Ann M. Ferris

Effect of fish oil on the fatty acid composition of human milk and maternal and infant erythrocytes.

To examine the effect of fish oil supplementation on the fatty acid (FA) composition of human milk and maternal and infant erythrocytes, five lactating women were supplemented with 6 g of fish oil daily for 21d. Usual maternal diets contained 1,147 mg of total n−3 FA, with 120 mg from very long-chain (>C18) n−3 FA. Supplementation increased dietary levels to 3,092 mg of total n−3 FA and 2,006 mg of very long-chain n−3 FA. Milk samples were collected daily, prior to fish oil ingestion, and at 4-h intervals on days 1, 7, 14 and 21. Milk n−3 FA content increased within 8 h and reached steady state levels within one week. The n−6 fatty acid content decreased. Erythrocyte eicosapentaenoic acid content increased from 0.24% to 1.4% (P<0.01) in mothers and from 0.11% to 0.70% (P<0.05) in infants. Docosapentaenoic acid increased from 1.4% to 2.2% (P<0.05) in mothers and from 0.30% to 0.78% (P<0.01) in infants. There was no significant change in docosahexaenoic acid or n−6 fatty acid content. Maternal platelet aggregation responses were variable. No differences in milk or plasma tocopherol levels were noted.

Changes in the lipids of human milk from 2 to 16 weeks postpartum.

Changes in total lipid, fatty acids, total cholesterol, free cholesterol, and lipid phosphorus in mature milk with time were investigated. Milk samples were collected from 10 mothers at 2, 6, 12, and 16 weeks postpartum. During 1 day, each mother donated two complete breast expressions. Expressions were taken using an electric breast pump 1 h after the previous a.m. and p.m. nursing. For each mother, the a.m. and p.m. samples were pooled for analysis. It was observed that the amount of total lipid increased significantly (p less than 0.05) from 3.9 g/100 ml at 2 weeks to 5.2 g/100 at 16 weeks postpartum. The total fatty acid composition remained uniform during the investigation. Average total cholesterol and free cholesterol in the milk were 10.3 mg/100 ml and 8.3 mg/100 ml, respectively. These concentrations did not change significantly with time postpartum. Average lipid phosphorus was 3.9 mg/100 ml and also remained constant throughout. We conclude that the fatty acid pattern, lipid phosphorus, total cholesterol, and free cholesterol of mature milk to 16 weeks postpartum remains relatively constant while total lipid concentration increases.

Composition of the lipids in human milk: a review

Recent publications on the composition of human milk are reviewed. The importance of proper sampling is discussed. Fat contents of 2.6–4.5% and cholesterol amounts of 200–650 mg/100 g fat were reported. The phytosterols in milk were increased by the consumption of these sterols. Phytosterols could contribute to the “total cholesterol” in milk if analyses are done colorimetrically. The fatty acid composition is remarkably uniform unless bizarre diets are consumed; the amounts of linoleic acid vary the most. Phospholipids contained more long chain polyunsaturated fatty acids than triacylglycerols.

Lipids in Human Milk: A Review. 1

SummaryA protocol for selection of donors of milk samples is presented. Various methods for the sampling of milk are critically reviewed and a tested procedure is described. The measurement of milk volume is reviewed. Analyses for milk lipids are presented and discussed. Results of the analyses rela

Prenatal and Perinatal Factors Associated with Breast-Feeding Initiation among Inner-City Puerto Rican Women

OBJECTIVE To identify factors associated with the initiation of breast-feeding in a predominantly Puerto Rican population living in inner-city Hartford, Conn. DESIGN Retrospective study of 144 Latino women (mean +/- standard deviation age = 26.3 +/- 5.7 years) with children at least 1 year old but younger than 6 years old (mean +/- standard deviation age = 3.0 +/- 1.2 years) at the time of the survey. Women were recruited from agencies sponsoring health programs for mothers and children. They were interviewed in their homes (69%) or at the Hispanic Health Council, Hartford, Conn (31%). SUBJECTS/SETTING Low-income Latino women who had at least 1 preschooler at the time of the interview. The women lived in inner-city Hartford, and the overwhelming majority were Puerto Rican and received welfare assistance and food stamps. Seventy-eight percent of the women chose to be interviewed in Spanish; the other 22% were interviewed in English. STATISTICAL ANALYSES Explanatory variables that related to breast-feeding initiation (P < or = .2) in bivariate chi 2 analyses were entered into a multivariate logistic regression model that was reduced using backward stepwise elimination procedures. RESULTS Multivariate analyses indicated that breast-feeding the previous child, shorter length of maternal residence in the United States, not receiving prenatal bottle-feeding advice, more recent birth, and higher birth weight were positively associated with breast-feeding initiation. A major reason for choosing not to breast-feed was that women felt socially uncomfortable doing it. APPLICATIONS Breast-feeding initiation was more likely in Latino women who received prenatal breast-feeding counselling and postpartum support. Mothers of low-birth-weight infants and women breast-feeding for the first time may need additional help. These findings can be used by programs like the Special Supplemental Nutrition Program for Women, Infants, and Children to increase breast-feeding initiation.

If you stock it, will they buy it? Healthy food availability and customer purchasing behaviour within corner stores in Hartford, CT, USA

OBJECTIVE Literature on food environments has expanded rapidly, yet most research focuses on stores and community characteristics without integrating customer-level data. The present study combines customer shopping behaviour with store food inventory data. DESIGN Face-to-face interviews were conducted with customers shopping in corner stores to measure food shopping behaviour, household food security and demographics. Store inventories were conducted to measure availability of healthy food in corner stores. Multilevel logistic regression models estimated the probability of customers purchasing a food item given the availability of that item in the store. SETTING Nineteen corner stores in Hartford, CT, USA, average size 669 ft(2) (62.15 m(2)). SUBJECTS Sample of 372 customers. RESULTS The majority of customers were Black or Hispanic (54 % and 40 %, respectively) and 61 % experienced food insecurity. For each additional type of fruits or vegetables available in the store, the estimated odds of a customer purchasing fruits increased by 12 % (P = 0.03) and the odds for purchasing vegetables increased by 15 % (P = 0.01). Customers receiving the Supplemental Nutrition Assistance Program (SNAP) were 1.7 times as likely to purchase fruit as those not receiving SNAP (P = 0.04). Greater availability of reduced-fat milk was not associated with increased likelihood of customers purchasing reduced-fat milk. CONCLUSIONS There is a positive association between fruit and vegetable variety and the probability that a customer purchases fruits and vegetables. Increasing the selection of produce in corner stores may increase their consumption by food-insecure and low-income residents at risk for health disparities. These findings have implications for future store interventions and food policies.

Effect of dietary intake of n-6 and n-3 fatty acids on the fatty acid composition of human milk in North America

To determine the effect of maternal dietary n-6 and n-3 polyunsaturated fatty acids (PUFA) on the amounts of these fatty acids in human milk, two criteria must be met. These are assessment of the maternal diet and accurate analysis of the milk fatty acids. This type of analysis requires gas-liquid chromatography with capillary columns to resolve important n-6 and n-3 C20 and C22 fatty acid. This type of analytic equipment has only recently become available; thus the amount of complete data on human milk fatty acids is limited. To assess actual fatty acid intakes by the infant, the fat content and volume of milk received by the infant must be known. Alterations in maternal dietary intake of PUFA cause similar changes in milk PUFA. Several investigators have shown that maternal supplementation with fish oils increases the amounts of 20:5n-3 and 22:6n-3 in milk and maternal and infant erythrocyte lipids. A new mathematic index for assessment of essential fatty acid status, the mean melting point of plasma phospholipid fatty acids, has been proposed. We found in some mother-infant pairs that maternal supplementation with fish oil lowered the mean melting points of erythrocyte lipids to levels seen in nonpregnant women.

Changes in Human Milk at 0600, 1000, 1400, 1800, and 2200 h

Milk from six mothers was collected every 4 h from 0600 to 2200 h. Total lipid and cholesterol, lactose, glucose, protein N, indicator acids 12:0, 14:0, and 18:2, and α- and γ-tocopherols were analyzed. Total calories were calculated. Although considerable variation was seen in the lipid content, this was not significant and was apparently due to individuality. Differences in the other lipid components were not significant and were generally related to the total lipid content. Except for protein N (p < 0.05), none of the other components varied significantly. Based upon these data and the results of others, the time of sampling of human milk should be matched to the population being studied to obtain consistent results, at least with lipids.

Determinants of Body Size Perceptions and Dieting Behavior in a Multiethnic Group of Hospital Staff Women

OBJECTIVE This study was designed to identify determinants of body size perceptions and their relationship to dietary behavior in a multiethnic group of women. DESIGN A single interview consisting of the Massara and Stunkard body image cards (1979) and questionnaires on sociocultural background, anthropometry, and dieting history were administered to volunteers from the staff of a hospital. SUBJECTS The sample was a convenience sample of 186 women representing a range of staff positions recruited from Methodist Hospital in Brooklyn, NY; 174 completed the study. Data on 150 women are presented in this article. RESULTS Height and weight-for-height were stronger predictors of accuracy of perceived body size than ethnicity. Tall, slight women were more likely to overestimate and short, heavy women were more likely to underestimate actual body size. Ethnicity had an interactive effect with height as taller European Americans were more likely to perceive their body size as larger than actual compared with Afro-Caribbeans and African Americans. Women with a history of dieting were more likely to overestimate their size and to view it as different from what is perceived as attractive to others. APPLICATIONS/CONCLUSIONS Based on the results, we conclude that body size is a stronger predictor of accuracy of perceived body size than ethnicity; and dieters overestimate their body size and believe it to be heavier than their social group would prefer.

Alpha and gamma tocopherols in pooled mature human milk after storage.

The α-and -γ-tocopherols in pooled stored human milk were determined. Storage times and temperatures were t = 0 (up to 2 h after start of pool collection); t = 8 h (25°, 4°C); t = 24 h (25°, 4°, – 11°C); and t = 72 h, 1, 4, 8, and 16 weeks (-11°, −20°, −70°C). Lipids were extracted with a modified Folch procedure and tocopherols were analyzed with high-performance liquid chromatography. There were no significant differences in α-or γ-tocopherol at any time or temperature. Therefore, mothers, milk bank operators, and researchers can be assured of the stability of tocopherol in human milk stored under the conditions of this study.