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.

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.

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.

[Comparison between the serum concentration of alpha-tocopherol in puerperal women assisted in public and private maternities in Northeastern Brazil]. / Comparação entre a concentração sérica de alfa-tocoferol de puérperas assistidas em maternidades públicas e privadas no Nordeste do Brasil.

PURPOSE: To compare the concentration of serum alpha-tocopherol during the postpartum period in women admitted to public and private hospitals in Natal (RN), Brazil. METHODS: The study included 209 women in the postpartum period, 96 of them from private hospitals and 113 from public hospitals, studied between 24 and 48 hours postpartum. Inclusion criteria were: mothers aged 12 years or more, without diseases associated with pregnancy, who had given birth to a singleton with no malformations. Clinically decompensated women with multiple fetuses were excluded. A 5 mL blood sample was obtained from each participant under fasting conditions, before the first meal of the day. The concentration of alpha-tocopherol in serum (µg/dL) was determined by high performance liquid chromatography (HPLC). The statistical difference between means was tested by the Student's t-test. RESULTS: The mean concentration of alpha-tocopherol was 1.115.7 µg/dL in puerperae from the public network and 1.355.7 ± 397.6 µg/dL in puerperae from the private network , with a significant difference between groups (p=0.000687). Vitamin E concentration was determined individually and an alpha-tocopherol level <11.6 µmol/L or <499.6 µg/dL was considered to indicate deficiency. Vitamin E deficiency was detected in 5.3% of puerperae from the public network (n=6), whereas no deficiency was detected among women from the private network. However, low concentrations of alpha-tocopherol (11.6 to 16.2 µmol/L or 499.6 to 697.7 µg/dL) was detected in both groups, i.e., in 9.7% of the women from the public network (n=11) and in 4.2% for the women from the private network (n=4). CONCLUSION: These results highlight that women assisted in the public sector were more vulnerable to developing low concentrations of alpha-tocopherol than women assisted in the private sector.

Comparação entre a concentração sérica de alfa-tocoferol de puérperas assistidas em maternidades públicas e privadas no Nordeste do Brasil / Comparison between the serum concentration of alpha-tocopherol in puerperal women assisted in public and private maternities in Northeastern Brazil

OBJETIVO: Comparar a concentração de alfa-tocoferol no soro entre puérperas atendidas em maternidades das redes pública e privada da cidade de Natal (RN), Brasil. MÉTODOS: Participaram do estudo 209 puérperas, sendo 96 mulheres provenientes da rede privada e 113, da rede pública, entre 24 e 48 horas pós-parto. Foram incluídas no estudo parturientes com idade a partir de 12 anos, sem patologias associadas à gestação, que tiveram concepto único sem má-formação. Mulheres descompensadas clinicamente e com gestação múltipla foram excluídas. Amostras de 5 mL de sangue de cada participante foram coletadas no período de jejum, antes da primeira refeição do dia. A concentração de alfa-tocoferol no soro (µg/dL) foi determinada por cromatografia líquida de alta eficiência (CLAE). A diferença estatística entre as médias foi testada utilizando o teste t de Student. RESULTADOS: As médias da concentração de alfa-tocoferol nas puérperas da rede pública e da rede privada, respectivamente, foram 1.115,7±341,4 μg/dL e 1.355,7±397,6 μg/dL, tendo sido observada diferença estatisticamente significante (p=0,000687). Para avaliação individual da concentração de vitamina E, a deficiência foi identificada quando alfa-tocoferol <11,6 μmol/L ou <499,6 µg/dL. As puérperas da rede pública tiveram um percentual de 5,3% (n=6) de deficiência, enquanto nas participantes da rede privada tal carência não foi encontrada. Todavia, baixas concentrações (alfa-tocoferol entre 11,6-16,2 μmol/L ou 499,6-697,7 µg/dL) ocorreram tanto na rede pública como na privada: 9,7% (n=11) e 4,2% (n=4), respectivamente. CONCLUSÃO: Esses resultados destacam que as mulheres assistidas ...

PURPOSE: To compare the concentration of serum alpha-tocopherol during the postpartum period in women admitted to public and private hospitals in Natal (RN), Brazil. METHODS: The study included 209 women in the postpartum period, 96 of them from private hospitals and 113 from public hospitals, studied between 24 and 48 hours postpartum. Inclusion criteria were: mothers aged 12 years or more, without diseases associated with pregnancy, who had given birth to a singleton with no malformations. Clinically decompensated women with multiple fetuses were excluded. A 5 mL blood sample was obtained from each participant under fasting conditions, before the first meal of the day. The concentration of alpha-tocopherol in serum (µg/dL) was determined by high performance liquid chromatography (HPLC). The statistical difference between means was tested by the Student's t-test. RESULTS: The mean concentration of alpha-tocopherol was 1.115.7 µg/dL in puerperae from the public network and 1.355.7±397.6 µg/dL in puerperae from the privte network , with a significant difference between groups (p=0.000687). Vitamin E concentration was determined individually and an alpha-tocopherol level <11.6 µmol/L or <499.6 µg/dL was considered to indicate deficiency. Vitamin E deficiency was detected in 5.3% of puerperae from the public network (n=6), whereas no deficiency was detected among women from the private network. However, low concentrations of alpha-tocopherol (11.6 to 16.2 µmol/L or 499.6 to 697.7 µg/dL) was detected in both groups, i.e., in 9.7% of the women from the public network (n=11) and in 4.2% for the women from the private network (n=4). CONCLUSION: These results highlight that women assisted in the public sector were more vulnerable to developing low concentrations of alpha-tocopherol than women assisted in the private sector. .

Aceitação e intenção de consumo de pão de forma enriquecido com soro de leite em pó e carbonato de cálcio / Consumer acceptance and purchase intention of bread enriched with milk serum and calcium carbonate

Neste trabalho foram avaliados sensorialmente um pão de forma enriquecido com soro de leite em pó e carbonato de cálcio, em comparação com uma amostra comercial, por indivíduos de diferentes idades. Os pães enriquecidos apresentaram teores de 783 mg de cálcio/100 g. Participaram grupos pertencentes a quatro diferentes estágios de vida (G1=crianças, G2=adolescentes, G3=adultos e G4=idosos). Para G1 aplicou-se teste de aceitação global por escala hedônica facial (cinco pontos) e para G2, G3 e G4 aplicou-se questionário para caracterizar hábitos de consumo, teste de aceitação (escala hedônica nove pontos) e intenção de consumo (escala hedônica cinco pontos). Os resultados dos testes sensoriais foram analisados pelo teste t-Student em nível de significância de 5%. Para G1, o pão enriquecido foi tão bem aceito quanto à amostra comercial (p>0,05). O G2 demonstrou melhor aceitação e atitude de consumo do pão enriquecido, para todos os atributos sensoriais. Para G3, o sabor teve melhor aceitação do que o pão comercial, sem diferenças nos demais tributos e na atitude de consumo (p>0,05). O G4 não diferiu na aceitação e na atitude de consumo dos pães (p>0,05). O pão de forma enriquecido analisado neste estudo demonstra ter elevado potencial de comercialização.