Efeito de dois protocolos de suplementação materna com alfa-tocoferol sobre o soro e o leite de lactantes até 60 dias pós-parto
Vitamin E deficiency (VED) is associated with serious complications to the health and development of newborns and children, generating subsequent effects in their adult life. Among the strategies to combat this deficiency, maternal supplementation during lactation presents itself as a viable conduct...
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Alfa-tocoferol Estudo clínico Suplementação nutricional Lactação Aleitamento materno Deficiência de vitamina E CNPQ::CIENCIAS BIOLOGICAS::BIOQUIMICA |
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Alfa-tocoferol Estudo clínico Suplementação nutricional Lactação Aleitamento materno Deficiência de vitamina E CNPQ::CIENCIAS BIOLOGICAS::BIOQUIMICA Lira, Larissa Queiroz de Efeito de dois protocolos de suplementação materna com alfa-tocoferol sobre o soro e o leite de lactantes até 60 dias pós-parto |
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Vitamin E deficiency (VED) is associated with serious complications to the health and development of newborns and children, generating subsequent effects in their adult life. Among the strategies to combat this deficiency, maternal supplementation during lactation presents itself as a viable conduct, even though there is no definition of an ideal protocol, mainly due to a lack of human studies. Thus, for the first time in humans, this study had as main objective analyzing the effect of two maternal supplementation protocols with alpha-tocopherol on the maternal biochemical nutritional status up to 60 days postpartum. For this purpose, eighty healthy lactating women were recruited at two public maternity hospitals in Natal – RN between 2013 and 2016. Eligible participants were randomly assigned to control, supplemented 1 or supplemented 2 groups, in a 1:1:1 ratio. Dietary information was collected on the 7th, 20th, 30th and 60th days postpartum. Serum and milk samples were collected at the 1st (0h), 20th, 30th and 60th days, with an additional milk collection on the 7th day. Immediately after the collection at day 1, the supplemented groups 1 and 2 received a (01) dose of 400 IU of RRR-alpha-tocopherol, and after the collection at day 20, the supplemented group 2 received the second supplemental dose. No supplementation was given to the control group. Alpha-tocopherol was quantified by high performance liquid chromatography. The usual vitamin E intake and its supply through milk were assessed according to specific recommendations (16 mg and 4 mg daily, respectively). Based on the results, none of the participants had adequate vitamin E intake throughout lactation. This characteristic was similar between the groups (~ 5.0 mg/day, p = 0.603), thus assuring the non-influence of maternal diet on the results of the supplementation schemes. For the three groups, serum alpha-tocopherol concentrations corresponding to the four postpartum periods were indicative of adequate nutritional status, with no differences between them regarding serum 0h (p > 0.05). Values in milk 0h were also not different between the groups (p > 0.05). As lactation progressed, due to the physiological decline of alpha-tocopherol in serum (p <0.01) and breast milk (p <0.01), there was an increase in the percentage of maternal VED and inadequate supply of vitamin E through milk in all three groups. However, such increases were less intense in the supplemented group 2 as result of the double alpha-tocopherol dose. This protocol was effective until the 30th day postpartum, at which time vitamin E (36%) and milk (160%) increased, compared to control, ensuring the total vitamin E requirement of the infant (5.2 mg/day). At the 60th day, milk provided only 84% of the recommended vitamin E (3.2 mg/day), although this value was 31% higher than that of the untreated group. On the other hand, the single-dose supplementation showed no effect on maternal serum during lactation and promoted an increase in milk vitamin E only up to the 20th day (35%), not being able to maintain the adequacy of vitamin supply to the infant at the end of the study (2.5 mg/day). Thus, both maternal supplementation protocols had restricted effects on serum and milk, although the two 400 IU doses of RRR-alpha-tocopherol have achieved lasting results in optimizing maternal nutritional status and milk supply of vitamin E over single dose. |
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Dimenstein, Roberto |
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Dimenstein, Roberto Lira, Larissa Queiroz de |
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doctoralThesis |
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Lira, Larissa Queiroz de |
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Lira, Larissa Queiroz de |
| title |
Efeito de dois protocolos de suplementação materna com alfa-tocoferol sobre o soro e o leite de lactantes até 60 dias pós-parto |
| title_short |
Efeito de dois protocolos de suplementação materna com alfa-tocoferol sobre o soro e o leite de lactantes até 60 dias pós-parto |
| title_full |
Efeito de dois protocolos de suplementação materna com alfa-tocoferol sobre o soro e o leite de lactantes até 60 dias pós-parto |
| title_fullStr |
Efeito de dois protocolos de suplementação materna com alfa-tocoferol sobre o soro e o leite de lactantes até 60 dias pós-parto |
| title_full_unstemmed |
Efeito de dois protocolos de suplementação materna com alfa-tocoferol sobre o soro e o leite de lactantes até 60 dias pós-parto |
| title_sort |
efeito de dois protocolos de suplementação materna com alfa-tocoferol sobre o soro e o leite de lactantes até 60 dias pós-parto |
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Brasil |
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2018 |
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https://repositorio.ufrn.br/jspui/handle/123456789/24803 |
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AT liralarissaqueirozde efeitodedoisprotocolosdesuplementacaomaternacomalfatocoferolsobreosoroeoleitedelactantesate60diasposparto |
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1773962470113673216 |
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ri-123456789-248032022-11-04T19:48:23Z Efeito de dois protocolos de suplementação materna com alfa-tocoferol sobre o soro e o leite de lactantes até 60 dias pós-parto Lira, Larissa Queiroz de Dimenstein, Roberto http://lattes.cnpq.br/8078401196736211 http://lattes.cnpq.br/8520928220989866 Bezerra, Danielle Soares http://lattes.cnpq.br/4545867903131219 Ramalho, Heryka Myrna Maia http://lattes.cnpq.br/7004568465714771 Melo, Illana Louise Pereira de http://lattes.cnpq.br/0775872968532285 Neves, Renata Alexandra Moreira das https://orcid.org/0000-0003-1014-0536 http://lattes.cnpq.br/6943193132756513 Alfa-tocoferol Estudo clínico Suplementação nutricional Lactação Aleitamento materno Deficiência de vitamina E CNPQ::CIENCIAS BIOLOGICAS::BIOQUIMICA Vitamin E deficiency (VED) is associated with serious complications to the health and development of newborns and children, generating subsequent effects in their adult life. Among the strategies to combat this deficiency, maternal supplementation during lactation presents itself as a viable conduct, even though there is no definition of an ideal protocol, mainly due to a lack of human studies. Thus, for the first time in humans, this study had as main objective analyzing the effect of two maternal supplementation protocols with alpha-tocopherol on the maternal biochemical nutritional status up to 60 days postpartum. For this purpose, eighty healthy lactating women were recruited at two public maternity hospitals in Natal – RN between 2013 and 2016. Eligible participants were randomly assigned to control, supplemented 1 or supplemented 2 groups, in a 1:1:1 ratio. Dietary information was collected on the 7th, 20th, 30th and 60th days postpartum. Serum and milk samples were collected at the 1st (0h), 20th, 30th and 60th days, with an additional milk collection on the 7th day. Immediately after the collection at day 1, the supplemented groups 1 and 2 received a (01) dose of 400 IU of RRR-alpha-tocopherol, and after the collection at day 20, the supplemented group 2 received the second supplemental dose. No supplementation was given to the control group. Alpha-tocopherol was quantified by high performance liquid chromatography. The usual vitamin E intake and its supply through milk were assessed according to specific recommendations (16 mg and 4 mg daily, respectively). Based on the results, none of the participants had adequate vitamin E intake throughout lactation. This characteristic was similar between the groups (~ 5.0 mg/day, p = 0.603), thus assuring the non-influence of maternal diet on the results of the supplementation schemes. For the three groups, serum alpha-tocopherol concentrations corresponding to the four postpartum periods were indicative of adequate nutritional status, with no differences between them regarding serum 0h (p > 0.05). Values in milk 0h were also not different between the groups (p > 0.05). As lactation progressed, due to the physiological decline of alpha-tocopherol in serum (p <0.01) and breast milk (p <0.01), there was an increase in the percentage of maternal VED and inadequate supply of vitamin E through milk in all three groups. However, such increases were less intense in the supplemented group 2 as result of the double alpha-tocopherol dose. This protocol was effective until the 30th day postpartum, at which time vitamin E (36%) and milk (160%) increased, compared to control, ensuring the total vitamin E requirement of the infant (5.2 mg/day). At the 60th day, milk provided only 84% of the recommended vitamin E (3.2 mg/day), although this value was 31% higher than that of the untreated group. On the other hand, the single-dose supplementation showed no effect on maternal serum during lactation and promoted an increase in milk vitamin E only up to the 20th day (35%), not being able to maintain the adequacy of vitamin supply to the infant at the end of the study (2.5 mg/day). Thus, both maternal supplementation protocols had restricted effects on serum and milk, although the two 400 IU doses of RRR-alpha-tocopherol have achieved lasting results in optimizing maternal nutritional status and milk supply of vitamin E over single dose. Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) A deficiência de vitamina E (DVE) está relacionada a graves complicações para a saúde e o desenvolvimento de recém-nascidos e crianças, produzindo efeitos subsequentes em sua vida adulta. Dentre as estratégias de combate a esta deficiência, a suplementação materna durante a lactação apresenta-se como conduta viável, embora não haja definição de um protocolo ideal, principalmente devido a escassez de pesquisas em humanos. Desta forma, pela primeira vez em humanos, este estudo teve como objetivo principal analisar o efeito de dois protocolos de suplementação com alfa-tocoferol sobre o estado nutricional bioquímico materno até 60 dias após o parto. Para tanto, oitenta lactantes saudáveis foram recrutadas em duas maternidades públicas de Natal - RN entre 2013 e 2016. As participantes elegíveis foram randomicamente alocadas nos grupos controle, suplementado 1 ou suplementado 2, na razão de 1:1:1. As informações dietéticas foram coletadas no 7º, 20º, 30º e 60º dias pós-parto. As amostras de soro e leite foram colhidas no 1º (0h), 20º, 30º e 60º dias, havendo uma coleta adicional de leite no 7º dia. Imediatamente após a coleta do 1º dia, os grupos suplementado 1 e 2 receberam uma (01) dose de 400 UI de RRR-alfa-tocoferol e, após a coleta do 20º dia, o grupo suplementado 2 recebeu a segunda dose da suplementação. Ao grupo controle não foi administrada suplementação alguma. O alfa-tocoferol foi quantificado por cromatografia líquida de alta eficiência. O consumo habitual de vitamina E e o seu fornecimento através do leite foram avaliados segundo recomendações específicas (16 mg e 4 mg ao dia, respectivamente). Com base nos resultados, tem-se que nenhuma participante apresentou adequação do consumo de vitamina E ao longo da lactação. Esta característica foi semelhante entre os grupos (~ 5,0 mg/dia; p = 0,603), garantindo, assim, a não influência da dieta materna sobre os resultados das suplementações. Para os três grupos, as concentrações séricas de alfa-tocoferol correspondentes aos quatro momentos pós-parto foram indicativas de adequado estado nutricional, não havendo diferença entre eles para o soro 0h (p > 0,05). Os valores no leite 0h também não foram diferentes entre os grupos (p > 0,05). Com a progressão da lactação, devido ao declínio fisiológico do alfa-tocoferol no soro (p < 0,01) e no leite (p < 0,01), houve aumento do percentual de DVE materna e de inadequação no fornecimento de vitamina E pelo leite, nos três grupos, embora com menor intensidade no grupo suplementado 2 em função da dupla dose de alfa-tocoferol. Este protocolo se mostrou eficaz até o 30º dia pós-parto, momento no qual possibilitou aumento na vitamina E do soro (36%) e do leite (160%), em relação ao controle, garantindo o requerimento total de vitamina E do lactente (5,2 mg/dia). E, ao 60º dia, forneceu pelo leite somente 84% da vitamina E recomendada (3,2 mg/dia), apesar desse valor ter sido 31% superior ao do grupo não tratado. Já a suplementação de dose única não mostrou efeito no soro materno e proporcionou incremento da vitamina E no leite somente até o 20º dia (35%), não sendo capaz de manter a adequação do fornecimento ao lactente ao final do estudo (2,5 mg/dia). Deste modo, ambos os protocolos de suplementação materna apresentaram efeitos restritos sobre a vitamina E do soro e do leite, embora as duas doses de 400 UI de RRR-alfa-tocoferol tenham alcançado resultados mais prolongados quanto a otimização do estado nutricional materno e do fornecimento de vitamina E pelo leite em detrimento da dose única. 2018-02-23T21:12:41Z 2018-02-23T21:12:41Z 2017-12-08 doctoralThesis LIRA, Larissa Queiroz de. Efeito de dois protocolos de suplementação materna com alfa-tocoferol sobre o soro e o leite de lactantes até 60 dias pós-parto. 2017. 128f. Tese (Doutorado em Bioquímica) - Centro de Biociências, Universidade Federal do Rio Grande do Norte, Natal, 2017. https://repositorio.ufrn.br/jspui/handle/123456789/24803 por Acesso Aberto application/pdf Brasil UFRN PROGRAMA DE PÓS-GRADUAÇÃO EM BIOQUÍMICA |