Iron, zinc, and copper concentrations in breast milk are independent of maternal mineral status

BACKGROUND: Little is known about the regulation of iron, zinc, and copper in breast milk and the transport of these minerals across the mammary gland epithelium. OBJECTIVE: The objective was to study associations between breast-milk concentrations of iron, zinc, and copper and maternal mineral status. DESIGN: Milk samples from 191 Swedish and Honduran mothers were collected at 9 mo postpartum. Iron, zinc, and copper concentrations were measured by atomic absorption spectrometry. Blood samples from mothers were analyzed for plasma zinc and copper and 4 indexes of iron status: hemoglobin, plasma ferritin, soluble transferrin receptors, and zinc protoporphyrin. Complementary food energy (CFE) intake was used as an inverse proxy for breast-milk intake. RESULTS: Mean (+/-SD) breast-milk concentrations of iron were lower in the Honduran than in the Swedish mothers (0.21 +/- 0.25 compared with 0.29 +/- 0.21 mg/L; P < 0.001), and mean breast-milk concentrations of zinc and copper were higher in the Honduran than in the Swedish mothers [0.70 +/- 0.18 compared with 0.46 +/- 0.26 mg/L (P < 0.001) and 0.16 +/- 0.21 compared with 0.12 +/- 0.22 mg/L (P = 0.001), respectively]. Milk iron was positively correlated with CFE intake (r = 0.24, P = 0.001) but was not significantly correlated with any iron-status variable. Milk zinc was negatively correlated with CFE intake (r = -0.24, P = 0.001) but was not significantly correlated with maternal plasma zinc. Milk copper was not significantly correlated with CFE intake or maternal plasma copper. CONCLUSIONS: Milk iron, zinc, and copper concentrations at 9 mo postpartum are not associated with maternal mineral status, which suggests active transport mechanisms in the mammary gland for all 3 minerals. Milk iron concentrations increase and milk zinc concentrations decrease during weaning [corrected]     

Boron concentrations in milk from mothers of exclusively breast-fed healthy full-term infants are stable during the first four months of lactation

Because boron is a bioactive element that satisfies several of the criteria for essentiality in humans, the aim of the present work was to determine the profile of boron metabolism in human milk during the first 4 mo of lactation. The concentration of boron and other minerals was determined in archived milk collected (1980-84) 1 time/mo for 4 mo from lactating mothers of full-term, exclusively breast-fed infants living in Houston, TX. A linear model (treating month as a continuous variable) indicated that B concentrations were stable (P = 0.14) between mo 1 [3.88 +/- 0.6 mumol (42 +/- 6.5 microg)/L milk] and 4 [3.24 +/- 0.6 micromol (35 +/- 6.5 microg)/L milk, mean +/- SEM]. Mg concentrations increased slightly over time (1.18 +/- 0.09 to 1.36 +/- 0.09 mmol/L, P < 0.0001), whereas Ca concentrations decreased slightly (7.01 +/- 0.29 to 6.68 +/- 0.29 mmol/L milk, P < 0.02) and Zn decreased substantially (0.04 +/- 0.004 to 0.02 +/- 0.004 mmol/L milk, P < 0.0001). Similarities in findings reported here and earlier (from samples collected in St. John's, Newfoundland) provide further evidence that boron may be metabolically regulated. Future investigations of boron regulatory mechanisms should focus on metabolism of bone as the major storage site of B and kidney excretion, the major excretory route for B.     

Effects of separate delivery of zinc or zinc and vitamin A on hemoglobin response, growth, and diarrhea in young Peruvian children receiving iron therapy for anemia

INTRODUCTION: Anemia is the most prevalent nutritional deficiency in the world. Attempts to improve iron indexes are affected by deficiency of and interaction between other micronutrients. OBJECTIVE: Our goal was to assess whether zinc added to iron treatment alone or with vitamin A improves iron indexes and affects diarrheal episodes. DESIGN: This was a randomized, placebo-controlled, double-blind trial conducted in Peru. Anemic children aged 6-35 mo were assigned to 3 treatment groups: ferrous sulfate (FS; n = 104), ferrous sulfate and zinc sulfate (FSZn; n = 109), and ferrous sulfate, zinc sulfate, and vitamin A (FSZnA; n = 110). Vitamin A or its placebo was supplied only once; iron and zinc were provided under supervision >/=1 h apart 6 d/wk for 18 wk. RESULTS: The prevalence of anemia was 42.97%. The increase in hemoglobin in the FS group (19.5 g/L) was significantly less than that in the other 2 groups (24.0 and 23.8 g/L in the FSZn and FSZnA groups, respectively). The increase in serum ferritin in the FS group (24.5 mug/L) was significantly less than that in the other 2 groups (33.0 and 30.8 mug/L in the FSZn and FSZnA groups, respectively). The median duration of diarrhea and the mean number of stools per day was significantly higher in the FS group than in other 2 groups (P < 0.005). CONCLUSION: Adding zinc to iron treatment increases hemoglobin response, improves iron indexes, and has positive effects on diarrhea. No additional effect of vitamin A was found.     

Trace element nutrition status and dietary intake of children with phenylketonuria

The trace element status (copper, iron, zinc, manganese, chromium, and selenium) of 20 dietetically treated phenylketonuric (PKU) children was assessed. Significantly higher intakes of copper (p = 0.002) and iron (p = 0.005) were noted in PKU children compared with their siblings. No significant differences were found for zinc, manganese, or chromium. Intake of selenium was significantly lower (p = 0.0001) in PKU children (8.4 +/- 3.9 micrograms/d) than in siblings (41.6 +/- 9.4 micrograms/d). Plasma and urine selenium and erythrocyte glutathione peroxidase activity (GSHpx) were significantly lower (p = 0.001) in PKU children (0.38 +/- 0.11 mumol/L, 58.0 +/- 34.5 nmol/d, and 14.2 +/- 5.5 U/g Hb, respectively) than in siblings (0.82 +/- 0.15 mumol/L, 165.2 +/- 49.4 nmol/d, and 22.7 +/- 5.2 U/g Hb, respectively). No differences were found in plasma and urine concentrations of other elements. Intake of selenium was significantly correlated with erythrocyte GSHpx (r = 0.87, p = 0.0001) and plasma selenium (r = 0.71, p = 0.0001) for the combined groups. The need and possible procedures, including dietary manipulation, for increasing selenium intake in PKU subjects are discussed.     

Brazil nuts: an effective way to improve selenium status

BACKGROUND: Brazil nuts provide a rich natural source of selenium, yet no studies have investigated the bioavailability of selenium in humans. OBJECTIVE: We investigated the efficacy of Brazil nuts in increasing selenium status in comparison with selenomethionine. DESIGN: A randomized controlled trial was conducted with 59 New Zealand adults. Participants consumed 2 Brazil nuts thought to provide approximately 100 mug Se, 100 mug Se as selenomethionine, or placebo daily for 12 wk. Actual intake from nuts averaged 53 mug Se/d (possible range: 20-84 mug Se). Plasma selenium and plasma and whole blood glutathione peroxidase (GPx) activities were measured at baseline and at 2, 4, 8, and 12 wk, and effects of treatments were compared. RESULTS: Plasma selenium increased by 64.2%, 61.0%, and 7.6%; plasma GPx by 8.3%, 3.4%, and -1.2%; and whole blood GPx by 13.2%, 5.3%, and 1.9% in the Brazil nut, selenomethionine, and placebo groups, respectively. Change over time at 12 wk in plasma selenium (P < 0.0001 for both groups) and plasma GPx activity in the Brazil nut (P < 0.001) and selenomethionine (P = 0.014) groups differed significantly from the placebo group but not from each other. The change in whole blood GPx activity was greater in the Brazil nut group than in the placebo (P = 0.002) and selenomethionine (P = 0.032) groups. CONCLUSION: Consumption of 2 Brazil nuts daily is as effective for increasing selenium status and enhancing GPx activity as 100 mug Se as selenomethionine. Inclusion of this high-selenium food in the diet could avoid the need for fortification or supplements to improve the selenium status of New Zealanders.     

Eighteen-month follow-up of infants fed evaporated milk formula.

In parts of Canada including Newfoundland and Labrador and among Aboriginal peoples, infants still consume evaporated milk (EM) formulas for cultural and economic reasons. At 3 and 6 months, full-term infants fed EM (n = 30) received low intakes of iron, thiamine, selenium and had higher weight velocity than breastfed (BF, n = 29) infants. EM infants had greater anemia, lowered transketolase activity (thiamine) and lowered glutathione peroxidase (selenium) activity (p < 0.05). To determine the later effect of early feeding deficit on nutritional status, we examined these same infants at 18 months of age. At that time, there were no differences in dietary intakes of energy, protein, zinc, copper, selenium and iron, nor in plasma levels of zinc, copper, vitamin C, nor in red blood cell activity levels of glutathione reductase (riboflavin), transketolase, glutathione peroxidase, nor in superoxide dismutase. However, EM infants weighed more and were more likely to visit a physician, have anemia, and have iron depletion than were BF infants. We conclude that infants consuming evaporated milk formulas should receive iron supplements throughout infancy.     

我国长寿地区高龄老人血浆微量元素水平调查分析

目的 了解我国5个长寿地区高龄老人血浆硒、锰、铁、铜、锌微量元素含量水平及差异.方法 检测我国河南省夏邑县(110名)、湖北省钟祥市(111名)、湖南省麻阳县(60名)、广东省三水区(113名)、广西永福县(52名)5个长寿地区共446名高龄老人血浆硒、锰、铁、铜、锌微量元素含量,其中100～岁组208名,90～岁组238名,并比较不同性别、不同地区和不同年龄组微量元素含量的差异.结果 高龄老人血浆微量元素含量用中位数(四分位数间距)表示,硒为1.44(0.91)μmol/L,锰为0.54(0.94)μmol/L,铁为69.17(102.85)μmol/L,铜为20.19(8.73)μmol/L,锌为31.66(32.51)μmol/L.夏邑、钟祥、麻阳、三水、永福地区高龄老人血浆硒分别为1.46(0.66)、1.30(0.80)、1.06(0.51)、2.39(1.53)、1.35(0.55)μmol/L,锰分别为0.56(0.51)、1.40(1.11)、0.35(0.71)、0.44(0.55)、0.15(0.21)μmol/L,铁分别为86.77(86.87)、141.42(101.83)、38.88(36.28)、31.38(46.19)、79.64(75.34)μmol/L,铜分别为22.16(8.11)、19.46(9.26)、21.36(12.38)、18.12(6.74)、21.47(7.85)μmol/L,锌分别为36.85(26.18)、36.59(35.94)、39.98(56.91)、25.05(24.92)、16.74(16.81)μmol/L,不同地区微量元素含量差异有统计学意义(F值依次为29.76、38.75、47.18、11.51、13.47,P值均<0.05).不同性别组间血浆硒、锰、铁、铜、锌元素含量[男女硒含量分别为1.38(0.83)、1.45(0.91)μmol/L,锰含量分别为0.52(0.95)、0.54(0.91)μmol/L,铁含量分别为69.23(104.06)、69.11(101.05)μmol/L,铜含量分别为20.28(8.72)、20.06(8.76)μmol/L,锌含量分别为28.39(32.58)、31.85(34.26)μmol/L]差异无统计学意义(t_硒=-1.82,P=0.07;t_锰=0.64,P=0.52;t_铁=0.65,P=0.52;t_铜=-1.90,P=0.06;t_锌=-0.96,P=0.34).100～岁组血浆硒、铁、铜含量均高于90～岁组[硒分别为1.63(0.94)、1.30(0.82)μmol/L,铁分别为112.63(119.78)、60.13(58.43)μmol/L,铜分别为21.07(9.03)、18.81(8.86)μmol/L,F值依次为41.99、27.32、24.45,P值均小于0.01],血浆锰含量低于90～岁组[分别为0.44(0.76)、0.64(0.93)μmol/L,F=10.76,P<0.01],血浆锌含量差异无统计学意义[分别为3I.78(34.06)、31.11(33.85)μmol/L,F=1.32,P=0.25].结论 长寿地区高龄老人血浆硒、锰、铁、铜、锌微量元素含量水平较高,血浆硒、铁、铜含量随年龄增长而增加.     

Prenatal iron supplements impair zinc absorption in pregnant Peruvian women

Prenatal iron supplements may adversely influence zinc absorption during pregnancy. To examine the impact of prenatal iron supplements on supplemental zinc absorption, fractional zinc absorption was measured in 47 pregnant Peruvian women during the third trimester of pregnancy (33 +/- 1 wk gestation). Of these 47 women, 30 received daily prenatal supplements from wk 10-24 of pregnancy until delivery. Supplements contained 60 mg of Fe and 250 microg of folate without [iron group (Fe), n = 16] or with [iron and zinc supplemented group (Fe + Zn), n = 14] 15 mg of Zn. The remaining 17 women [unsupplemented control group (C)] received no prenatal supplementation. Zinc concentrations were measured in plasma, urine and cord blood and percentage zinc absorption was determined following dosing with oral ((67)Zn) and intravenous ((70)Zn) stable zinc isotopes. Percentage zinc absorption was significantly lower than controls in fasting women receiving iron- containing prenatal supplements (20.5 +/- 6.4 vs. 20.2 +/- 4.6 vs. 47.0 +/- 12.6%, Fe, Fe + Zn and C groups, respectively, P: < 0.0001, n = 40). Plasma zinc concentrations were also significantly lower in the Fe group compared to the C group (8.2 +/- 2.2 vs. 9.2 +/- 2.2 vs. 10.9 +/- 1. 8 micromol/L, Fe, Fe + Zn and C groups, respectively, P: = 0.002), and cord zinc concentrations were significantly related to maternal plasma Zn levels (y = 6.383 + 0.555x, r = 0.486, P: = 0.002). The inclusion of zinc in prenatal supplements may reduce the potential for iron supplements to adversely influence zinc status in populations at risk for deficiency of both these nutrients.     

Breast milk retinol concentrations are not associated with systemic inflammation among breast-feeding women in Malawi

The acute phase response and inflammation are associated with lower plasma retinol concentrations, but their effect on breast milk retinol concentrations is unclear. We measured plasma retinol concentrations, acute phase proteins, and breast milk retinol concentrations in 237 breast-feeding women at 2 wk postpartum in Blantyre, Malawi; 16.5% of the women had plasma retinol < 0.70 micromol/L and 14.8% had breast milk retinol < 1.05 micromol/L. Among women with and without inflammation [alpha(1)-acid glycoprotein (AGP) > 1 g/L and/or C-reactive protein (CRP) > 5 mg/L], geometric mean (95% CI) plasma retinol was 0.89 (0.84, 0.94) and 1.05 (1.01, 1.17) mumol/L, respectively (P < 0.0001). Among women with and without inflammation, geometric mean (95% CI) breast milk retinol was 2.12 (1.89, 2.36) and 2.05 (1.75, 2.39) micromol/L, respectively (P = 0.74). In multiple linear regression models adjusting for age, parity, education, BMI, and days postpartum, plasma retinol concentrations were associated with plasma AGP and CRP concentrations (P < 0.0001 and P = 0.01, respectively), whereas breast milk retinol concentrations were unaffected by plasma AGP and CRP concentrations (P = 0.22 and P = 0.86, respectively). These findings suggest that breast milk retinol concentrations are not affected by systemic inflammation.     

Selenium and zinc status are suboptimal in a sample of older New Zealand women in a community-based study

The importance of selenium and zinc in the immune functioning of the aged is widely recognized. Seniors in New Zealand are at particularly high risk of low selenium status because of the low selenium soil environment. The zinc status of the New Zealand elderly has never been assessed. In this cross-sectional study, the biochemical selenium, zinc and lipid levels, physical functional capacity and dietary intakes of 103 randomly selected free-living New Zealand women (mean age +/- SD, 75 +/- 3 y) were assessed. Among nonusers of selenium supplements (n = 80), 80% [95% confidence interval (CI): 70; 88%] had plasma selenium levels (0.85 +/- 0.23 micromol/L) below 1.00 micromol/L [ approximately 10% below mean plasma selenium necessary for full expression of glutathione peroxidase (GPx) activity in New Zealand subjects]. Plasma selenium was strongly correlated with GPx: r = 0.56; P < 0.0001. For nonusers of zinc supplements (n = 88), serum zinc concentrations were 12.4 +/- 1.4 micromol/L, with 12% (95% CI: 6; 21%) having levels below the cut-off value (10.7 micromol/L). Estimated mean daily selenium and zinc intakes were 34 +/- 10 microg and 8.7 +/- 2.0 mg, respectively. Subjects in the highest tertile of a functional capacity index had higher biochemical zinc and selenium values than those in the lowest tertile (P < 0.05). The correlation between plasma selenium and GPx indicates that selenium intake in these women is still insufficient for full expression of GPx activity. Lower serum zinc levels also appear to be prevalent. Because a suboptimal trace element status may be more common among those with a poor physical functioning, promotion of the consumption of nutrient dense foods or supplements to improve selenium and zinc status of elderly women in New Zealand may be beneficial.     

Selenium status of term infants fed selenium-supplemented formula in a randomized dose-response trial

BACKGROUND: The optimal form and dose of selenium supplementation required to achieve indicators of selenium status equivalent to those in breastfed infants are unclear. OBJECTIVE: The objective was to evaluate the effect of fortifying infant formula (6 microg Se/L) with 2 concentrations of selenate (7 and 15 microg/L) on biochemical indicators of selenium status and growth at 16 wk in term infants. DESIGN: A randomized dose-response trial was conducted in 3 groups of term infants fed formula with different selenium concentrations [6 microg/L, F+0 (control); 13 microg/L, F+7; and 21 microg/L, F+15] and in a parallel breastfed reference group (BF; 11 +/- 2 microg Se/L). RESULTS: One hundred sixty-one (47% males) infants completed the 16-wk study. Baseline plasma selenium was 0.3 +/- 0.1 micromol/L. At 16 wk, plasma selenium had increased in all groups (P < 0.001) and was greater (P < 0.01) in the F+7 and F+15 groups and lower (P < 0.05) in the F+0 group than in the BF group. Plasma glutathione peroxidase increased in the F+15 group, decreased in the F+0 group, and, at 16 wk, was lower in the F+0 group than in the other groups (all P < 0.05). Erythrocyte selenium and glutathione peroxidase decreased in all groups (P < 0.05), but the magnitude of the change was greater in the F+0 than in the F+15 group (P < 0.05). There was no effect of selenium supplementation on growth. CONCLUSIONS: Selenate fortification of formula resulted in an increase in plasma indicators of selenium status relative to indicators observed in infants fed low-selenium-containing formula. Although the erythrocyte indicators decreased in all groups, the 21-microg/L dose (F+15 group) resulted in a smaller decrease and in higher erythrocyte selenium than did the standard formula. Supplementation of low-selenium formula to provide a net selenium concentration close to that found in the breast milk of US women (18 microg/L) may be justified.     

Selenium supplements do not increase plasma total homocysteine concentrations in men and women

Studies in rats indicate that plasma total homocysteine (tHcy) is decreased in selenium deficiency and increases with selenium supplementation. The aim of this study was to determine the effect of selenium supplements on plasma tHcy concentrations in a population that has suboptimal selenium status. Subjects from Dunedin, New Zealand (n = 189) were randomly assigned to receive a supplement containing 200 micro g selenium or placebo for 20 wk. At baseline, 67% (n = 112) of the participants had plasma selenium concentrations < 1.2 micro mol/L, a concentration believed to be that necessary for full glutathione peroxidase (Gpx) activity. At 20 wk, plasma selenium concentration and Gpx activity increased in the selenium group by 1.2 micro mol/L [95% confidence interval (CI): 1.1, 1.3] and 5.1 nkat/g protein (3.7, 6.5), respectively, changes that were significantly greater than the changes in the placebo group (P < 0.001). At 20 wk, mean changes in plasma tHcy concentrations were 0.1 micro mol/L (95% CI: -0.4, 0.5) and -0.2 micro mol/L (-0.7, 0.3) in the supplemented and placebo groups, respectively, compared to baseline. There was no difference in the mean changes in plasma tHcy between the supplemented and placebo groups (P = 0.54). These results suggest that selenium supplementation does not influence plasma tHcy concentrations in healthy populations in developed countries, whose selenium status is characterized by lower plasma selenium concentrations.     

The prevalence of low serum zinc and copper levels and dietary habits associated with serum zinc and copper in 12- to 36-month-old children from low-income families at risk for iron deficiency

OBJECTIVE: Iron and zinc share common food sources, and children at risk of iron deficiency may also develop zinc deficiency. We determined the prevalence of zinc and copper deficiency and examined factors associated with serum zinc and copper in young children from low-income families at risk of iron deficiency. DESIGN: A cross-sectional study design was used to assess serum zinc and copper, along with an interview-assisted survey to assess factors associated with serum zinc and copper in a convenience sample. SUBJECTS/SETTING: Participants were 435 children aged 12 to 36 months recruited from select clinics of the Special Supplemental Nutrition Program for Women, Infants, and Children in Contra Costa and Tulare Counties, California. STATISTICAL ANALYSES PERFORMED: Frequencies were used to report prevalence. Multiple linear regressions were conducted to examine factors associated with serum zinc and copper, controlling for age, sex, and ethnicity. RESULTS: The prevalence of low serum zinc level (<70 microg/dL [<10.7 micromol/L]) was 42.8%, and low serum copper level (<90 microg/dL [<14.2 micromol/L]) was <1%. Mean+/-standard deviation of serum copper was 150+/-22 microg/dL (23.6+/-3.5 micromol/L) and 140+/-24 microg/dL (22.1+/-3.8 micromol/L) for anemic and non-anemic children, respectively (t test, P=0.026). In multiple linear regression consumption of sweetened beverages was negatively associated with serum zinc level, and consumption of >15 g/day meat was positively associated with serum zinc level, whereas current consumption of breast milk and >15 g/day beans were positively associated with serum copper level. CONCLUSIONS: The prevalence of low serum zinc concentration in the sample was high, and warrants further investigation amongst vulnerable populations.     

Iron and copper in human milk

The reported concentrations of iron and copper in breast milk show a wide variation. Research published over the past 50 y has reported median values of 0.47 and 0.32 mg/L for iron and copper, respectively. The levels of both metals decrease with the progress of lactation. The calculated iron-to-copper ratio of reported means differs from 0.25 to 6.29 (median = 1.18). Maternal constitutional variables such as undernutrition, iron and copper body reserves, stage of lactation, adolescent motherhood, gestation length, and infection and environmental variables such as iron and copper dietary intake, in addition to supplementation, smoking, vegetarianism, and prolonged use of hormonal contraceptives before and during lactation did not consistently affect the concentrations of iron and copper in breast milk. Extreme cases of either low or high levels of body metal availability or altered metabolism due to chelating therapy or illnesses such as Wilson's disease and infections did not affect metal transfer from blood serum to breast milk. There is no clinical or scientific support for the need of extra iron or copper, besides the quantities provided by milk in the full-term breast-fed infant, at least during the first 6 mo.     

Mineral content of market samples of fluid whole milk

Results from the Food and Drug Administration's Total Diet Study on the nutrient element content of fluid whole cow's milk are presented and compared with previously published values. Whole milk was collected and analyzed yearly from 1975 through 1985. Yearly and overall means were similar for all elements except iron and iodine. The iron content of milk was generally low, but several samples had high levels. The distribution of iodine in whole milk was quite wide (0.002 to 0.094 mg/100 gm). The iodine content of milk is affected by the level of iodine added to cattle feed and by the use of iodophor sanitizing solutions used by the dairy industry. Overall mean levels of the elements in milligrams per 100 gm whole milk were: sodium, 42; potassium, 134; calcium, 106; phosphorus, 83; magnesium, 9.8; iron, 0.07; zinc, 0.37; copper, 0.009; manganese, 0.004; iodine, 0.034; and selenium, 0.001. Coefficients of variation were high (67% to 117%) for iron, copper, manganese, selenium, and iodine but ranged from 18% to 26% for the other elements. An 8-fl oz serving of whole milk is an excellent source of iodine, calcium, phosphorus, and potassium. It also provides some sodium, magnesium, zinc, and selenium but is not a reliable source of iron, copper, or manganese.     

Alterations in serum levels of trace elements in tuberculosis and HIV infections

OBJECTIVE: To evaluate serum concentrations of trace elements in tuberculosis (TB) patients with or with out human immunodeficiency virus (HIV) coinfection before and after anti-TB chemotherapy. SUBJECTS: A total of 155 TB patients, 74 of which were coinfected with HIV, and 31 healthy controls from Gondar, Ethiopia. METHODS: Serum levels of copper, zinc, selenium and iron were determined using an inductively coupled plasma mass spectrometer from all subjects at baseline and from 44 TB patients (22 with HIV coinfection) at the end of an intensive phase of anti-TB chemotherapy. RESULTS: Compared with the control group, the concentrations of iron, zinc and selenium were significantly lower (P<0.05) while that of copper and copper/zinc ratio was significantly higher (P<0.05) in the serum of TB patients. TB patients with HIV coinfection had significantly lower serum zinc and selenium concentrations and significantly higher copper/zinc ratio compared to that in TB patients without HIV coinfection (P<0.05). The serum concentration of zinc had significantly increased at the end of intensive phase of anti-TB chemotherapy in patients without HIV coinfection (P<0.05). An increase in serum selenium level was observed in TB patients with or without HIV coinfection after therapy. On the contrary, serum copper concentration and copper/zinc ratio declined significantly after anti-TB chemotherapy irrespective of HIV serostatus (P<0.05). CONCLUSIONS: The results indicate that TB patients have altered profile of trace elements in their sera. This warrants the need for further investigations so that strategies for trace elements supplementation can be planned in addition to their potential as diagnostic parameters in monitoring responses to anti-TB chemotherapy.     

Iron status of infants fed low-iron formula: no effect of added bovine lactoferrin or nucleotides

BACKGROUND: The appropriate level of iron fortification in infant formula remains undetermined. OBJECTIVES: We compared hematologic indexes and iron-status indicators in infants who were either breast-fed or fed formula with concentrations of 2 or 4 mg Fe/L and evaluated the effects of providing part of the iron as bovine lactoferrin and of adding nucleotides. DESIGN: Healthy term infants were exclusively breast-fed (n = 16) or fed formula (n = 10-12) from age 4 +/- 2 wk to 6 mo. Anthropometric measures were taken monthly, and blood samples were taken at 1, 4, and 6 mo. Hematologic indexes; indicators of iron, zinc, and copper status; and erythrocyte fatty acids were assessed. RESULTS: No significant differences in hematology or iron status were observed between groups at 4 and 6 mo of age. Although 34% of all infants had a hemoglobin concentration <110 g/L at 6 mo, the absence of iron deficiency or defective erythropoiesis suggests that this hemoglobin cutoff is too high for this age group. Neither the source or the concentration of iron in formula nor fortification with nucleotides had any significant effect on serum zinc or copper, and nucleotide fortification did not affect erythrocyte fatty acids. CONCLUSIONS: A concentration of 1.6 mg Fe/L formula meets the iron requirement of healthy term infants aged 相似文献   

Seasonal variations of antioxidant imbalance in Cuban healthy men

OBJECTIVE: To determine the antioxidant imbalance in healthy Cuban men 2y after the end of the epidemic neuropathy (50 862 cases from 1991 to 1993) and to evaluate its change over 1 y. DESIGN: Prospective study. SETTING: La Lisa health centres (Havana, Cuba). SUBJECTS: One-hundred and ninety-nine healthy middle-aged men were selected and 106 completed the study. Subjects were studied at 3 month intervals over 1 year. INTERVENTIONS: No invervention. MAIN OUTCOME MEASURES: An assessment of dietary intake and the determination of blood lipid peroxides (TBARS), glutathione, diglutathione, glutathione peroxidase, superoxide dismutase, vitamin E, carotenoids, copper, zinc and selenium were performed at each period. RESULTS: While dietary zinc, vitamins C and E, carotenoids and fat dietary intakes and blood concentrations were low for adult men compared to international reference ranges, serum TBARS concentrations were high at every period. Some significant seasonal variations were observed. The lowest carotenoids (P < 0.002) and vitamin C(P = 0.0001) intakes, serum beta-carotene (P = 0.0001) and lutein/zeaxanthin (P < 0.05) concentrations, and the highest blood TBARS (P = 0.0001) and diglutathione (P < 0.001) concentrations were observed at the end of the rainy season (October). This period seemed to pose the greatest risk of antioxidant imbalance. CONCLUSIONS: Cuban men still represent a vulnerable population in terms of antioxidant imbalance. A national program of vegetable growing and increase in fruit and vegetable consumption is now evaluated in Cuba.     

Zinc and iron nutrition in Chilean children fed fortified milk provided by the Complementary National Food Program

OBJECTIVE: Chilean infants are at risk for isolated zinc and iron deficiencies because of a low consumption of animal products in low socioeconomic sectors. In 1999, the National Complementary Food Program of Chile manufactured a new milk (2 kg of powdered milk/mo) fortified with iron (Fe; 10 mg/L), zinc (Zn; 5 mg/L), and copper (0.5 mg/L) to be provided to infants until age 18 mo and to pregnant women. We analyzed the nutrition status of zinc and iron at age 18 mo in infants who consumed the fortified cow's milk. METHODS: Forty-two healthy male children with normal growth and from lower socioeconomic groups were studied. A nutrition survey was conducted; blood and hair samples for Zn in plasma and hair, hemoglobin, hematocrit, and serum ferritin were obtained. RESULTS: Mean intakes were: energy, 106 +/- 27 kcal. kg(-1). d(-1); protein, 3.8 +/- 1.1 g. kg(-1). d(-1); Zn, 5.2 +/- 1.9 g/d (0.98 mg Zn/MJ; 68% of World Health Organization recommendations); Fe, 11.2 +/- 5.5 mg/d; and dietary fiber, 9.8 +/- 3.9 g/d. Plasma Zn in 54.8% of children was no greater than 12.3 microM/L; 36% had hair Zn level no greater than 1.23 microM/g and 39% had serum ferritin levels no greater than 10 microg/dL (12% were anemic). Hair Zn was correlated to socioeconomic level (Spearman's rank correlation, r = -0.53; P < 0.001) and plasma Zn was correlated to the z weight/length (r = 0.47; P < 0.05), subscapular skinfold (r = 0.46; P < 0.05), and Zn intake (r = 0.46; P < 0.05). CONCLUSIONS: The fortified powdered cow's milk provided to infants until age 18 mo by the Complementary Food Program in Chile favorably affects the Fe status of these children, but possibly not the Zn nutrition; we suggest re-evaluation of the levels of Zn fortification.     

Regular consumption of NaFeEDTA-fortified fish sauce improves iron status and reduces the prevalence of anemia in anemic Vietnamese women

BACKGROUND: Fish sauce is consumed daily by a large proportion of the Vietnamese population and could therefore be a potentially useful food vehicle for iron-fortification programs. OBJECTIVE: We evaluated the efficacy of iron-fortified fish sauce in improving the iron status of anemic women. DESIGN: In a randomized, double-masked study of 152 anemic (hemoglobin concentration of 81-119 g/L) women, a meal based on noodles or rice was served 6 d/wk with 10 mL fish sauce containing either 10 mg Fe as NaFeEDTA (iron-fortified group) or no added iron (control group). Concentrations of hemoglobin, serum ferritin (SF), and serum transferrin receptor (TfR) were measured at baseline and after 3 and 6 mo. RESULTS: After 6 mo, hemoglobin and SF concentrations were higher and TfR concentrations were lower in the iron-fortified group than in the control group [hemoglobin: 116.3 +/- 8.7 ( +/- SD) compared with 107.6 +/- 11.0 g/L (P < 0.0001); SF: 30.9 (95% CI: 23.4, 40.6) compared with 14.6 (11.3, 19.0) micro g/L (P = 0.0002); TfR: 7.2 (6.4, 7.9) compared with 9.0 (8.1, 9.9) mg/L (P = 0.002)]. The prevalence of iron deficiency (SF < 12 micro g/L or TfR > 8.5 mg/L) and iron deficiency anemia (iron deficiency with hemoglobin < 120 g/L) was lower in the iron-fortified group than in the control group [32.8% compared with 62.5% (P = 0.0005) and 20.3% compared with 58.3% (P < 0.0001), respectively]. CONCLUSIONS: Regular consumption of iron-fortified fish sauce significantly reduced the prevalence of iron deficiency anemia in Vietnamese women during the 6-mo intervention. Fortifying fish sauce with iron by using a water-soluble, highly bioavailable compound (NaFeEDTA) is a promising strategy for combating iron deficiency anemia in Vietnam.