Fatty acid composition of diet, cord blood and breast milk in Chinese mothers with different dietary habits Tingting Zhou, MD Peining Liu, MD Yongmei Peng, MD, MPH Qing Wang, MD R Zetterström, MD B Strandvik, MD Children's Hospital, Fudan University, Shanghai Women and Children Health Care Centre of Changzhou Karolinska Hospital, Karolinska Institute, Sweden Sahlgrenska Academy, Göteborg University, Sweden
What is Omega-3 fatty acids unsaturated fatty acids saturated fatty acids polyunsaturated fatty acids (PUFAs) Monounsaturated fatty acid (MUFAs) ω-6 PUFAs ω-3 PUFAs AA GLA α-Linolenic Acid (18:3ω3) ALA Eicosapentaenoic Acid (20:5 ω3) EPA Docosahexaenoic Acid(22:6 ω3) DHA
Background • Brain development is most active • at the end of pregnancy • and during the first postnatal months • A surge of EFA, and LCPUFAs, to the fetus over the placenta during the last trimester • Postnatally, breast milk(BM) is the source of the LCPUFAs in exclusively breast fed infants
Background • In newbaby, sufficient amounts • ofDHA are essential for development of neuronal tissue and visual function • and of AA for optimal growth • The fatty acid (FA) composition of BM varies with • the nutritional intake of the mothers, • especially the quality of the fat. DHA,22:6 3
Background • The BM in Hong Kong and Chongqing had different FA profiles due to different dietary habits and life-style • In rural of northern China： • the intake of linoleic acid (LA, 18:2 ω6) > α-linolenic acid (ALA, 18:3 3) and ω-3 • the ratio of ω-6/ ω-3 (19:1)was higher than other country
Background • Human and animal studies show that • maternal dietary FA intakes may influence the FA profiles of cord blood and fetal tissues Amusquivar E, Biol Neonate. 2003;83(2):136-45. De Vriese SR, PLEFA. 2002 ;67(6):389-96. • During the first postnatal weeks • neonates do not seem to synthesize sufficient amounts of LC-PUFAs from their precursors (LA and ALA) • Can not to satisfy their high needs Salem NJ, Proc Natl Acad Sci U S A. 1996;93(1):49-54.
Objectives • To help untangle the influence of two different dietary patterns on • maternal fatty acid intake • the composition of umbilical cord blood • transitional breast milk • To analyze the related factors on the composition of LC-PUFAs in • the BM • and the paired infants’ plasma PLs
Subjects mother-term infant pairs Ocean area (Wenzhou) Traditional chinese food area (Changzhou) 7-day forward dietary record during the last trimester recruited subjects before delivery Follow-up to 42days Day 5, day 42 breast milk Day 0、5、42 infant’s blood
Data Collection • Breast milkwas manually expressed into a plastic vial • Cord bloodwas obtained after the umbilical cord had been cut • Blood samples( infants) were obtained at day 5 and day 42 by venipuncture
Fatty acid analysis Extract The lipids were extracted with chloroform-methanol FractionateThe phospholipids(PLs) from plasma were fractionated on a single SEP-PAK aminopropyl cartridge Separate by capillary gas-liquid chromatography
Statistical Analysis • Mann-Whitney´s U testwas used to calculate • the differences of FA between dietary, cord blood and breast milk samples. • Spearman correlation testwas used for analyses of • associations between dietary intake and FA composition
Food comparison of the two types of dietary area ＊ Food (g) ＊ ＊＊ ＊＊ ＊＊ (g) Dairy Cereal Comestic Fresh-water food Sea food Oil
Fatty acid comparison of food in two types area Fatty acid (g)
EPA and DHA in food and milk ** Fatty acid (g) ** ** ** ** dietary d5milk d42milk
The change of blood DHA Fatty acid % Cord D5 blood D42 blood
ω-3 Fatty acid % Cord D5 blood D42 blood
ω-6 Fatty acid % Cord D5 blood D42 blood 脂肪酸类别
ω-6/ω-3 ratio Fatty acid % Cord D5 blood D42 blood
Relation of ALA in BM and in the plasma PLs of the infants at d 5 (r=0.39, p<0.01) and d 42 (r=0.55, p<0.001)
Relation of docosahexaenoic acid in BM and in the plasma PLs of the infants at d 5 ( r=0.30, p<0.05) and d 42 (r=0.48, p<0.001).
Relation of linolic acid in BM and in the plasma PLs of the infants at d 42(r=0.49, p<0.001)
Relation of in arachidonic acid in BM and in the plasma PLs of the infants at d 42 (n=45, r=0.48, p<0.001).
Implications • There were significant differences in maternal intakes of FA confirming different dietary habits, • which influenced the FA composition of cord plasma phospholipids and transitional breast milk. • Since FA influence gene expression , it implies that the long-term follow up of this cohort will be interesting • Mothers’ milk in Changzhou, had a ratio of ω-6/ω-3 around15, similar to rural area, north of Beijing in China, the ratio was 19.3 • the supply to the foetus and newborn of these FA depends on the dietary intake and the mother’s storage
复旦大学附属儿科医院 (新址) 谢谢! Thanks