A nutritional supplement during preconception and pregnancy increases human milk vitamin D but not B-vitamin concentrations
A nutritional supplement during preconception and pregnancy increases human milk vitamin D but not B-vitamin concentrations
Background & aims: Optimal maternal vitamin status during pregnancy and lactation is essential to support maternal and infant health. For instance, vitamin D
3 is involved in infant bone development, and B-vitamins are involved in various metabolic processes, including energy production. Through a double-blind randomised controlled trial, we investigated the effects of maternal supplementation from preconception throughout pregnancy until birth on human milk (HM) concentrations of vitamin D
3 and B-vitamins. In addition, we aimed to characterise longitudinal changes in milk concentrations of these vitamins. Methods: Both control and intervention supplements contained calcium, iodine, iron, β-carotene, and folic acid, while the intervention also contained zinc, vitamins B
2, B
6, B
12, and D
3, probiotics, and myo-inositol. HM samples were collected across 4 time points from 1 week to 3 months post-delivery from 158 mothers in Singapore, and 7 time points from 1 week to 12 months from 180 mothers in New Zealand. HM vitamin D was quantified using supercritical fluid chromatography and B-vitamins with mass spectrometry. Potential intervention effects on HM vitamins D
3, B
2, B
6, and B
9, as well as other B-vitamin (B
1 and B
3) concentrations were assessed using linear mixed models with a repeated measures design. Results: Over the first 3 months of lactation, HM 25-hydroxyvitamin D
3 concentrations were 20% (95% CI 8%, 33%, P = 0.001) higher in the intervention group, with more marked effects in New Zealand. There were no observed intervention effects on HM concentrations of vitamins B
1, B
2, B
3, B
6, and B
9. In New Zealand mothers, longitudinally, vitamin D
3 concentrations gradually increased from early lactation up to 12 months, while vitamins B
1 and B
2 peaked at 6 weeks, B
3 at 3 weeks, and B
6 and B
9 at 3 months. Conclusions: Maternal supplementation during preconception and pregnancy increased HM vitamin D, but not B-vitamin concentrations in lactation. Further studies are required to examine the discrete benefits of vitamin D supplementation starting preconception vs during pregnancy, and to further characterise the effects of supplementation on later offspring health outcomes. Clinical trial registration: Registered at ClinicalTrials.gov on the 16 July 2015 (identifier NCT02509988); Universal Trial Number U1111-1171-8056. This study was academic-led by the EpiGen Global Research Consortium.
25(OH)D3, Human milk, Lactation, Supplement, Vitamin B, Vitamin D
2443-2456
Han, Soo Min
a5553445-90bc-46c1-9a6c-c7a1e5465a44
Huang, Fang
535277e2-850a-411c-90f5-bb8342493fb8
Derraik, José G. B.
006119b3-8592-4cf9-975d-1bd34583f669
Vickers, Mark H.
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Devaraj, Surabhi
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Redeuik, Karine
4a90bdfe-272c-4f70-9e2e-61efed5dc1a8
Campos-Gimenez, Esther
a56eef3a-73f4-42f7-b379-3e165af61375
Pang, Wei Wei
ea5e4a08-2641-485d-854d-62734f51ffe4
Godfrey, Keith
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Chan, Shiao-Yng
3c9d8970-2cc4-430a-86a7-96f6029a5293
Thakkar, Sagar K.
9518fdfa-3c18-416f-9945-2d59bcd7ad54
Cutfield, Wayne
a01589bd-5b82-49fa-89e1-137e6f59e24d
December 2023
Han, Soo Min
a5553445-90bc-46c1-9a6c-c7a1e5465a44
Huang, Fang
535277e2-850a-411c-90f5-bb8342493fb8
Derraik, José G. B.
006119b3-8592-4cf9-975d-1bd34583f669
Vickers, Mark H.
6e05d089-9742-44f5-b4e1-3a505027d10c
Devaraj, Surabhi
f2813e88-9f3a-48f3-b99e-a43143a32151
Redeuik, Karine
4a90bdfe-272c-4f70-9e2e-61efed5dc1a8
Campos-Gimenez, Esther
a56eef3a-73f4-42f7-b379-3e165af61375
Pang, Wei Wei
ea5e4a08-2641-485d-854d-62734f51ffe4
Godfrey, Keith
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Chan, Shiao-Yng
3c9d8970-2cc4-430a-86a7-96f6029a5293
Thakkar, Sagar K.
9518fdfa-3c18-416f-9945-2d59bcd7ad54
Cutfield, Wayne
a01589bd-5b82-49fa-89e1-137e6f59e24d
Han, Soo Min, Huang, Fang, Derraik, José G. B., Vickers, Mark H., Devaraj, Surabhi, Redeuik, Karine, Campos-Gimenez, Esther, Pang, Wei Wei, Godfrey, Keith, Chan, Shiao-Yng, Thakkar, Sagar K. and Cutfield, Wayne
,
NiPPeR Study Group
(2023)
A nutritional supplement during preconception and pregnancy increases human milk vitamin D but not B-vitamin concentrations.
Clinical Nutrition, 42 (12), .
(doi:10.1016/j.clnu.2023.09.009).
Abstract
Background & aims: Optimal maternal vitamin status during pregnancy and lactation is essential to support maternal and infant health. For instance, vitamin D
3 is involved in infant bone development, and B-vitamins are involved in various metabolic processes, including energy production. Through a double-blind randomised controlled trial, we investigated the effects of maternal supplementation from preconception throughout pregnancy until birth on human milk (HM) concentrations of vitamin D
3 and B-vitamins. In addition, we aimed to characterise longitudinal changes in milk concentrations of these vitamins. Methods: Both control and intervention supplements contained calcium, iodine, iron, β-carotene, and folic acid, while the intervention also contained zinc, vitamins B
2, B
6, B
12, and D
3, probiotics, and myo-inositol. HM samples were collected across 4 time points from 1 week to 3 months post-delivery from 158 mothers in Singapore, and 7 time points from 1 week to 12 months from 180 mothers in New Zealand. HM vitamin D was quantified using supercritical fluid chromatography and B-vitamins with mass spectrometry. Potential intervention effects on HM vitamins D
3, B
2, B
6, and B
9, as well as other B-vitamin (B
1 and B
3) concentrations were assessed using linear mixed models with a repeated measures design. Results: Over the first 3 months of lactation, HM 25-hydroxyvitamin D
3 concentrations were 20% (95% CI 8%, 33%, P = 0.001) higher in the intervention group, with more marked effects in New Zealand. There were no observed intervention effects on HM concentrations of vitamins B
1, B
2, B
3, B
6, and B
9. In New Zealand mothers, longitudinally, vitamin D
3 concentrations gradually increased from early lactation up to 12 months, while vitamins B
1 and B
2 peaked at 6 weeks, B
3 at 3 weeks, and B
6 and B
9 at 3 months. Conclusions: Maternal supplementation during preconception and pregnancy increased HM vitamin D, but not B-vitamin concentrations in lactation. Further studies are required to examine the discrete benefits of vitamin D supplementation starting preconception vs during pregnancy, and to further characterise the effects of supplementation on later offspring health outcomes. Clinical trial registration: Registered at ClinicalTrials.gov on the 16 July 2015 (identifier NCT02509988); Universal Trial Number U1111-1171-8056. This study was academic-led by the EpiGen Global Research Consortium.
Text
NiPPeR_HM_Vitamins_ClinNutr_clean_20230907
- Accepted Manuscript
Text
1-s2.0-S0261561423002959-main
- Proof
More information
Accepted/In Press date: 9 September 2023
e-pub ahead of print date: 5 October 2023
Published date: December 2023
Additional Information:
Funding Information:
Public good funding for this investigator-led study is through the Medical Research Council (UK) (MRC) as part of an MRC award to the MRC Lifecourse Epidemiology Unit (MC_UU_12011/4), the Singapore National Research Foundation, the National Medical Research Council (SG) (NMRC) (NMRC/TCR/012-NUHS/2014), the National University of Singapore (NUS), the Agency for Science, Technology and Research (SG) as part of the Growth, Development and Metabolism Programme of the Singapore Institute for Clinical Sciences (H17/01/a0/005), and as part of Gravida, a New Zealand Government Centre of Research Excellence. KMG is supported by the National Institute for Health Research (NIHR Senior Investigator (NF-SI-0515-10042) and NIHR Southampton Biomedical Research Centre (NIHR203319)), and the European Union (Erasmus+ Programme ImpENSA 598488-EPP-1-2018-1-DE-EPPKA2-CBHE-JP). S-YC is supported by a Singapore NMRC Clinician Scientist Award (NMRC/CSA-INV/0010/2016; MOH-CSAINV19nov-0002). Funding for provision of the intervention and control drinks and to cover aspects of the fieldwork for the study was provided by Société des Produits Nestlé SA under a research agreement with the University of Southampton, Auckland UniServices Ltd., Singapore Institute for Clinical Sciences, National University Hospital Singapore PTE Ltd., and NUS. For the purpose of Open Access, the authors have applied a Creative Commons Attribution (CC BY) license to any Author Accepted Manuscript version arising from this submission.KMG, S-YC, and WSC are part of an academic consortium that has received grants from Société des Produits Nestlé SA relating to the submitted work, and from Abbott Nutrition, Danone, and BenevolentAI Bio Ltd. outside the submitted work. SMH, FH, JGBD, MHV, SD, KMG, S-YC, SKT, and WSC are co-inventors on patent filings by Société des Produits Nestlé SA relating to the NiPPeR intervention or its components. FH, SD, KR, EC-G, and SKT are employees of Société des Produits Nestlé SA. The authors report no other conflicts of interest.
Funding Information:
Public good funding for this investigator-led study is through the Medical Research Council (UK) (MRC) as part of an MRC award to the MRC Lifecourse Epidemiology Unit (MC_UU_12011/4), the Singapore National Research Foundation , the National Medical Research Council (SG) (NMRC) (NMRC/TCR/012-NUHS/2014), the National University of Singapore (NUS), the Agency for Science, Technology and Research (SG) as part of the Growth, Development and Metabolism Programme of the Singapore Institute for Clinical Sciences (H17/01/a0/005), and as part of Gravida, a New Zealand Government Centre of Research Excellence. KMG is supported by the National Institute for Health Research (NIHR Senior Investigator (NF-SI-0515-10042) and NIHR Southampton Biomedical Research Centre (NIHR203319)), and the European Union ( Erasmus+ Programme ImpENSA 598488-EPP-1-2018-1-DE-EPPKA2-CBHE-JP). S-YC is supported by a Singapore NMRC Clinician Scientist Award (NMRC/CSA-INV/0010/2016; MOH-CSAINV19nov-0002). Funding for provision of the intervention and control drinks and to cover aspects of the fieldwork for the study was provided by Société des Produits Nestlé SA under a research agreement with the University of Southampton, Auckland UniServices Ltd., Singapore Institute for Clinical Sciences, National University Hospital Singapore PTE Ltd., and NUS. For the purpose of Open Access, the authors have applied a Creative Commons Attribution (CC BY) license to any Author Accepted Manuscript version arising from this submission.
Publisher Copyright:
© 2023 The Author(s)
Keywords:
25(OH)D3, Human milk, Lactation, Supplement, Vitamin B, Vitamin D
Identifiers
Local EPrints ID: 483101
URI: http://eprints.soton.ac.uk/id/eprint/483101
ISSN: 0261-5614
PURE UUID: ceb4b137-da2f-4d46-953a-4f1d31d640e9
Catalogue record
Date deposited: 23 Oct 2023 16:49
Last modified: 14 Aug 2024 01:33
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Contributors
Author:
Soo Min Han
Author:
Fang Huang
Author:
José G. B. Derraik
Author:
Mark H. Vickers
Author:
Surabhi Devaraj
Author:
Karine Redeuik
Author:
Esther Campos-Gimenez
Author:
Wei Wei Pang
Author:
Shiao-Yng Chan
Author:
Sagar K. Thakkar
Author:
Wayne Cutfield
Corporate Author: NiPPeR Study Group
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