B-Vitamins and Choline in Human Milk Are Not Impacted by a Preconception Lipid-Based Nutrient Supplement, but Differ Among Three Low-to-Middle Income Settings—Findings From the Women First Trial

Frontiers in Nutrition

Beth McClure¹  Richard J Derman¹  Umber Khan¹  Veena Herekar¹  Farina Abrejo¹  S Yogeshkumar¹  The Women First Working Group¹  Sunil S Vernekar¹  Robert K Goldenberg¹  Sumera Aziz Ali²  Sarah Saleem²  Ana L. Garcés³  Lester Figueroa³  Daniela Hampel⁴  Lindsay Allen⁴  Bridget E. Young⁵  Jennifer Kemp⁶  Nancy F. Krebs⁶  K. Michael Hambidge⁶  Jamie Westcott⁶  Sangappa M. Dhaded⁷  Manjunath Somannavar⁷  Shivaprasad S. Goudar⁷ 

[1] ;Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan;Department of Maternal and Newborn Health, Institute of Nutrition in Central America and Panama (INCAP), Guatemala City, Guatemala;Department of Nutrition, University of California, Davis, Davis, CA, United States;Department of Pediatrics Allergy and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States;Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, CO, United States;KLE Academy of Higher Education and Research's, Jawaharlal Nehru Medical College, Belagavi, India;United States Department of Agriculture/Agricultural Research Service, Western Human Nutrition Research Center, Davis, CA, United States;

关键词: lipid nutrient supplement (LNS);    human milk;    B vitamins;    thiamin;    vitamin B12;    nutrition intervention;   

DOI  :  10.3389/fnut.2021.750680

来源: DOAJ

【 摘 要 】

Introduction: Optimal human milk (HM) B-vitamin concentrations remain undefined, especially in areas where undernutrition is prevalent. The impact of supplementation pre-conception through pregnancy on HM B-vitamin composition remains unknown.Methods: Human milk (HM) was collected at 2-weeks postpartum from 200 women in Guatemala, India, and Pakistan (the Women First Trial). The women were randomized to start a lipid-based nutrient supplement before conception, at end of the first trimester, or not at all; intervention continued until delivery. HM concentrations of eight B-vitamins and choline were assessed via ultra-performance liquid chromatography-tandem mass spectrometry. Maternal diet was assessed in early pregnancy, and infant growth followed through 6 months post-delivery.Results: Despite supplement exposure averaging 15.7 (pre-conception arm) and 6.0 months (prenatal arm), HM B-vitamins did not differ between arms, but site differences were evident. Guatemala had higher HM concentrations of vitamin B3 than Pakistan and India. Pakistan had higher HM concentrations of thiamin and vitamin B6 than India and Guatemala. Cohort average HM vitamin B2 (162 ± 79 μg/L) and B6 (31.8 ± 24.6 μg/L) fell below values defined as deficient in 81.5 and 85.5% of samples, potentially reflecting sampling procedures and timing. Maternal dietary intakes of only vitamin B6 and choline were associated with the corresponding concentrations in HM (p < 0.005). No HM B-vitamin concentrations were associated with infant growth.Conclusion: Prenatal supplementation for at least 6 months had no impact on HM B-vitamin concentrations at 2-weeks postpartum. Results suggest that the adequacy of HM composition was generally maintained, with potential exceptions of vitamin B2 and B6.

【 授权许可】

Unknown