Dietary share of ultra-processed foods and its association with vitamin E biomarkers in Brazilian lactating women.

Despite evidence showing that the intake of ultra-processed food has a negative impact on health, diet quality and dietary vitamin E, its impact on vitamin E nutritional status and breast milk remains unknown. This study aimed to assess the influence of the consumption of ultra-processed foods on vitamin E biomarkers of lactating women. A cross-sectional study was performed with 294 lactating women. Food consumption was obtained by 24-h dietary recall, and foods were grouped according to the NOVA classification. Levels of α-tocopherol were analysed by HPLC. Breast milk vitamin E (BMVE) adequacy was based on the quantity of the vitamin in the estimated intake volume. The Kruskal­Wallis test was used to compare the tertiles and linear regression to association between ultra-processed food consumption and biomarkers. Ultra-processed foods accounted for 16 % of energy intake and vitamin E intakes by all women were considered low. Serum α-tocopherol was 26·55 (sd 7·98) µmol/l, 5 % (n 11) showed inadequate vitamin E (< 12 µmol/l) and 78 % had an inadequate BMVE content (< 4 mg/780 ml). The regression showed that a higher dietary share of ultra-processed foods was associated with lower concentrations of serum α-tocopherol (ß = ­0·168, 95 % CI ­0·047, 0·010, P = 0·003) and inadequate BMVE content (ß = ­0·144, 95 % CI = ­0·505, 0·063, P = 0·012) (adjustment for income and maternal age). Thus, higher dietary shares of ultra-processed foods had an impact on vitamin E biomarkers, suggesting that inadequate dietary intake practices during lactation may reduce the supply of vitamin E to women and breast milk.

Dietary Lipid Intake Influences the Alpha-tocopherol Levels in Human Milk.

OBJECTIVE: Dietary lipid intake is associated with serum alpha-tocopherol levels; however, its impact on human milk is unknown. The objective of this study was to evaluate the relationship between maternal intake of vitamin E, lipids, and fatty acids and the concentration of alpha-tocopherol in human milk. METHODS: We conducted a longitudinal observational study, including 143 lactating women on 7, 30, and 90 days postpartum. Dietary intake was collected using 24-hour recall. On day 90, a human milk sample was collected and analyzed for alpha-tocopherol concentration. The prevalence of inadequate vitamin E intake was determined by the Estimated Average Requirement (16 mg/day), and the alpha-tocopherol concentration was analyzed by high-performance liquid chromatography. RESULTS: Dietary intake of vitamin E was associated with the intake of lipids (r = 0.237, P = 0.004) and fatty acids (P < 0.05), and 100% of the participants had inadequate vitamin intake. Mean alpha-tocopherol concentration in the human milk samples was 7.11 (standard deviation 3.95) µmol/L and was correlated with lipid (r = 0.201, P = 0.042) and polyunsaturated fatty acid intake (r = 0.235, P = 0.017). Higher vitamin E levels were found in participants with the highest quartile of polyunsaturated fatty acid intake. CONCLUSIONS: Alpha-tocopherol concentration was associated with the dietary intake of lipids and fatty acids, demonstrating that its bioavailability is associated with fats in the mammary gland. These results suggest development of appropriate strategies to increase the levels of vitamin E in breast milk that may help to prevent and treat vitamin E deficiency.

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

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

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.

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.

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.

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.

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.

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.

Correlation of vitamin A nutritional status on alpha-tocopherol in the colostrum of lactating women.

The adequate supply of vitamins A and E to newborns is essential. However, factors such as maternal nutritional status and nutrient interaction may limit its bioavailability. The aim of this study was to establish nutritional status for vitamins A and E and evaluate the correlation of retinol on colostrum alpha-tocopherol in lactating women. A total of 103 lactating women were recruited at a Brazilian public maternity hospital. Fasting serum and colostrum samples were collected in the immediate post-partum. Retinol and alpha-tocopherol levels were determined by high-performance liquid chromatography and nutritional status for these vitamins was defined from specific cut-off points for serum and colostrum. Mean serum and colostrum retinol (1.49 µmol L(-1) , 2.18 µmol L(-1) ) and alpha-tocopherol (26.4 µmol L(-1) , 26.1 µmol L(-1) ) indicated satisfactory biochemical status. However, we found a prevalence of subclinical deficiency of vitamin A and vitamin E in serum (15.5% and 16%) and colostrum (50% and 60%). Lactating women with serum retinol ≥ 1.05 µmol L(-1) showed an inverse correlation between serum retinol and alpha-tocopherol concentration in the colostrum (P = 0.008, r = -0.28). This association was not observed in serum level < 1.05 µmol L(-1) . The nutritional status of lactating women for vitamins A and E was adequate, although there is a risk of subclinical deficiency. The negative correlation of serum retinol on alpha-tocopherol concentration in the colostrum must be carefully evaluated in situations of vitamin A supplementation, because alpha-tocopherol bioavailability in maternal milk may be compromised.

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.

[Effect of vitamin E supplementation on alpha-tocopherol levels in human colostrum]. / Efeito da suplementação com vitamina E sobre a concentração de alfa-tocoferol no colostro humano.

OBJECTIVE: To assess the levels of alpha-tocopherol in human colostrum following supplementation with capsules containing vitamin A plus synthetic vitamin E. METHODS: Thirty healthy women about to give birth were recruited from a public maternity hospital. After overnight fasting, blood samples as well as colostrum samples (2 mL) were collected. After the first collection, the women received supplementation with a capsule containing retinyl palmitate (200,000 IU or 60 mg) plus synthetic vitamin E (49.4 mg dl-alpha tocopherol). Twenty-four hours after supplementation, a second 2 mL colostrum sample was collected after overnight fasting. RESULTS: The serum concentration of alpha-tocopherol was 1 042,9 ± 319.0 µg/dL. The concentration of alpha-tocopherol in colostrum before supplementation was 155.4 ± 811.0 µg/dL, vs. 1 396.3 ± 862.2 µg/dL 24 hours after supplementation (P > 0.05). A correlation was found between fasting levels of alpha-tocopherol in colostrum before supplementation and 24 hours after supplementation (P = 0.001; r = 0.58), but not between the concentrations in serum and colostrum. CONCLUSIONS: There was no increase in the levels of alpha-tocopherol in colostrum 24 hours after supplementation. This suggests that supplementation with synthetic vitamin E is not advantageous. However, the present results also suggest that if the nutritional state is adequate prior to supplementation, more tocopherol will be available in colostrum after supplementation. Further studies should be carried out to investigate the effects of supplementation with the natural form of alpha-tocopherol.

[Influence of gestational age and parity on the concentration of retinol in human colostrums]. / Influência da idade gestacional e da paridade sobre a concentração de retinol no colostro humano.

Vitamin A is particularly important during the critical periods of growth, proliferation and development of tissues such as pregnancy, neonatal period and childhood. This study aims to evaluate the influence of maternal variables such as gestational age and parity, on the levels of retinol in colostrum and verify that the concentration of vitamin A in the colostrum of those mothers provides the recommended amount of this micronutrient for newborns. We recruited 84 healthy pregnant women attended at a Brazilian public hospital. Retinol concentrations in colostrum were analyzed by high performance liquid chromatography. The retinol in colostrum from mothers at term (n=49) and preterm (n=35) showed values of 111.3 +/- 12.4 microg/dL and 79.2 +/- 10.6 microg/dL (p < 0.0001), respectively, and retinol concentration in colostrum from primiparous (n=40) (82.5 +/- 8.8 microg/dL) and multiparous (n=44) (116.9 +/- 10.3 microg/dL) was also statistically different (p < 0.0001). Retinol levels in colostrum at term and those whose mothers had one or more than one child in this study meet the needs of the child (400 microg retinol/day). However, levels of retinol in colostrum of preterm infants are not consistent with the recommendations of the DRI for premature infants, which is 420 microg retinol/day. These results demonstrate the need to supplement with vitamin A preterm mothers to ensure an adequate supply of this vitamin to the newborn.

Effect of storage on retinol concentration of Cobb and Ross strain chicken livers.

Liver is an important item in the human diet. The present study examined the retinol concentration in the fresh livers of Cobb and Ross chicken strains, after freezing at -18 degrees C for 90 days. The retinol dosage in the liver was determined by high-performance liquid chromatography. The poultry strain significantly influenced liver retinol levels. The mean retinol value in the fresh samples was 6,678.0+/-1,337.7 and 8,324.1+/-1,158.5 microg/100 g in the Cobb and Ross strains, respectively. These values decreased significantly with liver storage time and reached levels that were 44.1% lower than those of fresh liver after 90 days. The results showed a high concentration of retinol in the chicken livers and demonstrated that more than 30 days of storage causes decreased retinol. Despite the losses resulting from freezing, the ingestion of a typical 100 g portion of liver, regardless of the chicken strain analyzed, exceeds the tolerable upper intake level of vitamin A (3,000 microg/day) for adults.

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

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

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

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

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.

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.

Evaluation of retinol levels in human colostrum in two samples collected at an interval of 24 hours.

OBJECTIVE: To evaluate retinol concentration in colostrum samples collected with a 24 hour interval. METHOD: Colostrum was collected from 24 recently-delivered mothers at two points in time, 0 hours (T0) and 24 hours later (T24), and a pooled sample of colostrum from T0 and T24 was also analyzed. Fat content was determined by creamatocrit, and retinol assayed by high performance liquid chromatography. RESULTS: When expressed in terms of volume of milk (microg/dL), retinol levels varied across T0, T24 and the pooled sample: 94.9+/-58.9; 129+/-78.6 and 111.9+/-60.4 microg/dL, respectively. However, when expressed with relation to fat content (microg/g), no significant difference was observed. CONCLUSIONS: Retinol assayed in colostrum from a single sample should not be used as an indicator of vitamin A nutritional status, due to the great variation between samples collected at different times. It is suggested that results be expressed per gram of fat, in order to minimize variations resulting from the volume of milk.

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.