Fatty acid composition of diet, cord blood and breast milk in Chinese mothers with different dietary habits Yongmei Peng, MD, MPH Qing Wang, MD Tingting.

Fatty acid composition of diet, cord blood and breast milk in

Chinese mothers with different dietary habits

Yongmei Peng, MD, MPH Qing Wang, MD

Tingting Zhou , MD

Peining Liu, MD

Children's Hospital, Fudan University, Shanghai Women and Children Health Care Centre of Changzhou

Karolinska Hospital, Karolinska Institute, SwedenSahlgrenska Academy, Göteborg University, Sweden

R Zetterström, MD B Strandvik, MD

saturated fatty acids

polyunsaturated fatty acids (PUFAs)

unsaturated fatty acids

Monounsaturated fatty acid (MUFAs)

fatty acids

AA

ω-3 PUFAs

GLA α-Linolenic Acid (18:3ω3)

ALA

Eicosapentaenoic Acid (20:5 ω3)

EPA

Docosahexaenoic Acid(22:6 ω3) DHA

ω-6 PUFAs

What is Omega-3

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 of DHA 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 tissuesAmusquivar 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

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

Ocean area (Wenzhou) Traditional chinese food area (Changzhou)

Data Collection

Breast milk was manually expressed into a

plastic vial

Cord blood was 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

Fractionate The 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 test was used to calculate

the differences of FA between dietary, cord blood and breast milk samples.

Spearman correlation test was used for analyses of

associations between dietary intake and FA composition

Subjects at Baseline

　 Wenzhou Changzhou P

Mothers:age(y) weight(kg) height(cm) BMI

Babies:gestation age(w) birth wight(g)birth length(cm)

27.80±2.3355.60±9.36

159.90±3.6021.71±3.33

39.73±1.033422.00±384.8

950.20±0.65

26.96±2.8256.96±7.55

160.75±4.6522.02±2.61

39.58±1.043374.26±338.7

950.03±0.76

0.22 0.490.450.66

0.580.580.35

Food comparison of the two types of dietary area

0

500

1000

1500

2000

2500

乳 制 品 谷 类 畜 肉 类 河 鲜 类 海 鲜 类 油 脂 类

常州温州

＊＊＊

Dairy Cereal Comestic Fresh-water food Sea food Oil (g)

＊＊

＊

＊＊

Food (g)

Fatty acid comparison of food in two types area

0

0. 3

0. 6

0. 9

1. 2

1. 5

AA EPA** 22: 3** 22: 5** DHA**

常州温州

Fatty acid

(g)

EPA and DHA in food and milk

0

0. 4

0. 8

1. 2

1. 6

常州温州

dietary d5milk d42milk

**

**

** **

**

Fatty acid

(g)

0

2

4

6

8

脐血 5天血 42天血 DHA

脂肪

酸％

温州常州

The change of blood DHA

Cord D5 blood D42 blood

Fatty acid %

ω-3

0

2

4

6

8

10

脐血 5天血 42天血 n-3

脂肪

酸％

温州常州

Cord D5 blood D42 blood

Fatty acid %

脂肪酸类别

ω-6

20

25

30

35

40

45

脐血 5天血 42天血

n-6

脂肪

酸％

温州常州

Cord D5 blood D42 blood

Fatty acid %

ω-6/ω-3 ratio

0

2

4

6

8

10

脐血 5天血 42天血n-6/ n-3PUFAs

脂肪

酸％

温州常州

Cord D5 blood D42 blood

Fatty acid %

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)

0. 00

0. 05

0. 10

0. 15

0. 20

0. 25

0. 00 0. 50 1. 00 1. 50 2. 00 2. 50 3. 00 3. 50Breast mi l k ALA (mol %)

Plas

ma P

L AL

A (m

ol%)

day 5day 42

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).

0

1

2

3

4

5

6

7

8

0. 00 0. 50 1. 00 1. 50

Breast mi l k DHA (mol %)

Plas

ma P

L DH

A (m

ol%)

day 5day 42

Relation of linolic acid in BM and in the plasma PLs of the infants at d 42(r=0.49, p<0.001)

15

17

19

2123

25

27

29

31

15 20 25 30 35 40Breast mi l k LA (mol %)

Plas

ma P

L LA

(mo

l%)

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).

6789

101112131415

0. 20 0. 40 0. 60 0. 80 1. 00Breast mi l k AA (mol %)

Pla

sma PL AA

(mol

%)

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 around 15, 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

谢谢 !

复旦大学附属儿科医院 ( 新址 )

Thanks