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1.
Rev Environ Contam Toxicol ; 252: 97-129, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31346776

RESUMO

Human milk may sometimes contain chemical contaminants, which could have adverse effects on neonates or nursing infants. Lead (Pb) is of considerable interest due to its toxicity and occurrence. Furthermore, it has been suggested that human milk is a significant potential source of lead exposure to nursing infants. A systematic literature search in PubMed, Science Direct, and Google Scholar databases was performed to identify relevant studies, published in English until 2017, that investigated and explored common factors affecting the level of lead in human milk among lactating women around the world. Forty-nine papers were rated and explored the effect of one or several factors on the level of lead in human milk from 28 countries and carried out over a wide time frame from 1983 to 2017 and through Europe, Asia, America, and Africa, reviewing more than 5,000 subjects. Place of residence, maternal age, stage of lactation, smoking habits, maternal dietary intakes, and parity were the mostly assessed factors among the studies and considered as the main factors affecting Pb levels in BM. Other factors were not studied well enough and considered minor because few surveys evaluated their impacts. However, the literature findings are very controversial.


Assuntos
Poluentes Ambientais/metabolismo , Lactação , Chumbo/metabolismo , Leite Humano/metabolismo , Feminino , Humanos , Recém-Nascido , Gravidez
2.
J Agric Food Chem ; 67(50): 13922-13928, 2019 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-31746600

RESUMO

We compared phospholipids (PLs), PL fatty acid (FA) composition, and milk fat globule size and structure in human milk (n = 120) from mothers of full-term and preterm infants during lactation (colostrum, transition, 1 mo, 2 mo, and 3 mo) and 8 brands of infant formulas. The absolute quantification of PLs was analyzed using 31P NMR spectroscopy. Sphingomyelin was the dominant PLs (35.01 ± 3.31%) in human milk, whereas phosphatidylcholine and phosphatidylethanolamine were the dominant PLs in infant formulas. The PL content in preterm milk increased during lactation, whereas that in term milk remained stable. Saturated FAs (mainly 16:0 and 18:0) were the most abundant (>60%) PL FA in both preterm and term milk and increased throughout lactation. The mean diameter of milk fat globules in infant formulas was much smaller than that found in human milk (200 nm vs 5.63 µm). Significant differences were observed between human milk and infant formulas with regard to PLs, suggesting that more research is needed to mimic the PL profile in infant formulas.


Assuntos
Glicolipídeos/química , Glicoproteínas/química , Fórmulas Infantis/química , Leite Humano/química , Fosfolipídeos/química , Gravidez/metabolismo , Adulto , Feminino , Idade Gestacional , Glicolipídeos/metabolismo , Glicoproteínas/metabolismo , Humanos , Lactente , Lactação , Masculino , Leite Humano/metabolismo , Fosfolipídeos/metabolismo
3.
J Agric Food Chem ; 67(38): 10702-10712, 2019 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-31490688

RESUMO

Human milk oligosaccharides are complex carbohydrates with multibiofunctional health benefits to newborns. Human milk free oligosaccharides (HMOs) are well characterized. However, changes in the N/O-glycome during lactation are poorly reported. Herein, we qualitatively and quantitatively investigated N/O-glycome profiles and their alteration in human milk at different lactation stages. N-Glycans were mainly fucosylated and nonsialylated, nonfucosylated throughout lactation. O-Glycans mainly consisted of sialylated and nonsialylated, nonfucosylated in colostrum and transitional milk, and fucosylated and nonfucosylated, nonsialylated in mature milk. Fucosylated and sialylated N-glycans gradually decreased and increased, respectively, as lactation progressed; O-glycans showed the reverse. Interestingly, changes in HMO abundance decreased during lactation, complementing HMG N/O-glycome changes. In conclusion, temporal HMG glycosylation changes provide the groundwork for developing infant formula that is closer to breast milk at different lactation stages.


Assuntos
Glicoproteínas/química , Lactação , Leite Humano/química , Adulto , Colostro/química , Feminino , Glicoproteínas/metabolismo , Glicosilação , Humanos , Espectrometria de Massas , Leite Humano/metabolismo , Oligossacarídeos/química , Oligossacarídeos/metabolismo , Polissacarídeos/química , Polissacarídeos/metabolismo
4.
Environ Pollut ; 255(Pt 2): 113142, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31563777

RESUMO

Parabens, broad-spectrum antimicrobial preservatives widely used in various consumer products and food, are suspected to be linked with several adverse health effects in humans, especially newborn babies, infants, and young children. While human exposure to parabens has been frequently reported by measuring the concentration of parabens in urine, similar measurements in breast milk have rarely been made. To determine paraben concentrations in breast milk and possible sources of exposure, four major parabens, including methylparaben (MP), ethylparaben (EP), propylparaben (PP), and butylparaben (BP) were measured in breast milk samples collected from 260 lactating women in South Korea. Demographic, socioeconomic, and behavioral factors associated with the presence of parabens in breast milk were determined. EP concentrations were detected at the highest levels in breast milk samples, followed by MP, PP, and BP. Pre-pregnancy BMI, parity, use of basic skin care products, use of cosmetics, canned beverage, and type of milk consumption were associated with higher frequencies of paraben detection. In addition, type of milk, parity, and drinking status were significantly associated with the concentration of EP. Multiple regression analyses showed that colostrum and transitional milk samples had higher levels of EP than mature milk samples. The estimated daily intake of parabens in infants via breastfeeding appears to be negligible when compared to the acceptable daily intake values set forth by the European Food Safety Authority (EFSA); however, considering the vulnerability of breastfed infants and ubiquitous sources of exposure from daily use of household and personal toiletries, efforts to identify sources and mitigate exposure are warranted.


Assuntos
Poluentes Ambientais/metabolismo , Exposição Materna/estatística & dados numéricos , Leite Humano/metabolismo , Parabenos/metabolismo , Adulto , Aleitamento Materno , Criança , Pré-Escolar , Colostro/química , Cosméticos/análise , Demografia , Poluentes Ambientais/análise , Feminino , Humanos , Lactente , Recém-Nascido , Lactação , Leite Humano/química , Parabenos/análise , Gravidez , Conservantes Farmacêuticos , Análise de Regressão , República da Coreia , Adulto Jovem
5.
Sci Total Environ ; 692: 1106-1115, 2019 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-31539942

RESUMO

The aim of this study was to investigate levels of polybrominated diphenyl ethers (PBDEs) in breast milk samples from healthy primiparous mothers who had lived in Kampala capital city (urban area) and Nakaseke district (a rural area) for the last five years. Fifty samples were collected between March and June 2018 and were extracted by dispersive solid-phase extraction (SPE). Clean-up was performed on an SPE column and analysis was done using gas chromatography-mass spectrometry. Total (∑) PBDEs (BDE 28, 47, 49, 66, 77, 99, 100,138,153, 154, 183 and 209) ranged from 0.59 to 8.11 ng/g lipid weight (lw). The levels of PBDEs in samples from Kampala capital city were significantly higher than those from Nakaseke (p < 0.01, Mann-Whitney U test). The most dominant congeners were BDE-209 and -47 (contributed 37.1% and 20.2%, respectively to ∑PBDEs), suggesting recent exposure of mothers to deca-and penta-BDE formulations. Fish and egg consumption, plastics/e-waste recycling and paint fumes were associated with higher levels of BDE-47, -153 and -99, respectively, implying that diet and occupation were possible sources of the pollutants. Estimated dietary intakes (ng kg-1 body weight day-1) for BDE-47, -99 and -153 were below the US EPA reference doses for neurodevelopmental toxicity, suggesting minimal health risks to nursing infants who feed on the milk. Generally, the risk quotients for BDE-47, -99 and -153 were <1 in majority (96%) samples, indicating that the breast milk of mothers in Uganda was fit for human consumption.


Assuntos
Poluentes Ambientais/metabolismo , Éteres Difenil Halogenados/metabolismo , Exposição Materna , Leite Humano/metabolismo , Resíduo Eletrônico , Feminino , Humanos , Lactente , Bifenil Polibromatos , Uganda
6.
Medicine (Baltimore) ; 98(35): e16456, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31464890

RESUMO

Breast milk is recognized and strongly recommended by the World Health Organization (WHO) as the optimal feeding for all babies. Breastfeeding is associated with better nutritional and non-nutritional outcomes when compared to formula feeding, and has proven health benefits to both infants and their mothers. This clinical research is to examine the feasibility and efficacy of Acupoint-Tuina therapy in treating postpartum women who underwent C-sections and suffered from insufficient milk production.The patients in the control group received standard medical care, while the patients in the Tuina group received Tuina therapy during the next 48 hours in addition to standard care, given once daily for 2 days. To evaluate the efficacy of Tuina therapy, patients of both groups were assessed for surface temperature of breasts, volume of breasts, volume of breast milk production, serum PRL level, and uterus recovery at various time points.Tuina therapy significantly increased the milk production when compared to the control group, for as much as 13-fold and 10-fold of that in the control group on the third and fourth postpartum days. In addition, Tuina therapy also significantly increased the full breast enlargement and the serum PRL level change, and decreased the breast surface temperature rise. Last but not the least, Tuina therapy also accelerated the post-surgery recovery of uterus.During the early postpartum days, Tuina therapy increases the milk production and promotes other physiological changes supporting lactation for postpartum women with C-section delivery and insufficient breast milk production. The novel intervention is warranted for further investigation and validation.


Assuntos
Medicina Tradicional Chinesa/métodos , Leite Humano/metabolismo , Período Pós-Parto/sangue , Prolactina/sangue , Pontos de Acupuntura , Adulto , Aleitamento Materno , Cesárea/efeitos adversos , Determinação de Ponto Final , Feminino , Humanos , Lactação , Resultado do Tratamento
7.
Nutr. hosp ; 36(4): 799-804, jul.-ago. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-184703

RESUMO

Objective: we assessed the relationship between serum and human foremilk and hindmilk concentrations of ghrelin and leptin in nursing mothers according to the type of feeding. Methods: this cohort design was carried out on 131 mother-newborn dyads admitted to a physiological puerperium ward. The independent variables were the type of feeding, full breastfeeding (FBF, 56.5%) and partial breastfeeding (PBF, 43.5%). The dependent variables were the concentration of total ghrelin (pg/ml) and leptin (ng/ml) in serum, foremilk and hindmilk at eight and 16 weeks. Fasting blood samples were obtained from the nursing mothers at four months for serum assays. Unpaired Student's t-test, Mann-Whitney U test, Pearson's correlation tests, coefficient of determination and linear regression were used. Results: the concentration of ghrelin and leptin in hindmilk was higher than that of foremilk in both groups at eight and 16 weeks. The concentration of ghrelin and leptin was higher in serum than in foremilk in both groups. These values showed a direct and significant linear correlation with the exception of ghrelin in the FBF group. The serum concentration of leptin in mothers explained 32% of the variance of its concentration in foremilk in the FBF and 13% in the PBF groups. Conclusion: the hindmilk/foremilk gradient suggests an intake regulating mechanism during the fed. The concentration of ghrelin and leptin was higher in the serum than in foremilk and its correlation and determination coefficients could suggest plasma-milk transfer in addition to synthesis regulation by the mammary gland, adipose tissue or other organs


Objetivo: evaluar la relación entre la concentración de suero y la leche materna y la concentración de grelina y leptina en leche materna en madres lactantes según el tipo de alimentación. Métodos: diseño de cohorte realizado en 131 diadas madre-lactante que ingresaron en una sala de puerperio fisiológico. Variables independientes: tipo de alimentación, lactancia materna completa (LMC, 56,5%) y lactancia materna parcial (LMP, 43,5%). Variables dependientes: concentración sérica de grelina total (pg/ml) y leptina (ng/ml), leche humana pre-tetada y pos-tetada a las ocho y 16 semanas. Se utilizaron pruebas no pareadas t de Student, U de Mann-Whitney, correlación de Pearson, coeficiente de determinación y regresión linear. Resultados: la concentración de grelina y leptina en leche humana pre-tetada fue mayor que en leche humana pos-tetada en ambos grupos a las ocho y 16 semanas. La concentración de grelina y leptina fue mayor en suero que en leche humana en ambos grupos; estos valores mostraron una correlación lineal directa y significativa con la excepción de la grelina en el grupo de LMC. La concentración sérica de leptina en las madres explicó el 32% de la varianza de su concentración en leche humana en LMC y el 13% en madres en LMP. Conclusión: el gradiente de leche humana pre-tetada/pos-tetada sugiere un mecanismo de regulación e ingestión de leche. La concentración de grelina y leptina fue mayor en suero que en leche humana y los coeficientes de determinación sugieren una transferencia de suero-leche, además de una regulación de la síntesis por la glándula mamaria, el tejido adiposo u otros órganos


Assuntos
Humanos , Feminino , Leite Humano/metabolismo , Grelina/análise , Leptina/análise , Estudos de Coortes , Grelina/metabolismo , Leptina/metabolismo , Modelos Lineares , Tecido Adiposo , Ensaio de Imunoadsorção Enzimática
8.
Nutrients ; 11(7)2019 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-31277502

RESUMO

BACKGROUND: Mother's own milk is the optimal source of nutrients and provides numerous health advantages for mothers and infants. As they have supplementary nutritional needs, very preterm infants may require fortification of human milk (HM). Addressing HM composition and variations is essential to optimize HM fortification strategies for these vulnerable infants. AIMS: To analyze and compare macronutrient composition in HM of mothers lactating very preterm (PT) (28 0/7 to 32 6/7 weeks of gestational age, GA) and term (T) infants (37 0/7 to 41 6/7 weeks of GA) over time, both at similar postnatal and postmenstrual ages, and to investigate other potential factors of variations. METHODS: Milk samples from 27 mothers of the PT infants and 34 mothers of the T infants were collected longitudinally at 12 points in time during four months for the PT HM and eight points in time during two months for the T HM. Macronutrient composition (proteins, fat, and lactose) and energy were measured using a mid-infrared milk analyzer, corrected by bicinchoninic acid (BCA) assay for total protein content. RESULTS: Analysis of 500 HM samples revealed large inter- and intra-subject variations in both groups. Proteins decreased from birth to four months in the PT and the T HM without significant differences at any postnatal time point, while it was lower around term equivalent age in PT HM. Lactose content remained stable and comparable over time. The PT HM contained significantly more fat and tended to be more caloric in the first two weeks of lactation, while the T HM revealed higher fat and higher energy content later during lactation (three to eight weeks). In both groups, male gender was associated with more fat and energy content. The gender association was stronger in the PT group, and it remained significant after adjustments. CONCLUSION: Longitudinal measurements of macronutrients compositions of the PT and the T HM showed only small differences at similar postnatal stages in our population. However, numerous differences exist at similar postmenstrual ages. Male gender seems to be associated with a higher content in fat, especially in the PT HM. This study provides original information on macronutrient composition and variations of HM, which is important to consider for the optimization of nutrition and growth of PT infants.


Assuntos
Leite Humano/metabolismo , Valor Nutritivo , Nascimento Prematuro , Nascimento a Termo , Adulto , Fatores Etários , Desenvolvimento Infantil , Gorduras na Dieta/metabolismo , Ingestão de Energia , Feminino , Idade Gestacional , Humanos , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido , Recém-Nascido Prematuro/crescimento & desenvolvimento , Lactose/metabolismo , Estudos Longitudinais , Masculino , Proteínas do Leite/metabolismo , Estado Nutricional , Gravidez , Estudos Prospectivos , Fatores Sexuais , Fatores de Tempo
9.
Nutrients ; 11(7)2019 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-31261649

RESUMO

Human milk (HM) carbohydrates may affect infant appetite regulation, breastfeeding patterns, and body composition (BC). We investigated relationships between concentrations/calculated daily intakes (CDI) of HM carbohydrates in first year postpartum and maternal/term infant BC, as well as breastfeeding parameters. BC of dyads (n = 20) was determined at 2, 5, 9, and/or 12 months postpartum using ultrasound skinfolds (infants) and bioelectrical impedance spectroscopy (infants/mothers). Breastfeeding frequency, 24-h milk intake and total carbohydrates (TCH) and lactose were measured to calculate HM oligosaccharides (HMO) concentration and CDI of carbohydrates. Statistical analysis used linear regression/mixed effects models; results were adjusted for multiple comparisons. Higher TCH concentrations were associated with greater infant length, weight, fat-free mass (FFM), and FFM index (FFMI), and decreased fat mass (FM), FM index (FMI), %FM and FM/FFM ratio. Higher HMO concentrations were associated with greater infant FFM and FFMI, and decreased FMI, %FM, and FM/FFM ratio. Higher TCH CDI were associated with greater FM, FMI, %FM, and FM/FFM ratio, and decreased infant FFMI. Higher lactose CDI were associated with greater FM, FMI, %FM, and FM/FFM, ratio and decreased FFMI. Concentrations and intakes of HM carbohydrates differentially influence development of infant BC in the first 12 months postpartum, and may potentially influence risk of later obesity via modulation of BC.


Assuntos
Composição Corporal , Aleitamento Materno , Desenvolvimento Infantil , Carboidratos da Dieta/metabolismo , Fenômenos Fisiológicos da Nutrição do Lactente , Lactação , Leite Humano/metabolismo , Valor Nutritivo , Adiposidade , Fatores Etários , Feminino , Humanos , Lactente , Estudos Longitudinais , Masculino , Estado Nutricional , Projetos Piloto , Estudo de Prova de Conceito
10.
Int J Mol Sci ; 20(13)2019 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-31262082

RESUMO

Adiponectin (Ad) is a cytokine produced by adipocytes that acts on specific receptors of several tissues through autocrine, paracrine, and endocrine signaling mechanisms. Ad is involved in the regulation of cell survival, cell growth, and apoptosis. Furthermore, Ad plays an important pathophysiological role in metabolic activities by acting on peripheral tissues involved in glucose and lipid metabolism such as skeletal muscle, and the liver. Adiponectin has anti-inflammatory, anti-atherogenic, and insulin-sensitizing effects. For this reason, low levels of Ad are associated with the development of cardiovascular complications of obesity in adulthood. Numerous studies have shown that, even in children and adolescents, Ad is associated with risk factors for cardiovascular diseases. In obese children, reduced levels of Ad have been reported and Ad plasma levels are inversely related with abdominal obesity. Moreover, lower Ad concentrations are associated with the development of metabolic syndrome, insulin resistance and hypertension in pediatric subjects. In addition to a higher prevalence of cardiovascular risk factors, plasma values of Ad are also inversely associated with early organ damage, such as an increase in carotid intima-media thickness. It has been suggested that low Ad levels in childhood might predict the development of atherosclerosis in adulthood, suggesting the possibility of using Ad to stratify cardiovascular risk in obese children. Some evidence suggests that lifestyle modification may increase Ad plasma levels. The aim of this review is to summarize the evidence on the relationship between Ad, obesity, metabolic alterations and hypertension in children and adolescents, and to address the possibility that Ad represents an early marker of cardiovascular risk in pediatric subjects. Furthermore, the effects of non-pharmacological treatment (weight loss and physical activity) on Ad levels are considered.


Assuntos
Adiponectina/sangue , Doenças Cardiovasculares/sangue , Síndrome Metabólica/sangue , Obesidade Pediátrica/sangue , Adiponectina/metabolismo , Adolescente , Animais , Biomarcadores/sangue , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Criança , Humanos , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/etiologia , Leite Humano/metabolismo , Obesidade Pediátrica/epidemiologia , Obesidade Pediátrica/etiologia
11.
Nutrients ; 11(8)2019 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-31357543

RESUMO

Human-milk-targeted metabolomics analysis offers novel insights into milk composition and relationships with maternal and infant phenotypes and nutritional status. The Biocrates AbsoluteIDQ® p180 kit, targeting 40 acylcarnitines, 42 amino acids/biogenic amines, 91 phospholipids, 15 sphingolipids, and sum of hexoses, was evaluated for human milk using the AB Sciex 5500 QTRAP mass-spectrometer in liquid chromatography-tandem mass-spectrometry (LC-MS/MS) and flow-injection analysis (FIA) mode. Milk (<6 months lactation) from (A) Bangladeshi apparently healthy mothers (body mass index (BMI) > 18.5; n = 12) and (B) Bangladeshi mothers of stunted infants (height-for-age Z (HAZ)-score <-2; n = 13) was analyzed. Overall, 123 of the possible 188 metabolites were detected in milk. New internal standards and adjusted calibrator levels were used for improved precision and concentration ranges for milk metabolites. Recoveries ranged between 43% and 120% (coefficient of variation (CV): 2.4%-24.1%, 6 replicates). Milk consumed by stunted infants vs. that from mothers with BMI > 18.5 was lower in 6 amino acids/biogenic amines but higher in isovalerylcarnitine, two phospholipids, and one sphingomyelin (p < 0.05 for all). Associations between milk metabolites differed between groups. The AbsoluteIDQ® p180 kit is a rapid analysis tool suitable for human milk analysis and reduces analytical bias by allowing the same technique for different specimens. More research is needed to examine milk metabolite relationships with maternal and infant phenotypes.


Assuntos
Cromatografia Líquida de Alta Pressão , Metaboloma , Metabolômica/métodos , Leite Humano/metabolismo , Valor Nutritivo , Espectrometria de Massas em Tandem , Fatores Etários , Índice de Massa Corporal , Estudos de Casos e Controles , Desenvolvimento Infantil , Feminino , Transtornos do Crescimento/metabolismo , Transtornos do Crescimento/fisiopatologia , Humanos , Lactente , Lactação , Saúde Materna , Estudo de Prova de Conceito , Reprodutibilidade dos Testes
12.
Molecules ; 24(15)2019 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-31357571

RESUMO

Early life exposure to folate has long lasting effects on development and health. Newborns obtain part of their folate from maternal milk. Studies on health effects of milk folate require rapid, affordable and reliable measurements in large numbers of samples from cohort studies. Recently, a competitive chemiluminescence assay for quantification of folate has become available for automated diagnostic measurement of folate in human serum or plasma. We tested if this method ("FOLA" from Siemens Healthcare) could also be used for human milk. To minimize interference and matrix effects, samples had to be skimmed, diluted seven times with demineralized water, and heated for 5 min at 90 °C. Folate could thus be measured in a linear range between 8.4 and 111.7 nM, with recoveries for the most relevant form, 5-methyltetrahydrofolate (5-MeTHF), of 96%-107%. Results were comparable to those with a recently validated Liquid Chromatography/Mass Spectrometry method (Y = 0.998X - 0.2; R2 = 0.807). The FOLA method was subsequently used for samples from the LIFE Child cohort in Germany, providing first data of breast milk folate in this country (range: 6.2-100.7 nM). This technique could indeed prove useful for large cohorts with multiple samplings.


Assuntos
Ácido Fólico/metabolismo , Medições Luminescentes , Leite Humano/metabolismo , Cromatografia Líquida , Feminino , Humanos , Medições Luminescentes/métodos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Espectrometria de Massas em Tandem
13.
Nutrients ; 11(6)2019 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-31174304

RESUMO

Maternal obesity is associated with metabolic changes in mothers and higher risk of obesity in the offspring. Obesity in breastfeeding mothers appears to influence human milk production as well as the quality of human milk. Maternal obesity is associated with alteration of immunological factors concentrations in the human milk, such as C-reactive protein (CRP), leptin, IL-6, insulin, TNF-Alpha, ghrelin, adiponectin, and obestatin. Human milk is considered a first choice for infant nutrition due to the complete profile of macro nutrients, micro nutrients, and immunological properties. It is essential to understand how maternal obesity influences immunological properties of human milk because alterations could impact the nutrition status and health of the infant. This review summarizes the literature regarding the impact of maternal obesity on the concentration of particular immunological properties in the human milk.


Assuntos
Aleitamento Materno , Saúde do Lactente , Fenômenos Fisiológicos da Nutrição Materna , Leite Humano/imunologia , Mães , Estado Nutricional , Obesidade/metabolismo , Índice de Massa Corporal , Proteína C-Reativa/metabolismo , Citocinas/metabolismo , Feminino , Hormônios/metabolismo , Humanos , Leite Humano/metabolismo , Obesidade Pediátrica/etiologia
14.
Cells ; 8(6)2019 05 29.
Artigo em Inglês | MEDLINE | ID: mdl-31146419

RESUMO

Adiponectin and leptin play roles in the hunger response, and they can induce the inflammatory process as the initial mechanism of the innate immune response. It is possible for alterations in the levels of these adipokines to compromise the functional activity of human colostrum phagocytes. Therefore, the objective of this study is to analyze the effects of adiponectin and leptin on colostrum mononuclear (MN) cells. Colostrum was collected from 80 healthy donors, who were divided into two groups: the control group and the high body mass index (BMI) group. MN cells were used to analyze phagocytosis by flow cytometry, and reactive oxygen species (ROS), intracellular calcium, and apoptosis were assessed by fluorimetry using a microplate reader. Adipokines restored the levels of phagocytosis to the high BMI group (p < 0.05), with a mechanism that is action-dependent on the release of ROS and intracellular calcium. However, adiponectin and leptin simultaneously contributed to better microbicidal activity, thus reflecting an increase in the apoptosis level (p < 0.05) in the high BMI group. Probably, the maintenance of the balance between adiponectin and leptin levels enhances the protection and decreases the indices of neonatal infection in the breastfeeding infants of women with high BMI values. Therefore, policies that support pre-gestational weight control should be encouraged.


Assuntos
Adiponectina/farmacologia , Inflamação/patologia , Leptina/farmacologia , Leite Humano/metabolismo , Obesidade/patologia , Adulto , Apoptose/efeitos dos fármacos , Índice de Massa Corporal , Cálcio/metabolismo , Colostro/efeitos dos fármacos , Feminino , Humanos , Fagocitose/efeitos dos fármacos , Gravidez , Explosão Respiratória/efeitos dos fármacos
15.
Drugs ; 79(10): 1053-1063, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31183768

RESUMO

The inflammatory bowel diseases commonly affect individuals during their peak reproductive years. Patients are often concerned about the impact of medical therapies on their ability to conceive, effect on the fetus, as well as the ability to breastfeed, which has led to poor medical adherence during pregnancy. However, most medications are safe, and discontinuation may lead to active disease, which is associated with adverse materno-fetal outcomes. The anti-TNF biologic therapies, infliximab and adalimumab have been extensively studied in the context of pregnancy. They are actively transferred to the placenta during the second and third trimesters; these have not been associated with an increased rate of congenital abnormalities or fetal death. The minimal amounts of drug that are transferred to breast milk are proteolyzed by the infant's digestive system with no reported short- or long-term adverse effects. There is a paucity of clinical data for the other approved anti-TNF agents or newer anti-integrin (vedolizumab) and anti-interleukin (ustekinumab) therapies used in the management of inflammatory bowel disease; however, no significant safety signals have been documented thus far. The new oral small molecule therapy, tofacitinib is teratogenic in animal models and is contra-indicated in patients attempting pregnancy. It is important that patients, as well as physicians managing patients with these conditions, be aware of the impact of these medical therapies during pregnancy.


Assuntos
Adalimumab/administração & dosagem , Anticorpos Monoclonais Humanizados/administração & dosagem , Doenças Inflamatórias Intestinais/tratamento farmacológico , Infliximab/administração & dosagem , Ustekinumab/administração & dosagem , Adalimumab/efeitos adversos , Administração Oral , Anticorpos Monoclonais Humanizados/efeitos adversos , Aleitamento Materno , Desenvolvimento Infantil/efeitos dos fármacos , Feminino , Humanos , Recém-Nascido , Infliximab/efeitos adversos , Leite Humano/química , Leite Humano/metabolismo , Gravidez , Transdução de Sinais , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Ustekinumab/efeitos adversos
16.
BMC Pregnancy Childbirth ; 19(1): 210, 2019 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-31226953

RESUMO

BACKGROUND: Small for gestational age (SGA) infants are those born small for their gestational age, with weight below the 10th percentile. Not only do SGA infants suffer growth issues after birth, they have elevated risk for the development of metabolic and cardiovascular diseases later in life. Current research has suggested that in cases of SGA infants, maternal milk and breastfeeding are not affected. The mother of an SGA infant was diagnosed with placental insufficiency and Gestational Diabetes Mellitus (GDM) during her pregnancy. The infant was born term, at 38 weeks 3 days, and SGA. The mother had a low milk supply and her milk composition differed from reference values such that the daily infant intake provided less than 50% of the required energy intake at 3 months. CONCLUSION: In cases of SGA and/or GDM, maternal milk quality and quantity may be compromised. This requires follow-up in order to reduce the disease risk for SGA infants and the corresponding public health implications.


Assuntos
Complicações do Diabetes/complicações , Diabetes Gestacional/metabolismo , Transtornos da Lactação/metabolismo , Leite Humano/metabolismo , Valor Nutritivo , Adulto , Aleitamento Materno , Ingestão de Energia , Feminino , Humanos , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional , Transtornos da Lactação/etiologia , Leite Humano/química , Gravidez
17.
PLoS One ; 14(5): e0215285, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31048865

RESUMO

Mothers are recommended to exclusively breastfeed their infants for the first six months of their lives. Also, after the sixth month, breastfeeding should continue with added complementary foods to the diets of children. Studies designed to sought the views of mothers on breastfeeding practices are limited. The aim of this study was to explore challenges to breastfeeding practices by considering spatial, societal and maternal characteristics in Ghana. Twenty mothers aged 15-49 years were interviewed purposively in selected communities within two regions of the country. Thematic content analytical procedures were applied to interpret and present findings. Challenges (to both exclusive breastfeeding and complementary feeding) spanned across spatial (home and work places), societal, and maternal characteristics. Key themes identified were in relation to household chores, work schedules, family influence, low breast milk production, swollen breasts or sore nipples, access to food items and preparation or giving foods. Addressing these challenges would require co-creation of supportive environments between couples and significant others as well as tackling institutional barriers that obstruct adequate breastfeeding among mothers. On complementary feeding, there is the need to form community health volunteers help educate mothers more on how to appropriately use local foods to feed their children.


Assuntos
Aleitamento Materno , Fenômenos Fisiológicos da Nutrição do Lactente , Mães/psicologia , Adolescente , Adulto , Família/psicologia , Feminino , Gana , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Leite Humano/metabolismo , População Rural , População Urbana , Local de Trabalho , Adulto Jovem
19.
Medicina (Kaunas) ; 55(5)2019 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-31137596

RESUMO

Background and objectives: Many studies indicate that the maternal diet is an important factor affecting human milk composition. Human milk composition among lactating women in Latvia, as well as the maternal diet during lactation, has not been sufficiently studied. The aim of this research was to assess dietary habits and macronutrient intake among lactating women in Latvia and to examine the effect of diet on human milk composition. Materials and Methods: Research was conducted between November 2016 and December 2017. Mature human milk samples (n = 61) along with a 72h food diary, a food frequency questionnaire (FFQ), and a questionnaire about maternal and infant characteristics were obtained from voluntary women who were recruited via an invitation published in a social media member group for nursing mothers. Fat content in human milk was determined by LVS ISO 2446:2008, protein content was determined by LVS EN ISO 8968-1:2014, lactose was determined by ISO 22662:2007, and the fatty acid profile was analyzed using gas chromatography. Dietary data were evaluated using the Finnish food composition database Fineli, release 19 (3 March 2018). Results: Median values for fat, protein, and lactose in mature human milk were 4.40%, 1.08%, and 6.52%, respectively. Predominant fatty acids in human milk were oleic acid (C18:1 n9c), palmitic acid (C16:0), and linoleic acid (C18:2 n6c) at 34.60%, 24.00%, and 11.00% of total fatty acids, respectively. The trans elaidic acid (C18:1 n9t) level was <0.10% in all human milk samples. Significant, positive associations (p < 0.05) were found between maternal dietary intake of linoleic, α-linolenic, docosahexaenoic, total cis-monounsaturated, total cis-polyunsaturated, and total n-6 and n-3 polyunsaturated fatty acids, the ratio of n-6/n-3, and the level of these fatty acids in human milk. Total energy and carbohydrate intake among participants were lower, but total fat, saturated fat, and sugar intake were higher than recommended. Protein, linoleic acid, and α-linolenic acid intake were adequate, but docosahexaenoic acid intake was noticeably lower than recommended. Women should be supported with information regarding their nutritional needs during lactation and the possible impact of diet on human milk composition. Conclusion: Macronutrient (fat, protein, and lactose) content in human milk is not affected by maternal diet. Conversely, the human milk fatty acid profile is affected by the immediate diet consumed by the mother. Habitual dietary habits can also impact the fatty acid profile of human milk.


Assuntos
Dieta/normas , Lactação/metabolismo , Leite Humano/enzimologia , Adulto , Dieta/métodos , Gorduras na Dieta/análise , Proteínas na Dieta/análise , Feminino , Humanos , Letônia , Leite Humano/metabolismo , Gravidez , Inquéritos e Questionários
20.
Syst Appl Microbiol ; 42(4): 506-516, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31128887

RESUMO

The infant gut harbors a diverse microbial community consisting of several taxa whose persistence depends on adaptation to the ecosystem. In healthy breast-fed infants, the gut microbiota is dominated by Bifidobacterium spp.. Cutibacterium avidum is among the initial colonizers, however, the phylogenetic relationship of infant fecal isolates to isolates from other body sites, and C. avidum carbon utilization related to the infant gut ecosystem have been little investigated. In this study, we investigated the phylogenetic and phenotypic diversity of 28 C. avidum strains, including 16 strains isolated from feces of healthy infants. We investigated the in vitro capacity of C. avidum infant isolates to degrade and consume carbon sources present in the infant gut, and metabolic interactions of C. avidum with infant associated Bifidobacterium longum subsp. infantis and Bifidobacterium bifidum. Isolates of C. avidum showed genetic heterogeneity. C. avidum consumed d- and l-lactate, glycerol, glucose, galactose, N-acetyl-d-glucosamine and maltodextrins. Alpha-galactosidase- and ß-glucuronidase activity were a trait of a group of non-hemolytic strains, which were mostly isolated from infant feces. Beta-glucuronidase activity correlated with the ability to ferment glucuronic acid. Co-cultivation with B. infantis and B. bifidum enhanced C. avidum growth and production of propionate, confirming metabolic cross-feeding. This study highlights the phylogenetic and functional diversity of C. avidum, their role as secondary glycan degraders and propionate producers, and suggests adaptation of a subpopulation to the infant gut.


Assuntos
Adaptação Fisiológica , Microbioma Gastrointestinal , Propionibacteriaceae/genética , Propionibacteriaceae/metabolismo , Bifidobacterium bifidum/crescimento & desenvolvimento , Bifidobacterium bifidum/metabolismo , Bifidobacterium longum subspecies infantis/crescimento & desenvolvimento , Bifidobacterium longum subspecies infantis/metabolismo , Fezes/microbiologia , Microbioma Gastrointestinal/genética , Genes Bacterianos/genética , Variação Genética , Genoma Bacteriano/genética , Humanos , Lactente , Interações Microbianas , Leite Humano/metabolismo , Filogenia , Polissacarídeos/metabolismo , Propionatos/metabolismo , Propionibacteriaceae/classificação , Propionibacteriaceae/crescimento & desenvolvimento , Análise de Sequência de DNA
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