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      A Comparison of Vitamin and Lutein Concentrations in Breast Milk from Four Asian Countries

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          Abstract

          Vitamins are the essential elements for human life and, particularly, for infant health. Human milk is the best source of nutrients for newborns, however, the information of vitamins in Asian maternal milk is still limited. In this study, we have collected 580 Asian maternal milk samples from Korea ( n = 254), China ( n = 137), Pakistan ( n = 92), and Vietnam ( n = 97). The vitamin concentrations, including vitamin B-groups (8 vitamins), fat-soluble vitamin (retinol, D, E, K) and lutein in the breast milk of were investigated. The concentration of thiamin (B 1), biotin (B 7), and folic acid (B 9) in mother’s milk of four countries were not considerably different, while riboflavin (B 2), pantothenic acid (B 5), and pyridoxine (B 6) level in Vietnam samples were significantly lower than those in other countries. In contrast, retinol (A) and tocopherol (E) were found to be higher levels in Vietnamese maternal milk. Korean and Chinese maternal milk had low concentrations of retinol that may cause vitamin A deficiency in children. However, Chinese mother’s milk was distinguished with a high concentration of lutein. Pakistani mother’s milk was observed as having a significant problem of folic acid (B 9) deficiency. Regardless of the country, vitamin B 12, K, and D did not seem to be provided sufficiently through maternal milk. The moderate positive correlations were found between vitamin concentrations in each country and the pooled sample. The data obtained in this study were able to provide vital information to assess the nutritional status of breast milk in Asian countries and contributed to the efforts of ensuring the best nutrition for Asian children.

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          B vitamins in breast milk: relative importance of maternal status and intake, and effects on infant status and function.

          Infants should be exclusively breastfed for the first 6 mo of life. However, maternal deficiency of some micronutrients, conveniently classified as Group I micronutrients during lactation, can result in low concentrations in breast milk and subsequent infant deficiency preventable by improving maternal status. This article uses thiamin, riboflavin, vitamin B-6, vitamin B-12, and choline as examples and reviews the evidence for risk of inadequate intakes by infants in the first 6 mo of life. Folate, a Group II micronutrient, is included for comparison. Information is presented on forms and concentrations in human milk, analytical methods, the basis of current recommended intakes for infants and lactating women, and effects of maternal supplementation. From reports of maternal and/or infant deficiency, concentrations in milk were noted as well as any consequences for infant function. These milk values were used to estimate the percent of recommended daily intake that infants fed by a deficient mother could obtain from her milk. Estimates were 60% for thiamin, 53% for riboflavin, 80% for vitamin B-6, 16% for vitamin B-12, and 56% for choline. Lack of data limits the accuracy and generalizability of these conclusions, but the overall picture that emerges is consistent across nutrients and points to an urgent need to improve the information available on breast milk quality.
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            Vitamin B-12 supplementation during pregnancy and early lactation increases maternal, breast milk, and infant measures of vitamin B-12 status.

            Pregnant women in resource-poor areas are at risk of multiple micronutrient deficiencies, and indicators of low vitamin B-12 status have been associated with adverse pregnancy outcomes, including anemia, low birth weight, and intrauterine growth retardation. To evaluate whether daily oral vitamin B-12 supplementation during pregnancy increases maternal and infant measures of vitamin B-12 status, we performed a randomized, placebo-controlled clinical trial. Pregnant women <14 wk of gestation in Bangalore, India, were randomly assigned to receive daily oral supplementation with vitamin B-12 (50 μg) or placebo through 6 wk postpartum. All women were administered iron and folic acid supplements throughout pregnancy. One hundred eighty-three women were randomly assigned to receive vitamin B-12 and 183 to receive placebo. Compared with placebo recipients, vitamin B-12-supplemented women had significantly higher plasma vitamin B-12 concentrations at both the second (median vitamin B-12 concentration: 216 vs. 111 pmol/L, P < 0.001) and third (median: 184 vs. 105 pmol/L, P < 0.001) trimesters. At 6 wk postpartum, median breast milk vitamin B-12 concentration was 136 pmol/L in vitamin B-12-supplemented women vs. 87 pmol/L in the placebo group (P < 0.0005). Among vitamin B-12-supplemented women, the incidence of delivering an infant with intrauterine growth retardation was 33 of 131 (25%) vs. 43 of 125 (34%) in those administered placebo (P = 0.11). In a subset of infants tested at 6 wk of age, median plasma vitamin B-12 concentration was 199 pmol/L in those born to supplemented women vs. 139 pmol/L in the placebo group (P = 0.01). Infant plasma methylmalonic acid and homocysteine concentrations were significantly lower in the vitamin B-12 group as well. Oral supplementation of urban Indian women with vitamin B-12 throughout pregnancy and early lactation significantly increases vitamin B-12 status of mothers and infants. It is important to determine whether there are correlations between these findings and neurologic and metabolic functions. This trial was registered at clinicaltrials.gov as NCT00641862.
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              Lutein and preterm infants with decreased concentrations of brain carotenoids.

              Lutein and zeaxanthin are dietary carotenoids that may influence visual and cognitive development. The objective of this study was to provide the first data on distribution of carotenoids in the infant brain and compare concentrations in preterm and term infants.
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                Author and article information

                Journal
                Nutrients
                Nutrients
                nutrients
                Nutrients
                MDPI
                2072-6643
                17 June 2020
                June 2020
                : 12
                : 6
                : 1794
                Affiliations
                [1 ]Department of Food and Nutrition, Chungnam National University, Daejeon 34134, Korea; mytuyen1108@ 123456gmail.com (M.T.T.N.); ai0107380@ 123456gmail.com (J.K.); dlguswns122@ 123456gmail.com (H.L.); elementyoon@ 123456gmail.com (S.W.)
                [2 ]College of Agriculture, Can Tho University, Can Tho City 900000, Vietnam
                [3 ]Central Research Laboratory, Maeil Co., Ltd., 63 Jinwiseo-ro, Jinwi-myeon Pyeongtaek, Gyeonggi-do 17706, Korea; kim6767@ 123456maeil.com (Y.K.); jungjia@ 123456maeil.com (J.A.J.)
                [4 ]College of Food Science and Engineering, Changchun University, Changchun 130022, China; drlidan@ 123456yahoo.com
                [5 ]Department of Obstetrics and Gynecology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam; tomaixuanhong@ 123456ump.edu.vn (X.H.M.T.); tranghnk08@ 123456gmail.com (K.T.N.H.)
                [6 ]Faculty of Nursing and Medical Technology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam; thanhvan.vatlytrilieu@ 123456gmail.com
                [7 ]Faculty of Food, Nutrition and Home Science, University of Agriculture, Faisalabad 38000, Pakistan; beenish_israr@ 123456hotmail.com
                [8 ]Graduate School of Analytical Science and Technology, Chungnam National University, Daejeon 34134, Korea; hjan@ 123456cnu.ac.kr
                Author notes
                [* ]Correspondence: jaykim@ 123456cnu.ac.kr ; Tel.: +82-042-821-6834
                [†]

                Both authors contributed equally.

                Author information
                https://orcid.org/0000-0002-5711-9665
                https://orcid.org/0000-0001-9719-9957
                Article
                nutrients-12-01794
                10.3390/nu12061794
                7353211
                32560305
                04e200d0-f685-4176-ab3a-1a8fbe8018b0
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 29 April 2020
                : 15 June 2020
                Categories
                Article

                Nutrition & Dietetics
                human milk,quantification,vitamin,liquid-chromatography,mass spectrometry
                Nutrition & Dietetics
                human milk, quantification, vitamin, liquid-chromatography, mass spectrometry

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