38.7 % and 36.0 % for canola oil; 42.2 %and 22.2 % in soybean oil; 28.3 % and 29.2 % in sunflower oil; 39.0 % and 17.9 % in corn oil, respectively.The concentrations of alpha- and gamma-tocopherol in vegetable oils significantly decreased after the storageperiod under the conditions used in this study.

Gestational diabetes: a risk of puerperal hypovitaminosis A?

The influence of gestational diabetes on vitamin A deficiency in lactating women and, consequently, in their newborn has been verified through a cross-sectional case-control study conducted with volunteer puerperal women. The control group consisted of healthy women and the test group was composed of women with gestational diabetes. One hundred and seven women were recruited, corresponding to 71 controls and 36 cases. Personal, gestational and newborn data were collected directly from medical records during hospitalization. The retinol was determined in maternal colostrum and serum by High Performance Liquid Chromatography. Postpartum women with gestational diabetes were older, had more children and a higher prevalence of cesarean delivery. No difference was found in retinol concentration in maternal milk and serum between the groups. However, it was observed that 16.7% had vitamin A deficiency in the group of patients with diabetes and only 4.1% had such deficiency in the control group. Although no difference was found in colostrum and serum retinol concentration between women with and without gestational diabetes, the individual analysis shows that those with diabetes are at higher risk of being vitamin A deficient.

Effect of maternal vitamin A supplementation on retinol concentration in colostrum / Efeito da suplementação materna com vitamina A sobre a concentração de retinol no colostro

OBJECTIVE: To investigate the effect of vitamin A supplementation on the retinol concentration in colostrum under fasting and postprandial conditions. METHODS: This was a quasi-experimental study, with before and after assessments, conducted with 33 patients treated at a public maternity hospital. Blood and colostrum samples were collected under fasting conditions in the immediate postpartum period. A second colostrum collection occurred two hours after the first meal of the day, at which time a mega dose of 200,000 IU of retinyl palmitate was administered. On the following day, the colostrum was collected again under fasting and postprandial conditions. Serum and colostrum retinol concentrations were determined by high performance liquid chromatography. RESULTS: The serum retinol concentration was 37.3 (16.8-62.2) µg/dL, indicating adequate nutritional status. The colostrum retinol concentration before supplementation was 46.8 (29.7-158.9) µg/dL in fasting and 67.3 (31.1-148.7) µg/dL in postprandial condition (p < 0.05), showing an increase of 43.8%. After supplementation, the values were 89.5 (32.9-264.2) µg/dL and 102.7 (37.3-378.3) µg/dL in fasting and postprandial conditions, respectively (p < 0.05), representing an increase of 14.7%. CONCLUSIONS: This study demonstrated that maternal supplementation with high doses of vitamin A in postpartum resulted in a significant increase of the retinol concentration in colostrum under fasting conditions, with an even greater increase after a meal. .

OBJETIVO: Investigar o efeito da suplementação com vitamina A sobre a concentração de retinol no leite colostro em condições de jejum e pós-prandial. MÉTODOS: Estudo quase-experimental, do tipo antes e depois, realizado com 33 parturientes atendidas em uma maternidade pública, das quais foram coletadas, em jejum, amostras de sangue e leite colostro, no pós-parto imediato. Uma segunda coleta de colostro ocorreu duas horas após a primeira refeição do dia, momento em que uma megadose de 200.000 UI de palmitato de retinila foi administrada. No dia seguinte, uma nova coleta de colostro foi realizada em condições de jejum e pós-prandial. As concentrações de retinol no soro e no colostro foram determinadas por cromatografia líquida de alta eficiência. RESULTADOS: A concentração de retinol sérico foi de 37,3 (16,8-62,2) µg/dL, evidenciando um estado nutricional adequado. No colostro, a concentração de retinol antes da suplementação foi de 46,8 (29,7-158,9) µg/dL em jejum e 67,3 (31,1-148,7) µg/dL em condições pós-prandiais (p < 0,05), mostrando um aumento de 43,8%. Após a suplementação, os valores foram de 89,5 (32,9-264,2) µg/dL e 102,7 (37,3-378,3) µg/dL em jejum e pós-prandial, respectivamente (p < 0,05), representando um aumento de 14,7%. CONCLUSÕES: Este trabalho demonstrou que a suplementação materna com altas doses de vitamina A no pós-parto resultou em um aumento significativo da concentração de retinol no colostro em condições de jejum, sendo este valor ainda maior após a refeição. .

Maternal supplementation with natural or synthetic vitamin E and its levels in human colostrum.

OBJECTIVES: Newborns are considered a high-risk group for vitamin E deficiency. Breast milk is a source of alpha-tocopherol (α-TOH), a form of vitamin E that prevents deficiency. The present study aimed to assess whether supplementation with a natural or synthetic form of α-TOH, in addition to maternal sources of vitamin E, would increase the concentration of α-TOH in colostrum. METHODS: A total of 109 healthy lactating women were recruited from a Brazilian public maternity clinic and randomized into 3 groups: control without supplementation (n = 36), natural α-TOH supplementation (n = 40), and synthetic α-TOH supplementation (n = 33). Blood and colostrum samples were collected before and after supplementation to check the nutritional status of these women by high-performance liquid chromatography. The Kruskal-Wallis test was applied for independent samples, and Tukey test was used for 2-way analysis of the averages of the groups. The baseline nutritional status of vitamin E of all of the lactating women enrolled in the trial was considered adequate. RESULTS: Women who received supplementation had higher concentrations of α-TOH in colostrum than the control group, with 57% and 39% increases in women supplemented with the natural and synthetic forms of α-TOH, respectively. CONCLUSIONS: Supplementation with both forms of α-TOH increased vitamin E concentrations in colostrum; however, the natural form was more efficient in increasing the levels.

Effect of maternal vitamin A supplementation on retinol concentration in colostrum.

OBJECTIVE: To investigate the effect of vitamin A supplementation on the retinol concentration in colostrum under fasting and postprandial conditions. METHODS: This was a quasi-experimental study, with before and after assessments, conducted with 33 patients treated at a public maternity hospital. Blood and colostrum samples were collected under fasting conditions in the immediate postpartum period. A second colostrum collection occurred two hours after the first meal of the day, at which time a mega dose of 200,000 IU of retinyl palmitate was administered. On the following day, the colostrum was collected again under fasting and postprandial conditions. Serum and colostrum retinol concentrations were determined by high performance liquid chromatography. RESULTS: The serum retinol concentration was 37.3 (16.8-62.2) µg/dL, indicating adequate nutritional status. The colostrum retinol concentration before supplementation was 46.8 (29.7-158.9) µg/dL in fasting and 67.3 (31.1-148.7) µg/dL in postprandial condition (p < 0.05), showing an increase of 43.8%. After supplementation, the values were 89.5 (32.9-264.2) µg/dL and 102.7 (37.3-378.3) µg/dL in fasting and postprandial conditions, respectively (p < 0.05), representing an increase of 14.7%. CONCLUSIONS: This study demonstrated that maternal supplementation with high doses of vitamin A in postpartum resulted in a significant increase of the retinol concentration in colostrum under fasting conditions, with an even greater increase after a meal.

Vitamin E concentration in human milk and associated factors: a literature review, / Concentração de vitamina E no leite humano e fatores associados: uma revisão de literatura,

Objective: To systematize information about vitamin E concentration in human milk and the variables associated with this composition in order to find possible causes of deficiency, supporting strategies to prevent it in postpartum women and infants. Source: Studies published between 2004 and 2014 that assayed alpha-tocopherol in human milk of healthy women by high performance liquid chromatography were evaluated. The keywords used were "vitamin E", "alpha-tocopherol", "milk, human", "lactation", and equivalents in Portuguese, in the BIREME, CAPES, PubMed, SciELO, ISI Web of Knowledge, HighWire Press, Ingenta, and Brazilian Digital Library of Theses and Dissertations databases. Summary of the findings: Of the 41 publications found on the subject, 25 whose full text was available and met the inclusion criteria were selected. The alpha-tocopherol concentrations found in milk were similar in most populations studied. The variable phase of lactation was shown to influence vitamin E content in milk, which is reduced until the mature milk appears. Maternal variables parity, anthropometric nutritional status, socioeconomic status, and habitual dietary intake did not appear to affect the alpha-tocopherol levels in milk. However, the influence of the variables maternal age, gestational age, biochemical nutritional status in alpha-tocopherol, and maternal supplementation with vitamin E had conflicting results in the literature. Conclusion: Alpha-tocopherol concentration in milk decreases during lactation, until the mature milk appears. To confirm the influence of some maternal and child variables on milk vitamin E content, further studies with adequate design are needed. .

Objetivo: Sistematizar informações sobre a concentração de vitamina E no leite humano e variáveis associadas a essa composição, a fim de encontrar possíveis causas de deficiência, subsidiando estratégias para prevenção desta em puérperas e lactentes. Fonte dos dados: Foram avaliados estudos publicados entre 2004 e 2014 que determinaram o alfa-tocoferol no leite humano de mulheres saudáveis por Cromatografia Líquida de Alta Eficiência. Os descritores utilizados foram "leite humano", "alfa-tocoferol", "vitamina E", "lactação" e seus equivalentes em inglês, nas bases de dados BIREME, Periódicos CAPES, Pub-Med, SciELO, ISI Web of Knowledge, HighWire Press, Ingenta e Biblioteca Digital Brasileira de Teses e Dissertações. Síntese dos dados: Das 41 publicações encontradas sobre a temática, 25 foram selecionadas, por possuirem texto completo disponível e se encaixarem nos critérios de inclusão. As concentrações encontradas de alfa-tocoferol no leite foram semelhantes na maioria das populações estudadas. A variável fase de lactação mostrou influenciar o conteúdo dessa vitamina no leite, que vai sendo reduzido até o leite maduro. As variáveis maternas paridade, estado nutricional antropométrico, condição socioeconômica e ingestão dietética habitual parecem não afetar os níveis de alfa-tocoferol no leite. Entretanto, a influência das variáveis idade materna, idade gestacional, estado nutricional bioquímico em alfa-tocoferol e suplementação materna com vitamina E possui resultados conflitantes na literatura. Conclusão: A concentração de alfa-tocoferol no leite diminui durante a lactação, até chegar ao leite maduro. Para confirmar a influência de algumas ...

Alpha-tocopherol concentration in serum and colostrum of mothers with gestational diabetes mellitus.

OBJECTIVE: To evaluate and compare the levels of α-tocopherol in colostrum and in the serum of healthy and diabetic mothers. METHODS: This cross-sectional study enrolled 51 volunteer mothers, 20 with the diagnosis of gestational diabetes mellitus and 31 without associated diseases. Serum and colostrum samples were collected in fasting in the immediate postpartum period and α-tocopherol was analyzed by high performance liquid chromatography (HPLC). In order to define the nutritional status of vitamin E, the cutoff point for the serum (697.7µg/dL) was adopted. Student's t-test for independent variables compared the average concentrations of α-tocopherol in the serum and in the colostrum between control and gestational diabetes mellitus groups. Pearson's correlation was used to assess the relationship between the concentration of α-tocopherol in serum and colostrum for both groups. Differences were considered significant when p<0.05. RESULTS: The α-tocopherol concentration in colostrum was 1,483.1±533.8µg/dL for Control Group and 1,368.8±681.8µg/dL for diabetic women, without differences between groups (p=0.50). However, α-tocopherol concentration in the serum was 1,059.5±372.7µg/dL in the Control Group and 1,391.4±531.5µg/dL in the diabetic one (p<0.01). No correlation was found between the concentration of α-tocopherol in the serum and in the colostrum for control and diabetic groups. CONCLUSIONS: The groups had adequate nutritional status of vitamin E. Gestational diabetes was not associated with changes in α-tocopherol concentration in colostrum.