Klevor Moses K, Haskell Marjorie J, Lartey Anna, Adu-Afarwuah Seth, Zeilani Mamane, Dewey Kathryn G
Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, Davis, CA; Department of Nutrition and Food Science, University of Ghana, Accra, Ghana; and.
Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, Davis, CA;
J Nutr. 2016 Feb;146(2):335-42. doi: 10.3945/jn.115.217786. Epub 2016 Jan 6.
Vitamin A deficiency remains a global public health problem. Daily supplementation with a lipid-based nutrient supplement (LNS) has potential for increasing milk vitamin A concentrations.
The objective of this study was to determine whether daily supplementation with approximately the recommended daily intake of vitamin A in an LNS or a multiple-micronutrient supplement (MMN) during pregnancy and the first 6 mo postpartum has an effect on breast milk retinol concentration at 6 mo postpartum.
Women ≤20 wk pregnant (n = 1320) were randomly assigned to receive either the MMN providing 18 micronutrients, including 800 μg retinol equivalents of vitamin A, or the LNS with the same nutrients as the MMN group, plus 4 minerals and macronutrients, until 6 mo postpartum; a control group received iron and folic acid during pregnancy and a placebo (calcium tablet) during the first 6 mo postpartum. Breast milk samples collected at 6 mo postpartum were analyzed for retinol and fat concentrations by HPLC and creamatocrit, respectively, in a subsample of 756 women.
The breast milk retinol concentration was (mean ± SD) 56.3 ± 2.1 nmol/g fat, with no significant differences between groups [iron and folic acid (n = 243): 59.1 ± 2.8; MMN (n = 260): 55.4 ± 2.5; LNS (n = 253): 54.7 ± 2.5 nmol/g fat; P = 0.45], regardless of whether the woman had or had not received a high-dose vitamin A supplement (200,000 IU) soon after childbirth. Around 17% of participants had low milk retinol (≤28 nmol/g fat). We estimated that 41% of infants were potentially receiving vitamin A at amounts above the Tolerable Upper Intake Level (600 μg retinol activity equivalents/d), with no group differences in percentages with low or high milk retinol concentration.
Daily consumption of approximately the recommended intake of vitamin A did not increase breast milk retinol concentrations in this sample of Ghanaian women. This trial was registered at clinicaltrials.gov as NCT00970866.
维生素A缺乏仍然是一个全球性的公共卫生问题。每日补充基于脂质的营养补充剂（LNS）有可能提高乳汁中维生素A的浓度。
本研究的目的是确定在孕期及产后前6个月每日补充约推荐摄入量的维生素A（以LNS或多种微量营养素补充剂（MMN）的形式）是否会对产后6个月时母乳中的视黄醇浓度产生影响。
将孕周≤20周的孕妇（n = 1320）随机分配，一组接受提供18种微量营养素（包括800μg视黄醇当量的维生素A）的MMN，另一组接受与MMN组营养素相同但还添加了4种矿物质和宏量营养素的LNS，直至产后6个月；对照组在孕期接受铁和叶酸，在产后前6个月接受安慰剂（钙片）。在756名妇女的子样本中，分别通过高效液相色谱法（HPLC）和乳脂比容测定法对产后6个月采集的母乳样本进行视黄醇和脂肪浓度分析。
母乳视黄醇浓度为（均值±标准差）56.3±2.1nmol/g脂肪，各组之间无显著差异[铁和叶酸组（n = 243）：59.1±2.8；MMN组（n = 260）：55.4±2.5；LNS组（n = 253）：54.7±2.5nmol/g脂肪；P = 0.45]，无论该妇女在产后不久是否接受过高剂量维生素A补充剂（200,000IU）。约17%的参与者母乳视黄醇水平较低（≤28nmol/g脂肪）。我们估计41%的婴儿可能摄入了超过可耐受最高摄入量（600μg视黄醇活性当量/天）的维生素A量，母乳视黄醇浓度低或高的百分比在各组之间无差异。
在该组加纳妇女样本中，每日摄入约推荐量的维生素A并未提高母乳视黄醇浓度。该试验在clinicaltrials.gov上注册，注册号为NCT00970866。
