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      Selenium Intake in Iodine-Deficient Pregnant and Breastfeeding Women in New Zealand

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          Abstract

          Selenium plays a role in antioxidant status and, together with iodine, in thyroid function. Iodine deficiency exists in New Zealand during pregnancy and lactation, and selenium deficiency may further affect thyroid function. This study investigated selenium intakes of pregnant and lactating women, in Palmerston North, in the North Island of New Zealand. Dietary intake was estimated using three repeated 24-h dietary recalls. Dietary intake in pregnancy was also estimated from 24-h urinary excretion of selenium. Selenium concentrations were determined in urine and breastmilk using inductively-coupled plasma mass spectrometry. Median selenium intakes based on dietary data were 51 (39, 65) μg/day in pregnancy and 51 (36, 80) μg/day in lactation, with 61% and 68% below estimated average requirement (EAR). Median daily selenium intake in pregnancy based on urinary excretion was 49 (40, 60) µg/day, with 59% below EAR. Median selenium concentration in breastmilk was 11 (10, 13) µg/L and estimated median selenium intake for infants was 9 (8, 10) µg/day, with 91% below the Adequate Intake of 12 μg/day. These pregnant and breastfeeding women were at risk of dietary selenium inadequacy. Further research is required to assess selenium status in relation to thyroid function and health in this group.

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          Methods of assessment of selenium status in humans: a systematic review.

          To understand the effect of selenium intake on health, it is important to identify sensitive and population-specific biomarkers of selenium status. The objective of this systematic review was to assess the usefulness of biomarkers of selenium status in humans. The methods included a structured search strategy on Ovid MEDLINE, EMBASE (Ovid), and Cochrane databases; formal inclusion and exclusion criteria; data extraction into an Access database; validity assessment; and meta-analysis. The data from 18 selenium supplementation studies (of which 9 were randomized controlled trials and 1 was considered to be at low risk of bias) indicate that plasma, erythrocyte, and whole-blood selenium, plasma selenoprotein P, and plasma, platelet, and whole-blood glutathione peroxidase activity respond to changes in selenium intake. Although there is a substantial body of data for plasma selenium, more large, high-quality, randomized controlled trials are needed for this biomarker, as well as for the other biomarkers, to explore the reasons for heterogeneity in response to selenium supplementation. There was insufficient evidence to assess the usefulness of other potential biomarkers of selenium status, including urinary selenium, plasma triiodothyroxine:thyroxine ratio, plasma thyroxine, plasma total homocysteine, hair and toenail selenium, erythrocyte, and muscle glutathione peroxidase activity. For all potentially useful biomarkers, more information is needed to evaluate their strengths and limitations in different population groups, including the effects of varying intakes, the duration of intervention, baseline selenium status, and possible confounding effects of genotype.
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            The impact of iron and selenium deficiencies on iodine and thyroid metabolism: biochemistry and relevance to public health.

            Several minerals and trace elements are essential for normal thyroid hormone metabolism, e.g., iodine, iron, selenium, and zinc. Coexisting deficiencies of these elements can impair thyroid function. Iron deficiency impairs thyroid hormone synthesis by reducing activity of heme-dependent thyroid peroxidase. Iron-deficiency anemia blunts and iron supplementation improves the efficacy of iodine supplementation. Combined selenium and iodine deficiency leads to myxedematous cretinism. The normal thyroid gland retains high selenium concentrations even under conditions of inadequate selenium supply and expresses many of the known selenocysteine-containing proteins. Among these selenoproteins are the glutathione peroxidase, deiodinase, and thioredoxine reductase families of enzymes. Adequate selenium nutrition supports efficient thyroid hormone synthesis and metabolism and protects the thyroid gland from damage by excessive iodide exposure. In regions of combined severe iodine and selenium deficiency, normalization of iodine supply is mandatory before initiation of selenium supplementation in order to prevent hypothyroidism. Selenium deficiency and disturbed thyroid hormone economy may develop under conditions of special dietary regimens such as long-term total parenteral nutrition, phenylketonuria diet, cystic fibrosis, or may be the result of imbalanced nutrition in children, elderly people, or sick patients.
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              Studies in human lactation: milk volumes in lactating women during the onset of lactation and full lactation.

              After validation of test-weighing procedures milk volumes produced by 13 multiparous Caucasian women were followed longitudinally through the first year of lactation. All practiced exclusive breast-feeding for at least 5 mo. Milk transfer to the infant was low on days 1 and 2 and increased rapidly to 498 +/- 129 g/d (means +/- SD) on day 5 and then more slowly to 753 +/- 89 g/d during months 3-5. There was a characteristic milk volume for each mother-infant pair that was significantly related neither to milk yield on days 4-6 nor to birth weight. It was, however, strongly related to infant weight at 1 mo, suggesting that infant and/or maternal factors coming into play during the first month of life are strong determinants of subsequent milk transfer to the infant.
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                Author and article information

                Journal
                Nutrients
                Nutrients
                nutrients
                Nutrients
                MDPI
                2072-6643
                01 January 2019
                January 2019
                : 11
                : 1
                : 69
                Affiliations
                [1 ]School of Health Sciences, College of Health, Massey University, Palmerston North 4442, New Zealand; y.jin@ 123456massey.ac.nz
                [2 ]School of Food and Advanced Technology, College of Sciences, Massey University, Palmerston North 4442, New Zealand; j.coad@ 123456massey.ac.nz (J.C.); j.l.weber@ 123456massey.ac.nz (J.L.W.); j.a.thomson@ 123456massey.ac.nz (J.S.T.)
                Author notes
                [* ]Correspondence: l.brough@ 123456massey.ac.nz ; Tel.: +64-6-951-7575
                Article
                nutrients-11-00069
                10.3390/nu11010069
                6356683
                30609662
                e956e966-cb74-41ed-8354-0f411e24033a
                © 2019 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
                : 30 November 2018
                : 18 December 2018
                Categories
                Article

                Nutrition & Dietetics
                selenium,pregnancy,lactation,breastfeeding,infants
                Nutrition & Dietetics
                selenium, pregnancy, lactation, breastfeeding, infants

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