The Effect Of Maternal Diet During Pregnancy And Lactation On FA Composition Of Breast Milk And Infants' Blood As Well As Infants' Growth And Development

ObjectiveTo investigate the influence of maternal fatty acid(FA) intake during pregnancy and lactation on FA composition of breast milk and infants' plasma phospholipids;and the relationship between FA concentration of breast milk or infants' blood and infants' growth and development in their first 1.5 years.MethodsTwo districts with different dietary patterns were selected for study:one was Changzhou of Jiangshu province,which was an inland city with traditional Chinese southern dietary pattern;the other city was Wenzhou of Zhejiang provice,which was a coastal city with seafood dietary pattern.A 7-day dietary record was completed by women in their last trimester of pregnancy from these two places respectively.The FA composition in maternal diet was calculated using the 2002 Chinese food composition database.Umbilical cord blood samples were obtained when the umbilical cord was cut off at delivery.Blood samples from day 5,day 42 and month 12 of the infants were obtained by venipuncture.Breast milk samples were collected on postnatal day 5, day 42 and month 4.The FA composition of blood and breast milk was analyzed by capillary gas-liquid chromatography.In Changzhou,another 7-day dietary record was conducted by lactation mothers within 4 months after delivery.Anthropometric indices like weight,height and head circumference were measured at birth,day 42 and month 2,4,6,12,18.Cognitive assessment was estimated at 6 months and 1 year of age,using Gesell Developmental Diagnosis.Results1.The effect of different dietary patterns on maternal fatty acid intake and the fatty acid profile of colostrum and umbilical cord blood plasma phospholipids ①.There were significant differences in maternal dietary intake of LCPUFAs in these two areas,largely due to the higher intake of sea food and lower vegetable oil intake in Wenzhou(P＜0.001).②.Among mothers in Changzhou,linoleic acid(LA) andα-linolenic acid(ALA) intakes were higher(P＜0.05),while docosahexaenoic acid(DHA) and eicosapentaenoic acid(EPA) intakes were lower than mothers in Wenzhou(P＜0.01).There were no significant differences of arachidonic acid(AA) in maternal diet between these two areas(P＞0.05).③.The LA and ALA contents in colostrum of Changzhou were significantly higher than in that of Wenzhou(P＜0.001),while DHA content was significantly lower (P＜0.05).No significant differences were observed between sites in milk AA and EPA content(P＞0.05).④.The LA,ALA and AA contents in umbilical cord blood plasma phospholipids of Changzhou were significantly higher than in that of Wenzhou(P＜0.05),while EPA content was significantly lower(P＜0.001).There were no significant differences of DHA content between sites in cord blood plasma phospholipids(P＞0.05).2.The effect of maternal FA intake between pregnancy and lactation on FA composition of breast milk and infants' plasma phospholipidsIn Changzhou,there were no significant differences of total maternal food intake between pregnancy and lactation.Among lactation mothers,the sea food intake decreased,but the intakes of eggs,white meats and freshwater food increased compared with pregnant women(P＜0.05).During lactation,the intake of AA significant increased(P＜0.001),but there were no significant differences of LA,ALA, EPA and DHA intakes between these two periods(P＞0.05).The changes of maternal dietary FA intake were inconsistent with those of FA composition in breast milk and infants' plasma phospholipids.The LA and ALA contents were higher(P＜0.05) while the AA and DHA contents were lower(P＜0.001) in breast milk on day 42 than colostrums,but no significant differences were observed between milks in EPA content(P＞0.05).The LA,ALA and DHA contents in plasma phospholipids on day 42 were higher(P＜0.001),but the AA content was lower(P＜0.001) than in day 5 plasma. Meanwhile,there were no significant differences between day 5 and day 42 plasma in EPA content(P＞0.05).3.The relationship between FA status of breast milk or infants' blood and infants' growth in their first 1.5 years①.The birth weight of infants in Changzhou correlated negatively with the AA/DHA and n-6/n-3 ratio in cord blood plasma phospholipids(P＜0.05).②.The LA content and n-6/n-3 ratio in cord blood plasma phospholipids was inversely associated with the infants' length Z scores in 2,4 and 6 months of age(P＜0.05).Meanwhile,the AA/DHA ratio in cord blood was inversely associated with the infants' length Z scores in 42 days,4 and 6 months of age(P＜0.05).There were no significant correlations between FA status of breast milk or blood and the infants' weight,head circumference or growth rate at any age beyond 1.5 years(P＞0.05).③.The relationship between FA status of infants' blood plasma phospholipids and their BMI Z scores●The DHA and n-3 PUFAs contents in cord blood plasma phospholipids were inversely associated with the infants' BMI Z scores in 6,12 and 18 months of age,while the n-6/n-3 ratio was positively associated with them(P＜0.05).●The DHA and n-3 PUFAs contents in plasma phospholipids on day 5 were inversely associated with the infants' BMI Z scores in 12 months of age,while the n-6/n-3 ratio was positively associated with them(P＜0.01).●The DHA and n-3 PUFAs contents in plasma phospholipids on day 42 were inversely associated with the infants' BMI Z scores in 2,4,6,12 and 18 months of age,while the n-6/n-3 ratio was positively associated with them(P＜0.01).4.The relationship between FA status of breast milk or infants' blood and infants' cognitive development in their first one year of lifeSome FA contents of breast milk and blood plasma phospholipids were associated with infants' Gesell DQ(P＜0.05).But there were no consistent results of the relationship between FA status and infants' cognitive development here.Conclusion1.There were significant differences in maternal intakes of FA depending on their dietary habits and these dietary differences appear to influence the FA composition of colostrum and umbilical cord blood,which could finally impact the infants' growth and development.2.The maternal dietary FA intakes from pregnancy to lactation changed very little in mothers with the same dietary habits.The FA intakes were stable,but also with differences.But the FA composition in breast milk and infants' plasma phospholipids between these two periods was not consistent with the dietary FA intakes.So,the FA composition in breast milk and infants' plasma phospholipids may change with adaptive situations.3.The LA content,AA/DHA and n-6/n-3 ratios in cord blood plasma phospholipids were inversely associated with the infants' length Z scores in 4 and 6 months of age. So we think the n-6 PUFAs content in cord blood would have an inverse effect on infants' length during early infancy,but its long term effect cannot be ensured now.4.The n-3 PUFAs content in plasma phospholipids during early infancy may have great impact on infants' growth later.Highlight the blood n-3 PUFAs content(especially DHA) in early infancy may help the infants to achieve optimal body mass index (BMI) later.5.No exact relationships between FA status in breast milk or infants' blood plasma phospholipids and infants' cognitive development during the first year have been confirmed in the population with traditional Chinese southern dietary pattern. Further results will be made after being compared to the population with seafood dietary pattern.